The impact of COVID-19 on male reproductive health: a Systematic Review.

OBJECTIVE: This systematic literature review aims to assess the impact of COVID-19 on male fertility. DATA SOURCES: The study draws upon data extracted from PubMed, SciELO, and LILACS databases. STUDY SELECTION: The review incorporates cross-sectional studies, cohort studies, and clinical trials, encompassing investigations related to the subject matter. The studies included were published between June 2020 and March 2023, and encompassed content in English, Portuguese, and Spanish. Exclusion criteria encompassed review articles, case reports, abstracts, studies involving animal models, duplicate articles, and letters to the editor. DATA COLLECTION: Data extracted included the author's name and publication year, the number of patients studied, patient age, the presence of COVID-19 in semen, observed hormonal changes, and alterations in seminal quality. CONCLUSIONS: While hormonal changes and a decline in seminal quality were observed in COVID-19 patients, the virus itself was not detected in semen in the analyzed articles, which contradicts certain findings in the existing literature. It is essential to note that methodologies in the studies were diverse, and, due to the novelty of this infection, it is premature to definitively ascertain its long-term effects on male fertility or whether fertility can recover after a period of convalescence. This underscores the necessity for further research, utilizing more robust methodologies such as cohort studies.

Effects of major analgesics on male fertility: A systematic literature review.

OBJECTIVE: To verify, based on a systematic literature review, the effects of the main analgesics on male fertility. DATA SOURCES: The studies were analyzed from the PubMed, SciELO and LILACS databases. STUDY SELECTION: The articles selected for the present review included: cohort studies; cross-sectional studies, clinical trials; complete studies; studies with animal models that addressed the proposed theme and that were published within the stipulated period from March 1, 2013, to March 31, 2023, in English, Portuguese and Spanish. These would later have to go through inclusion stages such as framing the type of study and exclusion criteria. DATA COLLECTION: Author's name, year of publication, study population, number of patients, analgesic, administration time, dose, and effect. CONCLUSIONS: There are in vitro and in vivo studies that link paracetamol and ibuprofen to endocrine and seminal changes that are harmful to male fertility. However, more clinical research is needed to determine the doses and timing of administration that affect fertility. The effects of aspirin on male fertility are still unclear due to the lack of studies and consistent methodologies. There is not enough research on dipyrone and its relationship with male fertility, requiring more studies in this area.

The impact of thyroid disorders on the clinical outcome of assisted reproductive techniques: a systematic approach over the last 10 years.

OBJECTIVE: To verify from a systematic literature review the possible effects of thyroid diseases on assisted reproduction techniques. DATA SOURCES: The studies were analyzed from the PubMed, Cochrane Library, LILACS databases. SELECTION OF STUDIES: The articles selected for the review included: cross-sectional studies, cohort studies, and clinical trials that addressed the proposed theme and which were published within the period stipulated from January 1, 2012, to March 5, 2022, in English, Portuguese and Spanish. These would later have to go through stages of inclusion as a framework of the type of study and exclusion criteria that were review articles, case reports, abstracts, articles with animal models, and duplicate articles and letters to the editor. DATA COLLECTION: Author's name; Number of patients; Clinical outcome; Use of drugs; Control group (in case it had); Clinical outcome. DATA SYNTHESIS: In in vitro fertilization and intracytoplasmic sperm injection it was verified that thyroid diseases can lead to effects such as a reduction in the rate of recovered oocytes, a decrease in the number of embryos, lower pregnancy rates, and increased chances of congenital anomalies in these patients and a reduction in the rate of implantation. Levothyroxine can increase the number of cycle cancellations. CONCLUSIONS: Thyroid diseases may have deleterious effects on the clinical outcome of in vitro fertilization and intracytoplasmic sperm injection.

Vaginal microbioma and the presence of Lactobacillus spp. as interferences in female fertility: A review system.

The vaginal microbiome is dominated by Lactobacillus spp. and the depletion of these microorganisms have been associated with adverse conditions that can affect women's health. Disturbance of the vaginal niche with a non-lactobacillary microbiota is associated with susceptibility to some diseases, such as obstetric alterations and infertility, resulting in failure in natural pregnancies and increased demand for assisted reproduction treatments. The present study sought to understand the influence of Lactobacillus spp. and fertility female. A systematic search was performed in the following databases: PubMed, MEDLINE, SciELO and LILACS, using the keywords: "Microbiome"; "Lactobacillus" and "Female Infertility", published in the last five years. The search resulted in 92 articles; however, 38 articles were excluded due to duplicity, 23 articles were excluded in the selection title/abstract, leaving 31 articles for full reading. In the end, 18 articles were analyzed. The studies encompassed a total of 2,011 women, using 27 types of samples to verify the composition of the microbiome. The eighteen articles that reported the microbiome of fertile women were constituted by a dominance of Lactobacillus spp. who joined to positive predictive outcomes in reproduction, while infertile women showed a dysbiotic profile. Therefore, analyzing bacterial patterns would allow a personalized diagnosis, which could favor personalized therapy for prevention and treatment of certain diseases.

