exudates and Infertility

To explore the effect of the diagnosis of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome on affected Malaysian women.. Qualitative study with a quantitative component.. Pediatric and adolescent gynecology unit at Universiti Kebangsaan Malaysia Medical Centre, Malaysia.. Twelve women with MRKH.. Face-to-face interview and short questionnaire.. Thematic analysis was used to understand participants' experiences.. There were 7 themes identified: (1) delayed diagnoses; (2) doctors' roles and attitudes; (3) gender identity; (4) family and society's response; (5) reaction toward infertility; (6) managing sexual intimacy; and (7) coping mechanisms. Several participants consulted their physicians regarding their primary amenorrhea at an opportunistic setting. When they were referred to the gynecologists, they were dismayed at the lack of information given. The term, "MRKH" plays an important role to ease information-seeking. Participants felt that the doctors were insensitive toward them. Mental illness is a significant complication of MRKH. All participants acknowledged that infertility was the hardest part of the condition. The importance of blood lineage affects their outlook on childbearing options. Some were afraid of sexual intimacy and worried that they would not be able to satisfy their partners. Participants gained support and bonded with their counterparts in the MRKH support group.. A multidisciplinary approach including medical, psychological, and social support is essential for the management of MRKH. Adequate information and sexual education plays the utmost importance in preventing social-related complications of MRKH.

Topics: 46, XX Disorders of Sex Development; Adaptation, Psychological; Adult; Attitude of Health Personnel; Congenital Abnormalities; Delayed Diagnosis; Female; Gender Identity; Humans; Infertility; Malaysia; Mullerian Ducts; Physician's Role; Qualitative Research; Self Concept; Sexual Behavior; Social Support

The cervical microbiota constitutes an important protective barrier against the invasion of pathogenic microorganisms. A disruption of microbiota within the cervical milieu has been suggested to be a driving factor of sexually transmitted infections. These include Chlamydia trachomatis which frequently causes serious reproductive sequelae such as infertility in women. In this study, we profiled the cervical microbial composition of a population of 70 reproductive-age Malaysian women; among which 40 (57.1%) were diagnosed with genital C. trachomatis infection, and 30 (42.8%) without C. trachomatis infection. Our findings showed a distinct compositional difference between the cervical microbiota of C. trachomatis-infected subjects and subjects without C. trachomatis infection. Specifically, significant elevations of mostly strict and facultative anaerobes such as Streptococcus, Megasphaera, Prevotella, and Veillonella in the cervical microbiota of C. trachomatis-positive women were detected. The results from the current study highlights an interaction of C. trachomatis with the environmental microbiome in the endocervical region.

Topics: Academic Medical Centers; Adult; Bacteria, Anaerobic; Cervix Uteri; Chlamydia Infections; Chlamydia trachomatis; Cohort Studies; DNA, Bacterial; Female; Host-Pathogen Interactions; Humans; Infertility; Malaysia; Metagenomics; Microbiota; Outpatient Clinics, Hospital; RNA, Ribosomal, 16S; Young Adult

The study aimed to measure the relationship of sexual functioning between male and female partners, who sought infertility treatment in a university hospital setting in Malaysia.. This cross-sectional study was conducted on couples with infertility problems attending the Medically Assisted Conception Center (MACC). The female and male sexual functioning was measured using the Malay Version of Female Sexual Function Index (MVFSFI) and Malay Version of International Index of Erectile Function (IIEF), respectively. The relationship between the female and male sexual functioning was measured using correlation statistical analyses. A total of 269 subjects (150 females and 119 males) who met the requirement of the study, were recruited.. The female and male sexual functioning was moderately correlated (r=0.574). Female sexual arousal and sexual satisfaction domains scores had the largest correlation (r=0.522 and r=0.507 respectively) to IIEF total score. On the other hand, male intercourse satisfaction (IS) domain score had the highest correlation (r=0.574) to FSFI total score. A strong correlation between male and female sexual function was observed.. It is speculated that possible interaction of male and female sexual functioning may be multifactorial and complex.

