Shakeela Ishrat - Academia.edu (original) (raw)
Papers by Shakeela Ishrat
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2021
Background: Some men with severely defective sperm production commonly have excess aromatase acti... more Background: Some men with severely defective sperm production commonly have excess aromatase activity, reflected by low serum testosterone and relatively elevated estradiol levels. Elevated levels of estrogen lead to feedback inhibition of the hypothalamic -pituitary-gonadal axis, and the end result is a decrease in LH necessary for the production of testosterone, and FSH to optimize sperm production. The aim of this study was to evaluate the effect of aromatase inhibitor, letrozole on the semen parameters of infertile male having oligozoospermia, low serum testosterone level and testosterone to estradiol ratio <10.Methods: This Prospective study was conducted in the Department of Reproductive Endocrinology and Infertility at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from May 2019 to April 2020. The sample size was 30 subfertile men with oligozoospermia (≤ 10 million/ml), low serum testosterone level (<300 ng/dl) and low testosterone to e...
Scholars International Journal of Obstetrics and Gynecology
Background: Polycystic ovary syndrome (PCOS) is a common disorder in women of reproductive age cl... more Background: Polycystic ovary syndrome (PCOS) is a common disorder in women of reproductive age closely related to insulin resistance, obesity, dyslipidaemia and long term diseases including diabetes and cardiovascular disease. The management of PCOS may be challenging on account of the comorbidities associated with the disease. Objective: The objective of the study was to evaluate the effect of Levocarnitine supplementation on physical and biochemical parameters in polycystic ovary syndrome. Methods: This randomized controlled study was conducted in the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2021 to December 2021. Total 78 diagnosed cases of PCOS were selected for medication and were included in this study. Eligible women who gave their informed consent were allocated into either Group A (Levocarnitine) or Group B (Placebo) on the basis of computer generated table. Group A received Levocarnitine and G...
Gynecology & Obstetrics, 2021
Bangladesh Journal of Obstetrics & Gynaecology, 2016
Leiomyomas are common benign growth of muscle fibre and fibrous tissue often found in uterus 2. I... more Leiomyomas are common benign growth of muscle fibre and fibrous tissue often found in uterus 2. It is found in approximately 25% to 35% of reproductive age women. Uterine leiomyomas are one of the most common tumors found in women of reproductive age. Although leiomyoma usually derived from uterine smooth muscle but uncommonly arise from an unusual site, have rarely been reported in this age group 3,4. Identification of these lesions is important so that the patient can be treated appropriately. Leiomyomas at unusual site have been found in the remnants of a previous hysterectomy or myomectomy, or denovo 5,6 .
Bangabandhu Sheikh Mujib Medical University Journal, 2016
Background: When a pregnant woman gets rubella infection in early months of pregnancy, there is r... more Background: When a pregnant woman gets rubella infection in early months of pregnancy, there is risk of severe and multiple fetal defects ( congenital rubella syndrome), abortion and stillbirth. Screening of reproductive age women for susceptibility to rubella infection and vaccinating them can prevent this situation.Objective: The objective of the study was to find out the proportion of infertile women who are seronegative for rubella infection and to assess the need for vaccination against rubella before pregnancy.Methods: The observational study included three hundred and eighty infertile women who had their venous blood tested for anti-rubella antibodies as part ofpreconceptional preparation. Data was analyzed to estimate seronegativity and the need for vaccination.Results: A total of 55 (14.4%) women were seronegative for rubella and had to be vaccinated. The seronegativity decreased with age . The proportion of seronegativity was higher in those women who were professionals, ...
Mymensingh medical journal : MMJ, 2015
Tuberculosis is endemic in many developing countries of the world including Bangladesh. Genital t... more Tuberculosis is endemic in many developing countries of the world including Bangladesh. Genital tuberculosis is a significant cause of infertility in the women of these countries. The diagnosis of genital tuberculosis in infertile women is difficult as most of the cases are usually asymptomatic. A high index of clinical suspicion is required. Genital tuberculosis always affects the fallopian tubes. It affects the endometrium in half of the cases. In addition to tuberculin skin tests and interferon gamma release assays, procedures like hysterosalpingography, laparoscopy-dye test, endometrial curettage and laparoscopy with multiple sampling for smear microscopy and culture for mycobacterium tuberculosis can detect the cases. In recent years diagnosis has been improved by polymerase chain reaction targeted against mycobacterium tuberculosis DNA. Following early diagnosis, treatment with anti-tubercular drugs is favourable for fertility only when tubal and endometrial damage is minimal....
