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1.
J Prev Med Public Health ; 53(2): 73-81, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32268461

RESUMO

OBJECTIVES: The purpose of this study was to determine whether eating non-home-prepared meals (NHPM), including fast food, ready-to-eat foods, and frozen foods, was associated with self-reported infertility in the United States women. METHODS: Data on diet and infertility from women aged 20-49 years who participated in the 2013-2014 and 2015-2016 National Health and Nutrition Examination Surveys were analyzed (n=2143). Dietary information, including the number and types of NHPM consumed, was obtained from a self-reported questionnaire, and infertility status was analyzed using the following question, "Have you ever attempted to become pregnant over a period of at least a year without becoming pregnant?" RESULTS: The frequency of NHPM consumption was positively associated with self-reported infertility after adjusting for confounding effects (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.48 to 5.38 of >1 vs. 0 NHPM/d). The odds of infertility were 2-3 times higher in women who consumed fast food than in those who did not consume fast food (OR, 2.73; 95% CI, 1.15 to 6.48 of >1 vs. 0 times/d). CONCLUSIONS: The frequency and types of NHPM may be a factor contributing to infertility. Although our findings require confirmation, they suggest that eating out may be deleterious to women fecundity.


Assuntos
Fast Foods , Comportamento Alimentar , Alimentos Congelados , Infertilidade Feminina/epidemiologia , Refeições , Adulto , Estudos Transversais , Dieta , Ingestão de Alimentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Gravidez , Prevalência , Saúde Reprodutiva , Autorrelato , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
2.
BMC Int Health Hum Rights ; 19(1): 33, 2019 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856810

RESUMO

BACKGROUND: The issue of child marriage is a form of human rights violation among young women mainly in resource-constrained countries. Over the past decades, child marriage has gained attention as a threat to women's health and autonomy. This study explores the prevalence of child marriage among women aged 20-24 years in sub-Saharan Africa countries and examines the association between child marriage and fertility outcomes. METHODS: Latest DHS data from 34 sub-Saharan African countries were used in this study. Sixty thousand two hundred and fifteen women aged 20-24 years were included from the surveys conducted 2008-2017. The outcome variables were childbirth within the first year of marriage (early fertility), first preceding birth interval less than 24 months (rapid repeat of childbirth), unintended pregnancy, lifetime pregnancy termination, the use of modern contraceptive methods, lifetime fertility and any childbirth. The main explanatory variable was child marriage (< 18 years) and the associations between child marriage and fertility outcomes were examined from the ever-married subsample to estimate odds ratios (ORs) and 95% CIs using binary logistic regression models. RESULTS: In the study population, the overall prevalence of women who experience child marriage was 54.0% while results showed large disparities across sub-Saharan African countries ranging from 16.5 to 81.7%. The prominent countries in child marriage were; Niger (81.7%), Chad (77.9%), Guinea (72.8%), Mali (69.0%) and Nigeria (64.0%). Furthermore, women who experience child marriage were 8.00 times as likely to have ≥3 number of children ever born (lifetime fertility), compared to women married at ≥18 years (OR = 8.00; 95%CI: 7.52, 8.46). Women who experience child marriage were 1.13 times as likely to use modern contraceptive methods, compared to adult marriage women (OR = 1.13; 95%CI: 1.09, 1.19). Those who married before the legal age were 1.27 times as likely to have lifetime terminated pregnancy, compared to women married at ≥18 years (OR = 1.27; 95%CI: 1.20, 1.34). Also women married at < 18 years were more likely to experience childbirth, compared to women married later (OR = 5.83; 95%CI: 5.45, 6.24). However, women married at < 18 years had a reduction in early childbirth and a rapid repeat of childbirth respectively. CONCLUSION: Implementing policies and programmmes against child marriage would help to prevent adverse outcomes among women in sub-Saharan Africa. Also, social change programmes on child-marriage would help to reduce child marriage, encourage the use of modern contraceptive, which would minimize lifetime terminated pregnancy and also children ever born.


Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Infertilidade Feminina/epidemiologia , Casamento/estatística & dados numéricos , Adulto , África ao Sul do Saara/epidemiologia , Criança , Bem-Estar da Criança , Estudos Transversais , Feminino , Humanos , Gravidez , Saúde Reprodutiva/estatística & dados numéricos , Adulto Jovem
3.
BMC Womens Health ; 19(1): 163, 2019 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-31852486

RESUMO

BACKGROUND: Informal street traders are exposed on a daily basis to traffic emissions and biomass fuel smoke containing a variety of pollutants. These exposures are likely to place the female traders at increased risk for adverse reproductive outcomes. AIM: The aim of this study was to compare the reproductive outcomes among street traders exposed to pollutants from their work-related activities and traders without such exposure. METHODS: A cross-sectional study was conducted among 305 female traders selected from exposed and non-exposed areas within the Warwick Junction trading hub, located in Durban, South Africa. Validated reproductive questionnaires and clinical assessments were conducted on all participants. Adverse reproductive outcomes such as low birth weight, spontaneous abortions and infertility were assessed. RESULTS: The mean age of the traders was 43.6 years (SD:12.1), mostly single (63%) and worked in trading hub for an average of 14 years. There were 876 pregnancies reported in the total sample. Traders pregnant while working in this location accounted for 120 pregnancies There was an increased risk of exposed traders having a low birth weight infant as compared to non-exposed traders (OR = 3.7; CI: 1.8, 7.6). Exposed traders were also almost 3 times more likely to be infertile as compared to non-exposed traders (OR = 2.6; CI: 1.6, 4.3). CONCLUSIONS: This study has demonstrated that female street traders working within a trading hub in KwaZulu-Natal, South Africa; exposed to occupational pollutants show an association with developing infertility and low birth weight infants. Recommendations to mitigate adverse exposures have been suggested which include short term safety interventions and better cooking practices and future long term policy interventions.


Assuntos
Poluentes Atmosféricos/análise , Infertilidade Feminina/epidemiologia , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Complicações na Gravidez/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Infertilidade Feminina/etiologia , Pessoa de Meia-Idade , Doenças Profissionais/etiologia , Gravidez , Complicações na Gravidez/etiologia , Saúde Reprodutiva , Fatores de Risco , África do Sul/epidemiologia , Emissões de Veículos/análise
4.
Afr Health Sci ; 19(2): 1866-1874, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656469

RESUMO

Background: Prior studies on Hysterosalpingography (HSG) have shown that pelvic inflammatory disease (PID) related tubal adhesions accounted for 30 - 50% of female infertility, with as high as 80% reported in some studies. With improved access to contraceptives, antibiotics and promotion of safe practices, the abnormal findings in HSG may have reduced or altered. Objective: To document the imaging findings in the HSG of participants and to compare current findings with prior studies done nationally and internationally. Method: A retrospective evaluation of 974 HSGs done at the tertiary diagnostic center over a 7-year period was conducted and analyzed using diagnostic accuracy tables. Results: Tubal pathologies were the most common abnormality in this study, (35.1% of the cases), comprising tubal blockage and hydrosalpinges; followed by uterine masses seen in 223 (22.9%) of the clients. Tubal occlusion was higher in clients with multiple abnormal findings; while normal sized and large uterine cavities had a higher percentage of bilateral tubal patency. Conclusion: Tubal factors remain the most common abnormality seen in the HSGs of infertile women in this study, though with lower prevalence compared with prior older studies. Forty seven (47%) of the cases of female factor infertility had normal HSGs with bilateral tubal patency.


Assuntos
Doenças das Tubas Uterinas/diagnóstico por imagem , Tubas Uterinas/diagnóstico por imagem , Histerossalpingografia/métodos , Infertilidade Feminina/diagnóstico por imagem , Útero/diagnóstico por imagem , Adolescente , Adulto , Distribuição por Idade , Doenças das Tubas Uterinas/complicações , Doenças das Tubas Uterinas/epidemiologia , Feminino , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/etiologia , Estudos Retrospectivos , Fatores Socioeconômicos , Adulto Jovem
5.
BMC Womens Health ; 19(1): 114, 2019 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-31484531

RESUMO

BACKGROUND: Human instinctively desire to have offspring. Infertility can cause painful emotional experiences throughout the life mainly known as quality of life impairment. This study aimed to investigate the impact of infertility on a woman's quality of life. METHODS: A number of 180 infertile and 540 fertile women participated in this matched case-control study. The cases were selected through a combination of multistage stratified and cluster sampling methods. For each infertile woman three fertile women were randomly selected. The data gathering instrument consisted of demographic variables and the WHOQOL-BREF questionnaire. Data collection was conducted through interview with participants. The multivariate marginal model and SPSS software 21 were used for data analyses with a significance level of 0.05. RESULTS: The results of the multivariate modeling show infertility can potentially affect various aspects of women's quality of life such as physical health (p <  0.001), mental health (p <  0.001), social health (p <  0.001) and the total score of quality of life (p <  0.001) significantly. CONCLUSION: An infertile woman practice a relatively lower scores in QOL sub-scales of mental, physical and environmental health; while they experience a higher social health score than a fertile woman.


