Displaying publications 1 - 20 of 32 in total

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  1. Wong KK, Raman S
    Med J Malaysia, 1990 Mar;45(1):81-3.
    PMID: 2152076
    Two cases of ovarian hyperstimulation syndrome (OHSS) following the GIFT procedure are reported. This article highlights the potential dangers of this condition and discusses the classification and management.
    Matched MeSH terms: Ovulation Induction/adverse effects*
  2. Abdullah RB, Liow SL, Rahman AN, Chan WK, Wan-Khadijah WE, Ng SC
    Theriogenology, 2008 Sep 15;70(5):765-71.
    PMID: 18579196 DOI: 10.1016/j.theriogenology.2008.04.052
    The objective was to evaluate the effect of the interval between ovarian hyperstimulation and laparoscopic ovum pick-up (LOPU) on quality and developmental competence of goat oocytes before and after in vitro maturation (IVM) and intracytoplasmic sperm injection (ICSI). Estrus was synchronized with an intravaginal insert containing 0.3g progesterone (CIDR) for 10d, combined with a luteolytic treatment of 125 microg cloprostenol 36 h prior to CIDR removal. Ovaries were hyperstimulated with 70 mg FSH and 500 IU hCG given im 36, 60, or 72 h prior to LOPU (n=15, 16, and 7 does, respectively). For these groups, oocyte retrieval rates (mean+/-S.E.M.) were 24.7+/-2.9, 54.5+/-4.7, and 82.8+/-4.6% (P<0.001), and the proportions of cumulus-oocyte complexes (COC) with more than five layers of cumulus cells were 29.7+/-8.3, 37.6+/-6.9, and 37.3+/-7.0% (P<0.001). The proportion of IVM oocytes was highest at 72 h (82.1+/-2.8%; P<0.05), with no significant difference between 36 and 60 h (57.3+/-8.9% and 69.0+/-8.4%). Cleavage rates of ICSI embryos were 4.2+/-4.2, 70.9+/-8.4, and 78.9+/-8.2% with LOPU 36, 60, and 72 h post FSH/hCG (P<0.01), with a lower proportion of Grade-A embryos (P<0.05) following LOPU at 36 h compared to 60 and 72 h (29.7+/-8.3%, 37.6+/-6.9%, and 37.3+/-7.0%). In summary, a prolonged interval from FSH/hCG to LOPU improved oocyte retrieval rate and oocyte quality. Therefore, under the present conditions, LOPU 60 or 72 h after FSH/hCG optimized yields of good-quality oocytes for IVM and embryo production in goats.
    Matched MeSH terms: Ovulation Induction/veterinary*
  3. Thomas AG, Armstrong SL, Stewart-Williams S, Jones BC
    Evol Psychol, 2021;19(1):1474704920976318.
    PMID: 33412934 DOI: 10.1177/1474704920976318
    Previous research has found that women at peak fertility show greater interest in extra-pair sex. However, recent replications have failed to detect this effect. In this study, we add to this ongoing debate by testing whether sociosexuality (the willingness to have sex in the absence of commitment) is higher in women who are at peak fertility. A sample of normally ovulating women (N = 773) completed a measure of sociosexuality and had their current fertility status estimated using the backward counting method. Contrary to our hypothesis, current fertility was unrelated to sociosexual attitudes and desires, even when relationship status was included as a moderator. These findings raise further doubts about the association between fertility and desire for extra-pair sex.
    Matched MeSH terms: Ovulation
  4. Jamaludin J, Nordin NM, Mohamad N, Etta KM
    Malays J Reprod Health, 1988 Jun;6(1):65-9.
    PMID: 12281593
    Subcutaneous body fat and Quetelet's Indices (QI) of 52, 18-29 year old normal female volunteers were determined. These body mass indices were then grouped according to the phase of each subject's menstrual cycle, early or late follicular and early or late luteal phase. The subcutaneous body fat is 27.07 +or- 1.0% in the early follicular but drops to 24.68 +or- 1.84% in the late follicular phase. The value then rises significantly higher than that in the late follicular phase to 30.14 +or- 1.15% (P0.02) in the early luteal drops to 27.17 +or- 0.55% towards the level of the early follicular phase (P0.05). Variations in the values of QI during each menstrual cycle exactly mirror those for subcutaneous body fat. The fall in the 2 body mass indices during the late follicular phase coincides somewhat with the established preovulatory LH and FSH surges as well as the high levels of estrogen of this period. On the other hand the significant rise in the 2 parameters during the early luteal phase coincides with the marked rise in the ratio of progesterone to estrogen. Clearly, increased levels of progesterone relative to estrogen appear to cause an increase in the body fat during each menstrual cycle. The implication of this finding for women on contraceptive pills which are predominantly progesterone and those whose normal menstrual cycle is "interrupted" at the early luteal phase by a successful fertilization raises very interesting questions with regards to prediction of ovulation.