Mymensingh medical journal : MMJ, 2014
The hydatidiform mole with coexisting fetus is a rare condition. There have been few reports on t... more The hydatidiform mole with coexisting fetus is a rare condition. There have been few reports on this condition following ovulation induction and ART. We describe here the clinical features, management and outcome of a case of complete hydatidiform mole with coexisting viable twin fetus following Intra-cytoplasmic sperm injection. A 29 year old lady was pregnant following Intra-cytoplasmic Sperm Injection (ICSI) and Embryo Transfer. Three good quality embryo with two pronuclei on pronuclear check was transferred. A triplet pregnancy with two live fetus and a complete mole was delivered at 37 completed weeks of pregnancy. The antenatal period was uneventful and the human chorionic gonodotrophin returned to baseline by 4 weeks after delivery. There was no further complication at one year follow-up. Continuation of pregnancy as long as maternal complications are absent or controllable can be a safe and rewarding effort in managing the patient.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Poly cystic ovarian syndrome (PCOS) is a complex multifactorial disorder, affecting m... more Background: Poly cystic ovarian syndrome (PCOS) is a complex multifactorial disorder, affecting millions of women worldwide. Kisspeptin, a hypothalamic peptide encoded by the KISS1 gene, is widely reported as a key factor in the regulation of luteinizing hormone (LH)/follicular stimulating hormone (FSH) secretion, which may be potentially involved with the development of PCOS. The aim of the study was to estimate the serum kisspeptin level in PCOS patients and evaluate the association of kisspeptin with other biochemical, and hormonal parameters in women with PCOS. Methods: This case-control study was conducted at the department of reproductive endocrinology and infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from August 2020 to July 2021. A total of 90 patients between age 18-30 years were enrolled in this study. Data was collected on variables of interest by using the structured questionnaire designed for interview, observation, clinical examination, an...
Bangladesh Journal of Obstetrics & Gynaecology, 2009
Objective: Leptin is a hormone which regulates adipose tissue mass of the body. Substantial incre... more Objective: Leptin is a hormone which regulates adipose tissue mass of the body. Substantial increase of leptin during pregnancy and detection of leptin and leptin receptor in placenta have led to the speculation that leptin is a gestational hormone with a possible role in regulation of fetal growth. The study was done to find out whether maternal and cord blood leptin correlate with birthweight and weight of the placenta. Materials and methods: A prospective cross sectional study was undertaken in the Department of Obsterics and Gynecology, Bangabandhu Sheikh Mujib Medical University from January 2005 to June 2005. The study was carried out on 39 pairs of mothers and newborns. Maternal venous blood was sampled just before delivery. Cord blood was obtained, birth weight and placental weight measurements were taken just after delivery of the baby. Serum leptin levels were measured by enzyme linked immunosorbent assay. Results: Maternal serum leptin was 24.50 ng/ml (range- 13.15-45.60 ...
