Parveen Fatima

Improving manual vacuum aspiration service delivery, introducing misoprostol for cases of incomplete abortion, and strengthening postabortion contraception in Bangladesh

The Obstetrical and Gynaecological Society of Bangladesh was an important advocate in mobilizing government authorities to adopt new techniques for postabortion care and provide long‐acting contraceptives post abortion. With the support of the International Federation of Gynecology and Obstetrics (FIGO), the Society provided commodities and training to increase the use of these techniques in 7 private and public hospitals and clinics. Data from two of these institutes for the January 2012 to June 2013 period showed a rapid decrease in the use of dilation and curettage, an increase in the use of manual vacuum aspiration (MVA) and misoprostol, and the progressive adoption of long‐acting reversible contraceptives, permanent contraception, and injectable contraceptives in one of these two hospitals. The Directorates General of Health and Family Planning incorporated training in the use of MVA and misoprostol in their national operation plans. The success in these hospitals shows that the proposed changes have been well accepted by providers and clients.

FIGO postpartum intrauterine device initiative: Complication rates across six countries

To record and analyze complication rates following postpartum intrauterine device (PPIUD) insertion in 48 hospitals in six countries: Sri Lanka, India, Nepal, Bangladesh, Tanzania, and Kenya.

Impact of contraceptive counselling training among counsellors participating in the FIGO postpartum intrauterine device initiative in Bangladesh.

To evaluate the impact of structured training given to dedicated family planning counsellors on postpartum intrauterine device (PPIUD) services across six tertiary hospitals in Bangladesh.

Adenomyosis in Infertile Women : A Review

Adenomyosis is found during infertility work up in many women who delay pregnancy till their late thirties and in some women in their early age. Dysregulation of myometrial architecture and function and altered endometrial receptivity are among the possible mechanisms by which adenomyosis causes infertility. Adenomyosis and endometriosis may have similar pathogenesis as they have frequent association in women. Adenomyosis can be reliably diagnosed in symptomatic infertile women by non invasive means such as transvaginal ultrasound and magnetic resonance imaging as well as hysterosalpingography, hysteroscopy and laparoscopy. Early diagnosis by non-invasive means followed by surgical (adenomyomectomy) or non-surgical (MRgFUS) treatment of focal adenomyosis have promising effect on future pregnancy whereas diffuse severe adenomyosis have poor prognosis. Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 105-108

Thyroid Status of Infertile Women Attending at Infertility Outdoor in BSMMU

Aim : To evaluate the thyroid status in infertile women. Materials and methods : A cross sectional study was conducted in the department of Infertility of Bangabandhu Shaekh Mujib Medical University from January 2012 to December 2012. A total 400 patients of infertility were studied. The thyroid function status of the subjects were assessed and analyzed. Results : Of the 400 women enrolled for the study, 221(55%) patients with primary infertility and 179 (45%) patients were with secondary subfertility. The mean age of the responders were 22.3±4.6 years, the mean duration of marriage were 4.5±1.2 years and mean BMI were 23.2±3.1 kg/m2.Among the 400 patients 70.50% that is 293 patients were euthyroid, TSH level was increased in 23% or in 92 subjects. Depending upon the TSH levels, hypothyroid infertile women were further subdivided into subclinical hypothyroidism where TSH 4–6 mIU/L with normal FT4 (9-24 pmol/L) and clinical hypothyroidism where TSH > 6 mIU/L with raised FT4 level. It was found that 66 (71.74%) of hypothyroid infertile women were with subclinical and remaining 26 (28.26%) were with clinical hypothyroidism.Hyperthyroidism that is low TSH level (<.5 mIU/L) found in 15(3.75%) subjects and visible goiter was present in only 2 patients. In 96 hypothyroid infertile females, the mean TSH levels were 7.34 ± 2.13 mIU/L, and mean FT4 level was 17.34±3.23pmol/L. The mean PRL levels were 52.46 ±11.17 ng/ml. Conclusion : Thyroid dysfunction is an important factors for infertility. Early diagnosis and timely intervention can reduce the burden of infertility due to thyroid dysfunction. J Bangladesh Coll Phys Surg 2014; 32: 206-210

Urinary FSH has still a significant role for ovulation induction in infertile couples

Results : The efficacy of ovulation induction with puregon was 45% of pregnancy per woman and 37,5 % per cycle of stimulation, that can be compared with the efficacy of hMG treatment 43,3% per women and 37,1% per cycle. The frequency of OHSS developing occured in 10% of cases with puregon and 33,3% witn hMG.We noted no cases of undeveloping and multiple pregnancy with puregon. The rate of miscarriage and multiple pregnancy with hMG was 10%. The folliculogenesis induced by puregon was closer to parameters of spontaneous menstrual cycle in 25% of women 1 periovulatory follicle, spontaneous ovulation and average peak of estradiol(500-600 pmoV1) were noted. Conclusions : Ovulation induction using r-FSH has more advantages than hMG, such as reduced rate of complications : OHSS, multiple pregnancy and miscarriages. This happens because of the better physiologic parameters for the follicular development. It may increase the efficacy and safety of infertility treatment.