International Journal of Infertility & Fetal Medicine

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2021 | September-December | Volume 12 | Issue 3

EDITORIAL

Kamini A Rao

Editorial

[Year:2021] [Month:September-December] [Volume:12] [Number:3] [Pages:1] [Pages No:00 - 00]

PDF  |  DOI: 10.5005/ijifm-12-3-iv  |  Open Access |  How to cite  | 

Original Article

Rupali Gupta, Shweta Mishra, Abhilasha Parihar, Rinki Kumari

Knowledge, Attitude, and Practice of Menstrual Hygiene in Women Aged 13–45 Years Attending Hind Institute of Medical Sciences, Sitapur: A Cross-sectional Study

[Year:2021] [Month:September-December] [Volume:12] [Number:3] [Pages:6] [Pages No:49 - 54]

Keywords: Awareness, Menstrual hygiene, Menstruation, Reproductive women

PDF  |  DOI: 10.5005/jp-journals-10016-1224  |  Open Access |  How to cite  | 

Abstract

Background and aims and objectives: There is a substantial lacuna in the awareness of menstruation and menstrual hygiene practice among young girls and women of reproductive age. Menstruation is a normal hormonal process and the leading indicator of women\'s reproductive age groups’ reproductive health. Inadequate knowledge about menstrual hygiene influences education practice, social activity, environment, and women\'s daily activities. This study evaluates women\'s hygiene practices in the Sitapur district among women aged 13–45 years, evaluates their knowledge of menstrual hygiene, and promotes their knowledge about menstrual hygiene. Materials and methods: This was hospital-based cross-sectional research conducted in the woman age group of 13–45 years attending Gynecology\'s outpatient department. A predesigned, pretested, semi-structured questionnaire has been used as a questionnaire survey. The interview process has been used for data collection and obtaining informed consent from the participants. The SPSS 20v software analyzed data. Results: The mean age of participants was 29.00 ± 9.60 years; 76.8% of participants were not aware of menstruation before attaining menarche, around 23.78% were not known about the cause of menstruation, and 75.20% source of the blood of menstruation cycle in a rural area. In the rural area, only 4.72% used only sanitary pads, and the majority of participants, 79.39%, used old clothes, whereas 75% used sanitary pads in the urban. Only water used for cleaning the external genitalia was practiced by 52.36% of rural area subjects. Meaningfully deplorable menstrual hygiene practices associated with rural participates. Conclusion: The educational and communication program for public health care focusing on menstrual hygiene must be strengthened. Educational awareness and very well programs will play a key role in implementing health education in women.

Original Article

Prasanna L Kakarla, Anil K Bilolikar, Sukrutha G Reddy, Vyjayanthi Sreenivasan

Rubella Immune Status among Infertile Women: A Priority Vaccination Cohort

[Year:2021] [Month:September-December] [Volume:12] [Number:3] [Pages:5] [Pages No:55 - 59]

Keywords: Age-specific immunity, Congenital rubella syndrome, Laboratory research, MR vaccine, Preconception screening, Trend

PDF  |  DOI: 10.5005/jp-journals-10016-1227  |  Open Access |  How to cite  | 

Abstract

Aim and objective: Congenital rubella syndrome (CRS), a consequence of rubella virus infection in the first trimester of pregnancy is a silent crippling disease endemic in India. This study sought to find out and vaccinate rubella susceptible women attending a fertility clinic in an urban setup. Materials and methods: As an institutional policy, all females attending fertility clinic were screened for anti-rubella IgG antibodies. A total 2272 non-duplicate serum samples received between January 2011 and December 2017 were processed using enzyme-linked fluorescent assay using mini VIDAS system following standard recommendations. Any value <10 IU/mL was regarded negative, between 10 and 15 as equivocal and >15 as positive. Results: An average of 10.95% women was susceptible to rubella whereas 86.75% were immune to it. Samples from 52 women gave equivocal results and they were considered to be susceptible. All susceptible females were vaccinated with R-vac and treated for infertility one month after vaccination. Age-specific immune status was not significant. A trend analysis revealed steady increase in immunity from 2011 to 2017 with a slight drop in 2016. Conclusion: The proportion of susceptible females of reproductive age who need to be vaccinated is significant. This study emphasizes the need for preconception screening as we would have an opportunity to vaccinate susceptible women. Clinical significance: There is a need for preconception screening of rubella not only in infertile women but also normal reproductive age females. With successful eradication of polio, elimination of rubella and measles being the next targets, combined vaccination strategy is the key to rubella elimination.