    Matched MeSH terms: Ovulation*; Ovulation Detection*
  5. Muchlisin ZA, Musman M, Azizah MN
    PMID: 20482777 DOI: 10.1186/1477-7827-8-49
    Rasbora tawarensis is an endemic freshwater fish in Lake Laut Tawar, Aceh Province, Indonesia. Unfortunately, its status is regarded as critical endangered with populations decreasing in recent years. To date no information on the spawning activities of the fish are available. Therefore, this study provides a contribution to the knowledge on reproductive biology of R. tawarensis especially on spawning seasons as well as basic information for conservation of the species.
    Matched MeSH terms: Ovulation/physiology*
  6. Rashid MR, Ong FB, Omar MH, Ng SP, Nurshaireen A, Sharifah-Teh NS, et al.
    Med J Malaysia, 2008 Jun;63(2):113-7.
    PMID: 18942295 MyJurnal
    The long agonistic protocol for controlled ovarian hyperstimulation (COH) is effective and used most often, thus is considered the gold standard. Therefore any new regimen has to be compared in its results with those obtained with the long protocol. This report compares the efficacy of GnRH agonist and antagonist in a retrospective study of IVF/ICSI carried out in a tertiary teaching hospital from 2003 to 2006. Only the first COH cycle followed by IVF-ICSI from 200 couples (agonist = 120 and antagonist = 80) were analysed. The end points studied included the number of oocytes recovered, number of mature (MII) oocytes, fertilization, cleavage, morphology based embryo quality, pregnancy rate, quantity and cost of gonadotrophin. The average age of female subjects was 35.1 +/- 4.7 years with 50% being 35 years and above. Major infertility factors were tubal blockage, male factor and endometriosis altogether comprising 68%. GnRH agonist and antagonist cycle parameters were comparable except lesser amount of gonadotrophin was used with lower resultant costs (both p < 0.0005) in antagonistic regime. Antagonist regime produce somewhat more good quality embryos (p = 0.065), an insignificant difference. A clinical pregnancy rate per embryo transfer of 16.3% in agonist and 20.6% in antagonist regime was achieved respectively. In conclusion, GnRH antagonist protocol produced a COH response, embryonic development and pregnancy rates on par to GnRH agonist regime. Moreover GnRH antagonist protocol required a shorter stimulation period plus fewer complications. Hence GnRH antagonist regime provided means for a friendlier, convenient and cost effective protocol for patients.
    Matched MeSH terms: Ovulation Induction/methods*
  7. Tay PY, Raj VR, Kulenthran A, Sitizawiah O
    Med J Malaysia, 2007 Oct;62(4):286-9.
    PMID: 18551930 MyJurnal
    To determine the prognostic factors such as age, diagnosis, number of cycle attempts and semen parameters on the pregnancy rate of controlled ovarian hyperstimulation (COH) /intrauterine insemination (IUI). Three hundred and seventeen women who underwent 507 consecutive COH/IUI cycles were recruited from 1st January 2002 to 31st December 2005 inclusively. This retrospective study was done in University Malaya Medical Centre, a tertiary care academic centre. The main outcome measure was pregnancy rate according to age, infertility diagnosis, duration of infertility, semen parameters, and the number of treatment cycles. The overall pregnancy rates were 16.9% per cycle and 25.9% per couple. Pregnancy rates decreased with advancing maternal age. Pregnancy rate was also significantly lower in patient with postwash total motile sperm count (TMSC) < or = 20 million/ml compared to those with TMSC >20 million/ml. The cumulative pregnancy rates varied greatly by diagnosis from 16% for patients with male factor infertility to 60% for patients with ovulatory disorder. Pregnancies among patients with male infertility, tubal factors infertility and endometriosis were achieved during the first three cycles. There is a clear age-related decline in fecundity associated with COH/IUI treatment. Women of > 40 years old, couple with postwash TMSC < or = 20 million/ml, severe endometriosis and tubal factors have a particularly poor prognosis.