Microbiota and seminal quality: A systematic review.

The microbiota is composed of numerous resident microorganisms, which contribute to the health and illness of the individual. When the microbiota is in dysbiosis, it can cause some pathological processes and in men it can be correlated with male infertility, so the present study does a systematic review, identifying whether there is a correlation between the microbiota and seminal quality. We analyzed 7 papers published in PubMed, Medline and the Cochrane library databases, in English and published between 2012 and 2022. In men with normal semen parameters, a higher prevalence of Lactobacillus. There was a higher prevalence of Prevotella in patients who had some seminal alteration. We conclude that the microbiota is correlated with seminal quality, since the decrease in Lactobacillus and the increase in other species is seen in infertile men.

Impact of sperm DNA fragmentation on the clinical outcome of assisted reproduction techniques: a systematic review of the last five years.

OBJECTIVE: To elucidate through a systematic literature review the impact sperm DNA fragmentation has on embryos from assisted reproduction techniques. DATA SOURCE: Studies from the "PubMed", "Embase", and "BVS" databases were analyzed. STUDIES SELECTION: The articles selected in the review included: cohort and case-control studies that addressed the proposed theme, published between January 1, 2017, and January 31, 2022, in English, Portuguese, and Spanish. As inclusion criteria: cohort and case-control articles. As exclusion criteria: articles outside the scope of the research, review articles, case reports, articles using animal models, abstracts, letters to the editor, and articles found duplicates in the databases. DATA COLLECTION: Number of couples or cycles; age (men/women); collection type; DNA damage (%); assisted reproduction activity and techniques. DATA SYNTHESIS: In in vitro fertilization, a reduction in fertilization rate, blastocyst rate, and embryo quality was observed. In addition to implantation and increased abortion rates in patients with high sperm DNA fragmentation. High rates of sperm DNA fragmentation in intracytoplasmic sperm injection led to reduced blastocyst production rate, embryo quality, implantation, and live birth rate, and in intrauterine insemination, a reduction in pregnancy rate. CONCLUSION: Sperm DNA fragmentation was a potential limiting factor for assisted reproduction techniques.

Non-invasive preimplantation genetic testing: a literature review.

Non-invasive preimplantation genetic testing emerged from the discovery of embryonic DNA in spent embryo culture medium. Considering that such methodology would be an important advance in assisted reproduction, this study aimed to evaluate the current scientific evidence, based on the reliability of non-invasive chromosome screening, through a literature review. We analyzed 14 original research papers in PubMed and SciELO, in English and Portuguese, published between 2016 and 2021 related to the topic. The agreement rate for ploidy compared to the traditional method ranged from 3.5% - 93.8% raising the discussion about the possible causes of this large variation, which may be due to the day of collection, spent culture media contamination, amplification methodology or the cytogenetic method used by each author. We concluded that the non-invasive test has many advantages over the traditional method, but that clinical replacement is not yet possible, and further studies are needed in order to have an accurate clinical test with the non-invasive methodology.

Cytotoxic Activity of Antineoplastic Agents on Fertility: A Systematic Review.

OBJECTIVE: To analyze the long-term effects of antineoplastic treatments on patient fertility. SELECTION OF STUDIES: The studies were selected through the New PubMed, Scielo and Lilacs databases along with references used for the creation of the present work. For the selection of studies, articles published between the periods from January 1, 2015 to April 6, 2020 in the English, Portuguese and Spanish languages were used. As inclusion criteria: cohort studies and studies conducted in vitro. As exclusion criteria: review articles, reported cases, studies that do not address thematic reproduction, studies that do not address the cancer theme, articles that used animals, articles that address the preservation of fertility and articles in duplicate in the bases. DATA COLLECTION: The collected data included: age of the patient at the beginning of treatment, type of neoplasm, type of antineoplastic treatment, chemotherapy used, radiotherapy dosage, radiotherapy site, effect of antineoplastic agents on fertility and number of patients in the study. DATA SYNTHESIS: Thirty studies were evaluated, antineoplastic chemotherapy agents and radiotherapy modulate serum hormone levels, reduces germ cell quantities and correlated with an increase in sterility rates. The effects mentioned occur in patients in the prepubertal and postpubertal age. CONCLUSION: Antineoplastic treatments have cytotoxic effects on the germ cells leading to hormonal modulation, and pubertal status does not interfere with the cytotoxic action of therapies.

