Effect of Nursing Job on Fertility Potential of Nurses in Babylon Province

Objective: The aim of the study: To study the effect of nursing job on nurses fertility potential. Back ground: Fertility potential refers to the ability of couples to reproduce and depends on both female and male partners. Human Fertility Potential is a very sensitive process which can be influenced by many factors such as jobs opportunities.  Fertility potential can be measured by ovarian reserve markers. Methods: This is a case control study conducted in Hilla Teaching hospital and Babylon teaching hospital for maternity and pediatric; form: May 2015 - November 2015.  Fifty women were included in this study working as nurses in gynecological and obstetric department (Number =50) and eighty-one women as a control group (Number = 81). Assessment of effect of nursing job was done by standard questionnaire and basal Hormonal levels (follicle stimulating hormone, estradiol hormone, prolactin hormone and thyroid stimulating hormone) were determine women by using (mini VIDAS) method. Result: There is a significant difference in the residence, educational level, menstrual cycle regularity between nurses and control group (p<0.05). Significant differences (p<0.05) were identified in cycle day two serum level of Estradiol and Prolactin hormones, between the nurses group and control group . Conclusion: Nurses working in gynecological and obstetric wards are liable for the effects of shift work which may disturb circadian rhythm and may cause cycle irregularities and alter endocrine function and possibly the regulation of reproductive hormones and fertility. Key words: Fertility potential, follicle stimulating hormone, estradiol hormone, prolactin hormone, thyroid stimulating hormone, nursing job

‫بابل‬ ‫من‬ ‫نساء‬ ‫لدى‬ ‫المبكر‬ ‫المبيض‬ ‫فشل‬ ‫حدوث‬ ‫في‬ ‫الخطر‬ ‫امل‬ ‫عو‬ \ ‫اق‬ ‫العر‬ ‫الخالصة‬ ‫الخلفية‬ : ‫االستروجين‬ ‫هرمون‬ ‫مستوى‬ ‫انخفاض‬ ‫و‬ ‫الطمث‬ ‫بانقطاع‬ ‫يتميز‬ ‫الذي‬ ‫المبكر‬ ‫المبيض‬ ‫فشل‬ ‫هو‬ ‫النساء‬ ‫لدى‬ ‫للعقم‬ ‫الشائعة‬ ‫ا

Abstract Background: Premature ovarian failure (POF) is a common cause of infertility in women characterized by amenorrhea, hypoestrogenism and elevated gonadotrophin level in women under the age of 40. The ethnic prevalence variations pose possible etiologic differences also due to environmental, genetic, and nutritional factors. Conduction of etiologic studies in different settings or populations can help in improving the knowledge regarding etiology and predictors of POF. Objective: To determine possible risk factors of POF in subset of women from Babylon/Iraq. Patients and Methods: This study includesFifty-three Selected womenfrom Al-Amalclinic for infertility management and treatment in Babylon, patients were categorized in three groups, A: those women are the premature ovarian failure group, (comprise 26 patients, n= 26, age <40years (mean 30.23 years) follicular stimulating hormone (FSH) > 14 mIu\ml). Group B: twelve women who reached natural menopause (n= 12,age ≥40 years( mean 42.75 years) FSH> 20 mIu/ml, Group C: Fifteen known normally cycling fertile women mean age 27.06 years, FSH 7.05 mIu/ml (n=15). All studied groups were asked about their maternal age of natural menopause, body mass index (BMI) were calculated and asked about menstrual cycle pattern and if previous fertility is present or not. Blood group type was stated for all women. All inhabitants registered with an address in Babylon\Iraq. Results: There was no significant difference in maternal age of menopause between groups, neither in BMI. Blood group type O ranked higher significant percentage in group A women than other two groups, while other blood types show no significant difference. Sixty-five percent of group A women presented with infertility and irregular menstruation was reported in 80.8% of participants in the same group, which is significantly different from group B and C. Conclusion: Maternal age of menopause constitute no risk factor for POF in our study population this may be due to the fact that they have underwent extensive psychological and environmental pollution in the last 20 years that have detrimental effect on ovarian reserve of the female , or may be due to small sample size. Blood group O seems to be a risk factor as well as the presence of previous infertility and menstrual irregularities. Key words: POF, premature menopause, risk factors, blood group type. ‫بابل‬ ‫من‬ ‫نساء‬ ‫لدى‬ ‫المبكر‬ ‫المبيض‬ ‫فشل‬ ‫حدوث‬ ‫في‬ ‫الخطر‬ ‫امل‬ ‫عو

The Role of Antimullerian Hormone in the Diagnosis of Poly Cystic Ovarian Syndrom.