Original Article

Vandana Kamath, Vivi M Srivastava, Mary P Chacko, Yuvarani S, Samuel P Oommen, Beena Koshy

Phenotypic Features and Inheritance Pattern of Emanuel Syndrome: An Indian Perspective

[Year:2021] [Month:September-December] [Volume:12] [Number:3] [Pages:6] [Pages No:60 - 65]

Keywords: der(22)t(11,22)(q23,q11.2),t(11,22), Emanuel syndrome, Inheritance, Low copy repeats quality of life

PDF  |  DOI: 10.5005/jp-journals-10016-1228  |  Open Access |  How to cite  | 

Abstract

Aim and objective: To study the phenotypic features and inheritance patterns in children diagnosed with Emanuel syndrome (ES). Materials and methods: All children who underwent cytogenetic analysis at the Christian Medical College, Vellore and whose karyotypes showed the supernumerary chromosome 22 derived from an unbalanced translocation (11;22)(q23;q11.2) were included. Karyotypes of family members were retrieved from hospital records. Metaphases were obtained from phytohemagglutinin-stimulated peripheral blood cultured using standard protocols. At least 20 Giemsa-banded metaphases were analyzed and reported in accordance with the International System for Human Cytogenomic Nomenclature. The clinical features and imaging findings were retrieved from our medical records. The karyotype findings of parents and family history including the obstetric history of all mothers were recorded. Results: There were eight children, three girls and five boys, all of whom were from unrelated families. The age at presentation ranged from 8 months to 8 years of age. Three families presented with significant family history in the form of previous sibling deaths, recurrent abortions in the mother, and maternal siblings’ death. All eight children presented with global developmental delay. Preauricular sinus was found in six children (6/8,75%), while microcephaly and hypotonia in five each (5/8,62.5%). More than half of our children presented with structural cardiac and brain malformations. In three children, the der(22) was found to have originated from a maternal source of the t(11;22). All three mothers who harbored this translocation were phenotypically normal. Conclusion: The characteristic clinical features of ES found in our study included preauricular sinus, microcephaly, hypotonia, cardiac defects, and structural brain malformations. The maternal source of the t(11;22) was the commonest mode of inheritance among children diagnosed with ES. Clinical significance: Emanuel syndrome is a rare syndrome and it is extremely important to identify the phenotypic features of this clinical entity since early intervention can aid in appropriate counselling and offering prenatal testing. The majority of children diagnosed with ES were found to have inherited this genetic defect due to a translocation (11;22) running in the family. Hence, a clear understanding of the reproductive outcomes of the t(11;22) is of vital importance in counseling the family members and offering prenatal testing.

RESEARCH ARTICLE

Nihida Akhter, Asma Khanday, Irfan N Mir

Hypothyroidism and Hyperprolactinemia as a Cause of Primary Infertility: A Single Center Study

[Year:2021] [Month:September-December] [Volume:12] [Number:3] [Pages:3] [Pages No:66 - 68]

Keywords: Hyperprolactinemia, Primary infertility, Thyroid-stimulating hormone

PDF  |  DOI: 10.5005/jp-journals-10016-1222  |  Open Access |  How to cite  | 

Abstract

Introduction: Infertility is a common condition, with important medical economic and psychological implications. We have observed a surge in cases of primary infertility in our OPD of late. Hypothyroidism and hyperprolactinemia have been implicated as a cause of primary infertility. Materials and methods: We conducted a prospective cross-sectional study in our hospital, Government Medical College, on an OPD basis, between May 2017 and January 2019, to check for hypothyroidism and hyperprolactinemia as a cause of primary infertility among females, after ruling out other common implicated factors that may be the cause of infertility. We labeled the study group as group I and the control group as group II. Results: The mean age of patients in group I was 26.21 years, and that in group II was 25.63 years, respectively. The average time since marriage in group I was found to be 1.67 years and that in group II was 1.78 years, respectively. The rural–urban ratio of patients in group I was 23:27 and that in group II was 34:16. The mean TSH level in group I was found to be 7.11 ± 1.91 and that in group II was found to be 3.28 ± 2.11. The mean levels of serum prolactin in group I were 41.62 ± 20.02 and that in group II were 22.36 ± 15.61, respectively. There was a high prevalence of hypothyroidism and hyperprolactinemia in group I when compared with group II. Conclusion: This study showed significantly higher prolactin and TSH levels among the primary infertile female patients. Therefore, for proper management of infertile cases, it may be necessary to look for thyroid dysfunction and treat it accordingly.

RESEARCH ARTICLE

Sopia A Rajamanickam, Joseph PI Danislas, Kalyani Mohanram, Shanthi Dinakaran, Allen J Henry

Trifactorial Influence—Antisperm Antibody, Anti-Chlamydia Antibodies, and Thyroid Levels in Infertility

[Year:2021] [Month:September-December] [Volume:12] [Number:3] [Pages:4] [Pages No:69 - 72]

Keywords: Antisperm antibody, Chlamydia trachomatis, Cross-sectional study, Enzyme-linked immunosorbent assay, Infertility, T3, T4, Thyroid-stimulating hormone

