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Results for Year : "2017"
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Effects of socio-demographic, lifestyle and environmental factors on semen quality of men attending the sub fertility clinic in National Population and Family Development Board
Item Type: Research Report
Author: 
National Population and Family Development Board, Malaysia,  and
Author: 
Editor: 
Year:  02/01/2017
Abstract:  Couples are considered infertile if they are unable to conceive after one year of regular unprotected sex. The impact of lifestyle and environment on human fertility may vary depending on aetiology, demographic characteristics, genetic variation and other factors. As used by previous researchers, semen parameters were used to measure male infertility. Therefore, a decrease in semen quality is considered as a major factor in male infertility (http://en.wikipedia.org/wiki/Semen_quality). Previous studies (Kidd et al.2001,Eskenazi et al.2003, de La Rochebrochard and Thonneau 2003) have found that older men tend to have lower semen quality than younger ones. Testicular hyperthermia (elevated temperature) also has been known to affect male fertility. Men who like taking hot baths or sit in a sedentary position for a long time are at risk of having infertility. The objectives of this study are to identify the relationship between socio-demographic profile, lifestyle and environmental factors and semen quality, and to identify risk factors of poor semen quality among men attending the National Population and Family Development Board's (NPFDB) Subfertility Clinic. This study was done in Andrology Laboratory, NPFDB. Five hundred men from couples having their first infertility consultation between September 2010 abd June 2011 were recruited. Each patient was required to register, deposit semen and fill in the quesstionnaire. Sperm concentration, morphology and motility from semen analysis were used to study the relationship between semen quality and independent variables. Reference limits used were 15 cells x 10'6/ml, 4% and 40 %, respectively (World Health Organization, 2010). For statistical analysis, descriptive statistic, t test and ANOVA were used; 0.05 alpha value was chosen. Results showed that one-third of the study population were between 26 to 30 years of age and another one third were aged between 31 to 35 years old; mean age was 33.2. majority were Malays (71.2%), resided in Selangor (64.3%) and professionals (41.6%). Semen quality showed a negative relationship (p<0.05) with age. Meanwhile, sperm motility varied significantly for different ethnic group. Chinese (57.75%) had the highest motile-sperm compared to Malays (53.44%) and Indians (46.60%). Among lifestyles variables, frequency of sexual intercourse had a posive relationship (p<0.05) with sperm motility, whilst sedentary position had negative relationship (p<0.05) with the latter. Regression analysis was used to predict the risk factors of poor semen quality. This study found that men above 30 years old were two times more likely to have low sperm motility than men in the twenties. Moreover, less frequent sexual activity between couples was more likely (p<0.05) to have abnormal sperm compared to those who had sexual intercourse more frequently. In conclusion, this study suggested that age over 30 years and infrequent sexual activity were the risk factors to lower semen quality. Even though not regarded as a risk factor, sedentary work position had a negative impact on sperm motility. These factors may affect male fertility and cause difficulty in conception. Public awareness through advocacy programs and talks on infertility and its risk factors should be carried out regularly. Public education should be carried out to advice men to practice a healthy lifestyle and work life balance. This study has shown encouraging results, and should be replicated in the general population in Malaysia
 
 
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Kajian perbandingan penggunaan tiga jenis rawatan hormon FSH dalam kalangan pesakit subfertiliti yang menjalani prosedur permanian beradas di Lembaga Penduduk dan Pembangunan Keluarga Negara
Item Type: Research Report
Author: 
Lembaga Penduduk dan Pembangunan Keluarga Negara, Malaysia,  and
Author: 
Editor: 
Year:  02/01/2017
Abstract:  Since 1979, the National Population and Family Development Board (NPFDB) has been providing subfertility management services to the public especially middle-income group. In line with the rapid pace of the latest technology and research developments, there are various types of fertility drugs in the form of injections which had been used in subfertility treatment. The main function of this injection is to mature the follicles where the main hormone contained in this injection is the follicle stimulating hormone (Follicle Stimulating Hormone, FSH). In general, there are three types of FSH injections, which is a recombinant FSH (rFSH) that have 100 percent synthetic hormone, urinary FSH (uFSH) that derived from menopausal urine and highly purified urinary FSH (hp-uFSH) that also derived from menopausal urine but more pure state than uFSH. All three hormones have FSH’s activities but uFSH and hp-uFSH also have Luteinizing Hormone’s activity (LH). Thus, NPFDB has taken initiative to conduct a comparative study on the use of three types of FSH hormone treatment, namely Gonal F (rFSH), Folliova (uFSH) and Menopur (hp-uFSH), among subfertilitie’s patient who’s undergoing Intrauterine Insemination Technique (IUI). Among others, the three types of hormones were studied in terms of effevtivenee and cost burden. The study sample was from patients with unknown cause of subfertilitie’s problem and they visit NPFDB Subfertilitie’s Clinic, Headquarters, from June 2010 to May 2012. The sampling method was random. The patient and researcher do not know the treatment regimen to be initiated until a closed sample containing the treatment regimen code number is opened by the patient before starting treatment. Data were collected, recorded and anlyzed using Statistical Package for the Social Sciences (SPSS) software. Although originally a total of 90 female patients were targeted to be recruited into this study. 30 patients for each type of FSH hormone, but at the end of the study only 39 patients met all eligibility criteria and agreed to participate in this study. The result showed that average of the patients was 28.3 years and the majority were ethnic Malays (76.9%). Most of the patients had a household income between RM 5,000.00 and RM 10,000.00 (51.4%). The percentage of patients requiring more than three injections to procedure mature follicles was lowest for Folliova (41.7%), compared with Menopur (50.0%) and Gonal F (55.6%). Similarly in terms of the number of follicles produced, the Folliova regime (58.3%) produced more follicles (more than three follicles) than other regimes. A total of 16.7 percent of patients who took Menopur injections were confirmed pregnant, while no pregnany occurred among patients who took Folliova and Gonal F. In terms of cost, at the time of this study, the price of three 75IU injections was RM 334.20 for Gonal F, RM 187.20 for Folliova and RM 271.20 for Menopur. In conclusion, this study shows that, hp-uFSH (Menopur) gives the highest pregnancy rate compared to Gonal F and Folliova. Furthemore, the price of Menopur is moderate (affordable) for patients. Therefore, highly purified urinary FSH is a good gonadotropin choice for couples with unexplained subfertility undergoing an IUI procedure and it may be the main choice for patients who need a combination fertility pill stimulation regimen and gonadotropin injections. As a suggestion, such a study should be conducted with a larger sample size to obtain more significant results and be representative of actual population.
 
 
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