Maternal and infant microbiome and birth anthropometry.

Preterm birth is the leading cause of neonatal mortality and morbidity. Microbiome dysbiosis in the mother and infant may contribute to their adverse outcomes. 16S rRNA amplicon sequencing was performed on all samples. Phyloseq, microbiomeSeq, and NetCoMi were utilized for bioinformatics analysis. Statistical tests included the Wilcoxon test, ANOVA, permutational multivariate analysis of variance (PERMANOVA), and linear regression. Statistical significance was set at p value <0.05. The establishment of an infant's microbiome most likely begins in utero and is influenced by the maternal microbiome. Infants' samples were enriched with Salmonella. There is a complex interplay among the microbial taxa noticeable at birth, exhibiting variability in interaction within the same host and across different hosts. Both maternal and infant microbiomes influence the anthropometric measures determined at birth, and a sex-based difference in correlation exists. This study highlights the potential role of maternal and infant microbiomes in improving pregnancy and neonatal outcomes.

Does surgery to preserve fertility in Sertoli-Leydig cell tumours increase the likelihood of spontaneous conception?

A nulligravida in her 30s presented with primary infertility and secondary amenorrhoea. General examination revealed virilisation; sonological examination detected a right ovarian solid mass. International Ovarian Tumour Analysis (IOTA) was suggestive of malignancy and serum testosterone was raised. A strong clinical suspicion and negative tumour markers pointed towards androgen producing sex cord stromal ovarian neoplasm. MRI excluded pelvic lymphadenopathy. Given the patient's desire for conception, fertility sparing staging laparotomy was done. Histopathology confirmed Sertoli-Leydig cell tumour (SLCT) International Federation of Gynaecology and Obstetrics stage IA. Serum testosterone fell drastically by day 10. Spontaneous menstruation resumed within 30 days. The significance of SLCTs as a differential diagnosis in young women with secondary amenorrhoea and virilising features underscores the role of fertility-preserving surgery in certain circumstances. Here we discuss the clinical features, diagnostic challenges and management strategies for SLCTs, emphasising the need for multidisciplinary collaboration and option of fertility preservation in early stages.

Defending the disease view of pregnancy: a reply to our critics.

We recently suggested that there are both pragmatic and normative reasons to classify pregnancy as a disease. Several scholars argued against our claims. In this response, we defend the disease view of pregnancy against their criticism. We claim that the dysfunctional account of disease that some of our critics rely on has some counterintuitive results. Furthermore, we claim that our critics assume what needs to be argued that the primary function of our sexual organs is to reproduce. Since only a small percentage of sexual intercourse leads to pregnancy, it is far from obvious that reproduction is the primary biological function of our sexual organs. We also claim that while taking pregnancy itself as a reference class could avoid the conclusion that pregnancy is a disease, the strategy is problematic since it renders the Boorsean approach to disease and health circular and effectively deprives it of any utility in determining whether a particular phenomenon is a disease or not.

In vitro gametogenesis (IVG): reflections from a workshop.

Key ideas from a workshop convened by the National Academies of Sciences, Engineering, and Medicine to discuss developments in IVG (National Academies of Sciences, Engineering, and Medicine 2023) chaired by Dr Eli Y. Adashi (former Dean of Medicine and Biological Sciences at Brown University). The authors are solely responsible for the content of this paper, which does not necessarily represent the views of the National Academies of Sciences, Engineering, and Medicine.

Abuse of Anabolic-Androgenic Steroids as a Social Phenomenon and Medical Problem-Its Potential Negative Impact on Reproductive Health Based on 50 Years of Case Report Analysis.

