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Kelley EL, Kingsberg SA. Sexuality and Infertility. Obstet Gynecol Clin North Am 2024; 51:311-322. [PMID: 38777486 DOI: 10.1016/j.ogc.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Infertility diagnoses and treatment can lead to psychological distress and relationship strain. Infertility is commonly associated with disruptions in sexual function and satisfaction among women, in part due to overlapping etiologic factors (eg, comorbid medical conditions). Women and couples with infertility should be screened for sexual problems and provided education on the relationship between infertility and sexuality. Sexual dysfunction in the context of infertility is often best addressed using an interdisciplinary approach. This article provides a summary on the relationship between sexuality and infertility and recommendations for the assessment and management of sexual dysfunction in women with infertility.
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Affiliation(s)
- Erika L Kelley
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center; Department of Reproductive Biology, Case Western Reserve University, School of Medicine; Department of Urology, Case Western Reserve University, School of Medicine; MacDonald Women's Hospital, Mailstop 5034, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
| | - Sheryl A Kingsberg
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center; Department of Reproductive Biology, Case Western Reserve University, School of Medicine; Department of Urology, Case Western Reserve University, School of Medicine; MacDonald Women's Hospital, Mailstop 5034, 11100 Euclid Avenue, Cleveland, OH 44106, USA; Department of Psychiatry, Case Western Reserve University, School of Medicine, Cleveland, OH, USA
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2
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Sium AF, Surur F, Negash M. Opening the first and only public in vitro fertilization (IVF) center in sub-Saharan Africa: The experience of Ethiopia. Int J Gynaecol Obstet 2024. [PMID: 38796783 DOI: 10.1002/ijgo.15709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
SynopsisOpening public in vitro fertilization (IVF) center in low‐income countries is feasible and sustainable.
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Affiliation(s)
- Abraham Fessehaye Sium
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia
| | - Feiruz Surur
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia
| | - Mustefa Negash
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia
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3
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Zhang S, Li H, Jiang W, Chen X, Zhou H, Wang C, Kong H, Shi Y, Shi X. CircCamsap1 is dispensable for male fertility in mice. PeerJ 2024; 12:e17399. [PMID: 38799061 PMCID: PMC11122046 DOI: 10.7717/peerj.17399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
Background Circular RNAs (circRNAs) are a large class of RNAs present in mammals. Among these, circCamsap1 is a well-acknowledged circRNA with significant implications, particularly in the development and progression of diverse tumors. However, the potential consequences of circCamsap1 depletion in vivo on male reproduction are yet to be thoroughly investigated. Methods The presence of circCamsap1 in the mouse testes was confirmed, and gene expression analysis was performed using reverse transcription quantitative polymerase chain reaction. CircCamsap1 knockout mice were generated utilizing the CRISPR/Cas9 system. Phenotypic analysis of both the testes and epididymis was conducted using histological and immunofluorescence staining. Additionally, fertility and sperm motility were assessed. Results Here, we successfully established a circCamsap1 knockout mouse model without affecting the expression of parental gene. Surprisingly, male mice lacking circCamsap1 (circCamsap1-/-) exhibited normal fertility, with no discernible differences in testicular and epididymal histology, spermatogenesis, sperm counts or sperm motility compared to circCamsap1+/+ mice. These findings suggest that circCamsap1 may not play an essential role in physiological spermatogenesis. Nonetheless, this result also underscores the complexity of circRNA function in male reproductive biology. Therefore, further research is necessary to elucidate the precise roles of other circRNAs in regulating male fertility.
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Affiliation(s)
- Shu Zhang
- Center of Reproduction, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Haojie Li
- Center of Reproduction, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
- Changzhou Medical Center, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Department of Histology and Embryology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wei Jiang
- Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare Hospital, Nanjing, Jiangsu, China
| | - Xia Chen
- Center of Reproduction, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Han Zhou
- Center of Reproduction, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Chang Wang
- Department of Clinical Nursing, School of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Hao Kong
- State Key Laboratory of Reproductive Medicine and Offspring Health, Department of Histology and Embryology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yichao Shi
- Center of Reproduction, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Xiaodan Shi
- Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare Hospital, Nanjing, Jiangsu, China
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4
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Tian T, Wang Z, Liu F, Fu Y, Kong F, Wang Y, Li Q, Long X, Qiao J. Exposure to heavy metallic and trace essential elements and risk of diminished ovarian reserve in reproductive age women: A case-control study. JOURNAL OF HAZARDOUS MATERIALS 2024; 470:134206. [PMID: 38583203 DOI: 10.1016/j.jhazmat.2024.134206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
The associations between metallic elements and ovarian reserve function have remained uncertain yet. In this case-control study, we involved 149 women with diminished ovarian reserve (DOR) and 151 women with normal ovarian reserve, and assessed the levels of six heavy metallic (Cr, Cd, As, Hg, Pb, and Mn) and seven trace essential (Se, Fe, Zn, Co, Mo, Cu, I) elements in their follicular fluid with inductively coupled plasma mass spectrometry. Associations were examined with logistic regressions and Bayesian kernel machine regression (BKMR). As a result, we found that the medium and the highest tertiles of Pb were significantly associated with an increased likelihood of DOR compared to the lowest tertile, while the medium or/an the highest tertiles of Cu, I, and Fe showed significantly lower likelihoods of DOR compared to the lowest tertiles. Cu and Pb showed significantly non-linear associations with ovarian reserve markers such as follicle-stimulating, anti-mullerian hormone levels, and antral follicle count. With the rising overall concentrations of heavy metals, the likelihood of DOR increased although not significant. There was a trend of a "U-shaped" association across the whole concentration range of trace essential elements and the likelihood of DOR. Our study revealed that avoiding heavy metallic elements and properly supplementing trace essential elements are conducive to ovarian function.
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Affiliation(s)
- Tian Tian
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Zheng Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Fang Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Yu Fu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Fei Kong
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Yuanyuan Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Qin Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China; Department of Maternal and Child Health, School of Public Health, Peking University, China.
| | - Xiaoyu Long
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China.
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China; Beijing Advanced Innovation Center for Genomics, China; Peking-Tsinghua Center for Life Sciences, Peking University, China.
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5
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Fjeldstad J, Qi W, Siddique N, Mercuri N, Nayot D, Krivoi A. Segmentation of mature human oocytes provides interpretable and improved blastocyst outcome predictions by a machine learning model. Sci Rep 2024; 14:10569. [PMID: 38719918 PMCID: PMC11078996 DOI: 10.1038/s41598-024-60901-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
Within the medical field of human assisted reproductive technology, a method for interpretable, non-invasive, and objective oocyte evaluation is lacking. To address this clinical gap, a workflow utilizing machine learning techniques has been developed involving automatic multi-class segmentation of two-dimensional images, morphometric analysis, and prediction of developmental outcomes of mature denuded oocytes based on feature extraction and clinical variables. Two separate models have been developed for this purpose-a model to perform multiclass segmentation, and a classifier model to classify oocytes as likely or unlikely to develop into a blastocyst (Day 5-7 embryo). The segmentation model is highly accurate at segmenting the oocyte, ensuring high-quality segmented images (masks) are utilized as inputs for the classifier model (mask model). The mask model displayed an area under the curve (AUC) of 0.63, a sensitivity of 0.51, and a specificity of 0.66 on the test set. The AUC underwent a reduction to 0.57 when features extracted from the ooplasm were removed, suggesting the ooplasm holds the information most pertinent to oocyte developmental competence. The mask model was further compared to a deep learning model, which also utilized the segmented images as inputs. The performance of both models combined in an ensemble model was evaluated, showing an improvement (AUC 0.67) compared to either model alone. The results of this study indicate that direct assessments of the oocyte are warranted, providing the first objective insights into key features for developmental competence, a step above the current standard of care-solely utilizing oocyte age as a proxy for quality.
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Affiliation(s)
- Jullin Fjeldstad
- Clinical Embryology and Scientific Operations, Future Fertility, 3 Church St, Toronto, ON, M5E 1A9, Canada.
| | - Weikai Qi
- Data Science, Future Fertility, 3 Church St, Toronto, ON, M5E 1A9, Canada
| | - Nadia Siddique
- Clinical Embryology and Scientific Operations, Future Fertility, 3 Church St, Toronto, ON, M5E 1A9, Canada
| | - Natalie Mercuri
- Clinical Embryology and Scientific Operations, Future Fertility, 3 Church St, Toronto, ON, M5E 1A9, Canada
| | - Dan Nayot
- Chief Medical Officer, Future Fertility, 3 Church St, Toronto, ON, M5E 1A9, Canada
| | - Alex Krivoi
- Data Science, Future Fertility, 3 Church St, Toronto, ON, M5E 1A9, Canada
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Araya BM, Aldersey HM, Camara S, Alemu K, Dyer S, Velez MP. The varying estimation of infertility in Ethiopia: the need for a comprehensive definition. BMC Womens Health 2024; 24:280. [PMID: 38720297 PMCID: PMC11077700 DOI: 10.1186/s12905-024-03118-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 04/28/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Infertility is a marginalized sexual and reproductive health issue in low-resource settings. Globally, millions are affected by infertility, but the lack of a universal definition makes it difficult to estimate the prevalence of infertility at the population level. Estimating the prevalence of infertility may inform targeted and accessible intervention, especially for a resource-limited country like Ethiopia. This study aims to estimate the prevalence of female infertility in Ethiopia using the Demographic and Health Survey (DHS) through two approaches: (i) the demographic approach and (ii) the current duration approach. METHODS Data from 15,683 women were obtained through the 2016 Ethiopian DHS. The demographic approach estimates infertility among women who had been married/in a union for at least five years, had never used contraceptives, and had a fertility desire. The current duration approach includes women at risk of pregnancy at the time of the survey and determines their current length of time-at-risk of pregnancy at 12, 24, and 36 months. Logistic regression analysis estimated the prevalence of infertility and factors associated using the demographic approach. Parametric survival analysis estimated the prevalence of infertility using the current duration approach. All estimates used sampling weights to account for the DHS sampling design. STATA 14 and R were used to perform the statistical analysis. RESULTS Using the demographic definition, the prevalence of infertility was 7.6% (95% CI 6.6-8.8). When stratified as primary and secondary infertility, the prevalence was 1.4% (95% CI 1.0-1.9) and 8.7% (95% CI 7.5-10.1), respectively. Using the current duration approach definition, the prevalence of overall infertility was 24.1% (95% CI 18.8-34.0) at 12-months, 13.4% (95% CI 10.1-18.6) at 24-months, and 8.8% (95% CI 6.5-12.3) at 36-months. CONCLUSION The demographic definition of infertility resulted in a lower estimate of infertility. The current duration approach definition could be more appropriate for the early detection and management of infertility in Ethiopia. The findings also highlight the need for a comprehensive definition of and emphasis on infertility. Future population-based surveys should incorporate direct questions related to infertility to facilitate epidemiological surveillance.
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Affiliation(s)
- Bilen Mekonnen Araya
- Department of Rehabilitation Science, School of Rehabilitation Therapy, Queen's University, Kingston, Canada.
- Department of Clinical Midwifery, School of Midwifery, University of Gondar, Gondar, Ethiopia.
| | | | - Saionara Camara
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Kassahun Alemu
- Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Silke Dyer
- Department of Obstetrics & Gynaecology, Faculty of Health Sciences, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Maria P Velez
- Department of Obstetrics and Gynaecology, School of Medicine, Queen's University, Kingston, Canada.
