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Introduction Thyroid dysfunction has profound effects on menstrual function and female fertility. Hypothyroidism is often associated with increased prolactin level which again worsens the problem. This study was done to evaluate the prevalence of thyroid disorders in infertile women attending infertility outpatient department (OPD) in Tribhuvan University Teaching Hospital (TUTH) and to determine the association of hypothyroidism and hyperprolactenemia with obesity which is not well studied in our population. MethodsA hospital-based cross-sectional study was conducted in infertility OPD of TUTH reviewing women’s records who underwent infertility workup and relevant history, clinical finding and results of investigations including thyroid function test (TFT) and serum prolactin (PRL) level were documented. Descriptive and inferential statistical analyses were used to identify the prevalence and associations of predictors and outcome variables. ResultsOut of 213 participants, the majority of the participants were obese (90; 42.3%) with mean (±SD) body mass index (BMI) being 24.8 ± 4.5 kg/m2. The prevalence of thyroid disorder was 18.4% including hypothyroidism 13.6% and hyperthyroidism 4.8%. There was no significant association of BMI and hyperprolactinemia with thyroid disorder as well as of BMI with hyperprolactinemia however the thyroid stimulating hormone (TSH) had significant positive correlation with prolactin (r=0.23, p

Introduction: Infertility has been rising steeply as the prime health issue among women around the world these days. This study aims to investigate the causes, hormonal profi le, and clinical spectrum of infertility.Materials and Methods: This is a descriptive cross-sectional study conducted throughout a one year duration in an infertility clinic. The couples meeting the inclusion criteria were included and a pre-formed proforma was used to collect the data regarding history, examination, and investigations.Results: A total of 118 infertile couples were analyzed. The mean age of the females was 28.3±4.5 years. There were 72.1 %cases of primary infertility and 27.9 %of secondary infertility. Regarding obesity status,35.5% were overweight and 15.2 % were obese. Thirty-one (26.2%) males were smokers, 41 (34.7%) used to consume alcohol, and 14 (11.8%) had a habit of chewing tobacco. Among the different fi ndings of semen analysis, 21.1% asthenozoospermia, 9.3% oligoasthenozospermia,7.6% oligospermia, 1.6% azoospermia. Female factor accounted for 45.3%, the malefactor for 28% and in 19.3% the defi nite factor was not determined. The ovulatory disorder was diagnosed in 38.6% of females and hysterosalpingography (HSG) revealed that around 10% had a unilateral block and 1.7% had a bilateral block.Conclusions: Infertility is becoming a global issue affecting a signifi cant number of young couples. About forty-six percent were female aging more than thirty years. The female factor for infertility was more common than the male factor among which ovulatory disorder was the commonest one. Asthenozoospermiawas the commonest abnormal fi nding on semen analysis in a male partner.

Newborn weight exceeding 4000 g or 4500 g is considered as macrosomia, incidence of which varies from 6 to 10% of all deliveries. Maternal diabetes, obesity, age >35 years, male baby, history of previous macrosomia, multiparity are few risk factors. It is associated with several maternal and neonatal complications and presents an obstetric challenge as there is no consensus regarding the most appropriate route of delivery for macrosomic baby. We report a rare case of fetal macrosomia with birth weight of 6.25 kg delivered by cesarean section to 39 years old woman at 38 weeks 6 days period of gestation.

The Bombay blood group is a rare blood type with an incidence of around one in a million. There is no known reported case of an obstetric patient with the Bombay blood group from Nepal. People with this rare blood group can receive blood only from those with the same blood type. We report an elderly gravida with the Bombay blood group who had a pregnancy complicated by diabetes, placenta previa, and transverse lie (back up) following an in vitro fertilization. Placenta previa posed a greater risk of hemorrhage and hence the need for transfusion. The main challenge was arranging blood for transfusion, and as the Bombay blood group was unavailable, she was managed with autologous blood transfusion which was performed for the first time in a pregnant lady in our institute. She underwent Cesarean section for placenta previa with transverse lie, and both mother and baby were sent home in good health.