Topics: Adult; Coitus; Cross-Sectional Studies; Female; Humans; Infertility; Malaysia; Male; Orgasm; Personal Satisfaction; Sexual Behavior; Sexual Partners

The objective of this study was to determine the seroprevalence of cytomegalovirus (CMV) infections through antenatal screening data and the association of this virus with obstetric complications. Serum samples from 125 apparently healthy pregnant women sent for antenatal screening from various hospitals in Malaysia between January 2007 and December 2008, were examined for CMV specific IgM and IgG antibodies using an enzyme-linked immunosorbent assay method. Of the 125 pregnant women tested, anti-CMV IgG antibody was found in 105 (84%) of the cases and anti-CMV IgM in 9 cases (7.2%). Both CMV IgM and IgG were also found in another 37 women whose serum samples were sent for investigation of various obstetric complications: 17 cases of spontaneous abortions, 15 cases of fetal anomalies detected during ultrasound examination, 1 case of incomplete abortion, 3 cases with premature delivery of infant with congenital anomalies and 1 case of infertility. Our preliminary data which only represented a small study group has shown the prevalence of CMV infection among the local population and the association of CMV in obstetric complications.

Topics: Abortion, Incomplete; Congenital Abnormalities; Cytomegalovirus Infections; Female; Fetal Death; Humans; Infertility; Malaysia; Pregnancy; Pregnancy Complications, Infectious; Premature Birth; Seroepidemiologic Studies

In Malaysia, maggot debridement therapy (MDT) utilizes maggots of Lucilia cuprina (Wiedemann) to debride necrotic tissue from wound surface, reduce bacterial infection and therefore, enhance wound healing process. To evaluate the sterility of the sterile maggots produced after sterilization process before delivering onto patient wounds. Sterility of sterile maggots is crucial in ensuring the safe usage of MDT and patient's health. Eggs of L. cuprina collected from a laboratory colony were divided into treated group (sterilized) and control group (non-sterilized). Treated group underwent sterilization while eggs from control group were allowed to hatch without sterilization. Sodium hypochlorite and formaldehyde were the main disinfectants used in this sterilization process. Scanning electron microscope (SEM) was used to examine and ascertain the sterility of sterile maggots. SEM results showed that all sterilized L. cuprina eggs and maggots achieved sterility and all were cleared from bacterial contamination. In contrast, all non-sterilized eggs and maggots were found to be colonized by microorganisms. Sterilization method employed to sterilize eggs and maggots used in Malaysia MDT was proven successful and MDT is safe to be used as wound management tools.

Topics: Animals; Debridement; Diptera; Formaldehyde; Humans; Infertility; Larva; Malaysia; Microscopy, Electron, Scanning; Sodium Hypochlorite; Sterilization, Reproductive; Zygote

The aim was to determine pregnancy rate and its associated factors in Intrauterine Insemination (IUI) at IIUM Fertility Centre.. A retrospective analysis of 504 IUI cycles was conducted on all available records of infertile couples who had undergone IUI treatment at IIUM Fertility Centre between 2004 until 2008. The data was collected and then analyzed with multivariate logistic test with a significant level of 0.05.. The overall clinical pregnancy rate was 14.5% (73/504). Among 73 pregnancies, 44 cases were live births (60%), 23 cases were miscarriages (32%) and 6 were ectopic pregnancies (8%). Analysis from logistic regression revealed two predictive variables which influence the pregnancy; female age (OR:0.580, CI:0.338-0.996, p = 0.046) and male sperm count (OR:0.506, CI:0.304-0.843, p = 0.008). Pregnancy weren't related to the etiology of infertility, duration and type of infertility, cycle number of IUI, ovarian stimulation protocol and the number of dominant follicle.. IUI remain as a convenient and useful treatment option in women of younger age (< 30 years) and male with higher sperm count (> or =100 million per ml).

Topics: Adult; Age Factors; Female; Humans; Infertility; Insemination, Artificial; Malaysia; Male; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Retrospective Studies; Sperm Count

Intrauterine insemination (IUI) remains a therapeutic option within means of the majority of infertile couples in Malaysia. Therefore additional information on predictors of IUI success in the local context would provide a more concrete basis for counseling patients on expectations and treatment options. A retrospective analysis of 297 couples who underwent 445 IUI cycles from Jan 2005-Mar 2006 was undertaken. Four fifths were Malay with a mean paternal and maternal age of 35.53 +/- 5.82 (range 24-59) and 33.02 +/- 4.69 (range 21-46) years respectively. Causes of infertility were idiopathic (50%), endometriosis (17%) and anovulation/polycystic ovarian syndrome (15%). Almost 10% were oligoastenoteratozoospermic with another 23% oligozoospermic or astenozoospermic. Combined male and female factors occurred in 26%. A pregnancy rate (PR) of 9.4% per cycle; 14.1% per couple with a cumulative PR of 36.7% per 4 cycles was achieved. Those who became pregnant were significantly younger (31.29 +/- 4.43 vs. 33.21 +/- 4.68 years, p = 0.011) and had more follicles (13.95 +/- 9.72 vs. 11.43 +/- 6.67, p = 0.029) at the time of insemination. PR depreciated with maternal age and semen quality. Maternal and paternal age was inversely correlated to the number of follicles recruited (r = -0.30, p < 0.0005) and progressive sperm motility (r = -0.125, p = 0.013) respectively.