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7
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Sfakianoudis K, Zikopoulos A, Grigoriadis S, Seretis N, Maziotis E, Anifandis G, Xystra P, Kostoulas C, Giougli U, Pantos K, Simopoulou M, Georgiou I. The Role of One-Carbon Metabolism and Methyl Donors in Medically Assisted Reproduction: A Narrative Review of the Literature. Int J Mol Sci 2024; 25:4977. [PMID: 38732193 PMCID: PMC11084717 DOI: 10.3390/ijms25094977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
One-carbon (1-C) metabolic deficiency impairs homeostasis, driving disease development, including infertility. It is of importance to summarize the current evidence regarding the clinical utility of 1-C metabolism-related biomolecules and methyl donors, namely, folate, betaine, choline, vitamin B12, homocysteine (Hcy), and zinc, as potential biomarkers, dietary supplements, and culture media supplements in the context of medically assisted reproduction (MAR). A narrative review of the literature was conducted in the PubMed/Medline database. Diet, ageing, and the endocrine milieu of individuals affect both 1-C metabolism and fertility status. In vitro fertilization (IVF) techniques, and culture conditions in particular, have a direct impact on 1-C metabolic activity in gametes and embryos. Critical analysis indicated that zinc supplementation in cryopreservation media may be a promising approach to reducing oxidative damage, while female serum homocysteine levels may be employed as a possible biomarker for predicting IVF outcomes. Nonetheless, the level of evidence is low, and future studies are needed to verify these data. One-carbon metabolism-related processes, including redox defense and epigenetic regulation, may be compromised in IVF-derived embryos. The study of 1-C metabolism may lead the way towards improving MAR efficiency and safety and ensuring the lifelong health of MAR infants.
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Affiliation(s)
- Konstantinos Sfakianoudis
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece; (K.S.); (K.P.)
| | - Athanasios Zikopoulos
- Laboratory of Medical Genetics, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.Z.); (N.S.); (C.K.); (U.G.); (I.G.)
- Obstetrics and Gynecology, Royal Cornwall Hospital, Treliske, Truro TR1 3LJ, UK
| | - Sokratis Grigoriadis
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.G.); (E.M.); (P.X.)
| | - Nikolaos Seretis
- Laboratory of Medical Genetics, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.Z.); (N.S.); (C.K.); (U.G.); (I.G.)
| | - Evangelos Maziotis
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.G.); (E.M.); (P.X.)
| | - George Anifandis
- Department of Obstetrics and Gynecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41222 Larisa, Greece;
| | - Paraskevi Xystra
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.G.); (E.M.); (P.X.)
| | - Charilaos Kostoulas
- Laboratory of Medical Genetics, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.Z.); (N.S.); (C.K.); (U.G.); (I.G.)
| | - Urania Giougli
- Laboratory of Medical Genetics, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.Z.); (N.S.); (C.K.); (U.G.); (I.G.)
| | - Konstantinos Pantos
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece; (K.S.); (K.P.)
| | - Mara Simopoulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.G.); (E.M.); (P.X.)
| | - Ioannis Georgiou
- Laboratory of Medical Genetics, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.Z.); (N.S.); (C.K.); (U.G.); (I.G.)
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8
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Dyer SJ, Adamson GD, Inhorn MC, Zegers-Hochschild F. Achieving more equitable access to assisted reproduction. BMJ 2024; 385:e077111. [PMID: 38670597 DOI: 10.1136/bmj-2023-077111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Affiliation(s)
- Silke J Dyer
- Department of Obstetrics and Gynaecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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9
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Araya BM, Velez MP, Gelaye KA, Dyer S, Aldersey HM. Addressing the Rehabilitation Needs of Women Experiencing Infertility in Ethiopia: Time for Action. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:475. [PMID: 38673386 PMCID: PMC11049831 DOI: 10.3390/ijerph21040475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
The psychological, social, and financial disabilities caused by infertility are significant for women, particularly those living in low- and middle-income countries such as Ethiopia. Although rehabilitation can be an important form of support for such women, infertility is frequently overlooked as a disability or potential target of rehabilitation interventions. This study aimed to determine what rehabilitation-related services and supports are available for women experiencing infertility in Ethiopia. We used an Interpretive Description design. We purposefully selected fourteen rehabilitation, medical, and policy service providers from diverse institutions across three geographical locations. We used semi-structured questions during our in-person and telephone interviews. The data were analyzed using reflexive thematic analysis with the assistance of NVivo. We identified five main themes, including (a) policies related to infertility, (b) the concept that disabilities are physically visible fails to recognize infertility, (c) the need for rehabilitation services for women with infertility, (d) the importance of wellness services for women experiencing infertility, and (e) the role of religion in rehabilitation services. In conclusion, it is essential to strengthen the policies around infertility, incorporate rehabilitation services in fertility care, and view infertility as a disabling condition for women who experience it in Ethiopia.
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Affiliation(s)
- Bilen Mekonnen Araya
- Department of Rehabilitation Science, School of Rehabilitation Therapy, Queen’s University, 31 George St., Kingston, ON K7L 3N6, Canada
- Department of Clinical Midwifery, School of Midwifery, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Maria P. Velez
- Department of Obstetrics and Gynaecology, Queen’s University, Kingston, ON K7L 2V7, Canada;
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar P.O. Box 196, Ethiopia;
| | - Silke Dyer
- Department of Obstetrics and Gynaecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town 7701, South Africa;
| | - Heather M. Aldersey
- School of Rehabilitation Therapy, Queen’s University, 31 George St., Kingston, ON K7L 3N6, Canada;
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10
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Ashley-Martin J, Hammond J, Velez MP. Assessing preconception exposure to environmental chemicals and fecundity: Strategies, challenges, and research priorities. Reprod Toxicol 2024; 125:108578. [PMID: 38522558 DOI: 10.1016/j.reprotox.2024.108578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/04/2024] [Accepted: 03/17/2024] [Indexed: 03/26/2024]
Abstract
In 2022, approximately one out of six people globally experienced infertility at some point in their life. Environmental chemicals, particularly those with endocrine disrupting activity, may contribute to impaired fecundity and infertility. We review existing prospective cohort studies of environmental chemicals and fecundity, identify methodological challenges and biases, and outline future research priorities. Studies of preconception environmental chemical exposures and fecundity have occurred in US, Singapore, China and Denmark with recruitment as early as 1982-1986, as recent as 2015-2017 and sample sizes ranging from 99 to 936. Higher exposure to certain chemicals (e.g. heavy metals, perfluoroalkyl substances) was associated with longer time to pregnancy; yet the literature is scarce or nonexistent for many chemicals. Furthermore, prospective studies face challenges and potential biases related to recruiting participants prior to conception, measuring environmental chemicals during critical windows of exposure, and ascertaining when pregnancy occurred. Research priorities include expanding the scope of biomonitoring data collected during the preconception period, continuing to develop and validate analytic methods for self-sampled biospecimens in traditional and novel matrices, collecting data in male partners and investigating etiologic associations according to indicators of marginalization.
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Affiliation(s)
| | - Jacob Hammond
- School of Epidemiology and Public Health, University of Ottawa, Canada
| | - Maria P Velez
- Department of Obstetrics and Gynecology, Queens University, Canada
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11
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Velez MP, Soule A, Gaudet L, Pudwell J, Nguyen P, Ray JG. Multifetal Pregnancy After Implementation of a Publicly Funded Fertility Program. JAMA Netw Open 2024; 7:e248496. [PMID: 38662369 PMCID: PMC11046352 DOI: 10.1001/jamanetworkopen.2024.8496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/27/2024] [Indexed: 04/26/2024] Open
Abstract
Importance A publicly funded fertility program was introduced in Ontario, Canada, in 2015 to increase access to fertility treatment. For in vitro fertilization (IVF), the program mandated an elective single-embryo transfer (eSET) policy. However, ovulation induction and intrauterine insemination (OI/IUI)-2 other common forms of fertility treatment-were more difficult to regulate in this manner. Furthermore, prior epidemiologic studies only assessed fetuses at birth and did not account for potential fetal reductions that may have been performed earlier in pregnancy. Objective To examine the association between fertility treatment and the risk of multifetal pregnancy in a publicly funded fertility program, accounting for both fetal reductions and all live births and stillbirths. Design, Setting, and Participants This population-based, retrospective cohort study used linked administrative health databases at ICES to examine all births and fetal reductions in Ontario, Canada, from April 1, 2006, to March 31, 2021. Exposure Mode of conception: (1) unassisted conception, (2) OI/IUI, or (3) IVF. Main Outcomes and Measures The main outcome was multifetal pregnancy (ie, a twin or higher-order pregnancy). Modified Poisson regression generated adjusted relative risks (ARRs) and derived population attributable fractions (PAFs) for multifetal pregnancies attributable to fertility treatment. Absolute rate differences (ARDs) were used to compare the era before eSET was promoted (2006-2011) with the era after the introduction of the eSET mandate (2016-2021). Results Of all 1 724 899 pregnancies, 1 670 825 (96.9%) were by unassisted conception (mean [SD] maternal age, 30.6 [5.2] years), 24 395 (1.4%) by OI/IUI (mean [SD] maternal age, 33.1 [4.4] years), and 29 679 (1.7%) by IVF (mean [SD] maternal age, 35.8 [4.7] years). In contrast to unassisted conception, individuals who received OI/IUI or IVF tended to be older, reside in a high-income quintile neighborhood, or have preexisting health conditions. Multifetal pregnancy rates were 1.4% (95% CI, 1.4%-1.4%) for unassisted conception, 10.5% (95% CI, 10.2%-10.9%) after OI/IUI, and 15.5% (95% CI, 15.1%-15.9%) after IVF. Compared with unassisted conception, the ARR of any multifetal pregnancy was 7.0 (95% CI, 6.7-7.3) after OI/IUI and 9.9 (95% CI, 9.6-10.3) after IVF, with corresponding PAFs of 7.1% (95% CI, 7.1%-7.2%) and 13.4% (95% CI, 13.3%-13.4%). Between the eras of 2006 to 2011 and 2016 to 2021, multifetal pregnancy rates decreased from 12.9% to 9.1% with OI/IUI (ARD, -3.8%; 95% CI, -4.2% to -3.4%) and from 29.4% to 7.1% with IVF (ARD, -22.3%; 95% CI, -23.2% to -21.6%). Conclusions and Relevance In this cohort study of more than 1.7 million pregnancies in Ontario, Canada, a publicly funded IVF program mandating an eSET policy was associated with a reduction in multifetal pregnancy rates. Nevertheless, ongoing strategies are needed to decrease multifetal pregnancy, especially in those undergoing OI/IUI.
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Affiliation(s)
- Maria P. Velez
- Department of Obstetrics and Gynaecology, Queen’s University, Kingston, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Allison Soule
- Department of Obstetrics and Gynaecology, Queen’s University, Kingston, Ontario, Canada
| | - Laura Gaudet
- Department of Obstetrics and Gynaecology, Queen’s University, Kingston, Ontario, Canada
| | - Jessica Pudwell
- Department of Obstetrics and Gynaecology, Queen’s University, Kingston, Ontario, Canada
| | | | - Joel G. Ray
- ICES, Toronto, Ontario, Canada
- Department of Medicine and Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, St Michael’s Hospital, Toronto, Ontario, Canada
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Czétány P, Balló A, Márk L, Török A, Szántó Á, Máté G. An Alternative Application of Magnetic-Activated Cell Sorting: CD45 and CD235a Based Purification of Semen and Testicular Tissue Samples. Int J Mol Sci 2024; 25:3627. [PMID: 38612438 PMCID: PMC11011735 DOI: 10.3390/ijms25073627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024] Open
Abstract
Magnetic activated cell sorting (MACS) is a well-known sperm selection technique, which is able to remove apoptotic spermatozoa from semen samples using the classic annexinV based method. Leukocytes and erythrocytes in semen samples or in testicular tissue processed for in vitro fertilization (IVF) could exert detrimental effects on sperm. In the current study, we rethought the aforementioned technique and used magnetic microbeads conjugated with anti-CD45/CD235a antibodies to eliminate contaminating leukocytes and erythrocytes from leukocytospermic semen samples and testicular tissue samples gained via testicular sperm extraction (TESE). With this technique, a 15.7- and a 30.8-fold reduction could be achieved in the ratio of leukocytes in semen and in the number of erythrocytes in TESE samples, respectively. Our results show that MACS is a method worth to reconsider, with more potential alternative applications. Investigations to find molecules labeling high-quality sperm population and the development of positive selection procedures based on these might be a direction of future research.