Assuntos
Infertilidade Feminina/psicologia , Qualidade de Vida , Estresse Psicológico , Saúde da Mulher , Adulto , Estudos de Casos e Controles , Feminino , Disparidades nos Níveis de Saúde , Humanos , Infertilidade Feminina/epidemiologia , Irã (Geográfico)/epidemiologia , Saúde Mental/estatística & dados numéricos , Comportamento Social , Inquéritos e Questionários
6.
Surgery ; 166(4): 670-677, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31420214

RESUMO

BACKGROUND: The aim of this study was to assess the association of the mode of surgery on female fertility after restorative proctocolectomy with ileal pouch-anal anastomosis. METHODS: All female patients aged 18 to 44 years who underwent restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis, familial adenomatous polyposis, or Crohn's disease at the Cleveland Clinic Ohio or the Cleveland Clinic Florida from 1983 to 2012 were sent a standardized fertility questionnaire. Infertility was defined as lack of pregnancy after 1 year of unprotected sexual intercourse. Patients who had attempted to conceive after restorative proctocolectomy with ileal pouch-anal anastomosis were compared based on the surgical approach: laparoscopic ileal pouch-anal anastomosis versus open ileal pouch-anal anastomosis. RESULTS: A total of 890 female patients were surveyed, of which 519 (58.3%) responded. Of these, 161 (31%) had attempted pregnancy after surgery: 18 (12%) had laparoscopic ileal pouch-anal anastomosis and 143 (88%) had open ileal pouch-anal anastomosis. There were no significant differences regarding demographics between groups. There was no difference in reported infertility rates (61.1% vs 65%, respectively, P = 0.69) between the laparoscopic ileal pouch-anal anastomosis and open ileal pouch-anal anastomosis groups. The median time to pregnancy (3.5 months vs 9 months, respectively, log-rank P = 0.01) was reduced in patients who underwent laparoscopic ileal pouch-anal anastomosis compared with those who underwent open ileal pouch-anal anastomosis. CONCLUSION: Postoperative infertility rates were higher after ileal pouch-anal anastomosis regardless of mode of surgery. However, laparoscopy was associated with a significantly reduced time to conceive compared with the open approach.


Assuntos
Infertilidade Feminina/etiologia , Doenças Inflamatórias Intestinais/patologia , Doenças Inflamatórias Intestinais/cirurgia , Laparoscopia/efeitos adversos , Laparotomia/efeitos adversos , Proctocolectomia Restauradora/métodos , Centros Médicos Acadêmicos , Adolescente , Adulto , Estudos de Coortes , Colectomia/métodos , Colite Ulcerativa/patologia , Colite Ulcerativa/cirurgia , Doença de Crohn/patologia , Doença de Crohn/cirurgia , Feminino , Seguimentos , Humanos , Incidência , Infertilidade Feminina/epidemiologia , Laparoscopia/métodos , Laparotomia/métodos , Proctocolectomia Restauradora/efeitos adversos , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto Jovem
7.
Nutrients ; 11(8)2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31434238

RESUMO

We aimed to estimate the seroprevalence and the prevalence of coeliac disease (CD) in women with reproductive problems. A systematic review of English published articles until June 2019 was performed in PubMed and Scopus using the terms: (infertility and (coeliac disease OR gluten) OR (miscarriage and (coeliac disease OR gluten) OR (abortion and (coeliac disease OR gluten). All articles showing numerical data of anti-transglutaminase type 2 or anti-endomisium antibodies, or intestinal biopsy information were included. The study group comprised women with overall infertility, unexplained infertility, or recurrent spontaneous abortions. Two authors independently performed data extraction using a predefined data sheet. The initial search yielded 310 articles, and 23 were selected for data extraction. After meta-analysis, the pooled seroprevalence was very similar for overall and unexplained infertility, with a pooled proportion of around 1.3%-1.6%. This implies three times higher odds of having CD in infertility when compared to controls. The pooled prevalence could not be accurately calculated due to the small sample sizes. Further studies with increased sample sizes are necessary before giving specific recommendations for CD screening in women with reproductive problems, but current data seem to support a higher risk of CD in these women.


