Parents' perspectives on dental team as advisors to promote HPV vaccination among Spanish adolescents.

PURPOSE: Human papillomavirus (HPV) is a prevalent sexually transmitted infection responsible for many anogenital and oropharyngeal cancers. Dental care providers have the potential to influence vaccine uptake, yet little is known about how patients perceive their role in HPV education and prevention. METHODS: Parents of adolescents aged 9 to 17 years (n = 375) were recruited from Valdeorras District Hospital (Galicia, Spain) to investigate parents' attitudes concerning the involvement of dental care providers in discussions related to HPV. A survey was distributed to the participants, and 343 (91.5%) were included in the analysis. RESULTS: In general, nearly half of the parents reported feeling comfortable regarding discussing HPV with their dentist. Participants described more comfort with dentists than with dental hygienists. Parents' comfort levels were influenced by various social determinants of health, including education level, marital status, geographic origin, and child vaccination status (p > 0.05). CONCLUSION: Parents reported varying comfort levels when discussing HPV and its vaccine with dental professionals, displaying a preference for dentists. Dental settings have the potential to promote vaccination, but the existence of ongoing barriers needs to be addressed.

ASEBIR Quality Special Interest Group guidance for quality in assisted reproduction technology.

Assisted human reproduction has undergone rapid advances since its inception 45 years ago. To keep pace with these advances, assisted reproduction laboratories should adhere to a quality management system that addresses staffing and training, physical space and air quality, equipment maintenance and other operational matters, and ensures gamete and embryo handling in accordance with the latest quality and safety standards. Accordingly, this review aims to provide a reference document that highlights the critical aspects to consider when establishing and operating an ART laboratory. The review collates and expands upon published national and international guidelines and consensus documents, providing easier access to this large body of important information.

La norma UNE 179007: Sistemas de Gestión de la Calidad para Laboratorios de Reproducción Asistida, ¿obsoleta o vigente? / Une 179007: Quality management system applied to IVF laboratories, outdated or current

Los Laboratorios de Reproducción Humana Asistida (LRHA) deben tener implementado un Sistema de Gestión de Calidad (SGC) que favorezca el seguimiento de los procesos y técnicas realizadas en los mismos, así como la obtención de un servicio de alta calidad y fiabilidad para los pacientes. Con el fin de disponer de una certificación de calidad aplicada específicamente a los LRHA, en 2013 se publica la UNE 179007, otorgada por AENOR y basada en la norma de Sistema de Gestión de la Calidad de la Organización Internacional de Normalización (ISO) vigente en ese momento, es decir la ISO 9001:2008.En 2015 se publicó la 4ª versión de la ISO 9001 que incorporaba cambios de contenido y de formato, adaptándose a la estructura establecida por el Anexo SL, (elaborado con el fin de unificar estructuras en los estándares ISO). Ante esta nueva edición, como la UNE 179007 está basada en su versión ante-rior, surge la cuestión de si debido a estos cambios, la norma específica para los LRHA ha quedado obsoleta.En el presente trabajo se realizó una revisión a fondo de las estructuras y contenidos de las diferentes publicaciones para determinar hasta qué punto puede haber afectado a la vigencia de la UNE 179007. (AU)

Assisted reproductive laboratories have to provide a Quality Management System (QMS) to help the monitoring of the processes and techniques performed in them, as well as obtaining a high quality and reliable service for their patients. In order to have a quality certification specifically applied to IVF laboratories, it was published in 2013 UNE 179007 granted by AENOR and based on the Quality Management System of the International Organization for Standardization (ISO) in force in that year, ISO 9001:2008.The 4th version of ISO 9001 was published in 2015 including content and format changes tailoring to the structure fixed by Annex SL, which was prepared in order to unify structures in ISO standards. Faced to this new edition, as UNE 179007 is based in its previous version, these changes force us to consider if the specific standard for LRHA has become obsolete or is it still valid?In the present work, a thorough review of the structures and contents of the different publications was carried out to determine to what extent it may have affected the validity of UNE 179007. Once this exhaustive analysis was performed, we concluded that future updates should take into account the changes contemplated in ISO 9001:2015, which are more structural than content-related, as well as the evolution of the techniques used in the IVF laboratories. However, we believe that it cannot be consi-dered obsolete because it is still the only specific rule for the implementation of a QMS in assisted reproductive laboratories. (AU)

Single-embryo transfer: a key strategy to reduce the risk for multiple pregnancy in assisted human reproduction.

In the early days of assisted reproductive technology (ART), the main target was achieving gestation. Success rates were low, and multiple embryo transfers became common practice, with multiple pregnancies being 20 times higher than in natural conception. Multiple pregnancy is associated with a higher risk of complications for the mother and the baby than a singleton pregnancy. Added to healthcare costs, multiple pregnancy also involves other costs and psychosocial risks, with a high social and health costs. At present, success rates of assisted human reproduction (AHR) have improved dramatically, partially due to advances in laboratory techniques such as culture of blastocyst-stage embryos and vitrification. Additionally, there is a wide range of counseling, health and economic policies that have demonstrated being effective in increasing single-embryo transfer (SET) practices and reducing multiple pregnancies, which ensures satisfactory success rates. Therefore, single-embryo transfer emerges as the approach of choice for AHR to result in a full-term healthy newborn.