    Matched MeSH terms: Ovulation Induction*
  8. Rupinder KR, Pratap K
    Med J Malaysia, 2006 Mar;61(1):132-6; quiz 137.
    PMID: 16708754
    Introduction : Ovarian cancer accounts for approximately 4% of all cancers occurring in women and ranks the fourth most frequent cause of cancer-related death in women. Despite aggressive treatment modalities the 5 year survival rate remains less than 30%'. Almost 2.5% of all live births/ year result from assisted reproductive techniques (ARD2. Concern has been expressed that exposure to fertility drugs (FD) might be associated with a risk of ovarian tumors. Given the grave prognosis of ovarian cancer and the increasing use of ART, for the past several years this has been a subject of much scientific debate. The likely magnitude of risk may be 2 - 3 times that of the general population, which is at most 4-5% in a woman's lifetime. Several case control and cohort epidemiological studies have attempted to address this issue but failed to specifically look at drug treatment as risk factor and research to date demonstrates conflicting results.
    Review of literature : Ovulation induction (Ol) agents are commonly used in the treatment of infertility in patients with or without ovulatory disturbances. These agents include clomiphene citrate (CC), bromocryptine, gonadotropins (Gn), Gonadotropin releasing hormone (GnRH) and its analogues. In in vitro fertilization (IVF), combinations and different drug dosages of FD are given to stimulate production of multiple oocytes. Fertility drugs were first marketed since the 1960's. The first to hit the market was CC in 1967 followed 2 years later by human Menopausal Gonadotropin (hMG) & human Chorionic Gonadotropin (hCG)'. Until 1987, most IVF cycles used CC in combination with HMG followed by hCG. From 1987, GnRH agonists were introduced to replace Cc. From 1990, the main drug regimen was GnRH agonist in combination with HMG or Follicular Stimulating Hormone (FSH) followed by hCG.
    Matched MeSH terms: Ovulation Induction/adverse effects*
  9. Ismail M, Arshat H, Pulcrano J, Royston P, Spieler J
    Contraception, 1989 Jan;39(1):53-71.
    PMID: 2642781
    The BIOSELF 110 is a hand-held, non-invasive electronic instrument that measures basal body temperature and cycle length, and automatically identifies the fertile and infertile phases of the menstrual cycle with flashing red light and green light signals, respectively. The device was evaluated in 77 cycles from 33 ovulatory women in Kuala Lumpur, Malaysia. Ultrasound monitoring of maximum follicular diameter (MFD) and urinary LH measurements with Ovustick were used as reference methods to estimate the time of ovulation and the fertile period. Based on the MFD day, the BIOSELF correctly identified the entire fertile period, and at least four fertile days, in 89% and 94% of the cycles studied, respectively. The mean duration of the fertile period as determined by the number of flashing red light days was 11.0 days (SD 2.9). The device correctly identified the onset of the postovulatory infertile phase in 94% of cycles, with a mean duration of about 10 (green light) days. The results were similar using the LH peak day as the reference method. The mean interval from the onset of the fertile period (first flashing red light day) to the MFD day was 6.9 days (SD 2.6), and from the MFD day to the end of the fertile period, 3.1 days (SD 2.2). The BIOSELF 110 showed itself to be a reliable device for identifying the fertile and infertile phases of the menstrual cycle and, thus, should be a useful aid for couples seeking pregnancy. Prospective clinical trials are underway to assess the contraceptive effectiveness of the device.
    Matched MeSH terms: Ovulation Detection/methods
  10. Noorashikin M, Ong FB, Omar MH, Zainul-Rashid MR, Murad AZ, Shamsir A, et al.
    J Assist Reprod Genet, 2008 Jul;25(7):297-303.
    PMID: 18654847 DOI: 10.1007/s10815-008-9239-9
    Low dose stimulation (LS) is emerging as an alternative regime in assisted reproductive technology (ART). This study aimed to compare the cost-effectiveness of LS to the high dose GnRH antagonist (Atg) regime.
    Matched MeSH terms: Ovulation Induction/methods*
  11. Wang T, Sun Z, Lim JP, Yu Y
    Libyan J Med, 2019 Dec;14(1):1597327.