Bangladesh Journal of Child Health, 2010
Journal of Bangladesh College of Physicians and Surgeons
Introduction: The male factor responsible for infertility includes oligospermia. According to WHO... more Introduction: The male factor responsible for infertility includes oligospermia. According to WHO criteria, oligospermia is sperm concentration less than 15 million per millilitre of semen. Vitamin D is a steroid hormone synthesized in the skin and derived from the diet. A serum level less than 20 ng/dl is regarded as vitamin D deficiency. The deficiency of vitamin D has been linked to many reproductive disorders. This study was designed to analyze the association between serum vitamin D level and oligospermia. Methods: A cross-sectional comparative study was conducted in the Department of Reproductive Endocrinology and infertility of Bangabandhu Sheikh Mujib Medical University, Dhaka, during the period of July 2018 to June 2019. There are 157 infertile males with oligospermia in one group and 157 infertile males with normozoospermia in another group. A base line semen analysis for evaluation of male infertility was done, and serum vitamin D level was estimated. Results: The mean vi...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Oligospermia or low concentration of sperm is a common finding in male infertility. A... more Background: Oligospermia or low concentration of sperm is a common finding in male infertility. Alterations in the expression of angiotensin converting enzyme (ACE) may be one of the mechanisms underlying male infertility and ACE inhibitors may improve the sperm count. The objective was to compare the effects of lisinopril and zinc-folic acid with zinc-folic acid alone on idiopathic oligospermia in infertile males.Methods: This randomized controlled trial was conducted in the Department of Reproductive Endocrinology & Infertility of a medical university from March 2021 to February 2022. A total 78 diagnosed cases of infertile males with idiopathic oligospermia were selected for this study. Eligible men who gave their informed consent were randomly allocated to receive either a combination of low dose lisinopril (2.5 mg) and zinc-folic acid or zinc-folic acid alone for 12 weeks. Pretreatment and post treatment semen parameters, including sperm concentration, sperm motility and total ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Women with infertility may be benefitted from sonohysterosalpingography (SHSG), a tra... more Background: Women with infertility may be benefitted from sonohysterosalpingography (SHSG), a transvaginal ultrasound procedure that uses a contrast medium to assess the endometrial cavity and tubal patency. It could be a safer and more viable alternative to radiographic hysterosalpingography (HSG). The aim of the study was to evaluate the uterine cavity and fallopian tube patency in infertile women by SHSG using transvaginal ultrasound.Methods: The prospective comparative study was carried out in a total of 35 cases of infertile women between the reproductive age of 20-40 years following the inclusion and exclusion criteria, from July 2016 to June 2017. Detailed history and physical examinations were carried out and appropriate management was instituted as per the needs of the individual patient.Results: In the present study, 41.2% of the women belonged to the age range of 25-29 years. Out of 35 women, 50% women were in the state of primary infertility and remaining were in a secon...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Letrozole is a third-generation aromatase inhibitor. As there is aberrant aromatase p... more Background: Letrozole is a third-generation aromatase inhibitor. As there is aberrant aromatase production by endometriotic stromal cells and the growth and regression of endometriosis is estrogen-dependent, the use of letrozole to reduce the size and symptoms of endometrioma especially in recurrent cases is a promising medical intervention. Dienogest is a fourth-generation progestin which is being used for the treatment of endometriosis due to its antiproliferative and antiangiogenic properties on endometrial tissue. The present study was conducted to compare the effects of letrozole and dienogest on endometrioma recurrent after surgery.Methods: This randomized controlled study was conducted on 38 women having recurrence of endometrioma after surgery. They were randomly assigned to receive either letrozole (2.5 mg daily) or dienogest (2 mg once daily) for 6 months. Size of the endometrioma was measured by transvaginal ultrasound and the pain (dysmenorrhoea) was measured on a visual...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Polycystic ovary syndrome (PCOS) is the largest single cause of anovulatory infertili... more Background: Polycystic ovary syndrome (PCOS) is the largest single cause of anovulatory infertility. PCOS is associated with oxidative stress. Coenzyme q10 (Coq10) is an antioxidant that protects the mitochondria from damage caused by either insulin resistance or oxidative free radicals. The objective of the study was to compare the effect of combined Coq10 and letrozole than of letrozole alone for ovulation induction in women with PCOS.Methods: This open label parallel design randomized controlled trial study was conducted on 80 infertile women with PCOS selected for ovulation induction. Eligible women were randomized either to combined Coq10 and letrozole (40 patients, 83 cycles) or letrozole alone (38 patients, 91 cycles). The outcome measures were mature follicles, adequate endometrial thickness, ovulation and pregnancy.Results: Mature follicles (≥18-25 mm) were significantly higher in women given Coq10 at 2nd (74.2% vs 31.3%) and 3rd cycles (83.3% vs 28.6%). Adequate endometria...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Premature ovarian aging as evidenced by AMH levels less than 0.5 ng/ml is predictive ... more Background: Premature ovarian aging as evidenced by AMH levels less than 0.5 ng/ml is predictive of reduced success in management of infertility. The most effective treatment is in vitro fertilization which is not affordable or acceptable to most of our patients with low socioeconomic background. Intra-ovarian injection of autologous platelet rich plasma (PRP) improves the ovarian reserve markers but it remains to be seen whether it improves the pregnancy rate.Methods: This was a prospective study of 29 patients with poor ovarian reserve (age between 30-40 years, AMH<0.5 ng/ml), AFC<4 in both ovaries) who received intra ovarian injection of platelet rich plasma. The patients were followed up for one year and data was collected about clinically relevant outcomes like pregnancy.Results: Four women (13.8%) had pregnancy, of which 3 were spontaneous and one was following ovarian stimulation and intrauterine insemination. All had diagnosed clinical pregnancy, of which two women had...
