Repeated use of medications for ovulation induction after unsuccessful treatment: A cause of concern for infertile couples

This is a Letter to Editor and does not have an abstract

The relationship of the psychological coping and adjustment strategies of infertile women with the success of assisted reproductive technology

Background: The success of assisted reproductive techniques plays a very important role in the quality of life of infertile couples and decreases the negative behavior states of infertility. Objective: This study aimed at determining the relationship between psychological coping and adjustment strategies with the success of assisted reproductive technology (ART). Materials and Methods: This correlational study was conducted on 204 women visiting Milad Infertility Center in Mashhad during 2015-2016. The research instruments included Fertility Adjustment Scale and Infertility Coping Strategies Scale. The positive result of two pregnancy tests within 48 hours was considered as the success of ART. Results: The mean and standard division score of adjustment in the group achieved treatment success (34.3±8.2) exceeded the group failed (33.6±8.8), the difference was not statistically significant (p= 0.381). Also, there was no significant difference between groups in the median and interquartile range of total coping strategies 81 (13) vs. 79.5 (12.25), (p= 0.369). Based on the logistic regression model for one increased transferred embryo, the chance of getting pregnant is 1.3 times, and for each unit increase in FSH level, the chance of ART success decreases 18%. Conclusion: The results of this study showed that there is no relationship between psychological coping and adjustment strategies with ART success. However, the number of transferred fetus and tirthday FSH are introduced as factors that are related to the success of ART. Key words: Infertility, Psychological adjustment, Coping skills, (ART)

Estimation of Foetal Weight

Background Foetal weight is an important consideration when making decisions about intervention in labour. Although weight is estimated in the beginning of labour, the relevant decisions are made at the end of labour. It is not clear whether the estimation of weight at the beginning of labour is more accurate than the estimation at the end of labour. Method This prospective study included 214 pregnant women. Foetal weights were estimated at the time of admission, at full dilatation or before Cesarean section (CS) using Johnson’s formula and multiplying symphysio-fundal height by the abdominal girth measurement. Results The accuracy of estimation of weight by the Johnson formula (insert measuring tape) at the beginning of labour was similar to weight at the end of labour, but the weight obtained by multiplying the symphysio-fundal height by the abdominal girth (insert the measuring tape and holding it straight) at the beginning of labour was more accurate than the same process at the end of labour (p < 0.001). However, using the Johnson formula (holding the meter straight) at the end of labour was more accurate than it was at the beginning of labour (p = 0.02). Conclusion The accuracy of estimated weight varies depending on time, the method used, and the formula of measurement

The Relationship between Cormic Index and Mode of Delivery

Background & aim: The risks of maternal mortality and morbidity associated with cesarean delivery are three and two times higher than vaginal delivery, respectively. The majority of cesarean sections are due to failure to progress in labor. One of the common risk factors for failure to progress is small maternal body size. Cormic index is an indicator of body composition assessment, which estimates trunk and leg length. In this study, we aimed to investigate the relationship between Cormic index and mode of delivery. Methods: This descriptive, cross-sectional study was performed on 170 pregnant women referred to Omolbanin Hospital of Mashhad, Iran. Standing and sitting heights were measured at the onset of active phase of labor. Cormic index was calculated as sitting height/standing height×100. Mode of delivery was followed and recorded. Kruskal-Wallis and Bonferroni-corrected Mann-Whitney tests were performed, using SPSS version 16. Results: The mean Cormic index was 52.04±2.85. There was a significant relationship between mode of delivery and Cormic index, sitting and standing heights, and leg length measures. However, there was no significant relationship between body mass index and mode of delivery. Conclusion: Our findings indicated that mode of delivery is associated with Cormic index. With high Cormic indices (long trunk and short legs) the rate of assisted delivery rose compared to vaginal and cesarean deliveries

The Effect of Intravenous Fentanyl on Pain and Duration of the Active Phase of First Stage Labor

Objectives: Opioids are most widely used for pain relief during childbirth. An alternative opioid, fentanyl, has been shown to be a good option for pain management and has fewer side-effects on both mother and fetus. Therefore, the purpose of this study is to determine the effect of fentanyl on pain as well as the duration of the active phase of labor.Methods: This clinical trial was conducted on 70 multiparous parturients having labor from May to July 2006 at Tamin Ejtemai Hospital. They were selected by convenience sampling at the beginning of the active phase of labor. The samples were then randomly divided into the case and control groups. The case group received fentanyl 50 micrograms in two doses, one hour apart after being diluted (0 and 60 mins). Vital signs were recorded pre-administration and 5, 15, 30, 45, 60 minutes post-administration. Pain intensity was estimated by visual pain scale (0-10) four times (before and 1, 2, 3 hours after the intervention). Data analysis was done using the student t-test, repeated measure ANOVA and chi-square tests via SPSS 11.5 software.Results: The results showed a significant reduction in pain (p=0.002) and HR (p=0.001) in the case group. The mean pain score also decreased from 8±1 to 5±1. There was a significant difference in terms of the duration of the active phase between the two groups (p=0.001). However, there were no significant differences in terms of systolic blood pressure and diastolic blood pressure between the two groups.Conclusion: Fentanyl provides good analgesic effect for pain management during labor by considerably reducing the duration of the active phase, and can therefore be used as an acceptable analgesic agent during labor