    PMID: 30935302 DOI: 10.1080/19932820.2019.1597327
    Many undergoing in vitro fertilization-embryo transfer (IVF-ET) procedures treatments have been tried for older infertile patients, but still can not reverse the aging effect on oocyte, and infertility treatment is expensive, even for people in developed countries. The study aimed to compare outcomes following the application of luteal phase ovulation induction (LPOI) and ultra-short gonadotropin-releasing hormone agonist (GnRH-a) protocols in patients aged more than 40 years undergoing IVF-ET and to examine the effectiveness and feasibility of LPOI. A total of 266 IVF-ET cycles in 155 patients aged 40 years and over were retrospectively analyzed. Of these patients, 105 underwent the ultra-short GnRH-a protocol (GnRH-a group) and 50 underwent LPOI (LPOI group). Various clinical outcomes were compared between these two groups using either t-tests or the chi-square test. The study showed patients in the LPOI group required a higher dosage of human menopausal gonadotropin and a lower dosage of recombinant follicle stimulating hormone than those in the GnRH-a group. Furthermore, though the total dosage of gonadotropin was higher in the LPOI, its cost was lower. Finally, fertilization rates were higher and high-quality embryo rates were lower in the LPOI group, and the live birth rate of LPOI group is higher than (GnRH-a group) . These between-group differences were all significant (P
    Matched MeSH terms: Ovulation Induction/methods*
  12. Garcia-Guerra A, Kamalludin MH, Kirkpatrick BW, Wiltbank MC
    Biol Reprod, 2018 03 01;98(3):335-349.
    PMID: 29425274 DOI: 10.1093/biolre/iox156
    The newly discovered Trio high-fecundity allele produces multiple ovulations in cattle. This study evaluated (1) size and growth rates of follicles in Trio carriers during a synchronized follicular wave, induced by follicle aspiration; (2) follicle-stimulating hormone (FSH) patterns associated with the follicular wave; (3) size of corpora lutea (CL) and circulating progesterone; and (4) intrafollicular estradiol concentrations prior to normal deviation. Trio carriers had mean dominant follicles that were significantly smaller in diameter and volume than noncarriers. Onset of diameter deviation occurred at ∼3 days after the last follicle aspiration in both genotypes despite Trio carriers having much smaller individual follicles. Follicles of Trio carriers grew at a slower rate than noncarrier follicles (∼65% in mm/day or ∼30% in mm3/day) resulting in much smaller individual dominant follicles (∼25% volume). However, total dominant follicle volume, calculated as the sum of all dominant follicles in each animal, was similar in carriers and noncarriers of Trio throughout the entire follicular wave. Circulating FSH was greater in Trio carriers during the 24 h encompassing deviation. Trio carriers had significantly more ovulations than noncarriers, and individual CL volume was smaller, although total luteal tissue volume and circulating P4 were not different. Thus, increased ovulation rate in Trio carriers relates to smaller individual follicles (one-third the volume) near the time of deviation due to slower follicle growth rate, although time of deviation is similar, with increased circulating FSH near deviation leading to selection of multiple dominant follicles in Trio carriers with similar total follicle volume.
    Matched MeSH terms: Ovulation/genetics*
  13. Zain MM, Jamaluddin R, Ibrahim A, Norman RJ
    Fertil. Steril., 2009 Feb;91(2):514-21.
    PMID: 18321486 DOI: 10.1016/j.fertnstert.2007.12.002
    To determine the first-line medication to be used in anovulatory patients with polycystic ovary syndrome (PCOS) for ovulation induction and pregnancy achievement.
    Matched MeSH terms: Anovulation/ethnology; Anovulation/etiology; Anovulation/physiopathology; Anovulation/therapy*; Ovulation/drug effects*; Ovulation/ethnology; Ovulation Induction/methods*
  14. Kamal DAM, Salamt N, Zaid SSM, Mokhtar MH
    Molecules, 2021 May 03;26(9).