Background/Objectives: Illegal anabolic-androgenic steroids are a significant lifestyle factor in infertility. The aim of our study was to analyze clinical cases resulting from their use for their frequency, geographical location, dynamics, substances used, the age and gender of the users, and the types of clinical complications. Methods: Publications were obtained by searching PubMed for the following terms: 'anabolic-androgenic steroids' and 'clinical case'. Publications from 1973 to 2022 were qualified for the analysis. Results: An increasing trend in the number of clinical cases resulting from the use of steroids, as well as the number of substances used simultaneously, was observed. The substances changed over the decades, but in the last 20 years, testosterone, nandrolone, stanozolol, methandienone, trenbolone, and methenolone have predominated. Cardiological side effects predominated in each period, with a continuous increase in their occurrence. The most common among these were myocardial infarctions and hypertrophic cardiomyopathy. The next most numerous adverse events involved psychiatric, endocrinological, hepatic, and oncological problems. We demonstrated a possible relationship between the use of individual steroids and medical issues; the strongest associations were between testosterone and endocrine complications, and methylstenbolone and hepatic complications. Conclusions: There has been an increasing trend in case reports describing serious health problems associated with the use of anabolic-androgenic steroids, a tendency to use several substances simultaneously, and a preferential use of substances with a high potential of causing serious side effects. These phenomena mainly concern men, with an average age of 30, and the health problems that dominate in clinical case reports-including serious cardiological, psychiatric, endocrinological, hepatic, and oncological diseases-may potentially affect reproductive health and pose a challenge for reproductive medicine.

Precision medicine activities and opportunities for shaping maternal and neonatal health in Qatar.

Precision Medicine (PM) is a transformative clinical medicine strategy that aims to revolutionize healthcare by leveraging biological information and biomarkers. In the context of maternal and neonatal health, PM enables personalized care from preconception through the postnatal period. Qatar has emerged as a key player in PM research, with dedicated programs driving advancements and translating cutting-edge research into clinical applications. This article delves into neonatal and maternal health in Qatar, emphasizing PM programs and initiatives that have been implemented. It also features noteworthy clinical cases that demonstrate the effectiveness of precision interventions. Furthermore, the article highlights the role of pharmacogenomics in addressing various maternal health conditions. The review further explores potential advancements in the application of PM in maternal and neonatal healthcare in Qatar.

[Box: see text].

Torsion of a large subserosal fibroid along with omental torsion adherent to it: a rare cause of acute abdomen.

A woman in her 30s presented to emergency with complaints of acute lower abdominal pain for 3 days, not associated with any menstrual, bowel or urinary symptoms. Examination revealed an abdominopelvic mass corresponding to an 18-week gravid uterus with diffuse tenderness and guarding over her lower abdomen. The patient was a follow-up case of subserosal fibroid uterus, chronic kidney disease stage 4 and rheumatic heart disease on anticoagulants. Fibroid degeneration or torsion was suspected. Ultrasound revealed a large posterior wall subserosal fibroid with free fluid in the pelvis. As findings did not suggest degeneration or pedunculated fibroid, noncontrast CT was done, which showed a similar mass with a pedicle arising from the uterine fundus with free fluid with no other evident cause of acute abdomen. The patient was taken up for emergency laparotomy. Intraoperatively, it was found to be a case of subserosal fibroid with greater omentum adhered to it and twisted around its axis about eight times. This case is being reported to highlight a rare cause of acute abdomen.

Risky sexual behaviour and its determinants among undergraduate students residing in hostels of Kathmandu Metropolitan City, Nepal: a cross-sectional study.