Bangladesh Journal of Obstetrics & Gynaecology
Objective: To explore the menstrual phenotypes associated with endocrine, metabolic characteristi... more Objective: To explore the menstrual phenotypes associated with endocrine, metabolic characteristics of infertile women with polycystic ovary syndrome. Materials and methods : The cross sectional study was carried out among 125 infertile women with polycystic ovary syndrome attending Infertility wing of the Department of Obstetrics & Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2017 to December 2017. The women were evaluated by clinical history, examination, transvaginal sonogram and for endocrine and metabolic parameters. The women were divided into 5 groups according to their menstrual phenotypes: i) cycle length 21-35 days ii) oligomenorrhoea or cycle length > 35 days but less than 6 months iii) secondary amenorrhoea or cycle length ³6 months iv) polymenorrhoea or cycle length <21 days v) oligomenorrhoea alternating with polymenorrhea. One way ANOVA was used for analyzing the variance between groups. Categorical variables were analyzed for ass...
Bangabandhu Sheikh Mujib Medical University Journal
The objective of this study is to explore how hyperinsulinemia and insulin resistance relate to t... more The objective of this study is to explore how hyperinsulinemia and insulin resistance relate to the clinical, endocrine and metabolic factors in the infertile women with polycystic ovary syndrome. This study was conducted on 121 consecutive infertile women with polycystic ovary syndrome attending the Infertility unit from January 2017 to December 2017. They were divided into two groups: insulin resistant and insulin sensitive. There was significant difference in body mass index and waist circumference between the two groups. Serum lipids were not associated with insulin resistance. Hyperinsulinemia was significantly associated with metabolic syndrome. Reducing body mass index and waist circumference may improve insulin resistance in infertile women with polycystic ovary syndrome. Screening the infertile women with polycystic ovary syndrome for hyperinsulinemia and insulin resistance and subsequent counseling is recommended to address the long-term risks of metabolic syndrome.
Bangladesh Journal of Obstetrics & Gynaecology, 2020
Background: Endometriosis is frequently associated with gastrointestinal symptoms, inaddition to ... more Background: Endometriosis is frequently associated with gastrointestinal symptoms, inaddition to dysmenorrhoea, dyspareunia and infertility. Gastrointestinal tract is not alwaysinvolved when gastrointestinal symptoms are present. Method: A cross sectional study was conducted in the department of Obstetrics &Gynaecology of Bangladesh Sheikh Mujib Medical University (BSMMU) on 55 infertile womenwith surgical diagnosis of endometriosis with the objective to determine the frequency ofgastrointestinal symptoms in our population of women with endometriosis and to find outwhether they were relevant to severity of endometriosis. Results: There was a high prevalence (37.5%) of gastrointestinal symptoms in women withendometriosis. Bloating was the most frequent gastrointestinal symptom. Among the womenwith severe stage IV endometriosis, 57.6% had gastrointestinal symptoms. Conclusion: A gynecologist must consider the gastrointestinal symptoms while dealing withthe women with endometriosis. Fu...
