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Background: Egypt’s family planning programs have followed a similarly unsteady course. Debated by Egyptian social scientists since the 1930s, Egypt’s high population growth became widely viewed as an acute problem in the 1960s, when the government acknowledged the serious economic and social problems associated with it. Objectives: Analyzing the factors associated with contraceptive methods discontinuation among women aged 15- 49 years and contraceptive use dynamics in the study area. We also examined the effect of counseling on percent of continuation. Study design: A cross sectional survey was carried out among the eligible women. Study setting: The study areas included Assiut Governorate family planning units in different places providing contraceptive methods. Study population: One thousand and ten women in reproductive age from 15-49 who used contraceptive methods once or more, has one child or more were included. Study tools: An interview questionnaire was constructed including data about used contraceptive methods, discontinuation and its causes, failure and its fate. We asked about ten steps of counseling. Data entry after revising and editing was done via EXCEL software while data analysis was carried out via SPSS program version 11. Results: the most commonly used modern method was IUD (43.0%). The results revealed that 69.7% of methods had been stopped within 2 years of starting for various reasons. The percent of discontinuation decreased significantly with increasing age. Discontinuation was the lowest when there were four or more living children and increased significantly by decreasing number of living children. It decreased significantly with increasing the number of sons. As regards infant deaths; discontinuation was insignificant among those who did not experience infant deaths, and presence of one and two deaths respectively. University graduated women showed least discontinuation level. As regards causes of discontinuations; side effects and health concerns were the most common reason of discontinuation. Most of method failure as expressed by pregnancy ended in live births. The results indicated that a higher score on counseling was significantly associated with continuation. Conclusion: Counseling should emphasize the possibility of side effects, stressing the fact that most will be transient, and the need to identify a backup method. Follow-up visits should be scheduled for 1 to 2 months after a prescription is written.

Background: Egypt’s family planning programs have followed a similarly unsteady course. Debated by Egyptian social scientists since the 1930s, Egypt’s high population growth became widely viewed as an acute problem in the 1960s, when the government acknowledged the serious economic and social problems associated with it. Objectives: Analyzing the factors associated with contraceptive methods discontinuation among women aged 15- 49 years and contraceptive use dynamics in the study area. We also examined the effect of counseling on percent of continuation. Study design: A cross sectional survey was carried out among the eligible women. Study setting: The study areas included Assiut Governorate family planning units in different places providing contraceptive methods. Study population: One thousand and ten women in reproductive age from 15-49 who used contraceptive methods once or more, has one child or more were included. Study tools: An interview questionnaire was constructed including data about used contraceptive methods, discontinuation and its causes, failure and its fate. We asked about ten steps of counseling. Data entry after revising and editing was done via EXCEL software while data analysis was carried out via SPSS program version 11. Results: the most commonly used modern method was IUD (43.0%). The results revealed that 69.7% of methods had been stopped within 2 years of starting for various reasons. The percent of discontinuation decreased significantly with increasing age. Discontinuation was the lowest when there were four or more living children and increased significantly by decreasing number of living children. It decreased significantly with increasing the number of sons. As regards infant deaths; discontinuation was insignificant among those who did not experience infant deaths, and presence of one and two deaths respectively. University graduated women showed least discontinuation level. As regards causes of discontinuations; side effects and health concerns were the most common reason of discontinuation. Most of method failure as expressed by pregnancy ended in live births. The results indicated that a higher score on counseling was significantly associated with continuation. Conclusion: Counseling should emphasize the possibility of side effects, stressing the fact that most will be transient, and the need to identify a backup method. Follow-up visits should be scheduled for 1 to 2 months after a prescription is written.