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Affiliation(s)
- Péter Czétány
- Urology Clinic, University of Pécs Clinical Centre, 7621 Pécs, Hungary; (P.C.); (A.B.); (G.M.)
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary;
| | - András Balló
- Urology Clinic, University of Pécs Clinical Centre, 7621 Pécs, Hungary; (P.C.); (A.B.); (G.M.)
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary;
- Pannon Reproduction Institute, 8300 Tapolca, Hungary;
| | - László Márk
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary;
- Department of Analytical Biochemistry, Institute of Biochemistry and Medical Chemistry, University of Pécs Medical School, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, 7624 Pécs, Hungary
| | - Attila Török
- Pannon Reproduction Institute, 8300 Tapolca, Hungary;
| | - Árpád Szántó
- Urology Clinic, University of Pécs Clinical Centre, 7621 Pécs, Hungary; (P.C.); (A.B.); (G.M.)
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary;
| | - Gábor Máté
- Urology Clinic, University of Pécs Clinical Centre, 7621 Pécs, Hungary; (P.C.); (A.B.); (G.M.)
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary;
- Pannon Reproduction Institute, 8300 Tapolca, Hungary;
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Afferri A, Dierickx S, Allen H, Bittaye M, Marena M, Pacey A, Balen J. 'It's about time': policymakers' and health practitioners' perspectives on implementing fertility care in the Gambian health system. BMC Health Serv Res 2024; 24:282. [PMID: 38443896 PMCID: PMC10916196 DOI: 10.1186/s12913-024-10701-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/09/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Infertility is a major health issue worldwide, yet very few examples of interventions addressing infertility in the Global South have been documented to date. In The Gambia, West Africa, infertility is recognised as a burden and the health authorities have included it in several health policies and the new National Reproductive Health Strategy however, a detailed operationalisation plan for fertility care has not yet been established. Here, we aim to understand and document the factors that influence the implementation of fertility care in The Gambia. METHODS We conducted 46 semi-structured interviews with policymakers, implementers, and health practitioners in both the public and private sectors from July to November 2021. The interviews were transcribed, anonymised and analysed with NVivo Pro version 1.6.1. The analysis was initially inductive, with themes arising from the coding categorised according to the WHO health systems building blocks framework. RESULTS This study identified several barriers to a successful implementation of fertility care in The Gambia, including (i) a lack of routinely collected infertility data; (ii) an absence of financial protection mechanisms for patients, and/or a specific budget for infertility; (iii) limited cooperation between the public and private sectors in the provision of fertility care; and (iv) gaps in fertility care training among health practitioners. Conversely, enablers included: (i) strong national infertility leadership; and (ii) the integration of infertility care within public reproductive health services. CONCLUSION The Gambian health system is not yet in the position to support a comprehensive fertility care package in its public health facilities. Several aspects of the implementation of fertility care must be considered in operationalising the health strategy including the systematic collection of infertility data, fertility awareness, and the provision of specialised fertility care training. Furthermore, a stronger partnership between the public and private sectors must be developed. Given the increasing availability of assisted reproductive technologies in the sub-Saharan Africa region, and the tendency to locate these technologies in the private sector, further research is needed to understand and identify the processes underlying the implementation of fertility care and to foster better integration with the existing health system.
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Affiliation(s)
- Anna Afferri
- School of Health and Related Research- ScHARR, The University of Sheffield, Sheffield, UK.
| | - Susan Dierickx
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Research Centre Gender, Diversity and Intersectionality - RHEA, Vrije Universiteit, Brussel, Belgium
| | - Haddijatou Allen
- Medical Research Council- MRC Unit The Gambia at LSHTM, Fajara, The Gambia
| | - Mustapha Bittaye
- The Gambia Ministry of Health, Banjul, The Gambia
- School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia
| | - Musa Marena
- The Gambia Ministry of Health, Banjul, The Gambia
- School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia
| | - Allan Pacey
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Julie Balen
- Medical Research Council- MRC Unit The Gambia at LSHTM, Fajara, The Gambia
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, UK
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Fauser BCJM, Adamson GD, Boivin J, Chambers GM, de Geyter C, Dyer S, Inhorn MC, Schmidt L, Serour GI, Tarlatzis B, Zegers-Hochschild F. Declining global fertility rates and the implications for family planning and family building: an IFFS consensus document based on a narrative review of the literature. Hum Reprod Update 2024; 30:153-173. [PMID: 38197291 PMCID: PMC10905510 DOI: 10.1093/humupd/dmad028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/25/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Family-planning policies have focused on contraceptive approaches to avoid unintended pregnancies, postpone, or terminate pregnancies and mitigate population growth. These policies have contributed to significantly slowing world population growth. Presently, half the countries worldwide exhibit a fertility rate below replacement level. Not including the effects of migration, many countries are predicted to have a population decline of >50% from 2017 to 2100, causing demographic changes with profound societal implications. Policies that optimize chances to have a child when desired increase fertility rates and are gaining interest as a family-building method. Increasingly, countries have implemented child-friendly policies (mainly financial incentives in addition to public funding of fertility treatment in a limited number of countries) to mitigate decreasing national populations. However, the extent of public spending on child benefits varies greatly from country to country. To our knowledge, this International Federation of Fertility Societies (IFFS) consensus document represents the first attempt to describe major disparities in access to fertility care in the context of the global trend of decreasing growth in the world population, based on a narrative review of the existing literature. OBJECTIVE AND RATIONALE The concept of family building, the process by which individuals or couples create or expand their families, has been largely ignored in family-planning paradigms. Family building encompasses various methods and options for individuals or couples who wish to have children. It can involve biological means, such as natural conception, as well as ART, surrogacy, adoption, and foster care. Family-building acknowledges the diverse ways in which individuals or couples can create their desired family and reflects the understanding that there is no one-size-fits-all approach to building a family. Developing education programs for young adults to increase family-building awareness and prevent infertility is urgently needed. Recommendations are provided and important knowledge gaps identified to provide professionals, the public, and policymakers with a comprehensive understanding of the role of child-friendly policies. SEARCH METHODS A narrative review of the existing literature was performed by invited global leaders who themselves significantly contributed to this research field. Each section of the review was prepared by two to three experts, each of whom searched the published literature (PubMed) for peer reviewed full papers and reviews. Sections were discussed monthly by all authors and quarterly by the review board. The final document was prepared following discussions among all team members during a hybrid invitational meeting where full consensus was reached. OUTCOMES Major advances in fertility care have dramatically improved family-building opportunities since the 1990s. Although up to 10% of all children are born as a result of fertility care in some wealthy countries, there is great variation in access to care. The high cost to patients of infertility treatment renders it unaffordable for most. Preliminary studies point to the increasing contribution of fertility care to the global population and the associated economic benefits for society. WIDER IMPLICATIONS Fertility care has rarely been discussed in the context of a rapid decrease in world population growth. Soon, most countries will have an average number of children per woman far below the replacement level. While this may have a beneficial impact on the environment, underpopulation is of great concern in many countries. Although governments have implemented child-friendly policies, distinct discrepancies in access to fertility care remain.
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Affiliation(s)
- Bart C J M Fauser
- University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | | | | | | | | | - Silke Dyer
- Groot Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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15
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Yuan Y, Yang L, Hu J, Deng Y, Zhang H. Knowledge, attitude and practice on ovarian reserve function among women of childbearing age: a prospective cross-sectional study in Chongqing and surrounding regions. BMJ Open 2024; 14:e080890. [PMID: 38431304 PMCID: PMC10910424 DOI: 10.1136/bmjopen-2023-080890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVES To evaluate the knowledge, attitudes and practice (KAP) on ovarian reserve function among women of childbearing age in Chongqing and surrounding regions, China. DESIGN Cross-sectional study. SETTING Chongqing and surrounding regions, China. PARTICIPANTS Women of childbearing age (18-48 years) by convenience sampling. PRIMARY AND SECONDARY OUTCOME MEASURES The demographic characteristics of the respondents and their KAP on ovarian reserve function were collected by administering 38-item questionnaires. RESULTS A total of 510 valid questionnaires were collected. The mean knowledge score of all respondents was 7.56±2.03 (possible range: 0-10), the mean attitude score was 29.12±3.98 (possible range: 8-40) and the mean practice score was 23.45±3.58 (possible range: 6-30). The multivariable analysis showed knowledge level (OR 1.175, 95% CI 1.049 to 1.317, p=0.002), attitude level (OR 1.249, 95% CI 1.167 to 1.337, p<0.001) and eating habits (self-cooked vs eating out, OR 1.958, 95% CI 1.201 to 3.190, p=0.007) were independently associated with better practice level. The structural equation modelling analysis showed that knowledge had a direct influence on attitude (β=0.487, p=0.030) and practice (β=0.312, p=0.012) and an indirect influence on practice (β=0.213, p=0.016). Attitude had a direct influence on practice (β=0.438, p=0.007). The total influence of knowledge on practice was significant (β=0.525, p=0.012). CONCLUSIONS The women living in Chongqing and surrounding regions had good knowledge, moderate attitude and good practice towards ovarian reserve function. The knowledge aspect can be further improved by education, which in turn might also improve practice among women of childbearing age.
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Affiliation(s)
- Youfang Yuan
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Hu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yu Deng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongying Zhang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Bell SO, Makumbi F, Sarria I, Kibira SPS, Zimmerman LA. Reproductive autonomy and the experience of later-than-desired pregnancy: results from a cross-sectional survey of reproductive-aged women in Uganda. Reprod Health 2024; 21:20. [PMID: 38321541 PMCID: PMC10848551 DOI: 10.1186/s12978-024-01750-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/30/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The focus of reproductive autonomy research has historically been on the experience of unintended pregnancy and use of contraceptive methods. However, this has led to the neglect of a different group of women who suffer from constraints on their reproductive autonomy-women who experience pregnancies later than they desire or who are unable to become pregnant. This study examines the extent of later-than-desired pregnancy among women and evaluates the sociodemographic and reproductive factors associated with this experience in Uganda. METHODS We use data from the Performance Monitoring for Action Uganda 2022 female survey. We restricted the nationally representative sample of reproductive-aged women to those who were currently pregnant or who had ever given birth (n = 3311). We compared the characteristics of women across fertility intention categories (wanted pregnancy earlier, then, later, or not at all) of their current or most recent birth and used multivariable logistic regression to examine factors independently associated with having a pregnancy later than desired compared to at a desired time. RESULTS Overall, 28.3% of women had a later-than-desired pregnancy. Nearly all sociodemographic and reproductive characteristics were associated with the desired pregnancy timing of women's current or most recent pregnancy. Having higher education [adjusted odds ratio (aOR) 2.41, 95% confidence interval (CI) 1.13-5.13], having sought care for difficulties getting pregnant (aOR 2.12, 95% CI 1.30-3.46), and having less than very good self-rated health (good health aOR 1.74, 95% CI 1.12-2.71; moderate health aOR 1.77, 95% CI 1.09-2.86; very bad health aOR 4.32, 95% CI 1.15-16.26) were all independently significantly associated with increased odds of having a later-than-desired pregnancy. Being nulliparous (aOR 1.98, 95% CI 0.99-3.95) was also borderline significantly associated with having a later-than-desired pregnancy. CONCLUSIONS Identifying those who have later-than-desired pregnancies is essential if we seek to make progress towards supporting women and couples in achieving their reproductive goals, not just preventing pregnancies. Research on desired pregnancy timing in sub-Saharan Africa should be expanded to capture later-than-desired pregnancies, a population which is invisible in existing data. This work has public health implications due to commonalities in the factors associated with mistimed and unintended pregnancies and their link to poorer health and potentially poorer pregnancy outcomes.