OBJETIVO: Analisar os efeitos a longo prazo dos tratamentos antineoplásicos na fertilidade de pacientes. FONTES DE DADOS: Os estudos foram selecionados através das bases de dados New PubMed, Scielo e Lilacs, junto com as referências utilizadas para a confecção do trabalho. SELEçãO DOS ESTUDOS: Para a seleção dos estudos, foram utilizados artigos publicados entre os períodos de 01 de janeiro de 2015 a 06 de abril de 2020 nos idiomas inglês, português e espanhol. Como critérios de inclusão: estudos de coorte e estudos realizados in vitro. Como critérios de exclusão: artigos de revisão, relatos de caso, estudos que não abordavam a temática reprodução, estudos que não abordavam a temática câncer, artigos utilizando animais, artigos que abordavam preservação da fertilidade e artigos em duplicidade nas bases. COLETA DE DADOS: Os dados coletados incluíram: idade do paciente ao início do tratamento, tipo de neoplasia, tipo de tratamento antineoplásico, quimioterápicos utilizados, dosagem da radioterapia, local da radioterapia, efeito dos agentes antineoplásicos na fertilidade e número de pacientes dentro do estudo. SíNTESE DE DADOS: Trinta estudos foram avaliados. Os agentes quimioterápicos antineoplásicos e a radioterapia modulam níveis séricos hormonais de marcadores de fertilidade, reduzem a quantidade de células germinativas e estão correlacionados com um aumento da taxa de esterilidade. Os efeitos citados anteriormente ocorreram em pacientes com idade pré-púbere e pós-púbere. CONCLUSãO: Os tratamentos antineoplásicos possuem efeitos citotóxicos em células germinativas, levando a modulação hormonal, e o status puberal não interfere diretamente na ação citotóxica das terapias.

Cytotoxic activity of antineoplastic agents on fertility: a systematic review / Atividade citotóxica dos tratamentos antineoplásicos na fertilidade: Uma revisão sistemática

Abstract Objective: To analyze the long-term effects of antineoplastic treatments on patient fertility. Selection of Studies: The studies were selected through the New PubMed, Scielo and Lilacs databases along with references used for the creation of the present work. For the selection of studies, articles published between the periods from January 1, 2015 to April 6, 2020 in the English, Portuguese and Spanish languages were used. As inclusion criteria: cohort studies and studies conducted in vitro. As exclusion criteria: review articles, reported cases, studies that do not address thematic reproduction, studies that do not address the cancer theme, articles that used animals, articles that address the preservation of fertility and articles in duplicate in the bases. Data Collection: The collected data included: age of the patient at the beginning of treatment, type of neoplasm, type of antineoplastic treatment, chemotherapy used, radiotherapy dosage, radiotherapy site, effect of antineoplastic agents on fertility and number of patients in the study. Data Synthesis: Thirty studies were evaluated, antineoplastic chemotherapy agents and radiotherapy modulate serum hormone levels, reduces germ cell quantities and correlated with an increase in sterility rates. The effects mentioned occur in patients in the prepubertal and postpubertal age. Conclusion: Antineoplastic treatments have cytotoxic effects on the germ cells leading to hormonal modulation, and pubertal status does not interfere with the cytotoxic action of therapies.

Resumo Objetivo: Analisar os efeitos a longo prazo dos tratamentos antineoplásicos na fertilidade de pacientes. Fontes de dados: Os estudos foram selecionados através das bases de dados New PubMed, Scielo e Lilacs, junto com as referências utilizadas para a confecção do trabalho. Seleção dos estudos: Para a seleção dos estudos, foram utilizados artigos publicados entre os períodos de 01 de janeiro de 2015 a 06 de abril de 2020 nos idiomas inglês, português e espanhol. Como critérios de inclusão: estudos de coorte e estudos realizados in vitro. Como critérios de exclusão: artigos de revisão, relatos de caso, estudos que não abordavam a temática reprodução, estudos que não abordavam a temática câncer, artigos utilizando animais, artigos que abordavam preservação da fertilidade e artigos em duplicidade nas bases. Coleta de dados: Os dados coletados incluíram: idade do paciente ao início do tratamento, tipo de neoplasia, tipo de tratamento antineoplásico, quimioterápicos utilizados, dosagem da radioterapia, local da radioterapia, efeito dos agentes antineoplásicos na fertilidade e número de pacientes dentro do estudo. Síntese de dados: Trinta estudos foram avaliados. Os agentes quimioterápicos antineoplásicos e a radioterapia modulam níveis séricos hormonais de marcadores de fertilidade, reduzem a quantidade de células germinativas e estão correlacionados com um aumento da taxa de esterilidade. Os efeitos citados anteriormente ocorreram em pacientes com idade pré-púbere e pós-púbere. Conclusão: Os tratamentos antineoplásicos possuem efeitos citotóxicos em células germinativas, levando a modulação hormonal, e o status puberal não interfere diretamente na ação citotóxica das terapias.