Bangladesh Journal of Obstetrics & Gynaecology, 2022
Objective: To explore the clinical profile of infertile women with premature ovarian insufficienc... more Objective: To explore the clinical profile of infertile women with premature ovarian insufficiency, previously termed premature ovarian failure presenting to a public health facility. Materials and methods : A retrospective study was carried out in which the data collected over three years from 2015-2017 in the Gynae Endocrine Clinic of Infertility unit of the Department of Obstetrics & Gynaecology, Bangabandhu Sheikh Mujib Medical University. A total of 36 infertile women diagnosed as premature ovarian insufficiency were included in the study. Detailed data from the records of the clinic regarding symptoms, history related to possible etiology, investigations including endocrine profile and karyotype were included in the analysis. A follow up interview over cell phone was carried out in 2020 to have the information about any pregnancy and compliance with drug over 2- 5 years. Results: A total of 36 women with infertility which were due to premature ovarian insufficiency were includ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2021
Background: Some men with severely defective sperm production commonly have excess aromatase acti... more Background: Some men with severely defective sperm production commonly have excess aromatase activity, reflected by low serum testosterone and relatively elevated estradiol levels. Elevated levels of estrogen lead to feedback inhibition of the hypothalamic -pituitary-gonadal axis, and the end result is a decrease in LH necessary for the production of testosterone, and FSH to optimize sperm production. The aim of this study was to evaluate the effect of aromatase inhibitor, letrozole on the semen parameters of infertile male having oligozoospermia, low serum testosterone level and testosterone to estradiol ratio <10.Methods: This Prospective study was conducted in the Department of Reproductive Endocrinology and Infertility at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from May 2019 to April 2020. The sample size was 30 subfertile men with oligozoospermia (≤ 10 million/ml), low serum testosterone level (<300 ng/dl) and low testosterone to e...
Scholars International Journal of Obstetrics and Gynecology
Background: Polycystic ovary syndrome (PCOS) is a common disorder in women of reproductive age cl... more Background: Polycystic ovary syndrome (PCOS) is a common disorder in women of reproductive age closely related to insulin resistance, obesity, dyslipidaemia and long term diseases including diabetes and cardiovascular disease. The management of PCOS may be challenging on account of the comorbidities associated with the disease. Objective: The objective of the study was to evaluate the effect of Levocarnitine supplementation on physical and biochemical parameters in polycystic ovary syndrome. Methods: This randomized controlled study was conducted in the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2021 to December 2021. Total 78 diagnosed cases of PCOS were selected for medication and were included in this study. Eligible women who gave their informed consent were allocated into either Group A (Levocarnitine) or Group B (Placebo) on the basis of computer generated table. Group A received Levocarnitine and G...
Gynecology & Obstetrics, 2021
Bangladesh Journal of Obstetrics & Gynaecology, 2016
Leiomyomas are common benign growth of muscle fibre and fibrous tissue often found in uterus 2. I... more Leiomyomas are common benign growth of muscle fibre and fibrous tissue often found in uterus 2. It is found in approximately 25% to 35% of reproductive age women. Uterine leiomyomas are one of the most common tumors found in women of reproductive age. Although leiomyoma usually derived from uterine smooth muscle but uncommonly arise from an unusual site, have rarely been reported in this age group 3,4. Identification of these lesions is important so that the patient can be treated appropriately. Leiomyomas at unusual site have been found in the remnants of a previous hysterectomy or myomectomy, or denovo 5,6 .
Bangabandhu Sheikh Mujib Medical University Journal, 2016
Background: When a pregnant woman gets rubella infection in early months of pregnancy, there is r... more Background: When a pregnant woman gets rubella infection in early months of pregnancy, there is risk of severe and multiple fetal defects ( congenital rubella syndrome), abortion and stillbirth. Screening of reproductive age women for susceptibility to rubella infection and vaccinating them can prevent this situation.Objective: The objective of the study was to find out the proportion of infertile women who are seronegative for rubella infection and to assess the need for vaccination against rubella before pregnancy.Methods: The observational study included three hundred and eighty infertile women who had their venous blood tested for anti-rubella antibodies as part ofpreconceptional preparation. Data was analyzed to estimate seronegativity and the need for vaccination.Results: A total of 55 (14.4%) women were seronegative for rubella and had to be vaccinated. The seronegativity decreased with age . The proportion of seronegativity was higher in those women who were professionals, ...
Mymensingh medical journal : MMJ, 2015
Tuberculosis is endemic in many developing countries of the world including Bangladesh. Genital t... more Tuberculosis is endemic in many developing countries of the world including Bangladesh. Genital tuberculosis is a significant cause of infertility in the women of these countries. The diagnosis of genital tuberculosis in infertile women is difficult as most of the cases are usually asymptomatic. A high index of clinical suspicion is required. Genital tuberculosis always affects the fallopian tubes. It affects the endometrium in half of the cases. In addition to tuberculin skin tests and interferon gamma release assays, procedures like hysterosalpingography, laparoscopy-dye test, endometrial curettage and laparoscopy with multiple sampling for smear microscopy and culture for mycobacterium tuberculosis can detect the cases. In recent years diagnosis has been improved by polymerase chain reaction targeted against mycobacterium tuberculosis DNA. Following early diagnosis, treatment with anti-tubercular drugs is favourable for fertility only when tubal and endometrial damage is minimal....