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Affiliation(s)
- Suzanne O Bell
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA.
| | - Fredrick Makumbi
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Isabella Sarria
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
| | - Simon P S Kibira
- Department of Community Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Linnea A Zimmerman
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
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Liu LL, Yue JZ, Lu ZY, Deng RY, Li CC, Yu YN, Zhou WJ, Lin M, Gao HT, Liu J, Xia LZ. Long-term exposure to the mixture of phthalates induced male reproductive toxicity in rats and the alleviative effects of quercetin. Toxicol Appl Pharmacol 2024; 483:116816. [PMID: 38218207 DOI: 10.1016/j.taap.2024.116816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/30/2023] [Accepted: 01/09/2024] [Indexed: 01/15/2024]
Abstract
Phthalates (PEs), such as di(2-ethylhexyl) phthalate (DEHP), dibutyl phthalate (DBP) and butyl benzyl phthalate (BBP) could cause reproductive and developmental toxicities, while human beings are increasingly exposed to them at low-doses. Phytochemical quercetin (Que) is a flavonoid that has estrogenic effect, anti-inflammatory and anti-oxidant effects. This study was conducted to assess the alleviative effect of Que. on male reproductive toxicity induced by the mixture of three commonly used PEs (MPEs) at low-dose in rats, and explore the underlying mechanism. Male rats were treated with MPEs (16 mg/kg/day) and/or Que. (50 mg/kg/d) for 91 days. The results showed that MPEs exposure caused male reproductive injuries, such as decreased serum sex hormones levels, abnormal testicular pathological structure, increased abnormal sperm rate and changed expressions of PIWIL1 and PIWIL2. Furthermore, MPEs also changed the expression of steroidogenic proteins in steroid hormone metabolism, including StAR, CYP11A1, CYP17A1, 17β-HSD, CYP19A1. However, the alterations of these parameters were reversed by Que. MPEs caused male reproductive injuries in rats; Que. inhibited MPEs' male reproductive toxicity, which might relate to the improvement of testosterone biosynthesis.
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Affiliation(s)
- Li-Lan Liu
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou 325035, China; Zhejiang Provincial Key Laboratory of Watershed Science and Health, Wenzhou Medical University, Wenzhou 325035, China
| | - Jun-Zhe Yue
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou 325035, China
| | - Zhen-Yu Lu
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou 325035, China
| | - Ru-Ya Deng
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou 325035, China
| | - Can-Can Li
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou 325035, China
| | - Ye-Na Yu
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou 325035, China
| | - Wen-Jin Zhou
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou 325035, China
| | - Min Lin
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou 325035, China; Zhejiang Provincial Key Laboratory of Watershed Science and Health, Wenzhou Medical University, Wenzhou 325035, China
| | - Hai-Tao Gao
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou 325035, China; Zhejiang Provincial Key Laboratory of Watershed Science and Health, Wenzhou Medical University, Wenzhou 325035, China.
| | - Jiaming Liu
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou 325035, China; Zhejiang Provincial Key Laboratory of Watershed Science and Health, Wenzhou Medical University, Wenzhou 325035, China.
| | - Ling-Zi Xia
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou 325035, China; Zhejiang Provincial Key Laboratory of Watershed Science and Health, Wenzhou Medical University, Wenzhou 325035, China.
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Bueno-Sánchez L, Alhambra-Borrás T, Gallego-Valadés A, Garcés-Ferrer J. Psychosocial Impact of Infertility Diagnosis and Conformity to Gender Norms on the Quality of Life of Infertile Spanish Couples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:158. [PMID: 38397648 PMCID: PMC10888361 DOI: 10.3390/ijerph21020158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
Epidemiological data show that human reproductive disorders are a common problem worldwide, affecting almost one in six people of reproductive age. As a result, infertility has been identified by the World Health Organization as a public health disease. Reproductive problems can take a heavy toll on the psychosocial well-being of couples suffering from infertility. This is especially true for women, who tend to be the ones who undergo the most treatment. The main objective of the present study is to find out whether a sex-based infertility diagnosis influences the quality of life of couples with infertility. Also, we aim to find out whether the degree of adherence to gender norms influences their quality of life. A cross-sectional study was conducted using the Fertility Quality of Life Questionnaire (FertiQoL) and the Conformity to Feminine and Masculine Norms Inventories in a sample of 219 infertile Spanish couples (438 participants). The results show that, in all cases, regardless of the degree of conformity to gender norms and whether the infertility diagnosis was of female or male origin, women have lower scores on the self-perceived quality of life. This suggests that being female is already a psychosocial risk factor when assessing the psychosocial consequences of infertility.
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Affiliation(s)
- Lidia Bueno-Sánchez
- Polibienestar Research Institute, Universitat de València, 46022 València, Spain; (T.A.-B.); (A.G.-V.); (J.G.-F.)
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Azize Diallo A, Anku PJ, Darkoa Oduro RA. Exploring the psycho-social burden of infertility: Perspectives of infertile couples in Cape Coast, Ghana. PLoS One 2024; 19:e0297428. [PMID: 38271436 PMCID: PMC10810504 DOI: 10.1371/journal.pone.0297428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024] Open
Abstract
Infertility is a complex and often sensitive issue with far-reaching psycho-social ramifications for couples and their families. This study therefore seeks to delve into the psycho-social burden of infertility in Cape Coast, a major city in Ghana. Specifically, we explored the impact of infertility on the psychological and social health of infertile couples receiving fertility treatment. It also delves into the strategies they adopt to cope with their conditions. The study employs a qualitative approach to inquiry using phenomenology as a study design to explore the experiences of the study participants. In-depth interviews were conducted using interview guides, voice recorded and transcribed verbatim. Both inductive and deductive/framework coding techniques were used to code the data leading to the generation of themes and sub-themes. The results show that most of the study participants dealing with infertility faced psychological burdens from different sources including their families, society and themselves. These burdens take a toll on their mental health, pushing them into a state of desperation and depression. It was, however, revealed that infertile couples are able to cope with the help of their family, spouses and the church. Curiously, some of them opt for withdrawal from social events as a coping mechanism. Infertility exerts an enormous negative psycho-social impact on affected couples, especially women. The family and society serve as the main sources of stressors for infertile couples. Therefore, programmes that are aimed at fertility treatment should deliberately consider addressing the psychosocial burden of infertility through education targeting actors, especially interpersonal-level actors.
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Affiliation(s)
- Abdoul Azize Diallo
- Department of Obstetrics and Gynaecology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Department of Population and Health, Faculty of Social Sciences, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Prince Justin Anku
- Department of Population and Health, Faculty of Social Sciences, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Rhodalyn Adwoa Darkoa Oduro
- Department of Obstetrics and Gynaecology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Ma J, Xie Q, Zhang Y, Xiao Q, Liu X, Qiao C, Tian Y. Advances in microfluidic technology for sperm screening and in vitro fertilization. Anal Bioanal Chem 2024:10.1007/s00216-023-05120-9. [PMID: 38189916 DOI: 10.1007/s00216-023-05120-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/09/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024]
Abstract
About 18% of reproductive-age adults worldwide are affected by infertility. In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are widely used assisted reproductive technologies (ARTs) aimed at improving clinical outcomes. Efficient and noninvasive selection and isolation of highly motile sperm with intact DNA are essential for the success of IVF and ICSI and can potentially impact the therapeutic efficacy and the health of the offspring. Compared to traditional methods, microfluidic technology offers significant advantages such as low sample consumption, high efficiency, minimal damage, high integration, similar microenvironment, and high automation, providing a new platform for ARTs. Here, we review the current situation of microfluidic technology in the field of sperm motility screening and evaluation and IVF research. First, we focus on the working principle, structural design, and screening results of sperm selection microfluidic platforms. We then highlight how the multiple steps of the IVF process can be facilitated and integrated into a microfluidic chip, including oocyte capture, sperm collection and isolation, sperm sorting, fertilization, and embryo culture. Ultimately, we summarize how microfluidics can complement and optimize current sperm sorting and IVF protocols, and challenges and possible solutions are discussed.
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Affiliation(s)
- Jingtong Ma
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Qianlin Xie
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Yusongjia Zhang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Qirui Xiao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Xiaoyu Liu
- Department of Obstetrics and Gynaecology, General Hospital of Northern Theater Command, Shenyang, 110003, China.
| | - Chong Qiao
- Department of Obstetrics and Gynecology of Shengjing Hospital of China Medical University, Shenyang, 110022, China.
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, 110022, China.
| | - Ye Tian
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China.
- Foshan Graduate School of Innovation, Northeastern University, Foshan, 528300, China.
