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Efficacy and acceptability of depo-medroxy progesterone acetate injection among Iraqi women
كفاءة وقبول عقار ديبومدروكسي البروجسترون العراقيات كوسيلة لمنع الحمل لدى النساء

Author: Ali M. Murad د. علي محمد مراد
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2007 Volume: 20 Issue: 1 Pages: 73-76
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Objective: To determine the efficacy and acceptability of Depo-medroxy progesterone (Depo-Provera ) among the women using this method of contraception at Al-Yarmouk Teaching Hospital.Method: A preliminary cross sectional study and questionnaire analysis of 100 Iraqi women who had Depo-Provera as a method of contraception at the contraception clinic of Al Yarmouk teaching hospital over 6 months. Results: The mean age of the women was 31 years, and the mean parity was 6 There was no pregnancy reported during the period of use of contraceptive method which ranged from 3 months to 5 years. The side effects were mainly irregular spotting (68%), amenorrhea 9%, continuous bleeding pervaginum 5% , and menorrhagia 3% .The rest reported normal menstrual pattern .Irregular spotting was common in women who had used the method for less than 2 years while amenorrhea was the most common menstrual abnormality after 3 years of use. The other include weight gain, loss of hair, abdominal pain and backache. The side effects were not acceptable to 5% of the women and they tried other method of contraception. 20% of women get pregnant between 6 months to 2 years after stopping the injections.Conclusion: Depo-Provera is very effective form of contraception in our community. While a few of women 5% would try other methods if they were not happy with the side effects as long as desired prevention of pregnancy was guaranteed. Depo-Provera injection contraception. Key words: depo-medroxy progesterone acetate

الملخص :الأهداف : تقدير الكفاءة والقبول لعقار ديبومدروكسي البروجسترون بين السيدات المستخدمات لهذة الوسيلة في مستشفى اليرموك التعليمي . طريقة البحث : أجريت الدراسة الأولية بأستخدام الأستبيان على 100 سيدة عراقية يراجعن في عيادة تنظيم الأسرة في مستشفى اليرموك التعليمي على مدار ستة أشهر . النتائج : كان متوسط العمر هو 31 سنة وعدد مرات الولادة هو 6 . ولم تسجل حالة حمل واحدة خلال فترة الأستخدام التي تراوحت بين ثلاثة أشهر وخمس سنوات . كانت الأعراض الجانبية الأساسية كالتالي نزف بسيط غير منتظم (68%) امتناع الطمث (9%) نزف مهبلي مستمر (5%) والنزف الشديد (3%) وسجلن بقية السيدات نمطاً طمثياً عادياً . كان النزف البسيط غير المنتظم أكثر شيوعاً في السيدات اللآتي استخدمن الوسيلة لمدة أقل من عامين بينما الشكاوي الأخرى هي زيادة الوزن ، تساقط الشعر والآم البطن والظهر . ولم تتقبل 5% من السيدات هذه الأعراض وحاولن استخدام طريقة أخرى لمنع الحمل . وحملن حوالي 20% من السيدات بعد توقف استخدامهن للحقن في فترات تتراوح بين ستة أشهر وعامين. الأستنتاج : لايزال عقار الديبو بروفيرا مفضلاً كوسيلة لمنع الحمل في مجتمعنا .


Article
Progesterone Therapy Administered 24 hours Before Embryo Transfer in ICSI Cycle Improves Embryo Implantation and Pregnancy in Women With Luteal Phase Defect.

Authors: Saeeda A. AL-Anssari --- Mundhir T. Ridhaa --- Zuher Kanan --- Ahmed K. Allow --- et al.
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 1 Pages: 101-106
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Ovulation induction by human menopausal gonadotrophin (HMG) results in temporal luteal phase defect. Luteal support therapies are required to support embryo implantation in stimulated cycle especially in luteal phase defect infertile women. Objective: The objective of the present study was to investigate the clinical significance of progesterone, aspirin and HCG on human embryo implantation in women with luteal phase defect following ICSI and embryo transfer (ET). Patients and Methods: The female patients were divided into six groups depending on the type of the luteal support protocols (LSP). Group 1 (No= 54), received 10 mg oral progesterone (P), group 2 (No= 35) received P plus HCG, group 3 (No= 59) received P plus HCG plus oral aspirin, group 4 (No= 47) received vaginal P administered 24 hours before embryo transfer plus oral aspirin, group 5 (No= 40) received vaginal P administered 12 hours after embryo transfer plus oral aspirin and group 6 (No= 46) received intramuscular P plus oral aspirin. The LSP were continued for at least 12 weeks, when the B-HCG test was positive, (tested two weeks after embryo transfer). Results: Statistical analysis of the clinical data showed no significant differences between the LSP in regard to patient's age, body mass index (B/M2), basal FSH/LH ratio and estradiol concentration at the day of HCG injection. The ICSI rate, percentages of embryos developed in vitro, and the numbers of the transferable quality embryos were similar in all groups (P>0.05). The pregnancy rate was significantly higher (P < 0.05), in group 4 compared to other groups (38.66% versus 24.51%(G 1), 22.53% (G 2), 28.66% (G 3), 25% (G 5), 21.60% (G 6). The percentages of viable fetal sac development per patient were 31.49 (17/54), in G 1, 42.86 (15/35), in G 2, 49.16 (29/59), in G 3, 59.58 (28/47), in G 4, 32.50 (13/40), in G 5, and 34.79 (16/46), G 6. The percent of viable gestation sac was significantly higher in group 4 compared to other groups (P < 0.05). Conclusions: The administration of 400 mg /day vaginal progesterone 24 hours before ET and 100 mg/day aspirin five days after ET results in significant improvements in pregnancy and embryo implantation rates and development of viable fetuses in luteal phase defect infertile women undergoing ICSI-ET.

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