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Assaf S, Moonzwe Davis L. Unrealized fertility among women in low and middle-income countries. PLoS One 2022; 17:e0276595. [PMID: 36331909 PMCID: PMC9635705 DOI: 10.1371/journal.pone.0276595] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Background There has been little research on women who have fewer than their ideal number of children toward the end of their childbearing years in low and middle-income countries (LMICs). We examine the level and distribution of unrealized fertility in LMICs across three geographical regions. We also examine the role of sex preference and other factors associated with unrealized fertility. Data and methods We used Demographic and Health Survey (DHS) data for women age 44–48 in 36 countries from the three geographical regions of Western and Central Africa, Eastern and Southern Africa, and South and Southeast Asia. We conducted descriptive analysis to examine the distribution of unwanted fertility and unrealized fertility, and fit adjusted logistic regressions of unrealized fertility. The main variables are number of living children (including by sex) and the sex composition of children. Other variables included education, marital status, age at first childbirth, wealth quintile, place of residence, exposure to family planning messages, contraceptive use, and country. Results Unrealized fertility was highest in Western and Central Africa, followed by Eastern and Southern Africa. In all regions, there was a decrease in unrealized fertility with an increasing number of children. Findings for sex preference varied with little sex preference in the African regions, and some limited evidence of preference for sons in South and Southeast Asia. In most regions, higher levels of education, higher wealth quintile, and use of contraceptive methods were associated with decreased unrealized fertility. Conclusion Family planning programs and messages should consider regional and socioeconomic differences in unrealized fertility in order to give women and families the right to achieve the family size they desire regardless of their status.
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Affiliation(s)
- Shireen Assaf
- The DHS Program, Rockville, Maryland, United States of America
- ICF, Rockville, Maryland, United States of America
- * E-mail:
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Bagade T, Thapaliya K, Breuer E, Kamath R, Li Z, Sullivan E, Majeed T. Investigating the association between infertility and psychological distress using Australian Longitudinal Study on Women's Health (ALSWH). Sci Rep 2022; 12:10808. [PMID: 35752691 PMCID: PMC9233676 DOI: 10.1038/s41598-022-15064-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/17/2022] [Indexed: 11/09/2022] Open
Abstract
Infertility affects millions of people globally. Although an estimated 1 in 6 couples in Australia are unable to conceive without medical intervention, little is known about the mental health impacts of infertility. This study investigated how infertility impacts the mental health of women. The study used nationally representative Australian Longitudinal Study on Women's Health (ALSWH) data. We analysed data from survey periods 2-8 conducted every three years between 2000 and 2018 for 6582 women born in 1973-78. We used a Generalised Equation Modelling (GEE) method to investigate the association of primary, secondary and resolved fertility status and psychological distress over time. Multiple measures were used to measure psychological distress: the (1) the mental health index subscale of the 36-item short form survey (SF-36), (2) the Center for Epidemiological Studies Depression Scale (CESD-10), (3) the Goldberg Anxiety and Depression Scale (GADanx) anxiety subscale; and a (4) composite psychological distress variable. About a third (30%) of women reported infertility at any of the survey rounds; a steady increase over 18 years from 1.7% at round 2 to 19.3% at round 8. Half of the women reporting primary or secondary infertility reported psychological distress, with the odds of having psychological distress was higher in women reporting primary (odds ratio (OR) 1.24, 95% confidence interval (CI) 1.06-1.45), secondary (OR 1.27, 95% CI 1.10-1.46) or resolved infertility (OR 1.15, 95% CI 1.05-1.26) compared to women reporting normal fertility status. Women with partners, underweight or higher BMI, smoking, and high-risk alcohol use had higher odds of psychological distress, whereas women in paid work had significantly lower odds of psychological distress (p < 0.001). Diabetes, high blood pressure, asthma, and other chronic physical illness were independently associated with higher odds of psychological distress. Infertility has a significant impact on mental health even after it is resolved. Frequent mental health assessment and a holistic approach to address the lifestyle factors should be undertaken during the treatment of infertility.
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Affiliation(s)
- Tanmay Bagade
- College of Health, Medicine and Wellbeing, The University of Newcastle (UON), University Drive, Callaghan, NSW, 2308, Australia.