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Ben Messaoud K, Bouyer J, Guibert J, de La Rochebrochard E. The burden of very early dropout in infertility care: a nationwide population-based cohort study. Hum Reprod 2024; 39:102-107. [PMID: 37898958 PMCID: PMC10767936 DOI: 10.1093/humrep/dead226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/11/2023] [Indexed: 10/31/2023] Open
Abstract
STUDY QUESTION What is the frequency and the associated factors of very early dropout following unsuccessful clomiphene citrate (CC)/gonadotropin treatment in the context of full coverage of treatment cost. SUMMARY ANSWER Despite free treatment, almost one in four women had a very early dropout following unsuccessful CC/gonadotropin treatment, with patients below the poverty line being more likely to drop out early. WHAT IS KNOWN ALREADY Success of infertility care is tarnished by very high dropout rates. Infertility care dropout has been considered as resulting principally from financial barriers because of the high cost of treatment. Nearly all previous work addressed dropout following IVF/ICSI. Factors associated with dropout following CC/gonadotropins may be different and also need to be investigated. STUDY DESIGN, SIZE, DURATION Nationwide population-based cohort study. PARTICIPANTS/MATERIALS, SETTING, METHODS Using the French national health insurance and hospital databases, we included in the cohort 27 416 women aged 18-49 years unsuccessfully treated with CC/gonadotropins in 2017. The main outcome was very early dropout, defined as discontinuation of all infertility treatment after unsuccessful treatment for 1-3 months. Very early treatment dropout was analysed by multivariate logistic regression. MAIN RESULTS AND THE ROLE OF CHANCE Among women unsuccessfully treated with CC/gonadotropins, 22% dropped out of infertility care within 3 months. In multivariate analysis, higher early dropout following unsuccessful CC/gonadotropin treatment was associated with older and younger ages (≥35 and <25 years), being below the poverty line, being treated with CC prescribed by a general practitioner and lack of infertility tests or monitoring. LIMITATIONS, REASONS FOR CAUTION This study is based on health administrative data that do not include reasons for dropout and record only a limited amount of information. It is thus not possible to analyse the reason for early dropout. WIDER IMPLICATIONS OF THE FINDINGS Despite full coverage of all infertility treatment, women under the poverty line have a higher risk of very early dropout following unsuccessful CC/gonadotropin treatment. Better understanding is needed of the non-financial barriers and difficulties faced by these patients. To address disparities in infertility treatment, practitioner training could be reinforced to adapt to patients from different social and cultural backgrounds. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the ANR StimHo project, grant ANR-17-CE36-0011-01 from the French Agence Nationale de la Recherche. The authors have no conflict of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Khaoula Ben Messaoud
- Institut National d’Etudes Démographiques, Ined, Sexual and Reproductive Health and Rights Unit—UR14, Aubervilliers, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France
| | - Jean Bouyer
- Institut National d’Etudes Démographiques, Ined, Sexual and Reproductive Health and Rights Unit—UR14, Aubervilliers, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France
| | - Juliette Guibert
- Centre Médico-Chirurgical de la Baie de Morlaix, rond-point de la Vierge Noire, Morlaix, France
| | - Elise de La Rochebrochard
- Institut National d’Etudes Démographiques, Ined, Sexual and Reproductive Health and Rights Unit—UR14, Aubervilliers, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France
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22
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Fitzgerald O, Dyer S, Zegers-Hochschild F, Keller E, Adamson GD, Chambers GM. Gender inequality and utilization of ART: an international cross-sectional and longitudinal analysis. Hum Reprod 2024; 39:209-218. [PMID: 37943304 DOI: 10.1093/humrep/dead225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 10/11/2023] [Indexed: 11/10/2023] Open
Abstract
STUDY QUESTION What is the association between a country's level of gender equality and access to ART, as measured through ART utilization? SUMMARY ANSWER ART utilization is associated with a country's level of gender equality even after controlling for the level of development. WHAT IS KNOWN ALREADY Although gender equality is recognized as an important determinant of population health, its association with fertility care, a highly gendered condition, has not been explored. STUDY DESIGN, SIZE, DURATION A longitudinal cross-national analysis of ART utilization in 69 countries during 2002-2014 was carried out. PARTICPANTS/MATERIALS, SETTING, METHODS The Gender Inequality Index (GII), Human Development Index (HDI), and their component indicators were modelled against ART utilization using univariate regression models as well as mixed-effects regression methods (adjusted for country, time, and economic/human development) with multiple imputation to account for missing data. MAIN RESULTS AND THE ROLE OF CHANCE ART utilization is associated with the GII. In an HDI-adjusted analysis, a one standard deviation decrease in the GII (towards greater equality) is associated with a 59% increase in ART utilization. Gross national income per capita, the maternal mortality ratio, and female parliamentary representation were the index components most predictive of ART utilization. LIMITATIONS, REASONS FOR CAUTION Only ART was used rather than all infertility treatments (including less costly and non-invasive treatments such as ovulation induction). This was a country-level analysis and the results cannot be generalized to smaller groups. Not all modelled variables were available for each country across 2002-2014. WIDER IMPLICATIONS OF THE FINDINGS Access to fertility care is central to women's sexual and reproductive health, to women's rights, and to human rights. As gender equality improves, so does access to ART. This relation is likely to be reinforcing and bi-directional, with progress towards global, equitable access to fertility care also improving women's status and participation in societies. STUDY FUNDING/COMPETING INTEREST(S) External funding was not provided for this study. G.D.A. declares consulting fees from Labcorp and CooperSurgical. G.D.A. is the founder and CEO of Advanced Reproductive Care, Inc., as well as the Chair of the International Committee for Monitoring Assisted Reproductive Technologies (ICMART) and the World Endometriosis Research Foundation, both of which are unpaid roles. G.M.C. is an ICMART Board Representative, which is an unpaid role, and no payments are received from ICMART to UNSW, Sydney, or to G.M.C. to undertake this study. O.F., S.D., F.Z.-H., and E.K. report no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Oisín Fitzgerald
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health and School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Silke Dyer
- Department of Obstetrics & Gynecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- International Committee for Monitoring Assisted Reproductive Technologies, Vancouver, BC, Canada
| | - Fernando Zegers-Hochschild
- International Committee for Monitoring Assisted Reproductive Technologies, Vancouver, BC, Canada
- Clinica las Condes and Program of Ethics and Public Policies in Human Reproduction, School of Medicine, University Diego Portales, Santiago, Chile
| | - Elena Keller
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health and School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - G David Adamson
- International Committee for Monitoring Assisted Reproductive Technologies, Vancouver, BC, Canada
- Equal3 Fertility, Cupertino, CA, USA
| | - Georgina M Chambers
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health and School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- International Committee for Monitoring Assisted Reproductive Technologies, Vancouver, BC, Canada
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Nichols AR, Rifas-Shiman SL, Switkowski KM, Zhang M, Young JG, Hivert MF, Chavarro JE, Oken E. History of Infertility and Midlife Cardiovascular Health in Female Individuals. JAMA Netw Open 2024; 7:e2350424. [PMID: 38180761 PMCID: PMC10770770 DOI: 10.1001/jamanetworkopen.2023.50424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/16/2023] [Indexed: 01/06/2024] Open
Abstract
Importance Fertility status is a marker for future health, and infertility has been associated with risk for later cancer and diabetes, but associations with midlife cardiovascular health (CVH) in female individuals remain understudied. Objective To evaluate the association of infertility history with CVH at midlife (approximately age 50 years) among parous individuals. Design, Setting, and Participants Project Viva is a prospective cohort study of pregnant participants enrolled between 1999 and 2002 who delivered a singleton live birth in the greater Boston, Massachusetts, area. Infertility history was collected at a midlife visit between 2017 and 2021, approximately 18 years after enrollment. Data analysis was performed from January to June 2023. Exposures The primary exposure was any lifetime history of infertility identified by self-report, medical record, diagnosis, or claims for infertility treatment. Main Outcomes and Measures The American Heart Association's Life's Essential 8 (LE8) is a construct for ranking CVH that includes scores from 0 to 100 (higher scores denote better health status) in 4 behavioral (diet, physical activity, sleep, and smoking status) and 4 biomedical (body mass index, blood pressure, blood lipids, and glycemia) domains to form an overall assessment of CVH. Associations of a history of infertility (yes or no) with mean LE8 total, behavioral, biomedical, and blood biomarker (lipids and glycemia) scores were examined, adjusting for age at outcome (midlife visit), race and ethnicity, education, household income, age at menarche, and perceived body size at age 10 years. Results Of 468 included participants (mean [SD] age at the midlife visit, 50.6 [5.3] years) with exposure and outcome data, 160 (34.2%) experienced any infertility. Mean (SD) LE8 scores were 76.3 (12.2) overall, 76.5 (13.4) for the behavioral domain, 76.0 (17.5) for the biomedical domain, and 78.9 (19.2) for the blood biomarkers subdomain. In adjusted models, the estimated overall LE8 score at midlife was 2.94 points lower (95% CI, -5.13 to -0.74 points), the biomedical score was 4.07 points lower (95% CI, -7.33 to -0.78 points), and the blood subdomain score was 5.98 points lower (95% CI, -9.71 to -2.26 points) among those with vs without history of infertility. The point estimate also was lower for the behavioral domain score (β = -1.81; 95% CI, -4.28 to 0.66), although the result was not statistically significant. Conclusions and Relevance This cohort study of parous individuals found evidence for an association between a history of infertility and lower overall and biomedical CVH scores. Future study of enhanced cardiovascular preventive strategies among those who experience infertility is warranted.
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Affiliation(s)
- Amy R. Nichols
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Karen M. Switkowski
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Mingyu Zhang
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Jessica G. Young
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Diabetes Unit, Massachusetts General Hospital, Boston
| | - Jorge E. Chavarro
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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24
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Wu LY, Yang TH, Ou YC, Lin H. The role of probiotics in women's health: An update narrative review. Taiwan J Obstet Gynecol 2024; 63:29-36. [PMID: 38216265 DOI: 10.1016/j.tjog.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 01/14/2024] Open
Abstract
Probiotics, live microorganisms that confer health benefits to the host when administered in adequate amounts, have gained considerable attention for their potential role in maintaining women's health. This overview summarizes key clinical findings on the beneficial effects of probiotics in various aspects of women's health. Probiotics, particularly Lactobacillus species, contribute to vaginal health by promoting a balanced vaginal microbiome to prevent infections and maintain an acidic environment. In gynecologic conditions, probiotics show potential in preventing and managing bacterial vaginosis, vulvovaginal candidiasis, and sexually transmitted infections. Probiotic supplementation has also been associated with improvements in metabolic parameters and menstrual irregularities in polycystic ovary syndrome patients. During pregnancy, probiotics may be helpful in reducing the risk of gestational diabetes, maternal group B streptococcal colonization, obstetric anemia, and postpartum mastitis. In recent years, the potential role of probiotics in the prevention and management of gynecologic cancer has gained attention. Further research is needed to better understand the specific mechanisms and determine the optimal Lactobacillus strains and dosages regimens for gynecologic cancer prevention and therapy. In conclusion, probiotics offer a non-invasive and cost-effective approach to support women's health and prevent obstetric and gynecologic complications.
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Affiliation(s)
- Ling-Ying Wu
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tsai-Hwa Yang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Che Ou
- Department of Obstetrics and Gynecology, Chia-Yi Chang Gung Memorial Hospital, Chia-Yi, Taiwan
| | - Hao Lin
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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25
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Pinto S, Guerra-Carvalho B, Crisóstomo L, Rocha A, Barros A, Alves MG, Oliveira PF. Metabolomics Integration in Assisted Reproductive Technologies for Enhanced Embryo Selection beyond Morphokinetic Analysis. Int J Mol Sci 2023; 25:491. [PMID: 38203668 PMCID: PMC10778973 DOI: 10.3390/ijms25010491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
Embryo quality evaluation during in vitro development is a crucial factor for the success of assisted reproductive technologies (ARTs). However, the subjectivity inherent in the morphological evaluation by embryologists can introduce inconsistencies that impact the optimal embryo choice for transfer. To provide a more comprehensive evaluation of embryo quality, we undertook the integration of embryo metabolomics alongside standardized morphokinetic classification. The culture medium of 55 embryos (derived from 21 couples undergoing ICSI) was collected at two timepoints (days 3 and 5). Samples were split into Good (n = 29), Lagging (n = 19), and Bad (n = 10) according to embryo morphokinetic evaluation. Embryo metabolic performance was assessed by monitoring the variation in specific metabolites (pyruvate, lactate, alanine, glutamine, acetate, formate) using 1H-NMR. Adjusted metabolite differentials were observed during the first 3 days of culture and found to be discriminative of embryo quality at the end of day 5. Pyruvate, alanine, glutamine, and acetate were major contributors to this discrimination. Good and Lagging embryos were found to export and accumulate pyruvate and glutamine in the first 3 days of culture, while Bad embryos consumed them. This suggests that Bad embryos have less active metabolic activity than Good and Lagging embryos, and these two metabolites are putative biomarkers for embryo quality. This study provides a more comprehensive evaluation of embryo quality and can lead to improvements in ARTs by enabling the selection of the best embryos. By combining morphological assessment and metabolomics, the selection of high-quality embryos with the potential to result in successful pregnancies may become more accurate and consistent.
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Affiliation(s)
- Soraia Pinto
- Centre for Reproductive Genetics Alberto Barros, 4100-012 Porto, Portugal; (S.P.); (A.B.)
| | | | - Luís Crisóstomo
- Institute of Biomedicine, University of Turku, 20014 Turku, Finland;
| | - António Rocha
- CECA/ICETA–Centro de Estudos de Ciência Animal, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, 4200-135 Porto, Portugal;
| | - Alberto Barros
- Centre for Reproductive Genetics Alberto Barros, 4100-012 Porto, Portugal; (S.P.); (A.B.)
