A Prospective Multi-centric Study of Acceptance, Insertion and Follow-Up of Postpartum Insertions of IUCD.

Purpose of the Study: The unmet need for contraception in the postpartum period is a major challenge in our country. Unintended pregnancies are highest in the first year after birth, and postpartum IUCD insertion is an effective way to counter this problem. This study was planned to build up data for acceptance and follow-up of postpartum IUCD insertions. Methods: The present study has included data of PPIUCD insertions and follow-up from seven institutions over a period of 6 months. The case recruitment lasted for 3 months, including only those who had PPIUCD insertions in this period, and they were followed up for a period of 6 months. The follow-up of patients was at 6 weeks and 6 months. All issues were addressed including side effects, expulsions, myths surrounding the device, etc., along with routine postnatal care. Results and Conclusion: There were 5227 deliveries and 1895 insertions. The acceptance rate was 36%, and a follow-up at 6 weeks and 6 months showed up an expulsion rate of approximately 4% and a removal rate of 5%. Overall, at the end of 6 months we have a continuation rate of 90%. This shows that a dedicated approach to postpartum contraception will definitely bring down incidence of unintended pregnancies.

Gonadotropin Alone is a Better Drug for Ovarian Stimulation than in Combination with Clomiphene in Intrauterine Insemination.

OBJECTIVE: This study compares the efficacy of sequential clomiphene citrate (CC) + Gonadotropin to that of Gonadotropin alone with ultrasound monitoring. METHODS: It is a retrospective analytic study done on a total of 100 couples to compare two groups receiving CC + Gonadotropin and Gonadotropin alone for ovarian stimulation followed by intrauterine Insemination (IUI). We studied the cycle performance parameters. Cumulative pregnancy rates and ovulation rates were the primary outcomes. Results were analyzed following the intention-to-treat principle. RESULTS: There were no significant differences with respect to indications and the numbers of dominant follicles recruited. The endometrial thickness was significantly better in Gonadotropin-alone group (P < 0.05). Ovulation rate was better for CC + Gonadotropin at 95.91 %. Nine pregnancies were in the CC + Gonadotropin group (18.36 %) and 17 in Gonadotropin-alone group (33.3 %). CONCLUSIONS: Significant differences in pregnancy rates and endometrial thickness were seen. Gonadotropin alone thus appears to give better results, but CC + Gonadotropin seems to be a cost-effective drug.