Mymensingh medical journal : MMJ, 2014
The hydatidiform mole with coexisting fetus is a rare condition. There have been few reports on t... more The hydatidiform mole with coexisting fetus is a rare condition. There have been few reports on this condition following ovulation induction and ART. We describe here the clinical features, management and outcome of a case of complete hydatidiform mole with coexisting viable twin fetus following Intra-cytoplasmic sperm injection. A 29 year old lady was pregnant following Intra-cytoplasmic Sperm Injection (ICSI) and Embryo Transfer. Three good quality embryo with two pronuclei on pronuclear check was transferred. A triplet pregnancy with two live fetus and a complete mole was delivered at 37 completed weeks of pregnancy. The antenatal period was uneventful and the human chorionic gonodotrophin returned to baseline by 4 weeks after delivery. There was no further complication at one year follow-up. Continuation of pregnancy as long as maternal complications are absent or controllable can be a safe and rewarding effort in managing the patient.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Poly cystic ovarian syndrome (PCOS) is a complex multifactorial disorder, affecting m... more Background: Poly cystic ovarian syndrome (PCOS) is a complex multifactorial disorder, affecting millions of women worldwide. Kisspeptin, a hypothalamic peptide encoded by the KISS1 gene, is widely reported as a key factor in the regulation of luteinizing hormone (LH)/follicular stimulating hormone (FSH) secretion, which may be potentially involved with the development of PCOS. The aim of the study was to estimate the serum kisspeptin level in PCOS patients and evaluate the association of kisspeptin with other biochemical, and hormonal parameters in women with PCOS. Methods: This case-control study was conducted at the department of reproductive endocrinology and infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from August 2020 to July 2021. A total of 90 patients between age 18-30 years were enrolled in this study. Data was collected on variables of interest by using the structured questionnaire designed for interview, observation, clinical examination, an...
Bangladesh Journal of Obstetrics & Gynaecology, 2009
Objective: Leptin is a hormone which regulates adipose tissue mass of the body. Substantial incre... more Objective: Leptin is a hormone which regulates adipose tissue mass of the body. Substantial increase of leptin during pregnancy and detection of leptin and leptin receptor in placenta have led to the speculation that leptin is a gestational hormone with a possible role in regulation of fetal growth. The study was done to find out whether maternal and cord blood leptin correlate with birthweight and weight of the placenta. Materials and methods: A prospective cross sectional study was undertaken in the Department of Obsterics and Gynecology, Bangabandhu Sheikh Mujib Medical University from January 2005 to June 2005. The study was carried out on 39 pairs of mothers and newborns. Maternal venous blood was sampled just before delivery. Cord blood was obtained, birth weight and placental weight measurements were taken just after delivery of the baby. Serum leptin levels were measured by enzyme linked immunosorbent assay. Results: Maternal serum leptin was 24.50 ng/ml (range- 13.15-45.60 ...