Infertile couples' perceived needs after unsuccessful fertility treatment: A qualitative study

Introduction: Infertility is a major medical issue. Investigations and treatment of infertility are the beginning of a complex, time-consuming and stressful process for couples that may fail well. The present study explored the needs of infertile couples following treatment failure with Assisted Reproductive Technologies (ARTs). Methods: A descriptive qualitative study was conducted in an Iranian infertility center, in the Northeast of the country between April 2016 and June 2017. The researchers recruited 29 individuals including 9 couples, 9 women and two men with primary infertility through purposive sampling. The data were collected using semi-structured interviews and analyzed iteratively, using conventional content analysis with MAXQDA software. Results: The main concepts obtained from the data were classified into one theme titled: ""The need for support"" and four main categories along with their subcategories, and included the need for psychological support, the need for more useful information, the need for social support and the need to access to supplementary services. Conclusion: The findings show that following treatment failure, the infertile patients’ expressed needs and preferences were not met. Identifying and meeting their needs may help the infertile couples to deal with ARTs failure and to reach a decision about future treatment

Iranian infertile couples' strategies to manage social interactions after unsuccessful treatments with assisted reproductive technologies

Many infertile couples feel vulnerable after failed treatment cycles and find insensitive remarks or inappropriate support distressing. They fear that the stress of failed treatment cycles may affect their marriage and lead to marriage breakdown. This study explored the strategies a sample of infertile couples used to manage social interactions after unsuccessful treatment with assisted reproductive technologies. A descriptive qualitative study was conducted with 34 participants including nine infertile couples, nine infertile women and two infertile men with primary infertility, two relatives, and three fertility clinic staff. The participants were selected through purposive sampling at an infertility centre in Iran, between 2016 and 2017. Data were collected using semi-structured face-to-face interviews and analysed by qualitative content analysis approach. Participants found some social interactions after failed assisted reproductive treatment cycles to be distressing and painful. They described tolerating painful emotions which cause them sadness and sorrow as well as feeling embarrassed. As a result, they found they needed to maintain their adopting concealment strategies with their families through not permitting speculation, selective disclosure, not giving details and hiding the truth. This study showed that social interactions following failed assisted reproductive cycles can be upsetting for infertile couples. Couples use different strategies to manage potentially distressing social interactions. Healthcare providers and psychologists may provide a space for safe social interactions in order to help couples to use appropriate strategies in these circumstances

<span style="font-size:11.0pt;font-family: "Times New Roman";mso-fareast-font-family:"Times New Roman";mso-bidi-font-family: Mangal;mso-ansi-language:EN-GB;mso-fareast-language:EN-US;mso-bidi-language: HI" lang="EN-GB">Effect of <i>Dill</i> (<i style="mso-bidi-font-style:normal">Anethum graveolens</i> Linn.) seed on uterus contractions pattern in active phase of labor</span>

602-606Dill is herbaceous and aromatic herb used in order to convenient and shorter labor in Iran. The objective of this study was to evaluate the effect of Dill seed on uterus contractions in active phase of labor. In this historical cohort study, 40 women used Dill seed infusion in the case group and 60 women used nothing in the control group. Interpretable electronic fetal monitoring was obtained for half an hour at the beginning of the active phase. The Fall: Rise ratio was calculated by measuring the duration of time for a contraction to return to its baseline from its peak (fall) divided to the duration of its rise time to its peak (rise).The number of contractions in the case group was significantly more than the control group. The ratio of contraction’s fall time to its rise time in the case group was shorter than the control group. The study showed that Dill seed shortens duration of the first stage of labor. Since there is not enough information about correct amount and time for consuming this herb, more complete studies are needed

Evaluating the Relationship between Body Size and Body Shape with the Risk of Breast Cancer

Objective: This study aims to determine the relationship between body size and body shape with the risk of breast cancer.Methods: In this case control study, 480 women participated (240 women with breast cancer in case group and 240 healthy women in control group). After completing the interview form, the weight, height, waist circumference, hip circumference and breast size, were measured. The data were analyzed using statistical test by SPSS11.5.Results: The present study showed that the mean of hip circumference were significantly different in both groups (p=0.036). The size of the breast was statistically significant between the two groups. Thyroid type, one of the body shapes, was more seen in the case group than control group (p<0.001).Conclusion: This study revealed that the risk of breast cancer increases with increased hip circumference. In addition, the results indicate that body shape may be a useful predictor in determining the risk of breast cancer. More studies should be designed to address this subject