- i3S—Instituto de Investigação e Inovação em Saúde, University of Porto, 4200-135 Porto, Portugal
- Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Marco G. Alves
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Pedro F. Oliveira
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal;
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26
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Goud PT, Goud AP, Camp OG, Bai D, Gonik B, Diamond MP, Abu-Soud HM. Chronological age enhances aging phenomena and protein nitration in oocyte. Front Endocrinol (Lausanne) 2023; 14:1251102. [PMID: 38149097 PMCID: PMC10749940 DOI: 10.3389/fendo.2023.1251102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/22/2023] [Indexed: 12/28/2023] Open
Abstract
Background The average age of childbearing has increased over the years contributing to infertility, miscarriages, and chromosomal abnormalities largely invoked by an age-related decline in oocyte quality. In this study, we investigate the role of nitric oxide (NO) insufficiency and protein nitration in oocyte chronological aging. Methods Mouse oocytes were retrieved from young breeders (YB, 8-14 weeks [w]), retired breeders (RB, 48-52w) and old animals (OA, 80-84w) at 13.5 and 17 hours after ovulation trigger. They were assessed for zona pellucida dissolution time (ZPDT); ooplasmic microtubule dynamics (OMD); cortical granule (CG) status and spindle morphology (SM), as markers of oocyte quality. Sibling oocytes from RB were exposed to NO supplementation and assessed for aging phenomena (AP). All oocyte cumulus complexes were subjected to fluorescence nitrotyrosine (NT) immunocytochemistry and confocal microscopy to assess morphology and protein nitration. Results At 13.5 h from hCG trigger, oocytes from RB compared to YB had significantly increased ZPDT (37.8 ± 11.9 vs 22.1 ± 4.1 seconds [s]), OMD (46.9 vs 0%), CG loss (39.4 vs 0%), and decreased normal SM (30.3 vs 81.3%), indicating premature AP that worsened among oocytes from RB at 17 hours post-hCG trigger. When exposed to SNAP, RB AP significantly decreased (ZPDT: 35.1 ± 5.5 vs 46.3 ± 8.9s, OMD: 13.3 vs 75.0% and CG loss: 50.0 vs 93.3%) and SM improved (80.0 vs 14.3%). The incidence of NT positivity was significantly higher in cumulus cells (13.5 h, 46.7 ± 4.5 vs 3.4 ± 0.7%; 17 h, 82.2 ± 2.9 vs 23.3 ± 3.6%) and oocytes (13.5 h, 57.1 vs 0%; 17 h, 100.0 vs 55.5%) from RB compared to YB. Oocytes retrieved decreased with advancing age (29.8 ± 4.1 per animal in the YB group compared to 10.2 ± 2.1 in RB and 4.0 ± 1.6 in OA). Oocytes from OA displayed increased ZPDT, major CG loss, increased OMD and spindle abnormalities, as well as pronuclear formation, confirming spontaneous meiosis to interphase transition. Conclusions Oocytes undergo zona pellucida hardening, altered spindle and ooplasmic microtubules, and premature cortical granule release, indicative of spontaneous meiosis-interphase transition, as a function of chronological aging. These changes are also associated with NO insufficiency and protein nitration and may be alleviated through supplementation with an NO-donor.
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Affiliation(s)
- Pravin T. Goud
- Laurel Fertility Center, San Francisco, CA, United States
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, University of California Davis Medical School, Sacramento, CA, United States
- Department of Obstetrics and Gynecology, University of California Davis Medical School, Sacramento, CA, United States
| | - Anuradha P. Goud
- Department of Obstetrics and Gynecology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, Detroit, MI, United States
| | - Olivia G. Camp
- Department of Obstetrics and Gynecology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, Detroit, MI, United States
| | - David Bai
- Department of Obstetrics and Gynecology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, Detroit, MI, United States
| | - Bernard Gonik
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Michael P. Diamond
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Augusta University, Augusta, GA, United States
| | - Husam M. Abu-Soud
- Department of Obstetrics and Gynecology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, Detroit, MI, United States
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI, United States
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27
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Sengupta P, Dutta S, Liew FF, Dhawan V, Das B, Mottola F, Slama P, Rocco L, Roychoudhury S. Environmental and Genetic Traffic in the Journey from Sperm to Offspring. Biomolecules 2023; 13:1759. [PMID: 38136630 PMCID: PMC10741607 DOI: 10.3390/biom13121759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/04/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
Recent advancements in the understanding of how sperm develop into offspring have shown complex interactions between environmental influences and genetic factors. The past decade, marked by a research surge, has not only highlighted the profound impact of paternal contributions on fertility and reproductive outcomes but also revolutionized our comprehension by unveiling how parental factors sculpt traits in successive generations through mechanisms that extend beyond traditional inheritance patterns. Studies have shown that offspring are more susceptible to environmental factors, especially during critical phases of growth. While these factors are broadly detrimental to health, their effects are especially acute during these periods. Moving beyond the immutable nature of the genome, the epigenetic profile of cells emerges as a dynamic architecture. This flexibility renders it susceptible to environmental disruptions. The primary objective of this review is to shed light on the diverse processes through which environmental agents affect male reproductive capacity. Additionally, it explores the consequences of paternal environmental interactions, demonstrating how interactions can reverberate in the offspring. It encompasses direct genetic changes as well as a broad spectrum of epigenetic adaptations. By consolidating current empirically supported research, it offers an exhaustive perspective on the interwoven trajectories of the environment, genetics, and epigenetics in the elaborate transition from sperm to offspring.
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Affiliation(s)
- Pallav Sengupta
- Department of Biomedical Sciences, College of Medicine, Gulf Medical University, Ajman 4184, United Arab Emirates
| | - Sulagna Dutta
- School of Life Sciences, Manipal Academy of Higher Education (MAHE), Dubai 345050, United Arab Emirates
| | - Fong Fong Liew
- Department of Preclinical Sciences, Faculty of Dentistry, MAHSA University, Jenjarom 42610, Selangor, Malaysia
| | - Vidhu Dhawan
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - Biprojit Das
- Department of Life Science and Bioinformatics, Assam University, Silchar 788011, India
| | - Filomena Mottola
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy
| | - Petr Slama
- Laboratory of Animal Immunology and Biotechnology, Department of Animal Morphology, Physiology and Genetics, Faculty of AgriSciences, Mendel University in Brno, 613 00 Brno, Czech Republic
| | - Lucia Rocco
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy
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28
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Kong F, Wang Y, Li R, Qiao J. Assisted reproductive technology in China: introduction to the special issue. Hum Reprod 2023; 38:ii1-ii2. [PMID: 37982415 DOI: 10.1093/humrep/dead215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Indexed: 11/21/2023] Open
Affiliation(s)
- Fei Kong
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Yuanyuan Wang
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Rong Li
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Jie Qiao
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
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Mashaah T, Muziringa M, Gomo E, Chideme-Maradzika J, Madziyire MG, January J. Traditional management of female infertility in Africa: a scoping review protocol. BMJ Open 2023; 13:e079201. [PMID: 37977866 PMCID: PMC10661070 DOI: 10.1136/bmjopen-2023-079201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION Infertility adversely affects the sexual reproductive health and overall quality of life of people. Recent estimates show that about one in six people (both men and women) experience infertility in their lifetime. This scoping review will, therefore, map the existing evidence on traditional management of female infertility in Africa including the effectiveness of the traditional healthcare systems, to inform policy and practice. METHODS The scoping review will be guided by the Arksey and O'Malley framework in conjunction with the Joanna Briggs Institute updated methodological guidance for scoping reviews. A search strategy will be developed, which will target the following databases: PubMed, Scopus, Embase, CINAHL, Google Scholar and Africa-Wide Information including grey literature. The screening of titles, abstracts and full text will be done by two independent reviewers. Data will be extracted, analysed numerically and thematically. The reporting of the scoping review will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. ETHICS AND DISSEMINATION This scoping review will not require ethical approval as this is secondary analysis of peer-reviewed articles. The findings of the review will be disseminated on various platforms including conferences, meetings to key stakeholders and in a peer-reviewed journal for wider sharing.
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Affiliation(s)
- Thokozile Mashaah
- Department of Global Public Health and Family Medicine, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | | | - Exnevia Gomo
- Department of Laboratory Diagnostic and Investigative Sciences, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | - Julita Chideme-Maradzika
- Department of Global Public Health and Family Medicine, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
- Department of Health Sciences, Africa University, Mutare, Zimbabwe
| | - Mugove Gerald Madziyire
- Department of Child, Adolescent and Women's Health, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | - James January
- Department of Global Public Health and Family Medicine, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
- Department of Psychiatry and Mental Health, Kamuzu University of Health Sciences, Blantyre, Malawi
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Gao Y, Wang Q, Li G, Zhao X, Qin R, Kong L, Li P. Reliability and validity of the Chinese version of the Copenhagen Multi-Centre Psychosocial Infertility-Fertility Problem Stress Scales. Int J Nurs Pract 2023:e13219. [PMID: 37957031 DOI: 10.1111/ijn.13219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/26/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023]
Abstract
AIMS The aim of this study is to introduce the Copenhagen Multi-Centre Psychosocial Infertility (COMPI)-Fertility Problem Stress Scales (COMPI-FPSS) into China and test its applicability in Chinese infertile population. BACKGROUND Infertility-related stress not only influences patients' psychological well-being but is also strongly associated with reduced pregnancy rates and poorer assisted conception outcomes, thus warranting focussed attention. DESIGN The design used in this study is a cross-sectional survey. METHODS A total of 418 participants were recruited by convenience sampling from March to July 2022. The data were randomly divided into two parts: one for item analysis and exploratory factor analysis and the other for confirmatory factor analysis and reliability test. The critical ratio and homogeneity test were used to verify the differentiation and homogeneity of the COMPI-FPSS; the construct validity was determined by explanatory and confirmatory factor analyses; Cronbach's α coefficient and Spearman-Brown coefficient were used to assess the reliability; and criterion validity was expressed using correlation coefficients for the Perceived Stress Scale and the Negative Affect Scale as the validity criteria. RESULTS The revised Chinese version of COMPI-FPSS has 11 items and 2 dimensions (i.e., personal stress domain and social stress domain). Exploratory factor analysis showed that the cumulative variance contribution rate of the two factors was 68.6%, and confirmatory factor analysis indicated that the model fitted well. The score of the COMPI-FPSS was significantly and positively associated with perceived stress and negative affect. The Cronbach's α coefficient of the total scale was 0.905, and the Spearman-Brown coefficient was 0.836, explaining excellent reliability. CONCLUSION The revised Chinese version of COMPI-FPSS shows good reliability and validity, and it can be used to evaluate the infertility-related stress of infertile patients in China.
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Affiliation(s)
- Yiming Gao
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Qing Wang
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Guopeng Li
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Xiangyu Zhao
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Rui Qin
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Linghua Kong
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Ping Li
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
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Hashemian Z, Vosough Dizaji A, Lotfipanah M, Afsharian P, Vosough M. Research Performance in Reproductive Biomedicine: A National Scientometrics Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2023; 18:1-6. [PMID: 38041452 PMCID: PMC10692751 DOI: 10.22074/ijfs.2023.1995671.1446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/02/2023] [Accepted: 07/22/2023] [Indexed: 12/03/2023]
Abstract
Recent achievements in reproductive biomedicine have led to a revolution in infertility treatment. A comprehensive understanding of the current status of reproductive medicine is necessary for the development of a forward-looking plan by health policymakers, based on fundamental requirements. This study is a systematic review of the Scopus database to assess reproductive biomedicine publications within Iran and compared to the rest of the world from 1990 to 2020. The data were categorized by geographical distribution across five continents. National data were assessed in comparison with the world and with neighboring countries. Finally, prominent national research institutes in the field of reproductive biomedicine in Iran were identified, and their contributions to the field highlighted. Of the five continents, the highest number of publications and citations is from Europe (36% publications and 41.5% citations). Corresponding numbers for the other continents are 32 and 33% for America, and 26 and 18.4% for Asia respectively. The remaining publications and citations were from Australia (3.8 and 4.1%) and Africa (2.6 and 3.1%). In a national analysis, the highest-ranking institutes in reproductive biomedicine are in Tehran province (50.9% of all Iranian publications), Shiraz (8.8%), Yazd (7.8%), Isfahan (7.1%), and Tabriz (6.9%). More specifically, Tehran University of Medical Science (15.9%), the Royan Institute (12.2%), Shahid Beheshti Medical University (10.1%), Shahid Sadoughi University of Medical Sciences (6.9%), and Tarbiat Modares University (6.7%) account for more than 50% of all Iranian scientific publications. In recent decades, reproductive biomedical research has grown significantly in Iran. Reviewing publications in this field helps health policy decision makers to monitor the direction of research and adjust investment in the treatment of infertility. In addition, it is necessary to expand and organize inter-organizational and international collaborations to improve the research, gain the benefits of different experiences, and engage in international multicenter studies.