PDF  |  DOI: 10.5005/jp-journals-10016-1223  |  Open Access |  How to cite  | 

Abstract

Aim and objective: The present study determines the incidence of anti-Chlamydia antibodies (ACA), antisperm antibody (ASA), and thyroid levels in serum of infertility patients and statistically determines the significance of all three study parameters. Materials and methods: A cross-sectional study was conducted on volunteers of 190 patients both male and female reporting to the Infertility Clinic of hospital and 178 patients including pregnant women patients were used as control. Serum from patients was collected and analyzed for the presence of anti-Chlamydia antibodies, ASA, serum T3, T4, and thyroid-stimulating hormone (TSH) levels by enzyme-linked immunosorbent assay (ELISA). Results: Infertility patients representing 12.6% of the study population tested positive for anti-Chlamydia antibodies. 21.6% of 190 patients had high ASA levels and these levels were found to be statistically significant p < 0.001 when compared with control. Elevated thyroid levels of the study population observed as increased T3 in 26 patients and T4 in 18 patients with 16 patients having increased TSH and the increased levels of thyroid in infertility patients compared with control is statistically significant p value <0.01. Correlation between all three study parameters is statistically significant [0.01 level (two-tailed)]. Conclusion: Significantly higher levels of anti-Chlamydia antibodies and ASA are found associated in infertile patients as is elevated T3, T4, and TSH. All three parameters together can cause infertility showing the multidimensional factors for the development of infertility. Clinical significance: Patients with infertility should be screened for all three study parameters viz. ACA, ASA, and thyroid levels and subsequent treatment protocols to resolve all possible adverse results to within normal levels for the success of ART. Research highlights • The present study found higher levels of anti-Chlamydia antibody in patients with primary infertility compared with the control group indicating the strong association between chlamydial infections and infertility. • The present study found higher levels of antisperm antibodies in the serum of patients with primary infertility compared with the control group implying a significant role for ASA and development of infertility. • Thyroid disorders such as hypothyroidism due to elevated TSH and hyperthyroidism associated with increased total serum T3 or T4 are several times higher in infertility patients when compared with the general population providing evidence for thyroid imbalance and infertility. • All three study parameters—anti-Chlamydia antibodies, ASA, and thyroid levels occurring together in any one patient may tend to cause infertility.

RESEARCH ARTICLE

Saravanan Chinnaiyan, Bhavya Babu

A Study of Attitude, Awareness, and Knowledge of Vasectomy among Married Men in Urban Slums of Chennai, Tamil Nadu, India

[Year:2021] [Month:September-December] [Volume:12] [Number:3] [Pages:4] [Pages No:73 - 76]

Keywords: Male sterilization, Unmet needs, Vasectomy

PDF  |  DOI: 10.5005/jp-journals-10016-1226  |  Open Access |  How to cite  | 

Abstract

Background: Sterilization is a permanent birth control method, with nearly twice as many couples, are choosing female sterilization over male sterilization. Vasectomy is a safe, cheaper, less complicated, and simple procedure in permanent sterilization methods than tubectomy. Aim and objective: To assess attitude, awareness, and knowledge of vasectomy among married men in urban slums of Chennai, Tamil Nadu. Materials and methods: It is a descriptive cross-sectional study carried among married men in the urban slums of Chennai age 21–49. Simple random sampling is used to select the respondents. Descriptive analysis was done using appropriate R studio software. Results: Among our 132 respondents, most of them are from 20 to 29 (40.90%). About 84% of the participants heard about vasectomy. Awareness of contraceptive methods is mostly through television (75%) and by their family and friends (72%). Our study discovered a gap in the knowledge and attitudes toward vasectomy, which the study revealed that respondents had moderate knowledge but had a negative attitude toward vasectomy. Conclusion: Many men believe that avoiding pregnancy is exclusively the woman\'s responsibility. Men and women differed in their experience of sterilization. Family and physicians have an important role in ensuring that women know contraception options before the sterilization procedure. Adequate health education campaigns and regular counseling can bring out positive attitudes among people on vasectomy in the future.

CASE REPORT

Zhainagul Kozhabek, QiongZhen Zhao, Pang Min

A Rare of Klinefelter Syndrome with Normal Phenotype: A Case Report

[Year:2021] [Month:September-December] [Volume:12] [Number:3] [Pages:3] [Pages No:77 - 79]

Keywords: Infertility, Intracytoplasmic sperm injection, Klinefelter syndrome, Preimplantation genetic diagnosis

PDF  |  DOI: 10.5005/jp-journals-10016-1225  |  Open Access |  How to cite  | 

Abstract

Klinefelter syndrome (KS) is a genetic condition that results from male with one or more extra copy of the X chromosome. The primary features are infertility and small, poorly functioning testicles. Symptoms also include greater height, less body hair, weaker muscles, poor coordination, enlarged breast tissue, and less interest in sex. We present the case of a 36-year-old man who is KS with normal clinical and laboratory phenotype, which is a very rare finding in this syndrome. Most men with KS are infertility, they produce little or no sperm. Assisted reproductive procedures may help some men with KS to father a child. But the necessity of PGD during assisted reproductive treatment has always been a controversial topic. In this case, we examined five blastocysts of patient, two of them with abnormal karyotype and other three were normal. Therefore, it is necessary to carry out preimplantation genetic diagnosis for KS patients before implantation, even though their phenotypes are normal.

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