PURPOSE: The objective of this study was to compare the efficacy and safety of carbetocin, a long oxytocin analogue, with oxytocin in preventing postpartum hemorrhage.

METHODS: Sixty women eligible for the study were enrolled on this prospective, double-blinded randomized controlled trial. They were randomized to receive either a single dose of 100-microgram intravenous carbetocin or oxytocin infusion (a mixture of 10 IU oxytocin and 1 liter of D5 containing intravenous fluid) upon delivery of the anterior shoulder of the baby. The primary outcome measure was a difference in hemoglobin drop measure 242 hours postpartum.

RESULTS: A significant drop of hemoglobin level 24 hours  postpartum was observed in the oxytocin group (-1.1) compared to the carbetocin (-0.6). The incidence of additional uterotonic agents and average estimated blood loss were lower with carbetocin. Uterine massage was needed in almost all patients who received oxytocin compared to a negligible number of those in the carbetocin group. Blood pressure and pulse rate of the patients were logged though no statistical difference was observed. The onset and duration of action was rapid and longer, respectively with carbetocin. There was no difference in the incidence of side effects between the two groups.

CONCLUSION: Carbetocin appears to be more effective than a continuous infusion of oxytocin with similar safety profile, thus a good alternative to conventional  uterotonic agents.

Human ; Female ; Carbetocin ; Oxytocin ; Postpartum Hemorrhage ; Blood Pressure ; Parturition ; Delivery, Obstetric ; Postpartum Period ; Hemoglobins

Objectives: To describe the experience of the Center for Reproductive Medicine in the use of luteal phase support protocols in in-vitro fertilization (2005 - 2008).Design: A retrospective cohort study of couples undergoing in vitro fertilization using the different modalities of luteal phase support from 2005 to 2008 at CRM.Main outcome measure(s): clinical pregnancy rate. miscarriage rate and live birthrate.Result(s): From 2005 - 2008, 94 patients underwent in vitro fertilization.The center achieved a 36% clinical pregnancy rate, and 27.6% live birthrate. The most common luteal phase used was a combination of progesterone, estradiol and aspirin which achieved a 39% clinical pregnancy rate and a 28% live birthrate. The luteal phase support protocol which obtained the highest clinical pregnancy rate of 50% was that of progesterone alone which resulted in 50% live birthrate. But it did not reach clinical significance as compared to the other protocols (P>0.05). The use of the intramuscular (IM) progesterone showed a significant P value, with an odds ratio of 3.83, suggesting that it can increase the likehood of clinical pregnancy by as much as 4x.Conclusion(s): The most common luteal phase support protocol used was a combinatiion of progesterone and aspirin. Progesterone alone protocol achieved the highest clinical pregnancy rate of 50% which all resulted in live birht. Among the different types and routes of progesterone used, only the IM progesterone was shown to be clinically significant in increasing the pregnancy rate.
Human ; Female ; X

There are relatively few effective clinical options for preserving female fertility, particularly following aggressive chemotherapy and or radiotherapy treatment protocols. This paper reviews the scientific background, current technology, clinical results and potential future applications of two methods of preserving female fertility-ovarian tissue cryopreservation and oocyte cryopreservation. These technologies are investigational, although rapidly evolving and their list of appropriate indications may be expanded in the future.
CRYOPRESERVATION ; FERTILITY AGENTS, FEMALE