Effects of autologous stem cell therapy for fertility enhancement among women with premature ovarian insufficiency

Background: Premature ovarian insufficiency (POI) is a condition where the ovary loses its normal reproductive potential earlier than 40 years, compromising fertility. There is no treatment for POI, only ovum or embryo donation. Autologous stem cell ovarian transplant (ASCOT) may be a procedure that creates new eggs in the ovaries of women with POI. The aim of the study was to find out the efficacy of ASCOT in patients suffering from POI. Methods: A total of 50 patients were included according to inclusion and exclusion criteria in this prospective observational study. POI was confirmed with low levels of anti-mullerian hormone (AMH) (<0.5 ng/dl), high level of follicle stimulating hormone (FSH) >25 ng/ml, and or a low number of antral follicle count (AFC) (<3 in each ovary). Results: Results showed that after stem cell therapy, mean AMH values increased by 0.48±0.306 and mean FSH values increased by 2.73±3.98 but the difference was not statistically significant. AFC values significantly decreased by 1.33±0.625 at 1st post-stem-cell cycle. During the second cycle, AMH and AFC increased by 0.110±0.051 and 4.63±1.49, respectively, and FSH decreased by 7.4±2.78. In third cycle, AMH & FSH was significantly increased by 0.820±0.44 & 4.120±0.470 and FSH has been decreased by 2.150±3.625. The increase in AMH & AFC was statistically significant, and the decrease in FSH was not statistically significant compared to baseline values. Conclusions: The study showed that autologous stem cell therapy can have a significant effect on women’s ovarian function and fertility. It showed that ASCOT can increase AMH and AFC, and decrease FSH in patients with POI, with a total pregnancy rate of 4% after the third cycle follow-up

Zinc supplementation in male infertility

Background: Inferile males have been shown to have lower levels of seminal plasma zinc which have been associated with reduced levels of zinc in their blood. Supplementation improve semen parameters by improving zinc level in blood.  Objective: To fnd out whether zinc supplementation is effective in improving semen parameters in oligo­asthenozoospermic patients. Method: The study was carried out in the Infertility unit of the Dept of Obs & Gynae, BSMMU during the period of March 2011 to February 2012. Seventy five oligo-asthenozoospermic patients having no history of medical treatment were recruited for the study. The patients were divided into two groups by odd and even numbers. Odd numbers received tablet zinc 20 mg twice daily (Group A) and even numbers received placebo (Group B).Serum zinc level and seminal zinc level estimation were done by Graphite Furnace Atomic Absorption Spectropho­tometry and semen analysis was done according to WHO guidelines (1999). Data analysis was done using software SPSS (version 16) by applying ANOVA (PostHock) and Paired Student's 't' test. Results: Serum zinc level was low in oligo­zoospermic patients which showed significant improvement with zinc supplementation (A+ 197.83 mmol/1, P<0.01). Mean (±SD) seminal plasma zinc level showed significant improvement in group A following zinc supplementation (+942.39 mmol/L, P<0.001). The mean increase in sperm count, sperm motility, sperm rapid linear motility, sperm morphology in group A following zinc supplementation for 12 weeks was 14.83 million/ml (P<0.01), 16.30% (P<0.01), 11.96% (P<0.01), 4.26% (P<0.001) respectively, which was statistically significant. Conclusion: The study shows zinc deficiency affects sperm count, sperm motility, rapid linear motility and sperm morphology and with zinc supplementa­tion there can be significant improvement in semen parameters

Non Obstetric Causes and Presentation of Acute Abdomen among the Pregnant Women.

Objective:To identify the non-obstetric causes and presentation of acute abdomen among pregnant women. Materials and methods:This was a cross sectional hospital-based study among 128 pregnant women by face to face interview using a semi-structured questionnaire. This study was conducted at the Gynecology & Obstetric Ward of 250 Bed General Hospital, Noakhali, Bangladesh, from January to August 2013. Data were analyzed by a software package used for statistical analysis (SPSS) version 11.5 (SPSS, Inc., Chicago, IL, USA).Mean age of participants was 25±4 years. Our findings showed that 81% were Muslim, 67% were lower middle income group, as well as 47% completed primary level of education. The results revealed that 28% had biliary ascariasis, 24% had peptic ulcer disease and 10% had lower urinary tract infection. We also found that 6% had acute pyelonephritis, 6% had acute gastroenteritis, 6% had acute cholecystitis, 6% had acute appendicitis, 2% had acute pancreatitis, 3% had choledocolithiasis, 2% had ovarian solid mass, 2% had twisted ovarian cyst, 4% had renal colic, and 1% had renal calculus. In non-obstetrical presentation of acute abdomen, the study found that 84% of respondents complained their pain lasting more than 24 hours. Besides, half of respondents felt pain in epigastrium and right hypochondrium. Cramping, prickling and aching type of pain were more, while 66% suffered from continuous pain. Our results also showed that 73% did not explain any aggravating factor and relieving factor, and the rest said food, fasting state and position change aggravated pain as well as relieved pain. Conclusion:The study concludes that precise diagnosis of the acute abdomen in pregnant women by continual updating of abdominal assessment knowledge, and clinical skills is necessary in the management of abdominal pain in obstetric settings

Zinc supplementation in male infertility

Background: Inferile males have been shown to have lower levels of seminal plasma zinc which have been associated with reduced levels of zinc in their blood. Supplementation improve semen parameters by improving zinc level in blood. Objective: To fnd out whether zinc supplementation is effective in improving semen parameters in oligo­asthenozoospermic patients.Method: The study was carried out in the Infertility unit of the Dept of Obs &amp; Gynae, BSMMU during the period of March 2011 to February 2012. Seventy five oligo-asthenozoospermic patients having no history of medical treatment were recruited for the study. The patients were divided into two groups by odd and even numbers. Odd numbers received tablet zinc 20 mg twice daily (Group A) and even numbers received placebo (Group B).Serum zinc level and seminal zinc level estimation were done by Graphite Furnace Atomic Absorption Spectropho­tometry and semen analysis was done according to WHO guidelines (1999). Data analysis was done using software SPSS (version 16) by applying ANOVA (PostHock) and Paired Student's 't' test.Results: Serum zinc level was low in oligo­zoospermic patients which showed significant improvement with zinc supplementation (A+ 197.83 mmol/1, P&lt;0.01). Mean (±SD) seminal plasma zinc level showed significant improvement in group A following zinc supplementation (+942.39 mmol/L, P&lt;0.001). The mean increase in sperm count, sperm motility, sperm rapid linear motility, sperm morphology in group A following zinc supplementation for 12 weeks was 14.83 million/ml (P&lt;0.01), 16.30% (P&lt;0.01), 11.96% (P&lt;0.01), 4.26% (P&lt;0.001) respectively, which was statistically significant.Conclusion: The study shows zinc deficiency affects sperm count, sperm motility, rapid linear motility and sperm morphology and with zinc supplementa­tion there can be significant improvement in semen parameters