Assuntos
Doença Celíaca/epidemiologia , Infertilidade Feminina/epidemiologia , Aborto Habitual/epidemiologia , Autoanticorpos/sangue , Biópsia , Doença Celíaca/diagnóstico , Doença Celíaca/imunologia , Duodeno/patologia , Grupos Étnicos , Feminino , Proteínas de Ligação ao GTP/imunologia , Humanos , Imunoglobulina A/sangue , Gravidez , Transglutaminases/imunologia
8.
BMC Res Notes ; 12(1): 545, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31455408

RESUMO

OBJECTIVE: This study determined the association of anthropometric indices with hormonal imbalance among infertile women in a Ghanaian population. RESULTS: Follicle stimulating hormone (FSH) levels (18.47 vs. 8.67, p-value = 0.002), and luteinizing hormone (LH) (12.43 vs. 8.01, p-value = 0.044) were higher in women with primary infertility compared with women presenting with secondary infertility. Waist circumference (WC) and waist-to-height ratio (WHtR) showed significant negative partial correlation with prolactin in both primary and secondary infertile women. Also a significant negative partial correlation was observed between BMI and prolactin in secondary infertile women only. Waist-to-hip ratio (WHR) showed a positive association with LH in both primary and secondary infertility. WHR also showed significant positive correlation to LH/FSH ratio in secondary infertility whereas body adiposity index (BAI) showed a negative correlation to LH/FSH ratio. In a correlation analysis of anthropometric measures with hormonal profile and causes of infertility as a fixed factor, the association between anthropometric indices and fertility hormones was largely dependent on the underlying causes of infertility.


Assuntos
Antropometria/métodos , Peso Corporal , Hormônio Foliculoestimulante/metabolismo , Infertilidade Feminina/metabolismo , Infertilidade Feminina/fisiopatologia , Hormônio Luteinizante/metabolismo , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Infertilidade Feminina/epidemiologia , Masculino , Fatores de Risco , Adulto Jovem
10.
Biomed Res Int ; 2019: 6140285, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31281841

RESUMO

Background: Having a child is important among married women in Northern Ghana. Among married women, infertility is the main factor causing childlessness. Child adoption provides an alternative for married women to have children. The purpose of the study was to explore the perceived barriers of child adoption among women with infertility. Methods: The study used an exploratory qualitative approach to understand barriers of child adoption. The study was conducted among 15 women attending fertility clinic in a mission hospital in Northern Ghana. Participants were purposively recruited and data collected by individual face-to-face in-depth interviews. The interviews were audio-recorded, transcribed, and analysed using content analysis. Data were collected between January and March, 2016, in an office in the hospital. Results: The results suggest that barriers of child adoption include negative reaction of husbands, psychological dissatisfaction, and family dynamics. It was realised that husbands' reaction includes preference for biological children and marrying of second wives. Child adoption was psychologically dissatisfying to participants with some suggesting that it will make no difference and is a sign of acceptance of defeat in the quest to have biological children. The study findings also suggested that family dynamics that could hinder the practice of child adoption includes high value for blood relations, blaming of the woman, unpredictable family influence, discrimination against the adopted child, and family not allowing the adopted child to inherit property. Conclusion: The preference for biological children is by far an outstanding barrier and a major influence of all the emanating barriers associated with child adoption. There is the need for public education and special counselling session for husbands and other family members on child adoption as an alternative solution for infertility.


Assuntos
Adoção/psicologia , Infertilidade Feminina/epidemiologia , Pesquisa Qualitativa , Adulto , Criança , Família , Feminino , Gana/epidemiologia , Humanos , Casamento , Cônjuges
11.
Andrologia ; 51(9): e13370, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31332817