    PMID: 34063635 DOI: 10.3390/molecules26092675
    Tea is one of the most widely consumed beverages worldwide after water, and green tea accounts for 20% of the total tea consumption. The health benefits of green tea are attributed to its natural antioxidants, namely, catechins, which are phenolic compounds with diverse beneficial effects on human health. The beneficial effects of green tea and its major bioactive component, (-)-epigallocatechin-3-gallate (EGCG), on health include high antioxidative, osteoprotective, neuroprotective, anti-cancer, anti-hyperlipidemia and anti-diabetic effects. However, the review of green tea's benefits on female reproductive disorders, including polycystic ovary syndrome (PCOS), endometriosis and dysmenorrhea, remains scarce. Thus, this review summarises current knowledge on the beneficial effects of green tea catechins on selected female reproductive disorders. Green tea or its derivative, EGCG, improves endometriosis mainly through anti-angiogenic, anti-fibrotic, anti-proliferative and proapoptotic mechanisms. Moreover, green tea enhances ovulation and reduces cyst formation in PCOS while improving generalised hyperalgesia, and reduces plasma corticosterone levels and uterine contractility in dysmenorrhea. However, information on clinical trials is inadequate for translating excellent findings on green tea benefits in animal endometriosis models. Thus, future clinical intervention studies are needed to provide clear evidence of the green tea benefits with regard to these diseases.
    Matched MeSH terms: Ovulation
  15. Ahmad MF, Sugishita Y, Suzuki-Takahashi Y, Sawada S, Iwahata H, Shiraishi E, et al.
    J Adolesc Young Adult Oncol, 2020 08;9(4):496-501.
    PMID: 32283045 DOI: 10.1089/jayao.2019.0177
    Purpose:
    Our center is known as a pioneer center initiating oncofertility service since 2010 in Japan. We demonstrate our transition of this service in regional university hospitals ingenuously.
    Methods:
    We compared two phases of service: initial phase (2011 and 2012) and current phase (2019). The comparison included the number of women attending the oncofertility unit, diversity of breast cancer cases, the acceptability of preservation service, and the type of fertility preservation (FP) option offered in between these phases.
    Results:
    A total of 58 women were seen during the initial phase as compared with 41 women in the later phase. The mean age at diagnosis was not significantly different between the two periods. The majority of them were married and diagnosed with stage II luminar type. The current phase had a tendency to have a higher anti-Müllerian hormone level although not reaching significance. At least 50% of them declined FP and 84.5% never received ovarian control stimulation in the initial phase. Otherwise, 61% used aromatase inhibitor in the current phase. Only 15.5% in the initial phase received control ovarian stimulation whereas 63.4% in the current phase received it. The ovarian tissue cryopreservation was highly chosen during the initial phase (25.9%), whereas embryo cryopreservation (39%) was highly opted for during the current phase. All of our parameters are comparable between these two phases (p > 0.05).
    Conclusion:
    The significant changes of oncofertility practice were observed mainly due to the understanding of the oncofertility concept among reproductive physicians and the acceptance environment, including standard guidelines, supportive society, as well as advancements in cryobiology technique.
    Matched MeSH terms: Ovulation Induction
  16. Ahmad SM, Mat Jin N, Ahmad MF, Abdul Karim AK, Abu MA
    Horm Mol Biol Clin Investig, 2023 Dec 01;44(4):379-384.
    PMID: 38124670 DOI: 10.1515/hmbci-2022-0087
    OBJECTIVES: Unexplained subfertility (UEI) describes a couple whose standard subfertility workout consider acceptable but unable to conceived.

    METHODS: This retrospective study was conducted in the Advanced Reproductive Centre, UKM Hospital, Kuala Lumpur, from January 2016 to December 2019. The data of 268 UEI couples were obtained from the clinical database. Women aged 21-45 years old was included and further divided into four groups according to the female partner's age and subfertility duration: group A (age <35 years and subfertility <2 years), group B (age <35 years and subfertility >2 years), group C (age >35 years and subfertility <2 years), and group D (age >35 years and subfertility <2 years). All statistical analyses were performed using SPSS 22.0 for Windows.

    RESULTS: A total of 255 cases were included in this study. The mean age of the women was 32.9 ± 4.04 years, and the mean subfertility duration was 5.04 ± 2.9 years. A total of 51 (20 %) cases underwent timed sexual intercourse, 147 (57.6 %) cases had intrauterine insemination (IUI), whereas 57 (22.4 %) cases opted for in vitro fertilization (IVF). A total of 204 cases underwent active management (IUI/IVF), which showed a significant difference (p<0.05). Out of eight clinical pregnancies, half of them were from group B.

