Introduction: To investigate the questions that Muslim patients, embryologists, paramedics, clinical counsellor and doctors may have pertaining to the compliance of Assisted Reproductive Technique (ART) to Shari’aa.
Methods: As a preliminary study, an open-ended survey was administered to participants. Participants for the survey comprised of 21 patients, 2 embryologists, 2 doctors, 4 paramedics and 1 counsellor.
Results: Data analysis showed that most of the participants posed questions that fall into six classifications which are: Munakahat (Family Law), social Hukm, Fiqh Ibadah, Fiqh Qadha (Islamic Hukm), General Fiqh and Usul Fiqh.
Conclusion: It is clear that even though the participants were rather familiar with some of the existing Fatwas pertaining to ART and IVF in Malaysia, there are still remaining doubts which need to be clarified. This indicates that there are challenges faced in seeking and providing ART treatment to Muslim patients. This needs to be addressed perhaps in the form of Shari’aa-compliant guidelines to provide a clear explanation of each process and procedure in fertility treatment.
Introduction: To analyze the ART outcome and factors associated with successful ART treatment for infertile couples in a newly set up medical university IVF centre. Methods: A six-month cohort study of patients undergoing their first assisted reproductive technique cycle was conducted at IIUM fertility centre, Kuantan (from 15th June until 31st Dec 2009). Outcome measures include clinical pregnancy rate, ongoing pregnancy rate, take home baby rate and complications rate. Results: Fifty-five first cycles of IVF/ICSI were studied. Mean embryo per transfer was 2.1±0.8. Four patients were pregnant (23.5%) from a single embryo transfer (SET). Clinical pregnancy rate was 30.9% (17/55). Ongoing pregnancy rate was 23.6% (13/55) and take home baby rate was 21.8% (12/55). There was only one twin pregnancy. Nine patients (16.4%) had OHSS whereby 77.8% were mild and 22.2% were moderate. Conclusion: Take home baby rate at the IIUM fertility centre is comparable to most established ART centres in Malaysia considering that this is only the first year of operation.
Premature Ovarian Failure (POF) is associated with subfertility. Despite efforts to induce ovulation, success rates are low. We report a case of POF spontaneously conceiving twins while on hormone replacement therapy.
A patient with severe hyponatreamia secondary to chronic renal failure was treated with peritoneal dialysis (PD). On the third day of admission, she developed progressive obtundation. Neurological examination showed bilateral brisk reflexes with intact brain stem reflexes. Magnetic resonance imaging demonstrated patchy demyelination of the pontine area indicating central pontine myelinolysis (CPM). Despite supportive measures, the patient died on the fifteenth day of admission. The rate of correction of hyponatraemia with peritoneal dialysis can be rapid and detrimental to hyponatraemic chronic renal failure patients and careful monitoring of serum sodium level is advocated.
Seven cases of analgesic nephropathy due to excessive ingestion of paracetamol are reported. None of these patients had been taking any other analgesic. All had radiological features of papillary necrosis. With the increasing use of paracetamol as a mild analgesic it is necessary to be aware of the possibility that paracetamol may induce analgesic nephropathy.
A prospective study was performed on patients admitted to the medical and renal wards of General Hospital, Kuala Lumpur. Over a period of 14 months from 1 January 1982, 12 new cases of analgesic nephropathy (AN) were documented. Contrary to the experience in the West and in Australia, AN in Malaysia tends to have a male preponderance and occurs even in the younger age groups. The common analgesics abused are paracetamol, Chap Kaki Tiga and Chap Harimau. The main reasons for analgesic abuse are headache and arthritis. In addition to radiological features of renal papillary necrosis patients have the other manifestations of the disease such as peptic ulceration, anaemia, neuro-psychiatric disorders and ischaemic heart disease.
A one year study was carried out to determine the outcome of the seminal fluid parameters collected via masturbation and coitus interruptus in 151 patients who were undergoing intrauterine insemination (IUI) and patients who came for seminal analysis. There were no statistically significant differences in terms of volume, concentration, progressive motility and normal morphology from specimens collected via coitus interruptus compared to specimens collected via masturbation. Pregnancy outcomes were also comparable.
A renal transplant patient presented with ileal perforation due to histoplasmosis 3 years after transplantation. Mesenteric lymph nodes and lungs were also affected by the disease. She was successfully treated with amphotericin B followed by ketoconazole.