Experience of assisted reproductive technology at King Abdulaziz University Hospital.

AIM: To present the authors' experience with assisted reproductive technology (ART) at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. MATERIALS AND METHODS: Retrospective analysis of data collected from the charts of 264 women who were undergoing their first cycle of ART between September 2013 and March 2014. All the women were treated with gonadotropin-releasing hormone (GnRH) antagonist protocol. For all patients, the documented data included age, infertility type, cause, and hormone profile. Number of follicles > 10 mm, endometrial thickness, number of oocytes retrieved, number of fertilized ova, and number of embryos produced, as well as the number transferred, day of transfer, cancellation rate, and treatment administered for luteal phase support (oral and vaginal progesterone) treatment type, and outcome were recorded. The data was analyzed using the Statistical Package for the Social Sciences. RESULTS: The authors included women aged 21 to 39 years (mean ± standard deviation, 32.28 ± 5.51). Patients suffered from primary infertility in 69.7% of the cases; approximately 30% of the women had secondary infertility. Eighty of the 264 patients (30.3%) conceived; however, only 56 women (21.2%) had a live birth. The overall cancellation rate in the patients was 12.1%. The following reasons were documented for cases of failure: no oocytes, 16 (6.1%); no sperm, eight (3.0%); and no embryo, eight (3.0%). CONCLUSION: The success rate of ART at the present institution falls within the range reported in the medical literature. However, further studies should be conducted to investigate the course and outcome of ART in patients who undergo treatment in this institution.

Screening of sexual dysfunction in Saudi women before and after the age of 40 years.

OBJECTIVE: The aim was to assess sexual performance by screening Saudi women before and after the age of 40 years. MATERIALS AND METHODS: A cross-sectional study (March-May 2013), conducted at King Abdulaziz University Hospital (KAUH), with two groups of women under 40 years of age and aged 40 or more years, were randomly selected from OPD. Ethical committee approved the study. After verbal consent, one-paper self-administered questionnaire was distributed, and filled in anonymously and privately. Questionnaire included demographic data, the six-item version of female sexual function index (FSFI) to assess desire, lubricants, orgasm, satisfaction, and pain. If score was 19 or less, it meant that women needed further investigations (full assessment using FSFI- 19). RESULTS: Out of 194, 49.5% (96) were over 40 years of age and 50.5% (98) were under 40 years of age. Answering the six questions regarding sexual dysfunction in- dicated that women > 40 years had sexual dysfunction more than women <40 (statistically significant). A scored of less than 19 was found to be statistically significant in women > 40 years. Post-menopausal women, diabetics, women with urogynecological symptoms and/or psychological disorder required further evaluation. DISCUSSION: Using the six-item version of FSFI and calculating a score less than 19 for screening, women aged more than 40 years, reduction in estrogen, diabetes, urogynecological symptoms, and psychological disorder were all found to be important factors affecting female sexual dysfunction.

Comparison of the classic TVT and TVT-Secur.

BACKGROUND AND AIMS: Tension-free vaginal tape (TVT) is a well-established surgical procedure for the treatment of female stress urinary incontinence (SUI) and TVT-Secur was designed to reduce the undesired complications and to minimize the operative procedure as much as possible. AIM: To present the authors' experience in using the classic TVT and TVT-Secur and to evaluate and compare complications and short- and long-term results. MATERIALS AND METHODS: A retrospective study and analysis of 230 patients presented with SUI at King Abdulaziz University Hospital (KAUH) and United Doctor Hospital (UDH) from March 1, 2007 until July 3, 2010. Classical TVT and TVT-Secur with or without associated operation were performed. All patients were controlled at six months and complications, as well as objective results, have been reported. The study was approved by ethical committee of KAUH. RESULTS: All patients with SUI admitted to KAUH and UDH for sub-urethral tape were analyzed (230 patients); 149 had classical TVT and 81 had TVT-Secur. Their age ranged from 30 years to 73 years with a mean of 49.8 years and std of 9.4. Their parity ranged from two to 15 with a mean of 6.2 and std of 2.4. One hundred eighty patients had SUI and 50 patients had mixed incontinence. The type of anesthesia used was general anesthesia in 69.6% (160) of cases and regional anesthesia in form of epidural or spine in 30.4% (70) of cases. Operative complications revealed a bladder perforation in 3.5% (eight) of cases and 2.2% had bleeding of more than 200 ml, and 53 patients which contribute to 23% had retention and required a catheter for 48 hours or more. After three months, it was observed that erosion of the mesh occurred in three cases. Fourteen cases (7%) continue to have SUI failure rate. CONCLUSION: The classical TVT and TVT-Secur were found to be very effective, easy, and safe procedures and with excellent results.