Subject(s)
Obesity , Women's Health , Humans , Female , Obesity/epidemiology , Diabetes Mellitus/epidemiology , Diabetes Mellitus, Type 2ABSTRACT
OBJECTIVE: To evaluate the websites of Brazilian fertility clinics included in the 11th Report of the National Embryo Production System (SisEmbrio, 2017) for compliance with the 2004 American Society for Reproductive Medicine (ASRM) and the Brazilian Medical Council (Conselho Federal de Medicina, CFM) guidelines for advertising. METHODS: We performed an online evaluation of the websites of clinics listed in the 11th SisEmbrio report based on criteria from the 2004 ASRM guidelines (publication of success rates, live birth rates (LBR), method of LBR calculation, success rates by age range and diagnosis, experimental/investigational nature of procedures and the practice of comparison marketing) and CFM guidelines (clinic director name and register visible on the website; no prices displayed, no photos of patients nor success stories with patient identification). RESULTS: A total of 161 SiSEmbrio-registered clinics were evaluated: 153 (95.0%) had functional websites, and only seven were public clinics. Social media presence was as follows: 87 (54.03%) were on WhatsApp; 128 (79.5%) were on Facebook; and 122 (75.8%) were on Instagram. Seventy-five (46.6%) were on other social media platforms (YouTube, LinkedIn, and Twitter). Regarding CFM recommendations, 49 (30.4%) showed information of a registered director, 85 (52.8%) showed patient photos on their websites and/or social media accounts. Fifty-four clinics published success rates (33.5%) and 19 (11.8%) used their own data, whereas seven (4.3%) showed pregnancy rates by age. None reported LBR or advertised prices. CONCLUSIONS: The information published online by Brazilian fertility clinics is heterogeneous in nature. A significant portion of the websites does not follow some of the ASRM and CFM guidelines for advertising.
Subject(s)
Fertility Clinics , Reproductive Medicine , Pregnancy , Female , Humans , United States , Brazil , Reproduction , Pregnancy RateABSTRACT
In Brazil, women have free access to contraception through the public health system, the Unified Health System (SUS) which offers the following contraceptive methods: Male and female condoms, diaphragm, spermicide, copper intrauterine device (IUD), combined oral and injectable contraceptive hormones, progestin-only contraceptives and injections of medroxyprogesterone acetate (DMPA), emergency pill, female sterilization and vasectomy. However, difficulties in scheduling appointments, women's lack of information about contraceptive methods, and the limited availability of different methods all contribute to high rates of unintended pregnancies. The rate of contraceptive use by Brazilian women aged 18 to 49 is approximately 62%; poorer parts of the country and low levels of education are among the main factors associated with lower rates of contraceptive method use. There are therefore challenges to be taken up to minimize the rates of unwanted pregnancies, which are still too high, such as better distribution, better offer of different contraceptive methods for all regions of the country and better training of professionals involved in women's health care.
Title: La contraception dans d'autres pays - État de la situation au Brésil. Abstract: Au Brésil, les femmes ont un accès gratuit à la contraception à travers le système de santé publique, le Système de santé unifié (SUS), qui propose différentes méthodes contraceptives : préservatifs masculins et féminins, diaphragme, spermicide, dispositif intra-utérin au cuivre (DIU), hormones contraceptives combinées orales et injectables, progestatifs oraux microdosés et injections trimestrielles d'acétate de médroxyprogestérone (DMPA), pilule d'urgence, stérilisation féminine et vasectomie. Cependant, les difficultés à planifier les rendez-vous, le manque d'informations des femmes sur les méthodes contraceptives et l'offre limitée des différentes méthodes contribuent aux taux élevés de grossesses non désirées. Le taux d'utilisation des méthodes contraceptives par les femmes brésiliennes âgées de 18 à 49 ans est d'environ 62 % ; les régions les plus pauvres du pays et un faible niveau d'éducation sont parmi les principaux facteurs associés à un taux d'utilisation réduit. Des défis sont ainsi à relever pour minimiser les taux de grossesses non désirées, encore trop élevés, tels qu'une meilleure distribution et une meilleure offre pour toutes les régions du pays, ainsi qu'une meilleure formation des professionnels impliqués dans les soins de santé des femmes.
Subject(s)
Contraception , Adolescent , Adult , Brazil , Female , Humans , Male , Middle Aged , Pregnancy , Young AdultSubject(s)
COVID-19 , Female , Humans , Pandemics/prevention & control , SARS-CoV-2 , Surveys and Questionnaires , Women's HealthABSTRACT
Endometriosis Fertility Index (EFI) is a clinical staging system created to predict spontaneous pregnancy outcomes in patients with endometriosis. The present study aimed at evaluating the performance of EFI in symptomatic patients, submitted to laparoscopy for moderate and severe endometriosis associated to infertility in a Brazilian population. Seventy-seven women with endometriosis and pelvic pain, who desired to become pregnant, were selected from a tertiary care unit between those operated on between May 2007 and March 2017. All of them were submitted to laparoscopy for the surgical treatment of endometriosis and allowed to attempt natural conception for 36 months or immediately referred to in vitro fertilization (IVF). EFI was calculated according to surgical description and clinical information in medical records. Pregnancy rates and live birth rates after natural conception or IVF are reported and correlated to EFI. Fifty-three women tried natural conception and 24 were referred to IVF. Of the 53 who tried natural conception, 29 achieved pregnancy (54.7%) and 28 had live birth (52.8%). The majority of pregnancies (82.7%) occurred in the first 12 months after surgery and 75% of the patients who became spontaneously pregnant had EFI ≥ 7. Of the 24 patients referred to IVF, 13 became pregnant (54.1%) and 10 had live birth (41.7%). Infertility duration of 36 months or more and the presence of endometrioma increased the probability of having EFI ≤ 5. The overall live birth rate (LBR) for patients with low EFI scores (2-4) was 17% compared with 83.8% for those with higher EFI scores (6-9). EFI predicts pregnancy rates in patients operated on for moderate and severe endometriosis. Scores seem also to predict pregnancy rates after IVF.
