Asian Pacific Journal of Reproduction

52-57

Authors: Jyoti Sharma, Nitin Kumar Joshi, Yogesh Kumar Jain, Kuldeep Singh, Pankaj Bhardwaj

Objective: To assess the utilization of reproductive health services in urban slum of Jodhpur city, India. Methods: A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021. Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care (ANC) services, delivery and post-partum services. Results: The majority of females were aged less than 25 years (n=195; 65.0%), married after 18 years (n=240; 80%), living in extended families (n=265; 88.3%) and with monthly family income less than 10 000 rupees (n=182; 60.7%). Statistically significant associations were found between ≥4 ANC visits and educational level of secondary and above (OR 2.47, 95% CI 1.03–6.28; P=0.04), older age (OR 15.70, 95% CI 14.87–16.54 for women aged 26- 35 years, OR 16.14, 95% CI 12.12–20.01 for women aged ≥36 years; P<0.01), and backward and general castes (OR 15.91, 95% CI 13.57–17.85 for backward caste and OR 8.11, 95% CI 8.07–8.26 for general category of caste; P<0.01). Seven percent of females had undergone parturition. Older age was associated with higher risks of postpartum complications (OR 1.06, 95% CI 1.01–1.57 for women aged 26-35 years, OR 3.56, 95% CI 1.29–4.69 for women aged ≥36 years; P<0.01). In addition, risks of postpartum complications were associated with backward and general castes (OR 1.69, 95% CI 1.34–2.13 for backward classes and OR 5.01, 95% CI 4.29–5.31 for general category castes; P<0.01), and more than 4 ANC visits (OR 0.20, 95% CI 0.09–0.34; P<0.01). Conclusions: More frequent ANC visits are associated with a lower risk of postpartum complications. Furthermore, a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.

64-70

Authors: Maryam Shirmohamadi, Mehri Mashayekhy, Iraj Alipourfard, Javad Fazeli, Nasrin Ghasemi

Objective: To elucidate the possible role of unfractionated heparin in patients with failed repeated in in vitro fertilization and embryo transfer (IVF-ET) and thrombophilia. Methods: This case control study evaluated the efficacy of the unfractionated heparin in increasing the pregnancy and implantation ratio in women with recurrent IVF-ET failures. Eighty-six women received in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) with a record of three or more previous IVF-ET failures. Participants were randomly distributed into two groups. Group A (n=43) received unfractionated heparin 5 000 IU twice daily, and group B (n=43) did not take any antithrombotic drugs. Coagulation abnormalities such as factor V Leiden (FVL) mutation, methylene tetra hydro folate reductase (MTHFR) mutation and prothrombin mutation (FII) were evaluated. Age, body mass index, basal follicular stimulating hormone, basal estradiol, duration of infertility, and number of IVF-ET failures were compared between two groups. Results: 45.0% and 17.4% of women were pregnant with and without MTHFR and prothrombin mutation, respectively, when they received unfractionated heparin treatment. The implantation rate was more in group A (12.5%) than group B (4.3%) and differences in the fertilization rate of the two groups were observed (27.7% vs. 35.9%). The clinical pregnancy rate per cycle was remarkably more in group A (30.2%) than group B (14.0%). Conclusions: Heparin is a safe and valuable treatment for patients with repeated IVF-ET failures. The clinical pregnancy and implantation rates are higher in the heparin-treated group in contrast with the control group.

81-89

Authors: Olugbemi T Olaniyan, Ayobami Dare, Charles O. Adetunji, Gloria E. Okotie, Joseph B. Dare, Bosun M. Adigun, Femi Adebayo

Objective: To investigate the protective effect of vitamin E in dehydroepiandrosterone (DHEA)-induced polycystic ovary in rats. Methods: Premature female Wistar rats were randomly allocated into four groups, with 7 rats in each group. Group I received corn oil (vehicle) and served as the control group; group II received 0.2 mL of 0.06 mg/g DHEA in corn oil; group III received 200 mg/kg vitamin E; group IV received DHEA plus vitamin E. All treatments lasted for 15 days, with DHEA administered subcutaneously, while vitamin E and corn oil were administered orally. After the experiment, serum samples and ovaries were harvested for biochemical, immunohistochemical, hormonal, and histological analysis. The ovarian mRNA expression of androgen receptor was analyzed by reverse transcriptase quantitative polymerase chain reaction (qPCR). Results: The antioxidant and metabolic enzyme activity significantly decreased in the DHEA-treated rats compared to the control rats (P<0.05). Administration of vitamin E to DHEA- treated rats significantly decreased cytokines and malondialdehyde compared to the DHEA-treated rats. The histological analysis showed reduced atretic and cystic ovaries, increased E-cadherin and Bcl-2 expression, and reduced expression of Bax in the DHEA- treated rats co-treated with vitamin E. The mRNA expression of androgen receptor was upregulated in the DHEA-treated rats compared to the control rats. Conclusions: Vitamin E ameliorates the hyperandrogenic effect of DHEA-induced polycystic ovaries via metabolic, antioxidant, and anti-apoptotic pathways.