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Affiliation(s)
- Zohreh Hashemian
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
- Department of Applied Cell Sciences, Faculty of Basic Sciences and Advanced Medical Technologies, Royan Institute, ACECR, Tehran, Iran
| | - Ahmad Vosough Dizaji
- Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mahdi Lotfipanah
- Department of Medical Library and Information Sciences, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Parvaneh Afsharian
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Massoud Vosough
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
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Cheng ZX, Du L, He Z. The role of homozygous LOF variant of the PNLDC1 gene in oligo-astheno-teratozoospermia (OAT) and male infertility. Asian J Androl 2023; 25:754-755. [PMID: 37282384 DOI: 10.4103/aja202322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 04/18/2023] [Indexed: 06/08/2023] Open
Affiliation(s)
- Zi-Xin Cheng
- The Key Laboratory of Model Animals and Stem Cell Biology in Hunan Province, School of Medicine, Hunan Normal University; The Research Center of Reproduction and Translational Medicine of Hunan Province; The Manufacture-Based Learning and Research Demonstration Center for Human Reproductive Health New Technology of Hunan Normal University, Changsha 410013, China
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Rizzuti A, Alvarenga C, Stocker G, Fraga L, Santos HO. Early Pharmacologic Approaches to Avert Anabolic Steroid-induced Male Infertility: A Narrative Review. Clin Ther 2023; 45:e234-e241. [PMID: 37806813 DOI: 10.1016/j.clinthera.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/23/2023] [Accepted: 09/03/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE To review the impact of testosterone and other androgenic-anabolic steroids (AASs) on male fertility, exploring potential drugs that can be used to preserve or restore male fertility upon AAS use or prior contact. METHODS A review was performed to provide a unifying clinical link between drugs used to preserve or restore male fertility (ie, clomiphene citrate, human chorionic gonadotropin, selective estrogen receptor modulators, recombinant luteinizing and follicle-stimulating hormones, and human menopausal gonadotrophin) in the context of AAS-induced infertility and related aspects. FINDINGS Human chorionic gonadotropin (125-500 IU every other day), clomiphene citrate (12.5-50 mg/d), recombinant luteinizing hormone (125-500 IU every other day), recombinant follicle-stimulating hormone (75-150 IU 1-3×/wk), and human menopausal gonadotrophin (75-150 IU 1-3×/wk) are promising early pharmacologic approaches to avert AAS-induced male infertility. Additionally, a full partner assessment is crucial to the success of a couple planning to have children. The partner's age and gynecopathies must be considered. Egg or sperm cryopreservation can also be alternatives for future fertility. Reinforcing AAS cessation is imperative to achieving better success in misusers. IMPLICATIONS The exponential increase in AAS misuse raises concerns about the impact on male fertility. This review suggests that gonadotropin analogs and selective androgen receptor modulators (clomiphene citrate) are viable approaches to early preserve or restore fertility in men on AAS use or with previous contact. However, proper standardization of doses and combinations is required and hence physicians should also be aware of patients' and partners' fertility.
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Affiliation(s)
- André Rizzuti
- School of Medicine, Estácio de Sá University (UNESA), Rio de Janeiro, RJ, Brazil
| | - Conrado Alvarenga
- School of Medicine, Department of Urology, University of Sao Paulo (USP), Sao Paulo, Brazil
| | - Gustavo Stocker
- School of Medicine, University Center Assis Gurgacz Foundation (FAG), Cascavel, PR, Brazil
| | - Lucas Fraga
- School of medicine, Santa Casa da misericordia de Vitorica (EMESCAM), Vitória, ES, Brazil
| | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, MG, Brazil.
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Bongaerts E, Mamia K, Rooda I, Björvang RD, Papaikonomou K, Gidlöf SB, Olofsson JI, Ameloot M, Alfaro-Moreno E, Nawrot TS, Damdimopoulou P. Ambient black carbon particles in human ovarian tissue and follicular fluid. ENVIRONMENT INTERNATIONAL 2023; 179:108141. [PMID: 37603992 DOI: 10.1016/j.envint.2023.108141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/10/2023] [Accepted: 08/09/2023] [Indexed: 08/23/2023]
Abstract
Evidence indicates a link between exposure to ambient air pollution and decreased female fertility. The ability of air pollution particles to reach human ovarian tissue and follicles containing the oocytes in various maturation stages has not been studied before. Particulate translocation might be an essential step in explaining reproductive toxicity and assessing associated risks. Here, we analysed the presence of ambient black carbon particles in (i) follicular fluid samples collected during ovum pick-up from 20 women who underwent assisted reproductive technology treatment and (ii) adult human ovarian tissue from 5 individuals. Follicular fluid and ovarian tissue samples were screened for the presence of black carbon particles from ambient air pollution using white light generation by carbonaceous particles under femtosecond pulsed laser illumination. We detected black carbon particles in all follicular fluid (n = 20) and ovarian tissue (n = 5) samples. Black carbon particles from ambient air pollution can reach the ovaries and follicular fluid, directly exposing the ovarian reserve and maturing oocytes. Considering the known link between air pollution and decreased fertility, the impact of such exposure on oocyte quality, ovarian ageing and fertility needs to be clarified urgently.
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Affiliation(s)
- Eva Bongaerts
- Centre for Environmental Sciences, Hasselt University, 3590 Hasselt, Belgium
| | - Katariina Mamia
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden
| | - Ilmatar Rooda
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden
| | - Richelle D Björvang
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden; Department of Women's and Children's Health, Uppsala University, 75185 Uppsala, Sweden
| | - Kiriaki Papaikonomou
- Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden; Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Sebastian B Gidlöf
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden; Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Jan I Olofsson
- Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Marcel Ameloot
- Biomedical Research Institute, Hasselt University, 3590 Hasselt, Belgium
| | - Ernesto Alfaro-Moreno
- Nanosafety Group, International Iberian Nanotechnology Laboratory, 4715-330 Braga, Portugal
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, 3590 Hasselt, Belgium; Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
| | - Pauliina Damdimopoulou
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden.
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Panagiotopoulos D, Andriopoulou T, Spanou VM, Droggiti DI, Gkavogianni T, Giamarellos-Bourboulis EJ, Panagopoulos P. Deficiency of hydrogen sulfide production and pregnancy rate in an experimental model: Association with preterm delivery. Am J Reprod Immunol 2023; 90:e13764. [PMID: 37641370 DOI: 10.1111/aji.13764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/31/2023] Open
Abstract
PROBLEM Pro-inflammatory phenomena drive preterm delivery (PTD). Hydrogen sulfide is a gasotransmitter with anti-inflammatory properties produced through the activity of the enzyme cystathionine-γ-lyase (CSE), and its impact was studied in models of normal delivery and PTD in mice. METHOD OF STUDY Female CSE+/+ and CSE-/- mice were mated with male CSE+/+ mice; mating was done with drinking water unsupplemented and supplemented with cysteine. The pregnancy rate was monitored. PTD was induced by the intraperitoneal injection of bacterial lipopolysaccharide (LPS) on day 14.5 of pregnancy. Mice were sacrificed for tissue collection and splenocyte isolation after 6 and 12 h. Isolated splenocytes were stimulated for the production of tumor necrosis factor-alpha (TNFα), interleukin (IL)-10 and interferon-gamma (IFNγ); TNFα and vascular endothelial growth factor (VEGF) were measured in the fetuses and the placenta. RESULTS The successful pregnancy rate was lower in CSE-/- mice and it was restored with cysteine supplementation. CSE deficiency was associated with higher tissue concentrations of TNFα in the fetuses, attenuated IL-10 responses and higher IFNγ production from splenocytes. CSE deficiency was not associated with PTD. Following PTD induction, CSE-/- mice did not show attenuated IL-10 responses but the production of TNFα and IFNγ was lowered over-time; placental VEGF was also increased over-time. CONCLUSIONS CSE deficiency has an unfavorable impact on pregnancy. H2 S deficiency through CSE does not drive PTD but mediates pro-inflammatory phenomena in fetuses.
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Affiliation(s)
- Dimitrios Panagiotopoulos
- 3rd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Theano Andriopoulou
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Victoria-Marina Spanou
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dionysia-Irene Droggiti
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Theologia Gkavogianni
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | | | - Periklis Panagopoulos
- 3rd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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Thomsen AH, Gaml-Sørensen A, Brix N, Tøttenborg SS, Hougaard KS, Ernst A, Arendt LH, Toft G, Bonde JP, Ramlau-Hansen CH. Maternal alcohol intake in early pregnancy and biomarkers of fecundity in adult sons: A cohort study. Reprod Toxicol 2023; 119:108396. [PMID: 37217037 DOI: 10.1016/j.reprotox.2023.108396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/27/2023] [Accepted: 05/10/2023] [Indexed: 05/24/2023]
Abstract
Male fecundity may be largely determined through fetal programming and therefore potentially be sensitive to exposure to maternal alcohol intake during pregnancy. We investigated whether maternal alcohol intake in early pregnancy was associated with biomarkers of fecundity in adult sons. In total, 1058 sons from the Fetal Programming of Semen Quality (FEPOS) cohort nested in the Danish National Birth Cohort (DNBC) provided blood and semen samples at around 19 years of age. Information on maternal weekly average alcohol intake (0 drinks [ref], >0-1 drinks, >1-3 drinks, >3 drinks) and binge drinking episodes (intake of ≥5 drinks on one occasion: (0 [ref], 1-2, ≥3 episodes)) was self-reported at around gestational week 17. Outcomes included semen characteristics, testes volume and reproductive hormones. We found some small tendencies towards lower semen characteristics and an altered hormone level profile in sons of mother who had an intake of > 3 drinks/week in early pregnancy and sons of mother who had ≥ 3 episodes of binge drinking in pregnancy. However, the effect estimates were overall small and inconsistent and with no indication of a dose dependent association. Due to the limited number of mothers with a high weekly alcohol intake, we cannot exclude whether prenatal exposure to higher doses than 4.5 drinks/week of alcohol in early pregnancy might have a detrimental effect on the biomarkers of fecundity in adult sons..
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Affiliation(s)
- Anne Hjorth Thomsen
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark.
| | - Anne Gaml-Sørensen
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Nis Brix
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark; Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Karin Sørig Hougaard
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark; National Research Centre for Working Environment, Copenhagen, Denmark
| | - Andreas Ernst
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark; Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Linn Håkonsen Arendt
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark; Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Gunnar Toft
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Malekpour P, Hasanzadeh R, Javedani Masroor M, Chaman R, Motaghi Z. Effectiveness of a mixed lifestyle program in couples undergoing assisted reproductive technology: a study protocol. Reprod Health 2023; 20:112. [PMID: 37528465 PMCID: PMC10394976 DOI: 10.1186/s12978-023-01652-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND The desire for fertility is the manifestation of yearning for immortality. Infertility and assisted reproductive technology (ART) expose couples to great affective, anxiety, stress, and financial burden. Increasing evidence emphasize the impact of lifestyle on infertility. One of the most crucial factors affecting the fertility process is the nutrition patterns, the amount and quality of physical activities, emotional problems management; modulate stressors, relief from anxiety, and the living conditions of couples. Most ART treatment interventions in Iran are not integrated into lifestyle programs. Therefore, this research will investigate the impact of mixed fertility health-promoting programs in couples who use ARTs. METHODOLOGY/DESIGN This study entails three steps. The first step includes the systematic review of literature on a health-promoting lifestyle in infertile couples undergoing ARTs, a systematic review of observational studies and interventions in couple's lifestyle, then, a systematic review of qualitative studies on infertility in couples and their lifestyle, and in the final step couple's life style literature systematically will evaluate in Iran. In case of failure to obtain the required results from systematic reviews, cross-sectional studies will be carried out to determine the lifestyle of infertile couples receiving ARTs. In the second stage, by holding a panel of experts, an intervention is planned based on the results of the previous stages in order to improve the lifestyle of couples. In the final step, the designed intervention will be administered as a random clinical trial-on ART candidates, in intervention or control groups in one of Iran University of Medical Sciences hospitals. Afterward, the data's will be evaluated by using standard questionnaires, that include health-promoting lifestyle questionnaire (HPLII), Beck's depression inventory (BDI), international physical activity questionnaire-short form (IPAQ-SF), and food frequency questionnaire (FFQ). The statistical analysis will be carried out in SPSS software. During the study, subjects meeting the inclusion criteria were randomly selected and randomized into the intervention and control groups. The health-promoting lifestyle training program will be executed for the intervention group while the standard care program is administered to the control group. The content of this program will be obtained from the consensus opinions of the expert panel. The program includes diet recommendations, physical activity, and stress management. Appropriate time, frequency, duration and number of activities will be considered. Communication with subjects will be possible through private meeting special comfort room. Support to the participants will also be through clinical visits social media, SMS and phone calls. Nutritional changes, physical activity amount, anxiety and stress level, abdominal circumference (AC), and body mass index (BMI) will be measured after the completion of the specified time interval. The initial outcome includes examining chemical pregnancy (2 weeks after the transmission) and clinical pregnancy by ultrasound (6 weeks after). The secondary outcome will be live birth rate. Retrieved oocyte and embryo numbers will also be reported. DISCUSSION Health-promoting lifestyle programs are essential in assisted reproductive technologies to improve pregnancy results and live birth. These programs in association with in-vitro fertilization (IVF) influence the outcome of fertilization. In addition, enhancing parental health leads to healthy pregnancy outcome. Despite the frequency of lifestyle risk factors, employing proper methods helps reduce anxiety and stress, modify dietary patterns, and perform qualitatively and quantitatively balanced physical activities. In addition, having coping skills and mental health management methods, in nowadays modern world challenges seems crucial and effective in solving fertility problems and reducing them before pregnancy.
