Knowledge and attitude of reproductive-aged women towards planned oocyte cryopreservation in the United Arab Emirates.

BACKGROUND: Delayed conception is associated with a decline in oocyte number and quality. Oocyte cryopreservation techniques are used for medical or non-medical (elective) reasons. We aim to assess the knowledge and attitudes towards planned oocyte cryopreservation (POC) among reproductive-aged women in the United Arab Emirates (UAE) and to investigate the factors interfering with their decisions. METHODS: A cross-sectional study on 422 women (18-38 years) living in the UAE, using an online questionnaire with three sections: sociodemographic, knowledge, and attitudes towards POC. RESULTS: 91.2% of participants have heard of POC, 84.1% hold a bachelor's degree or higher, 65.4% with medical background, 54.3% employed, and 79.2% live in Sharjah and Dubai. Consideration of POC was significantly associated with age (p = 0.011), employment (p = 0.002), the Emirates they live (p < 0.001), and if they have heard of POC (p = 0.036). Mean knowledge score was 44.44%, which was significantly higher among those considering POC (49.66% vs. 40.55%), and social media was their main source of information. About 57% will not consider POC, mainly due to cost, cultural issues, and safety. Determinants of knowledge score were marital status (B = 0.44; 95%CI: 0.09-0.79; p value = 0.014) and education level (B = 0.35; 95%CI: 0.13-0.58; p value = 0.002), and after adjustment, only the education level remained significantly associated with knowledge score (B = 0.24; 95%CI: 0.01-0.47; p value = 0.042). CONCLUSION: Despite many participants being motivated to undergo POC, majority had poor knowledge, and cost was the main barrier. The main determinant of the knowledge score was education level. Awareness among couples of consequences of delaying childbearing and comprehensive information from medical practitioners are highly needed.

Vitamin D in endometriosis: a causative or confounding factor?

OBJECTIVE: The aim of this paper is to review the evidence from studies that evaluated the relationship between vitamin D and endometriosis. DESIGN: Comprehensive review. MATERIALS AND METHODS: Systematic literature search in Medline for relevant publications from 1946 until June 2013. RESULTS: Endometriosis risk may be influenced by dietary vitamin D intake and plasma hydroxyvitamin D concentration. Vitamin D receptor and vitamin D metabolizing enzymes, 24-hydroxylase and 1-α hydroxylase, are found in the normal cycling endometrium and also in the eutopic and ectopic endometrium of women with endometriosis. The endometrium is a target of 1, 25 dihydroxyvitamin D actions through regulation of specific genes and via immunomodulation. The endometrium in endometriosis expresses dysregulation of some vitamin D enzymes and receptors. If vitamin D and its metabolites are implicated in endometriosis-associated infertility, it is likely through interference with HOXA10 gene expression. The Gc2 phenotype of vitamin D binding protein is prevalent in women with endometriosis and may be implicated in its pathogenesis. In a mouse model, Elocalcitol, a VDR-agonist was shown to reduce the development of endometriotic lesions and recurrence. CONCLUSION: A biological plausibility for a role of vitamin D, as an immunomodulator and anti-inflammatory agent, in the pathogenesis and treatment of endometriosis is suggested in this article, but is difficult to illustrate due to sparse evidence from human studies limited primarily to case-control studies. A significant knowledge gap precludes the establishment of a clear cause-effect relationship. The intriguing leads presented herein need to be investigated further with placebo-controlled supplementation trials.