Bangladesh Journal of Child Health, 2010
Journal of Bangladesh College of Physicians and Surgeons
Introduction: The male factor responsible for infertility includes oligospermia. According to WHO... more Introduction: The male factor responsible for infertility includes oligospermia. According to WHO criteria, oligospermia is sperm concentration less than 15 million per millilitre of semen. Vitamin D is a steroid hormone synthesized in the skin and derived from the diet. A serum level less than 20 ng/dl is regarded as vitamin D deficiency. The deficiency of vitamin D has been linked to many reproductive disorders. This study was designed to analyze the association between serum vitamin D level and oligospermia. Methods: A cross-sectional comparative study was conducted in the Department of Reproductive Endocrinology and infertility of Bangabandhu Sheikh Mujib Medical University, Dhaka, during the period of July 2018 to June 2019. There are 157 infertile males with oligospermia in one group and 157 infertile males with normozoospermia in another group. A base line semen analysis for evaluation of male infertility was done, and serum vitamin D level was estimated. Results: The mean vi...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Oligospermia or low concentration of sperm is a common finding in male infertility. A... more Background: Oligospermia or low concentration of sperm is a common finding in male infertility. Alterations in the expression of angiotensin converting enzyme (ACE) may be one of the mechanisms underlying male infertility and ACE inhibitors may improve the sperm count. The objective was to compare the effects of lisinopril and zinc-folic acid with zinc-folic acid alone on idiopathic oligospermia in infertile males.Methods: This randomized controlled trial was conducted in the Department of Reproductive Endocrinology & Infertility of a medical university from March 2021 to February 2022. A total 78 diagnosed cases of infertile males with idiopathic oligospermia were selected for this study. Eligible men who gave their informed consent were randomly allocated to receive either a combination of low dose lisinopril (2.5 mg) and zinc-folic acid or zinc-folic acid alone for 12 weeks. Pretreatment and post treatment semen parameters, including sperm concentration, sperm motility and total ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Women with infertility may be benefitted from sonohysterosalpingography (SHSG), a tra... more Background: Women with infertility may be benefitted from sonohysterosalpingography (SHSG), a transvaginal ultrasound procedure that uses a contrast medium to assess the endometrial cavity and tubal patency. It could be a safer and more viable alternative to radiographic hysterosalpingography (HSG). The aim of the study was to evaluate the uterine cavity and fallopian tube patency in infertile women by SHSG using transvaginal ultrasound.Methods: The prospective comparative study was carried out in a total of 35 cases of infertile women between the reproductive age of 20-40 years following the inclusion and exclusion criteria, from July 2016 to June 2017. Detailed history and physical examinations were carried out and appropriate management was instituted as per the needs of the individual patient.Results: In the present study, 41.2% of the women belonged to the age range of 25-29 years. Out of 35 women, 50% women were in the state of primary infertility and remaining were in a secon...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Letrozole is a third-generation aromatase inhibitor. As there is aberrant aromatase p... more Background: Letrozole is a third-generation aromatase inhibitor. As there is aberrant aromatase production by endometriotic stromal cells and the growth and regression of endometriosis is estrogen-dependent, the use of letrozole to reduce the size and symptoms of endometrioma especially in recurrent cases is a promising medical intervention. Dienogest is a fourth-generation progestin which is being used for the treatment of endometriosis due to its antiproliferative and antiangiogenic properties on endometrial tissue. The present study was conducted to compare the effects of letrozole and dienogest on endometrioma recurrent after surgery.Methods: This randomized controlled study was conducted on 38 women having recurrence of endometrioma after surgery. They were randomly assigned to receive either letrozole (2.5 mg daily) or dienogest (2 mg once daily) for 6 months. Size of the endometrioma was measured by transvaginal ultrasound and the pain (dysmenorrhoea) was measured on a visual...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Polycystic ovary syndrome (PCOS) is the largest single cause of anovulatory infertili... more Background: Polycystic ovary syndrome (PCOS) is the largest single cause of anovulatory infertility. PCOS is associated with oxidative stress. Coenzyme q10 (Coq10) is an antioxidant that protects the mitochondria from damage caused by either insulin resistance or oxidative free radicals. The objective of the study was to compare the effect of combined Coq10 and letrozole than of letrozole alone for ovulation induction in women with PCOS.Methods: This open label parallel design randomized controlled trial study was conducted on 80 infertile women with PCOS selected for ovulation induction. Eligible women were randomized either to combined Coq10 and letrozole (40 patients, 83 cycles) or letrozole alone (38 patients, 91 cycles). The outcome measures were mature follicles, adequate endometrial thickness, ovulation and pregnancy.Results: Mature follicles (≥18-25 mm) were significantly higher in women given Coq10 at 2nd (74.2% vs 31.3%) and 3rd cycles (83.3% vs 28.6%). Adequate endometria...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Premature ovarian aging as evidenced by AMH levels less than 0.5 ng/ml is predictive ... more Background: Premature ovarian aging as evidenced by AMH levels less than 0.5 ng/ml is predictive of reduced success in management of infertility. The most effective treatment is in vitro fertilization which is not affordable or acceptable to most of our patients with low socioeconomic background. Intra-ovarian injection of autologous platelet rich plasma (PRP) improves the ovarian reserve markers but it remains to be seen whether it improves the pregnancy rate.Methods: This was a prospective study of 29 patients with poor ovarian reserve (age between 30-40 years, AMH<0.5 ng/ml), AFC<4 in both ovaries) who received intra ovarian injection of platelet rich plasma. The patients were followed up for one year and data was collected about clinically relevant outcomes like pregnancy.Results: Four women (13.8%) had pregnancy, of which 3 were spontaneous and one was following ovarian stimulation and intrauterine insemination. All had diagnosed clinical pregnancy, of which two women had...