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Affiliation(s)
| | - Robab Hasanzadeh
- Department of Midwifery, Bonab Branch, Islamic Azad University, Bonab, Iran
| | - Mojgan Javedani Masroor
- School of Medicine, Shahid Akbar-Abadi Clinical Research Development Unit (Sh A C R D U), Iran University of Medical Sciences, Tehran, Iran
| | - Reza Chaman
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Motaghi
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
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Kundarti FI, Titisari I, Rahayu DE, Kiswati, Jamhariyah. Mindfulness improves the mental health of infertile women: A systematic review. J Public Health Res 2023; 12:22799036231196693. [PMID: 37711728 PMCID: PMC10498716 DOI: 10.1177/22799036231196693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/04/2023] [Indexed: 09/16/2023] Open
Abstract
Infertility in women causes mental health problems, the bad ones. Women with infertility need psychological treatment using mindfulness interventions. This study's purpose was to analyze mindfulness's effect on the mental health of women with infertility through a systematic review. The method used in this systematic review was by searching through the following databases; ProQuest database, Wiley Library, Pubmed, Scopus, Science Direct, Sage Journal, Cochrane Library, and Cambridge Core from January 2011 to December 2021. Nine articles met the inclusion criteria. Results show that the use of mindfulness was found to be effective in reducing mental disorders in women with infertility. Nine articles that meet the criteria for inclusion. According to a study on the effects of mindfulness on infertile women, affect increasing mental health levels by reducing mental health disorder scores. Mindfulness has been proven to be an effective intervention for women undergoing infertility-related mental disorders such as stress, anxiety, and depression. However, different types of mindfulness-based interventions are used to target different mental health issues. For example, Mindfulness-Based Stress Reduction (MBSR) targets stress and anxiety while Mindfulness-Based Cognitive Therapy (MBCT) targets depression. Additionally, specific mindfulness for example, for the midwifery profession can be developed to improve the quality and treatment outcomes of healthcare for women struggling with infertility problems.
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Affiliation(s)
- Finta Isti Kundarti
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Ira Titisari
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Dwi Estuning Rahayu
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Kiswati
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Jamhariyah
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
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Naem A, Laganà AS. Editorial: Minimally invasive surgery as a mean of improving fertility: What do we know so far? Front Surg 2023; 10:1203816. [PMID: 37255744 PMCID: PMC10225725 DOI: 10.3389/fsurg.2023.1203816] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/03/2023] [Indexed: 06/01/2023] Open
Affiliation(s)
- Antoine Naem
- Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
- Department of Obstetrics, Gynecology, Gynecologic Oncology, and Senology, Bethesda Hospital Duisburg, Duisburg, Germany
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico – Di Cristina – Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
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Jain M, Mladova E, Shichanina A, Kirillova K, Povarova A, Scherbakova L, Samokhodskaya L, Panina O. Microbiological and Cytokine Profiling of Menstrual Blood for the Assessment of Endometrial Receptivity: A Pilot Study. Biomedicines 2023; 11:biomedicines11051284. [PMID: 37238954 DOI: 10.3390/biomedicines11051284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/18/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Endometrial receptivity (ER) is a key factor required for the successful implantation of the embryo. However, the evaluation of ER is challenging, as a nondisruptive sampling of endometrial biomaterial by conventional methods is only possible outside of the embryo transfer (ET) cycle. We propose a novel approach for the assessment of ER-microbiological and cytokine profiling of menstrual blood aspirated directly from the uterine cavity at the beginning of the cryo-ET cycle. The aim of the pilot study was to evaluate its prognostic potential regarding the outcome of the in vitro fertilization procedure. Samples collected from a cohort of 42 patients undergoing cryo-ET were analyzed by a multiplex immunoassay (48 various cytokines, chemokines, and growth factors) and a real-time PCR assay (28 relevant microbial taxa and 3 members of the Herpesviridae family). Significant differences between groups of patients who achieved and did not achieve pregnancy were observed for G-CSF, GRO-α, IL-6, IL-9, MCP-1, M-CSF, SDF-1α, TNF-β, TRAIL, SCF, IP-10, and MIG (p < 0.05), whereas microbial profiles were not associated with the outcome of cryo-ET. It appeared that levels of IP-10 and SCGF-β were significantly lower (p < 0.05), in patients with endometriosis. Menstrual blood may provide great opportunities to noninvasively investigate various parameters of the endometrium.
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Affiliation(s)
- Mark Jain
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Elena Mladova
- Institute of Reproductive Medicine "REMEDI", 123100 Moscow, Russia
| | - Anna Shichanina
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Karina Kirillova
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Anna Povarova
- Institute of Reproductive Medicine "REMEDI", 123100 Moscow, Russia
| | - Liya Scherbakova
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Larisa Samokhodskaya
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Olga Panina
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia
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Hiadzi RA, Woodward B, Akrong GB. Ethical issues surrounding the use of assisted reproductive technologies in Ghana: An analysis of the experiences of clients and service providers. Heliyon 2023; 9:e13767. [PMID: 36865469 PMCID: PMC9970979 DOI: 10.1016/j.heliyon.2023.e13767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 02/03/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
Since the advent of Assisted Reproductive Technologies (ART) in Ghana about three decades ago, IVF and ICSI treatments have enabled infertile Ghanaian couples to fulfill their aspirations and dreams of having children. In this extremely pronatalist society, ART has provided relief to many childless couples by reducing, if not eliminating, the shame of childlessness that they would otherwise have to suffer. However, as the provision and utilization of ART continue to increase, so do worries regarding the ethical difficulties surrounding this field of medicine, which challenge cultural ideals and personal desires. The study explores client and service provider experiences with ART in urban Ghana. Observation and in-depth interviews were employed to collect data, and the ethical dimensions of people's experiences relative to Ghanaian cultural and ethical values were analyzed. The results show that the provision of ART services for heterosexual couples in marital unions, the availability of PGT for sickle cell clients, the preference for multiple births emerging from embryo transfers, the lower preference for cryopreservation, the high cost of ART treatment, and the need for regulation of the provision of ART services in Ghana were some of the ethical concerns expressed by both clients and service providers.
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Affiliation(s)
| | | | - Godwin Banafo Akrong
- School of Management and Economics, University of Electronic Science and Technology of China, Chengdu, 611731, China,Corresponding author.
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Sousa E, Nery SF, Casalechi M, Thimóteo LC, Paiva SP, Silva-Filho AL, Reis FM. Characteristics, prevalence and sources of stress in individuals who discontinue assisted reproductive technology treatments: a systematic review. Reprod Biomed Online 2023; 46:819-825. [PMID: 36907754 DOI: 10.1016/j.rbmo.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/24/2023] [Indexed: 02/04/2023]
Abstract
By considering the reasons behind discontinuing assisted reproductive technology (ART) treatment, several studies have indicated that 'stress' is an important issue, but the prevalence of stressors and stress responses, either acute or chronic, remains unclear. In this systematic review, we evaluated the characteristics, prevalence and causes of what was perceived and reported as 'stress' by couples who discontinued ART treatment. Electronic databases were systematically searched, and studies were considered eligible if they evaluated stress as a possible reason for ART discontinuation. Twelve studies were included, with 15,264 participants from eight countries. In all studies, 'stress' was assessed through generic questionnaires or medical records, not by validated stress questionnaires or biomarkers. The prevalence of 'stress' ranged from 11-53%. When the results were pooled, 'stress' was cited as a reason for ART discontinuation by 775 out of 2507 participants (30.9%). Clinical factors associated with worse prognosis, physical discomfort due to treatment procedures, family demands, time pressure and economic burden were identified as sources of 'stress' that contributed to ART discontinuation. Precisely knowing the characteristics of the stress associated with infertility is essential to devise preventive or supportive interventions to help patients to cope and endure the treatments. Further studies are necessary to investigate whether the mitigation of stress factors can reduce ART discontinuation rates.
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Affiliation(s)
- Elaine Sousa
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Simone F Nery
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Maíra Casalechi
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Luiz C Thimóteo
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Sara Pc Paiva
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Agnaldo L Silva-Filho
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Fernando M Reis
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil.
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Bell SO, Karp C, Moreau C, Gemmill A. "If I use family planning, I may have trouble getting pregnant next time I want to": A multicountry survey-based exploration of perceived contraceptive-induced fertility impairment and its relationship to contraceptive behaviors. Contracept X 2023; 5:100093. [PMID: 37114162 PMCID: PMC10127128 DOI: 10.1016/j.conx.2023.100093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Objectives We aim to assess women's perceptions regarding contraceptive effects on fertility across a diversity of settings in sub-Saharan Africa and how they vary by women's characteristics. We also aim to examine how such beliefs relate to women's contraceptive practices and intentions. Study design This study uses cross-sectional survey data among women aged 15 to 49 in nine sub-Saharan African geographies from the Performance Monitoring for Action project. Our main measure of interest assessed women's perceptions of contraceptive-induced fertility impairment. We examined factors related to this belief and explored the association between perceptions of contraceptive-induced fertility impairment and use of medicalized contraception (intrauterine device, implant, injectable, pills, emergency contraception) and intention to use contraception (among nonusers). Results Between 20% and 40% of women across study sites agreed or strongly agreed that contraception would lead to later difficulties becoming pregnant. Women at risk of an unintended pregnancy who believed contraception could cause fertility impairment had reduced odds of using medicalized contraception in five sites; aORs ranged from 0.07 to 0.62. Likewise, contraceptive nonusers who wanted a/another child and perceived contraception could cause fertility impairment were less likely to intend to use contraception in seven sites, with aORs between 0.34 and 0.66. Conclusions Our multicountry study findings indicate women's perception of contraceptive-induced fertility impairment is common across diverse sub-Saharan African settings, likely acting as a deterrent to using medicalized contraceptive methods. Implications Findings from this study can help improve reproductive health programs by addressing concerns about contraception to help women achieve their reproductive goals.
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Affiliation(s)
- Suzanne O. Bell
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Corresponding author.
| | - Celia Karp
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Caroline Moreau
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Soins et Santé Primaire, CESP Centre for Research in Epidemiology and Population Health U1018, Inserm, Villejuif, France
| | | | - Alison Gemmill
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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