Topics: Adult; Age Factors; Female; Humans; Infertility; Insemination, Artificial; Malaysia; Male; Maternal Age; Middle Aged; Pregnancy; Pregnancy Rate; Retrospective Studies; Sperm Count; Sperm Motility; Treatment Outcome

Researchers have conducted considerable experiments on the effectiveness and therapeutic values of Chinese herbs and parts of plants. We should not ignore the significance of natural medicine. The Chinese have been perfecting medicinal therapy based on the raw ingredients of plants/herbs and their derivatives for thousands of years. Chinese practitioners of traditional medicine prescribe medicines based on yin and yang. Traditional medicine is communicated in a verb or written form. Natural resources used in traditional medicine to treat diseases are not limited to just medicinal plants but also include animals, shell fish, and minerals. Parts of plants used in traditional medicine are leaves, stems, flowers, bark, and root. Chinese medicine is the world's oldest continuous surviving tradition. The Chinese experimented with local plants, often resulting in mild to violent reactions. This process allowed them to become familiar with poisonous plants and those that could relieve pain or successfully treat illness. Current allopathic medicines are composed of synthetic compounds copied from natural chemical derivatives, which tend to be more potent than the original compound. Some medicinal plants used to effect conception/contraception include Striga astiatica (contraceptive); Eurycoma longifolia (male virility); and a mixture of lengkuas, mengkudu masak, black pepper seeds, ginger, salt, and 2 eggs (increase libido). Women in Malaysia take jamu to preserve their body shape and to provide nutrition during pregnancy. Praneem causes local cell-mediated immunity in the uterus. Clinical trials of Praneem with or without the hCG vaccine are planned.

Topics: Asia; Asia, Eastern; Asia, Southeastern; China; Contraception; Delivery of Health Care; Developing Countries; Family Planning Services; Health; Health Services; Infertility; Malaysia; Medicine; Medicine, Traditional; Plants, Medicinal; Reproduction

A representative group of 204 infertile couples from Kuala Lumpur, Malaysia were compared to a similar group of 633 couples from Aberdeen, UK in an attempt to study if there was any regional difference in the pattern of infertility seen. The protocol for investigation and diagnostic criteria for both centres were standardised. A significant difference (X2 = 63.43; p less than 0.001) was seen. The reasons for these differences are discussed.

Topics: Adolescent; Adult; Female; Humans; Infertility; Malaysia; Male; United Kingdom

This preliminary report details wxperience with office laparoscopy for female fertility assessment in 183 subjects at an urban Malaysian research clinic. Patients were admitted at about 8 AM and discharged at 3-4 PM after the procedure had been performed. Only 7.7% (14) of the subjects required inhalational anesthetic gases in addition to intravenous sedation and local anesthesia. The pick-up rate for pelvic abnormalities was about 22.4%. At laparoscopy, aspiration of ovarian cysts was carried out in 3 patients, lysis of adhesions in 6, salpingostomy in 3, and cautery of endometriotic spots in 30. 127 of the laparoscopies were performed by the consultant gynecologist, and 55 by medical officers. Minor difficulties occurred with 14 patients, including insufflation difficulty, and difficulty in trocar insertion and visualization. 1 uterine perforation occurred, and mild hemorrhage occurred in 2 patients after lysis and cautery procedures. 1 patient had respiratory depression after intravenous sedation. All complications were managed without hospital admission. It is suggested that all family planning clinics involved in fertility assessment and sterilization feature laparoscopy on an outpatient basis. However, proper training and adequate facilities for resuscitation are mandatory. More clinical triials are needed to discern the most suitable analgesia and anesthesia for office laparoscopy, including the possible use of acupuncture.

Topics: Ambulatory Care Facilities; Asia; Asia, Southeastern; Delivery of Health Care; Developing Countries; Diagnosis; Endoscopy; Evaluation Studies as Topic; Fertility; General Surgery; Gynecologic Surgical Procedures; Health; Health Facilities; Health Personnel; Infertility; Laparoscopy; Malaysia; Organization and Administration; Physical Examination; Physicians; Program Evaluation; Reproduction; Therapeutics