OBJECTIVES: To assess the prevalence of risky sexual behaviour (RSB) and its associated factors among Nepalese undergraduates residing in hostels of Kathmandu Metropolitan City, Nepal. DESIGN: Cross-sectional study SETTING: Hostels operating inside Kathmandu Metropolitan City were taken as the study setting. PARTICIPANT: A total of 361 undergraduate students residing in hostels in the Metropolitan City OUTCOME MEASURES: RSB was the outcome measure assessed using nine questions able to trace any risky sexual practice practiced by the participants within the past year prior to data collection. The question included participants' engagement in sexual activity before the age of consent, having unprotected vaginal sex even when pregnancy is not intended, engaging in vaginal sex with strangers without a condom, risky oral sex with a stranger and/or intimate partner, risky condom use, having multiple sex partners, having sex under the influence of alcohol and having sex with commercial sex workers. A positive response to any of these nine questions was considered indicative of RSB. Pearson's χ2 test and multivariable logistic regression analysis were performed to determine factors associated with RSB at the 5% level of significance. RESULTS: The prevalence of RSB was found to be 35.7% (95% CI: 30.2 to 40.2). RSB was found to be associated with higher age (≥25 years) (aOR: 3.938; 95% CI: 1.707 to 8.673), male gender (aOR: 3.233; 95% CI: 1.623 to 6.439), being in relationships in the past/current (aOR: 3.914, 95% CI: 2.099 to 7.012), lower education of mother (aOR: 3.655; 95% CI: 1.189 to 9.237) and peer pressure to have a sexual relationship (aOR: 2.356; 95% CI: 1.260 to 4.349). Notably, bivariate analysis illustrated problematic pornographic consumption to have a statistical relation with RSB, which was weakened and became non-significant after accounting for other factors in the adjusted model (aOR:1.213, 95% CI: 0.331 to 4.442). CONCLUSION: RSB is a concerning behaviour among undergraduate students and is linked with age, gender, relationship status, parental education and peer pressure. There is a need for comprehensive sex education programmes that equip students with the knowledge and skills needed to navigate healthy relationships, make safe choices and embrace responsible sexual practices.

Multilevel analysis of individual and community factors of awareness of obstetric fistula among women of childbearing age in Nepal: analysis of recent Nepal Demographic and Health Survey 2022 data.

BACKGROUND: According to the WHO, obstetric fistula (OBF) is an abnormal connection between the genital tract and the urinary tract that occurs as the result of obstetric trauma, typically from prolonged obstructed labour. In 2018, globally, 50 000 and 100 000 cases of OBF are reported each year. The core of activities focused on reducing fistulas depends on a review of the disorder's knowledge and the features of women at risk of having a lack of understanding. The effect of community-level factors on awareness of OBF was not yet known in Nepal. Therefore, we aimed to investigate the community-level and individual-level factors of awareness of OBF among childbearing-aged women in Nepal. METHODS: The 2022 Nepal Demographic and Health Survey data were used for this study. It included 14 845 childbearing-aged women. Because of the clustering effects of Demographic and Health Survey data and the binary nature of the outcome variable, a multilevel binary logistic regression model was applied. An adjusted OR (AOR) with a 95% CI was reported to declare the statistical significance. In addition, the model that had the lowest deviance was the one that best fit the data. RESULTS: The overall prevalence of awareness of OBF among childbearing women in Nepal was 35.9% (95% CI 35.1%, 36.7%). Educational status (women who attended secondary education (AOR=1.65; 95% CI 1.41, 3.03) and higher education (AOR=4.29; 95% CI 1.14, 36.70)), currently working status (AOR=1.85; 95% CI 1.04, 3.30), birth history (AOR=2.23; 95% CI 1.48, 4.10), media exposure (AOR=1.54; 95% CI 1.07, 3.09) and women's age from 30 to 39 (AOR=3.38; 95% CI 1.35, 8.93) and 40 to 49 years old (AOR=4.68; 95% CI 1.60, 13.67) at the individual level, as well as urban residence (AOR=1.53; 95% CI 1.99, 2.87) and high community-level media exposure (AOR=2.05; 95% CI 1.67, 2.64) at the community level were statistically significant factors with awareness of OBF. CONCLUSION: Our study revealed that awareness of OBF among childbearing-aged women in Nepal was low (35.9%). The findings of this study will assist policymakers and public health programmers in understanding the magnitude of OBF awareness and the contributory factors. In addition, it will be useful to increasing awareness of OBF in the communities and promoting primary prevention approaches through education and motivation efforts.

Obstetric outcomes among rural parturients across US urban and rural hospitals.

