A comparison of pregnancy outcome between high-order multiple and twin pregnancies: matched-pair retrospective study

OBJECTIVE. To compare the pregnancy outcome between high-order multiple and twin pregnancies. DESIGN. Matched-pair retrospective analysis. SETTING. University teaching hospital, Hong Kong. PATIENTS. Patient records from 38 high-order multiple pregnancies that were delivered over a period of 15 years, and those from matched twin pregnancies. MAIN OUTCOME MEASURES. Obstetric and perinatal outcomes. RESULTS. The incidence of high-order multiple pregnancies increased over the study period in association with the more frequent practice of ovulation induction and other assisted reproductive techniques. High-order multiple pregnancies were associated with a higher incidence of maternal complications and a significantly higher perinatal mortality rate than were twin pregnancies. CONCLUSION. Efforts should be made to prevent multiple pregnancies by carefully monitoring ovulation treatment and by limiting the number of embryos transferred.published_or_final_versio

The profile of women who seek emergency contraception from the family planning service

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Medical disorders in pregnancy

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Comparison of two dosages of recombinant human follicle-stimulating hormone in Chinese women undergoing controlled ovarian stimulation: Prospective randomised double-blind study

Objective: To compare two dosages of recombinant human follicle-stimulating hormone for controlled ovarian stimulation. Design: Prospective, randomised double-blind study. Setting: Tertiary assisted reproduction unit, Hong Kong. Participants: Forty subfertile Chinese women aged 24 to 38 years undergoing in vitro fertilisation. Entry criteria included good physical and mental health, and a body mass index between 18 and 29 kg/m2. Exclusion criteria were subfertility caused by an endocrine abnormality, polycystic ovarian syndrome, or absent ovarian function; previous assisted reproduction treatment in which fewer than three oocytes were retrieved; prior hospitalisation due to severe ovarian hyperstimulation syndrome; chronic cardiovascular, hepatic, renal, or pulmonary disease; alcohol or drug abuse; and the administration of investigational drugs within the previous 3 months. Intervention: Injection of recombinant follicle-stimulating hormone, 100 IU/d or 200 IU/d. Main outcome measures: The number of oocytes, total dose of drug used, and pregnancy rates. Results: Compared with the 20 women receiving 200 IU/d, the 20 who received 100 IU/d had a significantly lower median number of oocytes retrieved and median total dose of drug used (7.5 versus 15.0 [P<0.001] and 1200 IU versus 2000 IU [P<0.001], respectively). The pregnancy rates in the fresh cycles were similar (20%) in both groups, but the cumulative pregnancy rates in the 100 IU/d and 200 IU/d groups were 20.0% and 45.0% per stimulated cycle, respectively. The incidence of ovarian hyperstimulation syndrome in the 100 IU/d and 200 IU/d groups was 5.0% and 20.0%, respectively. Conclusions: Use of 100 IU/d of recombinant follicle-stimulating hormone requires a lower total dose but results in the harvest of half the number of oocytes compared with when a dosage of 200 IU/d is used.published_or_final_versio

Issues in second trimester induced abortion (medical/surgical methods)

Second trimester abortion remains a common procedure worldwide. Dilatation and evacuation (D&E) is the surgical method of choice, if the surgical expertise and facilities are available. Adequate cervical dilatation preoperatively is a prerequisite for a safe D&E. Medical abortion using misoprostol together with mifepristone is the medical method of choice. The recommended regimen is 200 mg mifepristone followed by 800 μg of vaginal misoprostol 36-48 h later. Subsequent doses of 400 μg of misoprostol can be given orally every 3 h up to a maximum of four more doses. Proper preoperative assessment would not only help to provide safe abortion treatment, but it also guides the choice of method. If the expertise and facilities of both methods are available, both methods should be discussed and offered to the patient so that the patient can make an informed choice. © 2010 Elsevier Ltd. All rights reserved.postprin

Ultrasonographic evaluation of endometrial growth in women undergoing assisted reproduction during the luteal phase in fresh and frozen embryo transfer cycles

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Domestic violence against pregnant women: The role of healthcare professionals

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Investigating a subfertile couple

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Male infertility

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Recent advances in induction of ovulation

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