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Abstract: Developmental anomalies of the mullerian duct system represent an interesting field of disorders in obstetrics and gynecology as they can affect any of the reproductive organs from the Fallopian tubes to the hymen. The purpose of this article is to review the available treatment options for mullerian duct anomalies with special emphasis on simple and advanced surgical approaches. Surgical options are presented based on a novel treatment plan classification system adapted from the American Fertility Society classification of mullerian duct anomalies. Care was taken to include all previously termed unclassified anomalies as well as the important category of longitudinal fusion defects. Important diagnostic approaches are discussed with special emphasis on detection of associated anomalies of the urinary system and other relevant systems. Early establishment of an accurate diagnosis is important for planning management options and preventing complications in the genital organs and surrounding systems. Classifying mullerian anomalies based on the available treatment options seems logical and the inclusion of previously unclassified entities is important for a comprehensive understanding and management of this group of disorders. The surgical approach for the correction of mullerian duct anomalies is individualized to the type of malformation. The value of a given surgical procedure should be assessed on terms of its capability to improve a patient's postoperative ability to have healthy sexual relations and achieve successful reproductive outcomes.

Abstract: Developmental anomalies of the mullerian duct system represent an interesting field of disorders in obstetrics and gynecology as they can affect any of the reproductive organs from the Fallopian tubes to the hymen. The purpose of this article is to review the available treatment options for mullerian duct anomalies with special emphasis on simple and advanced surgical approaches. Surgical options are presented based on a novel treatment plan classification system adapted from the American Fertility Society classification of mullerian duct anomalies. Care was taken to include all previously termed unclassified anomalies as well as the important category of longitudinal fusion defects. Important diagnostic approaches are discussed with special emphasis on detection of associated anomalies of the urinary system and other relevant systems. Early establishment of an accurate diagnosis is important for planning management options and preventing complications in the genital organs and surrounding systems. Classifying mullerian anomalies based on the available treatment options seems logical and the inclusion of previously unclassified entities is important for a comprehensive understanding and management of this group of disorders. The surgical approach for the correction of mullerian duct anomalies is individualized to the type of malformation. The value of a given surgical procedure should be assessed on terms of its capability to improve a patient's postoperative ability to have healthy sexual relations and achieve successful reproductive outcomes.

ABSTRACT Objective To present a preface for an updatable classification system of Mü llerian anomalies addressing the limitations of currently available classifications and focuses on adolescent needs. Methods We carried out a review of the literature, available classification systems, and reports of more than 400 cases of congenital malformation; then, we proposed the present preliminary report for a subsequent classification system. Results Among the currently available classifications, the American Fertility Society (AFS) classification system was found to be the most simple, widely accepted, and user friendly. The American Fertility Society classification as well as other classification systems had many limitations. We proposed a preface for an updatable classification system characterized by simplicity and clarity depending on the embryologic backgrounds, following a logical anatomical hierarchy, integrating clinical significance, addressing the limitations, focused on categories that compromise the reproductive health of adolescent females, and ultimately focused on treatment options. The available treatment options are revised and presented for each subclass whenever feasible. The suggested name of the proposed classification system is the 'adolescent-focused, treatment-based' classification. Conclusion The current proposal represents a nucleus for a logical and updatable classification of Mü llerian duct anomalies focusing on problems that compromise the health of adolescent females. It combined the advantages of uniformity, being based on embryologic backgrounds, and following anatomical, management complexity hierarchies, in addition to being potentially user friendly. Mullerian duct anomalies: Towards an adolescent-focused, treatment-based classification system - ResearchGate. Available from: http://www.researchgate.net/publication/234006182_Mullerian_duct_anomalies_Towards_an_adolescent-focused_treatment-based_classification_system [accessed Aug 3, 2015].