Background: Polycystic vary syndrome (PCOS) is a common endocrine disorder, affecting up to 10% of women of reproductive age. The cardinal features of PCOS are hyperandrogenism (HA) and oligo-anovulation. Many work teams recently have relate the severity of PCOS with Anti mullerian hormone (AMH) or antral follicle count (AFC). Objective: 1) to confirm if there is an increase of serum AMH in this group of patients with PCOS, 2) to relate the AMH level to the follicle status at ultrasound (U/S) in this group, and 3) to search if AMH or AFC can serve as surrogate for the definition of PCOS.  Patients and methods: Twenty five (control) and another 45 participants (with PCOS) were selected for this study. The control women had a mean age of 32.5 year (yr) and the patients group women had a mean age of 28.4 yr. Blood samples were collected from all participants, anthropometric measurements were calculated, and transvaginal U/S was performed to measure the AFC during the early follicular phase. The blood samples were assayed for AMH, follicle-stimulating hormone (FSH), Luteinizing Hormone (LH) and estradiol (E2) and total testosterone (TT). Results: Basal serum hormonal levels of LH, AMH and TT as well as AFC were significantly higher in the study group than in controls. While basal serum levels of E2 and FSH show no significant difference between the two groups. Body mass index (BMI) is significantly higher in PCOS patients. Basal serum levels of AMH  show significant positive correlation with both AFC and basal serum TT levels.The area under the receiver operating characteristic curve (ROCAUC ) for AMH and AFC show significant sensitive and specificities Conclusion: serum AMH and AFC appear as a sensitive and specific parameter that would probably help in the diagnosis of PCOS. Both criteria need to be incorporated into the Rotterdam definition for PCOS, and it indicates PCOS only if associated with HA and/or oligo-anovulation

Male fertility and its association with occupational and mobile phone towers hazards: An analytic study

Objective: The aim of the study is to determine the association of male fertility with the occupational and mobile phone towers hazards. Background: Male reproductive ability is likely to have multiple genetic and environmental determinants. A seminal fluid analysis is clinical marker of male reproductive potential. Aim: To find out whether environmental hazard such as mobile phone tower has an effect on male reproductive ability. Methods: Two hundred couples were enrolled, one hundred subfertile couples as a study group (n = 100), and one hundred fertile couples as a control group (n = 100). Environmental exposure to electromagnetic radiation from mobile phone towers and occupational state was assessed by standard questionnaire. Semen analysis was done for the subfertile males, because the fertile males (control group) refused to give semen samples. Results: The occupational hazard expressed significant difference between the subfertile and the control groups (38% versus 12%) (p < 0.05), with odds ratio (OR) = 4.5 and 95% Confidence Interval (CI): 2.175–9.288, and also the environmental factor (mobile tower within fifty meters from their house) showed significant difference (29% versus 12%) (p < 0.05), with OR = 3; 95% CI: 1.426–6.290. SFA of the subfertile males was 40% abnormal versus 60% normal semen analysis. These abnormalities were classified into 35% oligozoospermia, 55% asthenospermia, and 10% teratozoospermia. Oligozoospermia was associated with more occupational hazard (OR = 1.8, 95% CI: 0.569–5.527). Teratozoospermia was associated with more occupational hazard (OR = 5.23, 95% CI: 0.524–52.204), and with exposure to environmental hazard (OR = 2.6, 95% CI: 0.342–19.070), and associated with smoking hazard (OR = 1.7, 95% CI: 0.225–12.353). Conclusions: Male fertility represented by quality of semen might be affected by occupational and environmental exposures, so it seems that prevention of occupational and environmental risk factors, may lead to improvement of semen quality in subfertile men

Assessment of anti-Mullerian hormone level in reproductive age group women with diabetes mellitus type one

Objective: To assess the levels of anti-Mullerian hormone in women with type I diabetes mellitus during their reproductive age period. Background: Reproductive impairment in poorly controlled type one diabetes mellitus results from perturbations at different levels of the gonadotropic axis, including the hypothalamus/pituitary and the ovary. Methods: This study was designed as a case-control study. We evaluated anti-Mullerian hormone serum level in a female with type I diabetes mellitus (N = 60) who attended the Diabetes and Endocrine Center in Merjan Medical city in Babylon, from November 2015 to April 2016. These patients were compared with a healthy fertile female (N = 80) as a control group. The female's age ranges from 13 to 40 years for the two groups. Body mass index was calculated and serum samples for anti-Mullerian hormone serum levels were estimated. Results: There was a significant difference between patients and control group regarding body mass index, residence, educational level, fertility, and menarche. Anti-Mullerian hormone level is significantly lower in patient group when compared with the control group (p = 0.000∗). HbA1c level is significantly higher in a patient group when compared with the control group (p = 0.000∗). Conclusion: The results suggest that type I diabetes is an independent risk factor for decrease of anti-Mullerian hormone level in reproductive age group women

The impact of age on antimullerian hormone serum level in women attending chemotherapy Unit for primary breast cancer

Objective: The aim of the study is to evaluate serum level of Anti-Mullerian Hormone in patients with primary breast cancer proposed to have chemotherapy and to study the effect age on Anti-Mullerian Hormone and menstrual cycle pattern after chemotherapy. Background: In reproductive-aged breast cancer survivors, there is a need for “real-time” biomarkers of post-chemotherapy ovarian function. Method: This prospective cohort study had been conducted upon one hundred twenty women, sixty women as a patient group (n = 60), who are newly diagnosed with primary breast cancer and Sixty women as a control group (n = 60). Their ages between (21 and 41) years. Patients were subgrouped according to age as ≤35 and >35 years. Results: There were significant differences between patients and control groups regarding BMI,regularity of menstrual cycle (P < 0.05). There were significant differences between antimullerian hormone before and after the first dose of chemotherapy, in all age groups (p < 0.05). There was a significant difference in antimullerian hormone before and after administration of second dose of chemotherapy in those who are less or equal to 35 years. But no such difference in antimullerian hormone after the second dose of chemotherapy in those who were above 35 years. Conclusion: Serum AMH is a convenient and sensitive indicator of follicular depletion and recovery in young women during and after chemotherapy, this needs to be confirmed by larger size group. Keywords: Chemotherapy, Breast cancer, Women age, Anti mullarian hormon