    CONCLUSIONS: Active management in younger women with a shorter subfertility duration revealed a better pregnancy outcome. Otherwise, individualized treatment should be considered in selecting a suitable treatment plan.

    Matched MeSH terms: Ovulation Induction
  17. Ng SP, Jamil MA, Nurshaireen A, Zainul MR
    Med J Malaysia, 2006 Oct;61(4):499-500.
    PMID: 17243533 MyJurnal
    The empty follicle syndrome (EFS) is a rare complication of in vitro fertilization (IVF) treatment, leading to cycle cancellation. Low human chorionic gonadotropin (hCG) bioavailability and ovarian dysfunction have been implicated with this condition. This case report illustrates a typical case of EFS and several strategies suggested to overcome this problem.
    Matched MeSH terms: Ovulation Induction/methods
  18. Lee C, Mak FS, Keith J, Welsh D, Yapp P, Chin R
    Med J Malaysia, 2003 Mar;58(1):94-8.
    PMID: 14556331
    All cycles of IVF with pituitary down-regulation (n = 57) done at the Damansara Fertility Centre in the year 2000 were studied. All the 57 patients had controlled ovarian hyperstimulation, either using Metrodin HP (n = 27) or Gonal-F (n = 30). Of these, 53 patients reached oocyte pick-up, 26 patients in Metrodin HP group and 27 patients in Gonal-F group. Gonal-F resulted in a higher clinical pregnancy rate of 66.6% compared to Metrodin HP 38.5% (p < 0.05). The live birth rate tends to be higher in Gonal-F group (40.7%) compared to Metrodin HP (30.8%), (p > 0.05).
    Matched MeSH terms: Ovulation Induction*
  19. Omar MH, Ong FB, Adeeb NN, Sharif JM, Nasri N, Yassin MJ
    Med J Malaysia, 1999 Mar;54(1):65-71.
    PMID: 10972007
    A survey in 1996 of our female patients suggest that the three commonest causes of infertility were endometriosis, anovulation and idiopathic which comprises of about 70% of all the patients. In the male patients, sperm morphology evaluation by critical criteria showed that abnormal morphology was present in 71% while 87% of all the semen analysis were abnormal. The objective of this study was to assess the status of IUI before proceeding to formulate patient protocols for IVF in a tertiary infertility referral unit. A retrospective study of patients data was done from Jan 1995 to Dec 1996. Ovarian stimulation by clomiphene for anovulatory and idiopathic patients was performed on couples with at least one patent fallopian tube. Ovulation induction was by an intramuscular injection of 5000 i.u of HCG after follicular maturation. IUI was performed approximately 36-40 hours later. A total of 74 couples received 114 treatment cycles producing a total of 9 conceptions. The conception rate of IUI was therefore 7.89% per cycle and 12.16% per couple with the cumulative pregnancy rate of 28.21%. Associated success features of IUI found in this study were the age of the woman and the semen parameters of the husband.
    Matched MeSH terms: Ovulation Induction/methods
  20. Netw Res Triangle Park N C, 1981 Apr;2(3):1-2.
    PMID: 12281266
    PIP:
    The International Fertility Research Program is carrying out several studies focused on breastfeeding's contraceptive protection. A longitudinal study is investigating the relationship between breastfeeding and the return of ovulation and fertility after childbirth. The impact of factors such as the early introduction of supplementary foods, resumption of menses, and sexual practices on the return of ovulation will be analyzed. The study, which will be conducted at 4 geographic sites, will include a total of 100 women who are breastfeeding and a control group of 40 nonlactating mothers. Its ultimate goal will be to determine the optimum time for breastfeeding women with different cultural needs to start using contraceptives. A second study will seek to determine whether progestogen-only oral contraceptives (OCs) have advantages for lactating women. Trials in India, Malaysia, Argentina, and Egypt will compare 1000 lactating women who use progestogen-only OCs with an equal number of women who use nonhormonal contraception in terms of contraceptive acceptance and side effects and infant weight gain. The third study will survey breastfeeding patterns in relation to changing child spacing trends in a sample of 4000 women from Lagos, Nigeria. Analyzed will be the proportions of women who are using a modern method of fertility control, the proportions protected from unwanted pregnancy by the traditional practices of prolonged breastfeeding and sexual abstinence, and determinants of recent changes in the prevalence and duration of breastfeeding.
    Matched MeSH terms: Ovulation*
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