INTRODUCTION: The objective of this study is to evaluate severe maternal morbidity (SMM) of rural parturients delivering at rural compared to urban hospitals in the US. METHODS: We identified patients aged 18-40 years in a multi-institutional claims database who lived in a rural ZIP code and delivered at a rural or urban hospital between October-December of 2015 and October-December of 2022. The primary outcome was SMM, and the secondary outcome was SMM exclusive of blood transfusions. We combined exact ZIP code matching and propensity score matching to compare SMM risk among patients living in the same rural community and delivering in urban as compared to rural hospitals. RESULTS: A total of 214 296 patients from 571 ZIP codes were identified, including 47% delivering at rural facilities and 53% delivering at urban facilities. The SMM rate was 1.1% (0.3% excluding blood transfusions). After matching, urban versus rural delivery was associated with increased odds of SMM other than blood transfusion (odds ratio 2.44; 95% confidence interval 1.81-3.28), but was not associated with differences in risk of any SMM. CONCLUSION: There was no evidence of reduced SMM for rural patients delivering at an urban rather than a rural hospital. SMM exclusive of blood transfusions was increased for rural patients delivering at urban hospitals after matching on ZIP code and predictors of urban hospital delivery. Our findings undermine the assumption that delivery at a rural facility has inherently greater risks relative to delivery at an urban facility. As some health systems face challenges to maintain rural labor and delivery units, patient safety must be considered if confronted with the possibility of unit or hospital closures.

Stated preferences of adolescents and young adults for sexual and reproductive health services in Africa: a systematic review protocol.

BACKGROUND: Adolescence and young adulthood are critical life stages with varied healthcare needs. Adolescents and young adults (AYAs) are often confronted with challenges in their sexual and reproductive health (SRH) and rights. Uptake of SRH services among AYAs groups remains limited, especially in resource-limited settings. This could be partly attributed to the existing services not catering for the preferences of AYAs. However, there is no systematic evaluation of research to explore the preferences of AYAs for SRH services in Africa. Therefore, the objective of this systematic review is to assess AYAs's preferences for SRH in Africa. METHODS AND ANALYSIS: The systematic review will follow the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. Stated preference studies in the area of SRH services conducted among AYAs will be included. We will search MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, Global Health and Google Scholar databases. Two independent researchers will screen the articles, and any disagreement will be handled through discussion with the broader research team. The quality of the included papers will be assessed and reported. The preferences for attributes, the most important and least important attributes and preference heterogeneity will be reported. In addition, the preference research gap across African regions and SRH services among AYAs will be reported. ETHICS AND DISSEMINATION: Ethical approval is not required for this protocol. The systematic review findings will be published in a peer-reviewed journal and presented at conferences. PROSPERO REGISTRATION NUMBER: CRD42023386944.

Familial DMRT1-related non-obstructive azoospermia: a case report.

PURPOSE: To report an exceptional case of male-to-male transmission of genetically based non-obstructive azoospermia (NOA) and varicocele through a naturally obtained pregnancy. SUBJECTS AND METHODS: A father and his son were both diagnosed with NOA after centrifugation and varicocele. The father has no other clinical concerns apart from infertility, detected after many attempts of having another child, but given his urological situation (bilateral varicocele and NOA) assisted reproductive techniques were discouraged. After genetic counseling, several genetic-chromosomal analyses were carried out in the son (karyotype, chromosome Y microdeletions, CFTR screening, NGS infertility panels, and finally array-CGH). RESULTS: After a series of inconclusive tests, array-CGH detected a deletion of 224-283 kb (del9p24.3) involving part of the KANK1 and DMRT1 genes, inherited from the father. Haploinsufficiency of DMRT1 was therefore considered the determining factor in the development of azoospermia in the family by a loss of function mechanism. CONCLUSION: The confirmation of father-to-son transmission of a deletion including DMRT1 represents an important point for clinicians dealing with male infertility, even when complete azoospermia is repetitively detected, and must be of hope for a relevant portion of men. Inclusion criteria for the access to assisted reproductive techniques may also be reconsidered and worthy of a greater number of clinical insights. Finally, since DMRT1 alterations have been associated with NOA and abnormal testicular development, but not specifically with varicocele, further studies are required to validate this issue, as varicocele may have played a crucial role in this case.

