Experiences with Family Planning amongst Persons with Mental Health Problems: A Nationwide Patient Survey

High rates of unintended pregnancies in patients with mental health problems reflect the unmet need for tailored family planning. This study aims to explore aspects of family planning that are especially challenging for patients experiencing health problems by obtaining the perspective of (former) patients and those with close relationships with the (former) patients. In August 2021, members of a Dutch national mental health panel, consisting of (former) patients and close ones, were invited to respond to a 34-question online survey that included questions on four domains: reproductive history, decision making, parenting, and sexuality. This study has revealed the severe and adverse impact of mental health problems across all of the four domains of reproductive health and family planning, which the questions specifically targeted. Based on these results, we recommend discussing family planning with all patients experiencing or at risk for mental health problems and their partners. These discussions should address a desire to have children, (involuntary) childlessness, uncertainties about parenting and sexuality, while remaining considerate of experienced taboos.

Disulfide bonds determine growth hormone receptor folding, dimerisation and ligand binding

The growth hormone receptor contains seven cysteine residues in its extracellular domain. The six in the growth hormone binding domain form disulfide bonds, and help the receptor to gain its correct three-dimensional structure. In this study we replaced the cysteine for serine and alanine residues and investigated their role in growth hormone receptor folding, dimerisation and signal transduction. Folding and growth hormone binding capacity of the wild-type growth hormone receptor require less than two minutes for completion. Although less efficient, all mutant receptors arrive at the cell surface as pre-formed dimers. Disulfide bond C38-C48 is important for efficient maturation. The middle disulfide-bond, C83-C94, is important for ligand binding. Removing disulfide bond C108-C122 has little effect without affecting signalling. When two or all disulfide bonds are changed, ligand binding and activation are blocked. Dimerisation is delayed when all disulfide bonds are destroyed.