Cytology-Based Screening During Antenatal Care as a Method for Preventing Cervical Cancer

Background: Cervical cancer is one of the most serious threats to women's lives. Therefore, the present study aimed to know the dynamics in the collection of cytologic samples during antenatal care as a method of cervical cancer screening and to identify the factors associated with its performance. Material and Methods: Analytical cross-sectional study carried out with pregnant and postpartum women in Fortaleza, Ceará, Northeastern Brazil. Data were collected using a questionnaire addressing sociodemographic variables, antenatal care, pregnancy and cytology-based screening for cervical cancer during antenatal care. Measures of central tendency were calculated and the Chi-squared test and Fisher's exact test were used with a significance level of 5%. Results: Participants were 229 pregnant women and 89 postpartum women. Age ranged 18 to 43 years, with a mean of 27.9 years (SD=6.1). Only 35 (11%) participants had Pap smears during antenatal care. A total of 283 women did not have Pap smears during pregnancy; of these, 229 (80.9%) did not have the test because of lack of clear information from the health professional, 25 (8.8%) for fear of bleeding or abortion, and 29 (10.3%) because they had had the test before pregnancy. Undergoing cytology-based screening for cervical cancer was associated with high-risk pregnancy (p=0.002), antenatal care provided by a physician (p=0.003), knowledge about the possibility of having the test during pregnancy (p<0.001) and paid job (p=0.043). Conclusion: The percentage of cytology-based screening for cervical cancer during antenatal care was low. Therefore, health education is suggested to improve this figure. However, receiving antenatal care at MEAC, having consultations with a physician, and knowing that it is possible to have a Pap smear during pregnancy were significant protective factors for undergoing cytology screening during pregnancy.

Dinâmica de oferecimento e realização da citologia em gestante de Fortaleza

O câncer de colo uterino foi responsável pelo óbito de 265 mil mulheres no mundo em 2012. Com exceção do câncer de pele, esse tumor é o que apresenta maior potencial de prevenção e cura, quando diagnosticado precocemente. O teste citopatológico convencional (Papanicolaou) é a principal estratégia de programas de rastreamento do câncer do colo do útero no Brasil e no mundo.Sabe-se que, em países em desenvolvimento, muitas mulheres só procuram os Serviços de Saúde quando apresentam sintomas de doenças ou durante a gravidez. Portanto, a gravidez pode ser uma boa oportunidade de realizar uma colpocitologia com o objetivo de prevenção do câncer do colo uterino. O presente estudo teve o objetivo de avaliar a dinâmica de oferecimento e realização de coleta de citologia oncótica para rastreamento de câncer de colo uterino em gestantes em Fortaleza-CE. Trata-se de um estudo descritivo de abordagem quantitativa do tipo transversal. A pesquisa foi desenvolvida na Maternidade Escola Assis Chateaubriand, com amostra de 318 pacientes.Para análise univariada e bivariada foi utilizado o programa estatístico SPSS. Apenas 11% das pacientes aproveitaram as consultas pré-natais para realizar o exame citopatológico do colo do útero...

Cervical cancer was responsible for the death of 265,000 women in the world in 2012. With the exception of skin cancer, this tumor is the one with the greatest potential for prevention and cure when diagnosed early.The conventional Pap test (Papanicolaou) is the main strategy of screening programs for cervical cancer in Brazil and worldwide. It is known that, in developing countries, many women only seek health services when they show symptoms of disease or during pregnancy. Therefore, pregnancy can be a good opportunity to conduct a Pap smear with the aim of preventing cervical cancer.This study had the objective of assess the dynamics of offering and performing cytology collection for screening cervical cancer in pregnant women in Fortaleza-CE. This is a descriptive cross-sectional study with a quantitative approach. The research was conducted at the Maternity School Assis Chateaubriand(MEAC), with a sample of 318 patients.Univariate and multivariate analysis was performed using SPSS statistical software. Only 11% of all patients and 10.8% of patients over 25 years took advantage of the prenatal consultations to make the Pap smear. Among the 283 (89%) patients who did not realize cervical cancer prevention in pregnancy, the majority, 80.9%,did not doit because the health professional had not offered...