| | - Kailash Thapaliya
- College of Health, Medicine and Wellbeing, The University of Newcastle (UON), University Drive, Callaghan, NSW, 2308, Australia.,Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), North Terrace, Adelaide, SA, 5000, Australia
| | - Erica Breuer
- College of Health, Medicine and Wellbeing, The University of Newcastle (UON), University Drive, Callaghan, NSW, 2308, Australia
| | | | - Zhuoyang Li
- College of Health, Medicine and Wellbeing, The University of Newcastle (UON), University Drive, Callaghan, NSW, 2308, Australia
| | - Elizabeth Sullivan
- College of Health, Medicine and Wellbeing, The University of Newcastle (UON), University Drive, Callaghan, NSW, 2308, Australia
| | - Tazeen Majeed
- College of Health, Medicine and Wellbeing, The University of Newcastle (UON), University Drive, Callaghan, NSW, 2308, Australia
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Can nanomaterials support the diagnosis and treatment of human infertility? A preliminary review. Life Sci 2022; 299:120539. [PMID: 35390438 DOI: 10.1016/j.lfs.2022.120539] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/25/2022] [Accepted: 04/03/2022] [Indexed: 12/15/2022]
Abstract
Human infertilities are disorders that afflict many people all over the world. Both male and female reproductive systems must work together in a precise and coordinated manner and infertility has a wide range of problems for this system. Recent advances in nanomedicine immensely helped design the diagnostic and therapeutic approaches to alleviate human infertility in both sexes. Nanoscience has recently been used by researchers to increase the detection limit of infertility-related biomarkers via fabricating sensitive nanobiosensors for detecting follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-müllerian hormone (AMH), pregnancy-associated plasma protein-A (PAPP-A), progesterone, and testosterone. At the same time, a variety of nanostructures, including magnetic nanoparticles (i.e., zinc nanoparticles, cerium nanoparticles, gold nanoparticles, silver nanoparticles), nano-vitamins, extracellular vesicles, and spermbots, have shown promising outcomes in the treatment of human infertilities. Despite recent advancements, some nanostructures might have toxic effects on cells, especially germ cells, and must be optimized with the right ingredients, such as antioxidants, nutrients, and vitamins, to obtain the right strategy to treat and detect human infertilities. This review presents recent developments in nanotechnology regarding impairments still faced by human infertility. New perspectives for further use of nanotechnology in reproductive medicine studies are also discussed. In conclusion, nanotechnology, as a tool for reproductive medicine, has been considered to help overcome current impairments.
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Functional survey of decellularized tissues transplantation for infertile females. Cell Tissue Bank 2021; 23:407-415. [PMID: 34806123 DOI: 10.1007/s10561-021-09979-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 11/07/2021] [Indexed: 10/19/2022]
Abstract
Numbers of women worldwide face infertility, which will have a significant impact on a couple's life. As a result, assisting with the treatment of these individuals is seen as a critical step. Successful births following uterus and ovary donation have been reported in recent. When immunosuppressive drugs are used in patients who receive donated tissues, there are always problems with the drugs' side effects. In recent years, tissue engineering has mainly been successful in treating infertility using decellularization techniques. Engineered uterus and ovary prevent immunological reactions and do not require immunosuppressive drugs. The most important aspect of using decellularized tissue is its proper function after transplantation. These tissues must be able to produce follicles, secrete hormones and cause pregnancy. This study aimed to investigate research on decellularized tissues and transplanted into the female reproductive system. In this study, just tissues that, after transplantation, have the proper function for fertility were investigated.
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Ozturk A, Aba YA, Sik BA. The relationship between stigma, perceived social support and depression in infertile Turkish women undergoing in vitro fertilization-embryo transfer. Arch Psychiatr Nurs 2021; 35:434-440. [PMID: 34561056 DOI: 10.1016/j.apnu.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/03/2020] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
This study was conducted to determine the relationship between the perceived social support, stigmatization and depression in infertile women and the influencing factors. The study was conducted on 298 infertile women at a private hospital between March and September 2019 using a Personal Information Questionnaire, Infertility Stigma Scale (ISS), Beck Depression Inventory (BDI), and Multidimensional Scale of Perceived Social Support (MSPSS). BDI had a significantly positive correlation with ISS and negative correlation with MSPSS. And MSPSS had a significantly negative correlation with ISS. Infertility leads women to suffer various psychosocial problems. Nurses should be aware of these problems during diagnostic procedures for infertility treatment, which should also include psychiatric counseling.
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Affiliation(s)
- Ayfer Ozturk
- Department of Psychiatric Mental Health Nursing, Faculty of Health Science, Bartın University, Turkey
| | - Yılda Arzu Aba
- Bandırma Onyedi Eylül University, Faculty of Health Sciences, Department of Nursing, Turkey.
