Effect of female body mass index on intrauterine insemination outcomes: a systematic review and meta-analysis.

The prevalence of women with a raised body mass index (BMI) seeking assisted conception treatment is increasing. Findings of existing studies evaluating the effect of female BMI on intrauterine insemination (IUI) treatment outcomes remain inconsistent. This systematic review and meta-analysis evaluate the effect of female BMI on IUI treatment outcomes. Two authors independently conducted data extraction and assessed study quality. Risk ratios (RR) and 95% confidence intervals were calculated using the Mantel-Haenszel approach for dichotomous outcomes. 11 studies involving 23,145 IUI treatment events, comprising 21,211 cycles from 8 studies, and 1,934 participants in three studies, met the inclusion criteria for the meta-analysis. Two cohorts of women undergoing IUI treatment were compared - women with normal BMI < 25 kg/m2 were compared with a second cohort of women with a BMI category ≥ 25 kg/m2. There was no statistically significant difference in live birth rate (LBR) (RR 1.06, 95% CI 0.86-1.307); clinical pregnancy rate (CPR) (RR 0.94, 95% CI 0.78-1.13); miscarriage (RR 0.92, 95% CI 0.31-2.74) or ectopic pregnancy rate (RR 2.20, 95% CI 0.78-6.23). Our meta-analysis showed that a raised female BMI did not affect IUI treatment outcomes. Nevertheless, weight loss counselling should be offered to women with a raised BMI undergoing IUI, to reduce the associated obstetric morbidity.

A meta-analysis of 11 studies found that having a raised female BMI did not change IUI treatment outcomes.

Student perception of workplace-based assessment.

BACKGROUND: Workplace-based assessment (WPBA) is key to medical education, providing a framework through which the trainee can be assessed and receive feedback in the clinical setting. WPBA was introduced in 2008-2009 to students in year 4 at University College London Medical School (UCLMS). Students raised concerns about the lack of standardisation in grading. As a result, white-space areas were introduced on WPBA forms. The aim of this was to permit assessors to expand their feedback, thereby enhancing its developmental potential. The aim of the project was to assess student perception of WPBA at UCLMS, and to determine whether re-designing the form had altered this perception. METHOD: An online survey was circulated to students in year 4 at the end of the academic year 2009-2010, and was repeated with the next cohort of year-4 students at the end of the academic year 2010-2011. Students were asked to express a level of agreement with 12 statements and for free-text comments on their experience with WPBA. Survey responses were analysed using an unpaired two-tailed Student's t-test, and QSR NVivo was used to manage the thematic analysis of the free-text comments. RESULTS: Although there was no significant difference in student perception between cohorts, the analysis of free-text comments highlighted several themes for discussion. CONCLUSION: Students at UCLMS find WPBA valuable in highlighting areas for improvement and obtaining personalised feedback. They find the grading of WPBA too subjective, and that the attitudes of the assessors sometimes reduce its educational value. Suggestions are made to improve the value of WPBA in undergraduate medical education.