Bangladesh Journal of Obstetrics & Gynaecology
Objective: To explore the menstrual phenotypes associated with endocrine, metabolic characteristi... more Objective: To explore the menstrual phenotypes associated with endocrine, metabolic characteristics of infertile women with polycystic ovary syndrome. Materials and methods : The cross sectional study was carried out among 125 infertile women with polycystic ovary syndrome attending Infertility wing of the Department of Obstetrics & Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2017 to December 2017. The women were evaluated by clinical history, examination, transvaginal sonogram and for endocrine and metabolic parameters. The women were divided into 5 groups according to their menstrual phenotypes: i) cycle length 21-35 days ii) oligomenorrhoea or cycle length > 35 days but less than 6 months iii) secondary amenorrhoea or cycle length ³6 months iv) polymenorrhoea or cycle length <21 days v) oligomenorrhoea alternating with polymenorrhea. One way ANOVA was used for analyzing the variance between groups. Categorical variables were analyzed for ass...
Bangabandhu Sheikh Mujib Medical University Journal
The objective of this study is to explore how hyperinsulinemia and insulin resistance relate to t... more The objective of this study is to explore how hyperinsulinemia and insulin resistance relate to the clinical, endocrine and metabolic factors in the infertile women with polycystic ovary syndrome. This study was conducted on 121 consecutive infertile women with polycystic ovary syndrome attending the Infertility unit from January 2017 to December 2017. They were divided into two groups: insulin resistant and insulin sensitive. There was significant difference in body mass index and waist circumference between the two groups. Serum lipids were not associated with insulin resistance. Hyperinsulinemia was significantly associated with metabolic syndrome. Reducing body mass index and waist circumference may improve insulin resistance in infertile women with polycystic ovary syndrome. Screening the infertile women with polycystic ovary syndrome for hyperinsulinemia and insulin resistance and subsequent counseling is recommended to address the long-term risks of metabolic syndrome.
Bangladesh Journal of Obstetrics & Gynaecology, 2020
Background: Endometriosis is frequently associated with gastrointestinal symptoms, inaddition to ... more Background: Endometriosis is frequently associated with gastrointestinal symptoms, inaddition to dysmenorrhoea, dyspareunia and infertility. Gastrointestinal tract is not alwaysinvolved when gastrointestinal symptoms are present. Method: A cross sectional study was conducted in the department of Obstetrics &Gynaecology of Bangladesh Sheikh Mujib Medical University (BSMMU) on 55 infertile womenwith surgical diagnosis of endometriosis with the objective to determine the frequency ofgastrointestinal symptoms in our population of women with endometriosis and to find outwhether they were relevant to severity of endometriosis. Results: There was a high prevalence (37.5%) of gastrointestinal symptoms in women withendometriosis. Bloating was the most frequent gastrointestinal symptom. Among the womenwith severe stage IV endometriosis, 57.6% had gastrointestinal symptoms. Conclusion: A gynecologist must consider the gastrointestinal symptoms while dealing withthe women with endometriosis. Fu...
Bangladesh Journal of Obstetrics & Gynaecology, 2022
Objective: To explore the clinical profile of infertile women with premature ovarian insufficienc... more Objective: To explore the clinical profile of infertile women with premature ovarian insufficiency, previously termed premature ovarian failure presenting to a public health facility. Materials and methods : A retrospective study was carried out in which the data collected over three years from 2015-2017 in the Gynae Endocrine Clinic of Infertility unit of the Department of Obstetrics & Gynaecology, Bangabandhu Sheikh Mujib Medical University. A total of 36 infertile women diagnosed as premature ovarian insufficiency were included in the study. Detailed data from the records of the clinic regarding symptoms, history related to possible etiology, investigations including endocrine profile and karyotype were included in the analysis. A follow up interview over cell phone was carried out in 2020 to have the information about any pregnancy and compliance with drug over 2- 5 years. Results: A total of 36 women with infertility which were due to premature ovarian insufficiency were includ...