Oncologists' Knowledge, Practice and Attitude toward Fertility Preservation: A National Survey.

BACKGROUND: Improved chemotherapy and radiotherapy treatment protocols, fortunately, increased the rates of cancer survivors over the years. However, these treatments may result in infertility or subfertility. Oncologists are considered the gateway for knowledge about cancer and its treatments' effects. Several studies showed that many oncologists do not discuss fertility preservation with their patients. This study aimed to explore the perspective of oncologists in Oman on fertility preservation. METHODS: A cross-sectional study of physicians and surgeons dealing with patients with cancer was conducted from June 2021 to December 2021. A standardized and validated questionnaire was used to collect data. RESULTS: Participants reported that they are knowledgeable about sperm cryopreservation and gonadotropin-releasing hormone agonists use but not other methods of fertility preservation. About 94% of the participants reported that they need more knowledge about fertility preservation. More than half of the participants had never encountered cancer patients who used ovarian cryopreservation, testicular tissue cryopreservation, in vitro fertilization with embryo cryopreservation and oocyte cryopreservation. The majority (78%) agreed that discussing fertility preservation with newly diagnosed cancer patients is a high priority. CONCLUSIONS: Oncologists in Oman are supportive of fertility preservation. The lack of knowledge and unavailability of well-structured fertility preservation services in Oman hinders the initiation of fertility preservation discussions.

Parental consanguinity and ovarian reserve: A retrospective cohort study.

Background: Infertility affects around 10-15% of couples worldwide and is both a social and medical problem. Parental consanguinity is considered to reduce fertility reserve. Consanguineous marriages, especially first cousin marriages, are very common in Oman according to the Oman National Health Survey data. Objective: This study aimed to determine whether women born to consanguineous parents have reduced ovarian reserve. Materials and Methods: This cohort study was conducted on 414 women aged ≤ 39, treated for infertility at Sultan Qaboos University hospital and Royal hospital, Muscat, Oman from January 2019-December 2020. Each participant was interviewed and a complete history, including parental consanguinity and physical examination, were recorded. On day 2 of the menstrual cycle, serum concentration of the following was performed: follicle-stimulating hormone (FSH), luteinizing hormone, estradiol, prolactin, thyroid stimulating hormone, and anti-Müllerian hormone (AMH). AMH was done, if necessary, on other days of the cycle. Antral follicle count (AFC) was done on day 2 and 3 of the menstrual cycle. Results: Of the 414 women, parental consanguinity was present in 40.2% of couples. In women with low AFC, parental consanguinity was present in 15.3% compared to 13.0% in the non-consanguineous group. About 15% of women with low AMH had consanguineous parents, compared to 20.2% from the non-consanguineous group. High levels of FSH were present in 6.5% and 4.2% of the consanguineous and non-consanguineous groups, respectively. No significant difference was observed in AFC with reference to body mass index. Conclusion: The results from this study showed no statistically significant difference in low ovarian reserves (AFC, AMH, and FSH) in women whose parents had a consanguineous marriage.

Association of blood groups with ovarian reserve and outcome of in vitro fertilization treatment.

BACKGROUND: The association between ABO blood groups and ovarian reserve in infertile patients has been a point of controversy. OBJECTIVES: The aim of this study was to assess the correlation of certain blood groups with ovarian reserve and response to treatment in patients undergoing infertility treatment. DESIGN: Retrospective medical record review. SETTING: Infertility clinic in the assisted reproductive technology (ART) unit at King Faisal Specialist Hospital and Research Center, Riyadh Saudi Arabia. PATIENTS AND METHODS: All patients under 40 years of age who attended the infertility clinic at a tertiary care centre in 2010 and underwent in vitro fertilization (IVF) treatment in 2010 and 2011 were divided into groups according to blood type, and clinical parameters were compared. MAIN OUTCOME MEASURE(S): The association between blood groups and ovarian reserve using day 3 luteinzing hormone (LH) and follicular stimulating hormone (FSH) levels, and antral follical count (AFC). RESULTS: In 424 patients who underwent 566 IVF cycles, age, LH, FSH and AFC were similar among the different blood groups (P=.9, .1, .5, respectively). with controlled ovarian stimulation, no difference was observed among the four groups in menopausal gonadotrophin (hMG) dose or the duration of stimulation. The number of oocytes retrieved, fertilization rate, cleavage rate, and number of embryos transferred were similar. There was no difference in the cancellation rate or pregnancy rate among the groups. CONCLUSION: There was no significant association between blood type and ovarian reserve or response during IVF treatment in our population. LIMITATIONS: Anti-Mullerian hormone levels are best correlated with ovarian reserve testing. Unavailability of AMH levels. Retrospective design.

Fetal macrosomia. Risk factor and outcome.

OBJECTIVE: To determine the risk factors predisposing to fetal macrosomia and assess the maternal and perinatal outcome in these patients. METHODS: This was a retrospective analysis of all macrosomic deliveries in the Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, Sultanate of Oman, during a 3-year period from January 2001 -- December 2003. The maternal and neonatal records of infants with birth weight of > or =4000 g (n=275) were reviewed. Outcome variables included demographic profile, antenatal risk factors, mode of delivery and maternal and perinatal complications. RESULTS: A total of 7367 deliveries occurred during the study period. The rate of macrosomic deliveries was 3.75% and the rate of deliveries > or =4500 g was 0.48%. The mean birth weight of the study group was 4230 +/- 220 g. Obesity, diabetes, prolonged gestation and postpartum hemorrhage were significantly higher in the study group. The cesarean section rate was 25.8% for the study group compared to the general incidence of 13.1% during the study period (p<0.0001). The incidence of shoulder dystocia was 7.6% compared to the general incidence of 0.48% during the study period (p<0.0001). There were 7 cases of Erb's palsy, all except one recovered without sequelae by 3 months of age. CONCLUSION: Gestational diabetes, maternal obesity, increasing age and parity were the main risk factors for fetal macrosomia. The incidence of shoulder dystocia, birth injuries and neonatal morbidity increased in this group.