Testicular versus ejaculated spermatozoa for ICSI in patients without azoospermia: A systematic review.

The use of testicular spermatozoa in men without azoospermia has been proposed as a means to increase the chances of pregnancy following assisted reproductive treatment. The purpose of this systematic review is to assess whether clinical outcomes are better when testicular rather than ejaculated spermatozoa are used for intracytoplasmic sperm injection in patients with abnormal semen parameters without azoospermia. A literature search identified four eligible studies out of 757 initially found. In a prospective study in men with high DNA fragmentation index (DFI) and oligozoospermia, the probability of live birth was significantly higher with testicular compared to ejaculated spermatozoa (risk ratio [RR]: 1.75, 95% confidence interval [CI]: 1.14-2.70). This was not the case in a retrospective study in men with high DFI only (RR: 2.36, 95% CI: 0.98-5.68). Clinical pregnancy rates were similar in a randomized controlled trial in men with asthenozoospermia with or without teratozoospermia (RR: 2.85, 95% CI: 0.76-10.69) and in a retrospective study in men with isolated asthenozoospermia (RR: 1.09, 95% CI: 0.56-2.14). Currently, there is limited, low-quality evidence suggesting that a higher probability of pregnancy might be expected using testicular rather than ejaculated spermatozoa, only in men with high DFI and oligozoospermia.

Dietary practices of Saudi women during puerperium.

AIM: Poor maternal health sometimes can be a consequence of practicing different myths during puerperium. This cross-sectional study describes the practice of different myths regarding diet among Saudi women. MATERIAL AND METHODS: The study comprised women attending the postnatal clinic at the Mother and Child Hospital in Buraidah from January to December 2011. RESULTS: Almost 65.9% of women were using a combination of herbs such as ginger (zingiber officinale), hilba (fenugreek) and black seeds (nigella sativa). The multinomial logistic regression of herbs on age, education, occupation, parity and mode of delivery was statistically significant (χ² [48] = 214.645, P < 0.001). Hilba was more commonly used by women with instrumental delivery. It was common for women to avoid different fruits and vegetables (33.89%). Eggs were avoided by 16.5% of women and 11% avoided cold drinks. The multinomial logistic regression of diet on age, education, occupation, parity and mode of delivery was statistically significant (χ² [72] = 389.861, P < 0.001). Individuals below college level education were more likely to avoid fruits, vegetables and cold drinks in their diet. CONCLUSION: Health education programs are needed to improve knowledge about dietary malpractices during puerperium. This may help eliminate myths regarding avoidance of certain dietary components.

Induction of labor with prostaglandin e2 in women with previous cesarean section and unfavorable cervix.

BACKGROUND: Induction of labor is common in obstetric practice. According to the most current studies, the rate varies from 9.5 to 33.7 percent of all pregnancies annually. In the absence of a ripe or favorable cervix, a successful vaginal birth is less likely. Therefore, cervical ripening or preparedness for induction should be assessed before a regimen is selected. To objective is to study the pregnancy outcome of induction of labor with prostaglandin E2 (PGE2) in women with one previous lower segment cesarean section. METHODS: A prospective study was conducted at Maternity & Children Hospital, Buraidah (Qassim), Saudi Arabia. The sample included 153 consecutive women with one previous cesarean section, of whom 75 underwent induction of labor (study group) and 78 were admitted with spontaneous onset of labor (control group). Vaginal tablets of PGE2 were used for cervical ripening in the study group. Mode of delivery, neonatal outcome, indications for cesarean section, and rate of uterine rupture were compared between the groups. RESULTS: There were no significant differences between the study and control groups in mean (_S.D.) maternal age (30:9 _ 4:7 years versus 31:2 _ 4:8 years, P » 0:6), gestational age at delivery (39:2 _ 1:8 weeks versus 39:3 _ 1:6 weeks, P » 0:36), overall rate of cesarean section (24% versus 20.5%, P » 0:8), rates of low 5-min Apgar score (3.1% versus 3.7%, P » 0:67) or cesarean section performed for non-reassuring fetal heart rate (9.3% versus 7.69%, P » 0:1). There were no cases of uterine rupture, in both groups. CONCLUSION: The findings suggest that induction of labor in women with one previous cesarean section does not increase the risk of cesarean section rate and does not adversely affect immediate neonatal outcome. We cautiously suggest that when there is no absolute indication for repeated cesarean section, induction of labor may be considered.