Assessing the effect of concerns about contraceptive-induced fertility impairment on hormonal contraceptive use by parity and residence: evidence from PMA Ethiopia 2020 cross-sectional survey.

OBJECTIVES: This study aims to describe patterns of beliefs about contraceptive-induced infertility and assess their relationship with current contraceptive use, including whether these relationships vary by parity and residence. DESIGN: We use data from Performance Monitoring for Action Ethiopia, a nationally representative, cross-sectional survey of 7491 women, aged 15-49, to assess agreement with the statement 'If I use family planning, I may have trouble getting pregnant next time I want to.' We used multilevel hierarchical models to identify the association between agreement and use of a hormonal method of contraception among 3882 sexually active, fecund women who wish to prevent pregnancy. We include interaction terms for parity and residence. RESULTS: 4 in 10 women disagreed (42.3%) and 2 in 10 strongly disagreed (20.7%) with the statement. Relative to women who strongly disagreed, women who disagreed and women who agreed had significantly lower odds of using a hormonal method of contraception (adjusted OR (aOR) 0.65, 95% CI 0.44 to 0.97 and 0.46, 95% CI 0.46, 95% CI 0.30 to 0.70). The effect of agreeing with the statement was strongest among high parity women (aOR 0.54, 95% CI 0.30 to 0.95). Greater agreement with the statement at the community-level use was associated with a reduction in the odds of using hormonal contraception but only among rural women. CONCLUSIONS: Efforts to address concerns around contraceptive-induced fertility impairment through the provision of comprehensive counselling and through community education or mass media campaigns are necessary, particularly among high-parity women and in rural communities. Interventions should acknowledge the possibility of delayed return to fertility for specific methods and attempt to address the root causes of concerns.

Economic evaluation of GnRH-agonist long protocol and GnRH-antagonist protocol in IVT/ICSI among the Chinese population: using pharmacoeconomic models.

OBJECTIVE: This paper uses health economics methods to discuss the cost-effectiveness value of long protocol and antagonist protocol for in vitro fertilisation and embryo transfer (ET) in the Chinese population. DESIGN: Health economic evaluation study. SETTING: The data needed to construct the model for this study were derived from published studies and other secondary sources in China. PARTICIPANTS: No patients participated in the study. MEASURES: The main outcomes were live birth rate (LBR) and cost. From the societal perspective, we considered the direct and indirect costs over the course of the treatment cycles. A cost-effectiveness was measured using the incremental cost-effectiveness ratio and the probability that a protocol has higher net monetary benefit. Sensitivity analysis was carried out to verify the reliability of the simulation results. RESULTS: For the Chinese population, the long protocol resulted in a higher LBR than the antagonist protocol (29.33% vs 20.39%), but at the same time, it was more expensive (ï¿¥29 146.26 (US$4333.17) vs ï¿¥23 343.70 (US$3470.51)), in the case of considering only one fresh ET cycle. It was the same when considering subsequent frozen ET (FET) cycles (51.78% vs 42.81%; ï¿¥30 703.02 (US$4564.62) vs ï¿¥24 740.95 (US$3678.24)). The results of most subgroups were consistent with the results of the basic analysis. However, for certain populations, the long protocol was the inferior protocol (less effective and more expensive). CONCLUSION: For the Chinese population, when the monetary value per live birth was greater than ï¿¥65 420 (US$9726) and ï¿¥66 400 (US$9872), respectively, considering only one fresh cycle and considering subsequent frozen cycles, the long protocol is the preferred protocol. This threshold also varies for women of different ages and ovarian response capacities. For women in POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) group 2, group 3 and group 4, antagonist protocol is recommended as the preferred protocol. The results of this study need to be verified by further large-scale randomised controlled trials.