| | - Bulat Aytek Sik
- Istanbul Aydin University, Faculty of Medicine, Department of Obstetrics and Gynecology, Turkey
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Abebe MS, Afework M, Abaynew Y. Primary and secondary infertility in Africa: systematic review with meta-analysis. FERTILITY RESEARCH AND PRACTICE 2020; 6:20. [PMID: 33292584 PMCID: PMC7709409 DOI: 10.1186/s40738-020-00090-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/22/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Infertility is a practical concern of Africans due to social disgrace and exclusion. This meta-analysis aims to analyze the proportion of primary and secondary infertility and identify the etiologic factors based on the studies conducted in Africa. METHODS An internet-based search was conducted on the following databases; PubMed/Medline, EMBASE, Cochrane library, and google scholar. Both population and institution-based studies conducted among African couples, males, and females were included. Data extraction and critical appraisal of the articles were done by two independent investigators. Meta-analysis using a random effect model was conducted by Stata version 14. Forest plot, heterogeneity test, and funnel plot for publication bias were performed. RESULTS The pooled proportion of primary and secondary infertility in Africa was 49.91% (I2 = 98.7, chi-square = 1509.01, degree of freedom = 19 and p < 0.001) and 49.79% (I2 = 98.7, chi-square = 1472.69, degree of freedom = 19 and p < 0.001) respectively. The pooled prevalence of the causes of infertility indicated that 54.01% and 22.26% of the infertility cases were respectively due to female and male-related problems. In 21.36% of infertility cases, both sexes were affected, while 10.4% of the causes of infertility were unexplained. The pooled prevalence of mostly reported causes of male infertility was 31% (oligospermia), 19.39% (asthenozoospermia), and 19.2% (varicocele). The most commonly identified causes of female infertility were pelvic inflammatory disease, tubal factors, and abortion with a pooled prevalence of 39.38%, 39.17%, and 36.41% respectively. Conclusions In Africa, the proportion of primary and secondary infertility is approximately equal. Infertility is mostly due to female-related causes like; pelvic inflammatory diseases, uterine tube related problems, and abortion. Oligospermia, asthenozoospermia, and varicocele were the commonest causes of male-related infertility. It is suggested that interpretation and utilization of these findings should consider the presence of substantial heterogeneity between the included studies.
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Affiliation(s)
- Melese Shenkut Abebe
- Department of Anatomy, School of Medicine, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| | - Mekbeb Afework
- Department of Anatomy, School of Medicine, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yeshiwas Abaynew
- Department of Biostatistics and epidemiology, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Tanoomand A, Hajibemani A, Abouhamzeh B. Investigation of the association of idiopathic male infertility with polymorphisms in the methionine synthase (MTR) gene. Clin Exp Reprod Med 2019; 46:107-111. [PMID: 31401817 PMCID: PMC6736507 DOI: 10.5653/cerm.2018.00423] [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: 11/16/2018] [Accepted: 05/29/2019] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Spermatogenesis is a complex process that is regulated by a number of genes, some of which are involved in folate-dependent 1-carbon metabolism. Methionine synthase (encoded by MTR) is a key enzyme participating in this pathway. This study aimed to investigate the relationship of the MTR 2756A > G polymorphism with idiopathic male fertility in the Iranian population. METHODS The participants of this study included 100 men with idiopathic infertility and 100 healthy men as the control group. Genotyping of MTR 2756A > G was performed using the polymerase chain reaction and restriction fragment length polymorphism technique. The obtained data were analyzed using SPSS ver. 20.0 with a level of confidence of p< 0.05. RESULTS The frequencies of the A and G alleles at this locus were 77% and 23% in infertile patients and 84% and 16% in the control group, respectively. The frequencies of the GG, GA, and AA genotypes were 5%, 36%, and 59% in the infertile patients versus 3%, 27%, and 70% in the control group, respectively. No significant difference was observed in any genetic models. CONCLUSION In general, the findings of this study suggest that the MTR 2756A > G single-nucleotide polymorphism is not a predisposing factor for idiopathic infertility in men.
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Affiliation(s)
- Asghar Tanoomand
- Department of Basic Sciences, Faculty of Medicine, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Abolfazl Hajibemani
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabri, Iran
| | - Beheshteh Abouhamzeh
- Department of Anatomical Sciences, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
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Clinical outcomes of frozen embryo versus fresh embryo transfer following in vitro fertilization: a meta-analysis of randomized controlled trials. Arch Gynecol Obstet 2018; 298:259-272. [PMID: 29881888 DOI: 10.1007/s00404-018-4786-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 03/28/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE To examine available data from randomized controlled trials to assess if the freeze-all embryo and subsequent frozen-thawed embryo transfer (FET) results in better clinical outcomes than fresh embryo transfer (ET). METHODS Meta-analysis. RESULTS We conducted an electronic literature search on PubMed and Embase databases and manually supplemented another 2 articles from relevant citations. Seven studies were finally included in the meta-analysis,including 1141 women who underwent fresh embryo transfer and 1079 who underwent frozen embryo transfer. The results of the meta-analysis suggested that the live birth rate [RR (95% CI) 1.18 (1.08-1.30), P = 0.0003] and clinical pregnancy rate [RR (95% CI) 1.10 (1.02-1.19), P = 0.02] were significantly higher in FET group. Miscarriage rate [RR (95% CI) 0.62 (0.48-0.80), P = 0.0002], and moderate to severe OHSS occurrence rate [RR (95% CI) 0.22 (0.12 to 0.39), P < 0.00001] were significantly lower in FET group. Differences of biochemical pregnancy rate, ongoing pregnancy rate and implantation rate between the two groups did not reach the statistical significance. CONCLUSIONS Our results suggest that the IVF/ICSI with FET is more efficient and less risky for OHSS compared with ET. However, we should comprehensively inform patients with advantages, disadvantages and potential risks related to embryo cryopreservation, and carefully assess their fertility conditions to make the most beneficial clinical decision.
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Microbiological profile of cervix of females attending in-vitro fertilization clinic of a tertiary care hospital, North India. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.jrhm.2016.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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