Infertility: a health problem in the Muslim world

Infertility is one of the important health problems in the Muslim World. Islam has given a great attention to marriage and formation of the family. This has been mentioned in several verses of the Holy Quran, and Hadith. The total Muslim population in the world in the year 1988 was 1.14 billion, mostly residents in developing countries, particularly in Asia and Africa. According to the world survey in the year 1980, 24% of the population in developing countries are women in the reproductive age. If one considers that the incidence of infertility is 10% among married women in reproductive age, this means that almost 27 million of Muslim women will complain of infertility during their marital life. The following is a review of the problem of infertility in a Muslim country namely Egypt with 46 million Muslim as a model of the problem of infertility in Muslim world. During the period November 1980 - August 1989, 1488 infertile couples were fully investigated at Al-Azhar Endoscopy and Microsurgery Unit and the Egyptian I.V.F. and E.T. Center. The causes of infertility were male factors in 20.6%, female factors in 64%, both male and female factors in 12.2% and unknown factors in 3.3 percent of patients. Tubal factor was the commonest cause of female infertility [42%]. Pelvic tuberculosis and endometriosis accounted for 4.2 and 5.6 percent of cases respectively. Among those who needed induction monitoring of ovulation or medically assisted conception only 51% and 63% of patients respectively could afford to have the treatment which is only available on private basis

In vitro fertilization and embryo transfer, ethical aspects in techniques in the Muslim world

The introduction of medically assisted human reproduction [MAHR] in the Muslim World has to overcome initial resistance because of cultural, social, religious and financial limitations. The paper discusses the problems associated with the practice of I.V.F. and E.T. technique and its limitations in Egypt through the authors' experience during the period March 1986 - March 1989. The results of the management of 359 patients scheduled for the I.V.F. and E.T. program at the Egyptian I.V.F. and E.T. Center, Maadi, Cairo, using different protocols, are discussed. The maximum pregnancy rate achieved using the GnRH analogue agonist protocol for stimulation was 20.13 per transfer. The paper discusses the Ethical Aspects of I.V.F. and E.T. technique in the Muslim World and how these aspects may influence the results and achievements of such technique both at present and in the future

Microsurgical correction of lateral-end block of the fallopian tube for infertile patients

The study included 50 infertile patients with lateral-end block of the fallopian tubes. Twenty three patients had primary and 27 had secondary infertility. A history of previous operation was present in 12 cases. Preoperative assessment included analysis, postcoital test, premenstrual endometrial biopsy, hysterosalpingography and laparoscopy in all patients and hormonal assay when necessary. Thirty-four percent of the cases were suffering from mild, 46% from moderate and 20% from severe pelvic inflammatory disease. Microsurgical correction of the obstruction was done including salpingo/ovariolysis, salpingo-neostomy and fimbrioplasty. Postoperative follow-up of the cases was done for a period varying between 18-36 months. Tubal patency rate among the whole group was 94%. The intrauterine pregnancy rate was 36% and the live birth rate was 24%. Ectopic pregnancy rate was 6%. The extent of the tubal lesion was found to be the significant prognostic factor affecting the result of surgery

Al-Azhar experience with microsurgery for restoration of tubal patency

Thirty-five cases of tubal microsurgery were performed at Al-Azhar University Hospitals during the period November 1980 - 1982. All patients were followed up for assessment of tubal patency and the occurrence and outcome of pregnancy. Tubal patency was confirmed in 88% of the cases. Twenty patients were followed up for periods of six months and more. Pregnancy occurred in 8 patients [40%]. The paper describes in detail the profile of the patients included in the study, the technique and the factors which affect the results of the operation

value of the laparoscope in the diagnosis of polycystic ovary

In this paper we studied 171 patients with polycystic ovarian disease diagnosed by laparoscopy. The disturbances of the menstrual cycles varied between amenorrhoes, secondary or primary, oligohypomenorrhoea, menorrhagia or regular cycles. In performing laparoscopy 160 patients had general anesthesia and 11 patients had local anesthesia. Laparoscoy revealed that the polycystic changes of the ovaries were not always bilateral, but were sometimes unilateral. There were 141 patients with bilateral changes and 30 patients with unilateral changes in the left ovary. All the ovaries, however, showed a smooth, pearly, white thick surface with the loss of the surface indentations of the normal ovary

Clinical evaluation of U-coil progesterone releasing device versus inert U-coil IUD

Seventy six patients were randomly selected to be fitted with U-Coil intrauterine device. The inert U-Coil device was inserted in 39 patients and the progesterone releasing U-Coil device was inserted in 37 patients. Patients fitted with both types of device were followed up for 12 post insertion months. The present paper evaluates the efficacy and the side effects of the U-Coil progesterone releasing intrauterine device versus Inert U-Coil device. The effect of both types of device on menstrual blood loss was discussed in a previous publication