Early endovascular retrieval of a migrated Implanon NXT from a branch of the right pulmonary artery.

A woman in her 20s was referred to a tertiary hospital emergency department for management of a migrating Implanon NXT. The Implanon was inserted 1 week prior by the patient's general practitioner who was unable to palpate the Implanon after insertion and hence, ordered an ultrasound scan which showed an actively migrating Implanon in the left basilic vein. She had mild chest pain, and her physical examination, ECG and blood tests were unremarkable. A CT chest showed a 31 mm foreign body within the right lower lobar artery. The foreign body was removed by interventional radiology by accessing the right internal jugular vein under ultrasound guidance and inserting a 6 FR pig catheter into the pulmonary trunk. The position was confirmed with angiogram and the foreign body was removed using a goose neck snare. The patient was discharged the same day with no complications, and fell pregnant a few months afterwards.

Evaluation of the sperm parameters, oxidative stress, and histopathological effects of vitamin B12 in preventing Helicobacter pylori-induced testicular toxicity: An experimental study.

Background: Helicobacter pylori (H. pylori) causes sterility by affecting the reproductive system. Vitamin B12 improves sperm quantity and function. Objective: Vitamin B12 protection against H. pylori adverse effects was investigated. Materials and Methods: 40 C57 male mice (6 wk) were randomly assigned to 4 equal groups (n = 10) including, group 1 (control without any intervention), group 2 (H), 3 (HP), and 4 (HB) received 1 × 109 colony forming unit (CFU) of H. pylori, 1 × 109 CFU of H. pylori+phosphate buffered saline, 1 × 109 CFU of H. pylori+50 µ g/kg vitamin B 12 intraperitoneally, respectively. In the induction groups, the H. pylori was orogasterically injected 3 times with 1 cc phosphate buffered saline throughout the day. Then testicular metrics, sperm motility, viability, quantity, and shape, plasma levels of malondialdehyde (MDA), superoxide dismutase, glutathione peroxidase, and total antioxidant capacity were measured. Also, testicular-tissue changes were examined using Johnson scores, tubular differentiation index, and spermatogenesis index. Vitamin B12, homocysteine, and testosterone serum levels were examined. Results: The results showed a significantly lower Johnson score, tubular differentiation index, and spermatogenesis index, and serum level of testosterone and homocysteine as well as a higher MDA level in the H and HP groups than the HB group (p < 0.05). In contrast, the highest superoxide dismutase and glutathione peroxidase enzymes activity and total antioxidant capacity as well as the lowest serum level of MDA were found in the HB group compared to other groups (p < 0.05). Conclusion: Vitamin B 12 increased antioxidant enzyme activity, enhanced sperm parameters, and decreased injury to testicular tissue. It can be used as a potent antioxidant in reducing testicular damage induced by H. pylori.

The role of HnrnpF/H as a driver of oligoteratozoospermia.

Male subfertility or infertility is a common condition often characterized by men producing a low number of sperm with poor quality. To gain insight into this condition, we performed a quantitative proteomic analysis of semen samples obtained from infertile and fertile men. At least 6 proteins showed significant differences in regulation of alternatively spliced isoforms. To investigate this link between aberrant alternative splicing and production of poor-quality spermatozoa, we overexpressed the hnrnpH/F-orthologue Glorund (Glo) in Drosophila, which was also found to be abundant in poor quality human sperm. Transgenic animals produced low numbers of morphologically defective spermatozoa and aberrant formation of the "dense body," an organelle akin to the mammalian manchette. Furthermore, fertility trials demonstrated that transgenic flies were either completely infertile or highly subfertile. These findings suggest that dysregulation of hnrnpH/F is likely to result in the production of low-quality semen, leading to subfertility or infertility in men.

Reproductive and sexual health literacy and associated factors among late-adolescent high school students in Arba Minch and Sawla towns, Southern Ethiopia, 2023: a cross-sectional study.