Colonisation of the male reproductive tract in asymptomatic infertile men: Effects on semen quality.

The objective was to explore presence/detection of microorganisms in the male reproductive tract (PMMRT) in asymptomatic patients undergoing infertility treatment and their effects on semen quality in our region. This study enrolled 205 men (mean age, 35.9 years) in a single-centre, tertiary university hospital from December 2015 to December 2016. We used the modified Meares-Stamey test, real-time polymerase chain reaction (rt-PCR) and the National Institutes of Health Chronic Prostatitis Sympton Index (NHI-CPSI) questionnaire to address this issue. No patient met the prostatitis criteria by the modified Meares-Stamey 4-sample test, 33 (16.1%) were positive for rt-PCR in the first-voided urine for any of the Mycoplasma (Ureaplasma urealyticum/parvum, Mycoplasma hominis/genitalium) and C. trachomatis was detected in two cases (1%), and three for rt-PCR in semen for HPV high-risk genotypes non-16/18 (1.5%). Significant statistical differences were reported among patients with and without PMMRT in terms of lower rate of progressive spermatozoa (PR) (p < .034), total motile sperm count (p < .028), normal morphologic forms, especially in the sperm head (p < .001) and highest viscosity (p < .012). It was concluded that PMMRT, specially Mycoplasmas, in asymptomatic infertility men, affects semen quality. The NIH-CPSI questionnaire was not a valid initial screening to subsequently evaluate the presence of prostatitis/PMMRT.

Prevalence of genital Mycoplasma and response to eradication treatment in patients undergoing assisted reproductive techniques / Prevalencia de micoplasmas genitales y respuesta al tratamiento de descolonización en pacientes de reproducción humana asistida

INTRODUCTION: Several studies have reported greater success of fertilisation by ART in couples who were not infected by Ureaplasma. Increased semen quality and better results have also been observed in couples who were treated with antibiotics to eradicate the infection. The aim of this study was to determine the prevalence of genital mycoplasmas in urine samples from male partners enrolled in the Assisted Reproduction Program (ARP) in our healthcare area so that, positive cases can be treated prior to the use of ART in order to increase the quality of semen, improve the embryo implantation rates and minimize the risk of adverse effects during pregnancy. MATERIAL AND METHODS: This study included couples enrolled in the ARP during 2016. Mycoplasma detection was made using real-time PCR. In positive cases, both members of the couple were treated with antibiotics until eradication of the microorganism. The antibiotics used were: azithromycin, doxycycline, levofloxacin, moxifloxacin, and clindamycin. RESULTS: Of the 205 men studied, 33 were positive: Ureaplasma urealyticum 15.1%, Mycoplasma hominis 3.9%. Eradication treatment with azithromycin failed in 50% compared to 10.2% for doxycycline. Of the 5 cases treated with levofloxacin, only 2 achieved elimination of U. urealyticum. CONCLUSIONS: We consider that genital mycoplasma routine screening could be useful in order to increase the quality of semen which could simplify the in vitro fertilisation procedures and raise the success rate of embryo implantation and pregnancy, especially when fast, sensitive and specific technics as real time PCR are used

INTRODUCCIÓN: Se han publicado estudios que demuestran mayores tasas de éxito en las técnicas reproducción asistida (TRA) en parejas no infectadas por micoplasmas. El objetivo de este estudio fue determinar la prevalencia de los micoplasmas genitales en muestras de orina del miembro masculino de las parejas incluidas en el Programa de Reproducción Asistida en nuestro Área Sanitaria realizando un tratamiento descolonizador con el fin de incrementar la calidad del semen, mejorar las tasas éxito de la embriotransferencia y minimizar los efectos adversos sobre la gestación. MATERIAL Y MÉTODOS: Participaron parejas incluidas en el Programa de Reproducción Asistida durante 2016. La detección de los micoplasmas se realizó por PCR en tiempo real. En los casos positivos, la pareja fue tratada con antibióticos hasta la erradicación del microorganismo. Los antibióticos usados fueron: azitromicina, doxiciclina, levofloxacino, moxifloxacino y clindamicina. RESULTADOS: De los 205 hombres estudiados, 33 fueron positivos: Ureaplasma urealyticum 15,1%, Mycoplasma hominis 3,9%. Azitromicina fracasó en el 50% de los casos y doxiciclina en el 10,2%. Con levofloxacino solo en 2 de 5 se consiguió la erradicación de U. urealyticum. CONCLUSIONES: El cribado de rutina de los micoplasmas genitales puede ser útil para mejorar la calidad del semen. Esto permitiría simplificar los procedimientos de fertilización in vitro e incrementar las tasas de éxito en la implantación de los embriones y en la gestación, especialmente con la aplicación de técnicas diagnósticas rápidas y específicas como la PCR en tiempo real