ABSTRACT Objective To present a preface for an updatable classification system of Mü llerian anomalies addressing the limitations of currently available classifications and focuses on adolescent needs. Methods We carried out a review of the literature, available classification systems, and reports of more than 400 cases of congenital malformation; then, we proposed the present preliminary report for a subsequent classification system. Results Among the currently available classifications, the American Fertility Society (AFS) classification system was found to be the most simple, widely accepted, and user friendly. The American Fertility Society classification as well as other classification systems had many limitations. We proposed a preface for an updatable classification system characterized by simplicity and clarity depending on the embryologic backgrounds, following a logical anatomical hierarchy, integrating clinical significance, addressing the limitations, focused on categories that compromise the reproductive health of adolescent females, and ultimately focused on treatment options. The available treatment options are revised and presented for each subclass whenever feasible. The suggested name of the proposed classification system is the 'adolescent-focused, treatment-based' classification. Conclusion The current proposal represents a nucleus for a logical and updatable classification of Mü llerian duct anomalies focusing on problems that compromise the health of adolescent females. It combined the advantages of uniformity, being based on embryologic backgrounds, and following anatomical, management complexity hierarchies, in addition to being potentially user friendly. Mullerian duct anomalies: Towards an adolescent-focused, treatment-based classification system - ResearchGate. Available from: http://www.researchgate.net/publication/234006182_Mullerian_duct_anomalies_Towards_an_adolescent-focused_treatment-based_classification_system [accessed Aug 3, 2015].

ABSTRACT Objective To present a preface for an updatable classification system of Mü llerian anomalies addressing the limitations of currently available classifications and focuses on adolescent needs. Methods We carried out a review of the literature, available classification systems, and reports of more than 400 cases of congenital malformation; then, we proposed the present preliminary report for a subsequent classification system. Results Among the currently available classifications, the American Fertility Society (AFS) classification system was found to be the most simple, widely accepted, and user friendly. The American Fertility Society classification as well as other classification systems had many limitations. We proposed a preface for an updatable classification system characterized by simplicity and clarity depending on the embryologic backgrounds, following a logical anatomical hierarchy, integrating clinical significance, addressing the limitations, focused on categories that compromise the reproductive health of adolescent females, and ultimately focused on treatment options. The available treatment options are revised and presented for each subclass whenever feasible. The suggested name of the proposed classification system is the 'adolescent-focused, treatment-based' classification. Conclusion The current proposal represents a nucleus for a logical and updatable classification of Mü llerian duct anomalies focusing on problems that compromise the health of adolescent females. It combined the advantages of uniformity, being based on embryologic backgrounds, and following anatomical, management complexity hierarchies, in addition to being potentially user friendly. Mullerian duct anomalies: Towards an adolescent-focused, treatment-based classification system - ResearchGate. Available from: http://www.researchgate.net/publication/234006182_Mullerian_duct_anomalies_Towards_an_adolescent-focused_treatment-based_classification_system [accessed Aug 3, 2015].

ABSTRACT Objective To present a preface for an updatable classification system of Mü llerian anomalies addressing the limitations of currently available classifications and focuses on adolescent needs. Methods We carried out a review of the literature, available classification systems, and reports of more than 400 cases of congenital malformation; then, we proposed the present preliminary report for a subsequent classification system. Results Among the currently available classifications, the American Fertility Society (AFS) classification system was found to be the most simple, widely accepted, and user friendly. The American Fertility Society classification as well as other classification systems had many limitations. We proposed a preface for an updatable classification system characterized by simplicity and clarity depending on the embryologic backgrounds, following a logical anatomical hierarchy, integrating clinical significance, addressing the limitations, focused on categories that compromise the reproductive health of adolescent females, and ultimately focused on treatment options. The available treatment options are revised and presented for each subclass whenever feasible. The suggested name of the proposed classification system is the 'adolescent-focused, treatment-based' classification. Conclusion The current proposal represents a nucleus for a logical and updatable classification of Mü llerian duct anomalies focusing on problems that compromise the health of adolescent females. It combined the advantages of uniformity, being based on embryologic backgrounds, and following anatomical, management complexity hierarchies, in addition to being potentially user friendly. Mullerian duct anomalies: Towards an adolescent-focused, treatment-based classification system - ResearchGate. Available from: http://www.researchgate.net/publication/234006182_Mullerian_duct_anomalies_Towards_an_adolescent-focused_treatment-based_classification_system [accessed Aug 3, 2015].