BACKGROUND: Adequate literacy in reproductive and sexual health is essential for adolescents to obtain, comprehend, evaluate and apply information necessary for making well-informed decisions, as low literacy leads to harmful decision-making, risk-taking and poorer health and self-management. These factors increase the magnitude and severity of problems related to sexuality and reproduction, including unintended pregnancy, HIV/sexually transmitted infections, unsafe abortion and death. However, information regarding the status and affecting factors of literacy in the reproductive and sexual health of adolescents is scarce. OBJECTIVE: To assess reproductive and sexual health literacy status and associated factors among late-adolescent high school students. DESIGN: A cross-sectional, institution-based study. SETTING: The study included eight secondary schools in Arba Minch town (Gamo Zone) and three in Sawla town (Gofa Zone) in the South Ethiopia Region. METHODS: The study was done between 20 May and 20 June 2023, among late adolescent high school students. Using multistage sampling, 577 students were recruited. Reproductive health literacy was assessed using the Health Literacy Measure for Adolescents tool. Data were loaded into EpiData-V.3.1 and analysed using SPSS-V.25. Binary logistic regression analyses were used to identify associated factors. Variables with a p value <0.25 in bivariable logistic regression were candidates for multivariable logistic regression. A Hosmer-Lemeshow goodness-of-fit statistic was checked and satisfied. Statistical significance was indicated at a p value<0.05. RESULT: The proportion of students with limited reproductive and sexual health literacy was 69.6% (CI 65.3% to 72.8%). The limited literacy status was significantly associated with school type (public school AOR 0.28 (0.17 to 0.46)), mother's occupation (merchant AOR 0.42 (0.23 to 0.76)), family monthly income (income 10 000-20 000 birr AOR 0.45 (0.22 to 0.95)), having regular physical exercise >30 min (more than once per week, AOR 0.44 (0.23 to 0.84)), and knowledge about condoms (poor AOR 2.23 (1.38 to 3.64)). CONCLUSION: A notable segment of adolescents exhibited limited reproductive and sexual health literacy. The result emphasises the necessity of all relevant parties to work diligently to guarantee that school adolescents can easily obtain, comprehend, evaluate and use reproductive and sexuality-related information.

Twenty-year oncology sperm banking experience at a Canadian academic fertility centre: a retrospective study examining the usage and reproductive outcomes from oncology patients.

BACKGROUND: Many cancer treatments pose a threat to fertility for patients. Semen cryopreservation before cancer treatment is an effective method to preserve fertility. There are sparse long-term data on the usage of samples from Canadian oncology sperm banks. METHODS: A retrospective chart review of all oncology sperm banking samples at a Canadian academic fertility centre from 2001 to 2020 was conducted. RESULTS: From 2001 to 2020, 4521 samples were banked by 2504 patients. The most frequent diagnoses among these patients were testicular cancer (29.5%) and lymphoma (26.9%). Of these patients, only 81 (3.2%) patients returned to use their samples with intrauterine insemination (IUI) or in vitro fertilisation (IVF) treatment and 62 (2.5%) patients transferred their samples to another clinic. The time between banking and return for usage of the sperm ranged from 1 to 131 months with a median of 18 months after banking. A total of 66 IVF cycles (104 embryo transfers) and 101 IUI cycles from 67 patients were reviewed. Of the 67 couples who used their samples, 53.7% achieved a clinical pregnancy. The clinical pregnancy rate was 6.6% per cycle for IUI and 30.8% per embryo transfer for IVF. Higher sperm concentration or total motile count was not associated with a higher chance of pregnancy. Patients who conceived had on average 1.9 ± 0.8 (p=0.02) more usable embryos per cycle than those who did not conceive. CONCLUSIONS: Sperm cryopreservation provides a valuable option for patients with cancer to achieve parenthood after potentially gonadotoxic cancer treatment. However, the overall usage of banked oncology sperm samples is very low.