1.Younger women with ovulation disorders and unexplained infertility predict a higher success rate in superovulation (SO) intrauterine insemination (IUI).
Veronique VIARDOT-FOUCAULT ; Bee Choo TAI ; Ethiraj Balaji PRASATH ; Matthew S K LAU ; Jerry K Y CHAN ; Seong Feei LOH
Annals of the Academy of Medicine, Singapore 2014;43(4):225-231
INTRODUCTIONSuperovulation-intrauterine insemination (SO-IUI) is the most common assisted reproductive technique (ART) in the world, with good evidence of efficacy and cost-effectiveness. However, parameters affecting its success have not been consistently reported. So in this study, we aim at determining the parameters influencing the success rate of SO-IUI.
MATERIALS AND METHODSWe conducted a retrospective cohort study of 797 SO-IUI cycles from 606 patients, performed between 2007 and 2009 in a single centre. These women received clomiphene citrate (CC), recombinant FSH (rFSH) or both.
RESULTSThere were 127 clinical pregnancies with a pregnancy rate (PR) of 15.9% (127/797) per treatment cycle. Factors associated with higher PR included maternal age <38 (P = 0.02), subfertility diagnoses of ovulatory disorders, unexplained infertility, sexual dysfunction and unilateral tubal obstruction (P = 0.02), an endometrial thickness ≥8 mm (P = 0.03), total number motile spermatozoa (TNMS) of ≥1 million (P = 0.03), and spermatozoa normal forms (NF) ≥4% (P <0.01) on bivariate analysis. When CC is used, the endometrial thickness is more likely to be suboptimal (<8 mm). All the above parameters remained significant except the subfertility diagnoses on multivariate analysis.
CONCLUSIONPatients' selection with women <38 years old and preferably with ovulation disorders and unexplained infertility is associated with the highest PR in SO-IUI. Cycle parameters such as the use of rFSH alone, with the avoidance of CC, TNMS ≥1 million and NF ≥4% is likely to result in the best outcomes and reduce the high order multiple pregnancy risk.
Adult ; Age Factors ; Clomiphene ; therapeutic use ; Cohort Studies ; Female ; Fertility Agents, Female ; therapeutic use ; Humans ; Infertility, Female ; etiology ; Insemination, Artificial ; methods ; Pregnancy ; Pregnancy Rate ; Prognosis ; Retrospective Studies ; Superovulation
2.Obstructed Hemivagina and Ipsilateral Renal Anomaly--A Reproductive Surgical Unit's Experience.
Kai Lit TAN ; Edwin W H THIA ; Matthew S K LAU ; Steven B L TEO ; Jerry K Y CHAN ; Sadhana NADARAJAH ; Seong Fei LOH ; Veronique VIARDOT-FOUCAULT ; Heng Hao TAN
Annals of the Academy of Medicine, Singapore 2014;43(5):282-284
Abnormalities, Multiple
;
surgery
;
Adolescent
;
Child
;
Female
;
Humans
;
Kidney
;
abnormalities
;
Kidney Diseases
;
Retrospective Studies
;
Uterus
;
abnormalities
;
surgery
;
Vagina
;
abnormalities
;
surgery
;
Young Adult
3.Academy of Medicine-Ministry of Health Clinical Practice Guidelines: assessment and management of infertility at primary healthcare level.
Seong Feei LOH ; Rachna AGARWAL ; Jerry K CHAN ; Sing Joo CHIA ; Li Wei CHO ; Lean Huat LIM ; Matthew Sie Kuei LAU ; Sheila Kia Ee LOH ; Marianne Sybille HENDRICKS ; Suresh NAIR ; Joanne Hui Min QUAH ; Heng Hao TAN ; P C WONG ; Cheng Toh YEONG ; Su Ling YU
Singapore medical journal 2014;55(2):58-quiz 66
The Academy of Medicine (AMS) and Ministry of Health (MOH) have developed the clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level to provide doctors and patients in Singapore with evidence-based treatment for infertility. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the AMS-MOH clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical/2013/cpgmed_infertility.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
Evidence-Based Medicine
;
Female
;
Guidelines as Topic
;
Humans
;
Infertility
;
diagnosis
;
therapy
;
Male
;
Practice Guidelines as Topic
;
Primary Health Care
;
methods
;
standards
;
Public Health
;
standards
;
Singapore
4.The effectiveness of conducting home visits by medical students among Malaysians with type 2 diabetes: A retrospective analysis.
Kean Ghee LIM ; Yogarabindranath Swarna NANTHA ; Nurfazila Hanim KASIM ; Tarshandiny RAMAMOOTHY ; Annabelle YAM ; Ern Wei LIM ; Matthew LOH
Journal of the ASEAN Federation of Endocrine Societies 2019;34(1):56-61
BACKGROUND: Medical students at the International Medical University (IMU), Seremban, Malaysia were required to assess patients at home over a period of two years as a part of their curriculum. The students conducted six visits to educate their patients and help them utilize available resources to manage their disease.
This study aims to examine whether patients with diabetes visited improve their control of their disease, specifically in terms of their HbA1c measurement.
METHODOLOGY: We used a retrospective, matched before and after study design to prevent biased levels of effort by students conducting the home visits over two years. Information was obtained through reports written by IMU students. Convenient sampling was used to select outpatients undergoing treatment 'as usual' from a health clinic and were subsequently matched as controls.
RESULTS: There was a significant decrease in the mean HbA1c among 57 patients with diabetes who were CFCS subjects [from 8.4% (68 mmol/mol) to 7.3% (57mmol/mol) p<0.001], while the mean HbA1c levels among 107 matched control subjects rose significantly from 7.9% (63 mmol/mol) to 8.3% (67 mmol/mol) (p=0.019) over a similar period. The two groups were controlled for most biological and socioeconomic variables except for comorbidities, diabetic complications and medication dose changes between groups.
CONCLUSION: Behavioural intervention in the form of home visits conducted by medical students is an effective tool with a dual purpose, first as a student educational initiative, and second as a strategy to improve outcomes for patients with diabetes
Human ; House Calls ; Students, Medical ; Malaysia