RESUMO

Kisspeptin, a peptide hormone, plays a pivotal role in fertility and neuroendocrine regulation of hypothalamo-pituitary-gonadal axis. Increased kisspeptin and reproductive hormones are responsible for fertility in male and females. This study aimed to explore the role of kisspeptin on hypothalamo-pituitary-gonadal axis by comparing the levels of kisspeptin in fertile and infertile subjects and identifying single nucleotide polymorphisms (SNPs) of KISS1 gene in exon 2 and exon 3 of infertile male and female cohorts. A cross-sectional study was carried out on 80 males (44 infertile and 36 fertile) and 88 females (44 in each group). Significantly high levels of kisspeptin (KP), follicle-stimulating hormone (FSH), luteinizing hormone and testosterone were observed in fertile male and female subjects except low FSH levels in comparison with infertile female subjects. One polymorphism in exon 2 (E1225K [G/A 3673]) and three in exon 3 (P1945A [C/G 5833]; Insertion of T at 6075; G2026G [C/G 6078]) in infertile group were detected, with low KP and hormonal levels. Male subjects had abnormal sperm parameters and unsuccessful attempt of intracytoplasmic sperm injection in females. Expression of SNP in exon 2 and exon 3 of KISS1 could be responsible for alteration in release of reproductive hormones and gonadal functions, hence causing infertility.


Assuntos
Sistema Hipotálamo-Hipofisário/fisiopatologia , Infertilidade Feminina/genética , Infertilidade Masculina/genética , Kisspeptinas/genética , Adulto , Estudos Transversais , Éxons/genética , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/epidemiologia , Infertilidade Masculina/sangue , Infertilidade Masculina/epidemiologia , Kisspeptinas/sangue , Hormônio Luteinizante/sangue , Masculino , Pessoa de Meia-Idade , Mutação , Paquistão/epidemiologia , Polimorfismo de Nucleotídeo Único , Testosterona/sangue
12.
Cochrane Database Syst Rev ; 7: CD012711, 2019 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-31334846

RESUMO

BACKGROUND: Women with inflammatory bowel disease (IBD) may require surgery, which may result in higher risk of infertility. Restorative proctocolectomy with ileal anal pouch anastomosis (IPAA) may increase infertility, but the degree to which IPAA affects infertility remains unclear, and the impact of other surgical interventions on infertility is unknown. OBJECTIVES: Primary objective• To determine the effects of surgical interventions for IBD on female infertility.Secondary objectives• To evaluate the impact of surgical interventions on the need for assisted reproductive technology (ART), time to pregnancy, miscarriage, stillbirth, prematurity, mode of delivery (spontaneous vaginal, instrumental vaginal, or Caesarean section), infant requirement for resuscitation and neonatal intensive care, low and very low birth weight, small for gestational age, antenatal and postpartum hemorrhage, retained placenta, postpartum depression, gestational diabetes, and gestational hypertension/preeclampsia. SEARCH METHODS: We searched MEDLINE, Embase, CENTRAL, and the Cochrane IBD Group Specialized Register from inception to September 27, 2018, to identify relevant studies. We also searched references of relevant articles, conference abstracts, grey literature, and trials registers. SELECTION CRITERIA: We included observational studies that compared women of reproductive age (≥ 12 years of age) who underwent surgery to women with IBD who had a different type of surgery or no surgery (i.e. treated medically). We also included studies comparing women before and after surgery. Any type of IBD-related surgery was permitted. Infertility was defined as an inability to become pregnant following 12 months of unprotected intercourse. Infertility at 6, 18, and 24 months was included as a secondary outcome. We excluded studies that included women without IBD and those comparing women with IBD to women without IBD.. DATA COLLECTION AND ANALYSIS: Two review authors independently screened studies and extracted data. We used the Newcastle-Ottawa Scale to assess bias and GRADE to assess the overall certainty of evidence. We calculated the pooled risk ratio (RR) and 95% confidence interval (CI) using random-effects models. When individual studies reported odds ratios (ORs) and did not provide raw numbers, we pooled ORs instead. MAIN RESULTS: We identified 16 observational studies for inclusion. Ten studies were included in meta-analyses, of which nine compared women with and without a previous IBD-related surgery and the other compared women with open and laparoscopic IPAA. Of the ten studies included in meta-analyses, four evaluated infertility, one evaluated ART, and seven reported on pregnancy-related outcomes. Seven studies in which women were compared before and after colectomy and/or IPAA were summarized qualitatively, of which five included a comparison of infertility, three included the use of ART, and three included other pregnancy-related outcomes. One study included a comparison of women with and without IPAA, as well as before and after IPAA, and was therefore included in both the meta-analysis and the qualitative summary. All studies were at high risk of bias for at least two domains.We are very uncertain of the effect of IBD surgery on infertility at 12 months (RR 5.45, 95% CI 0.41 to 72.57; 114 participants; 2 studies) and at 24 months (RR 3.59, 95% CI 1.32 to 9.73; 190 participants; 1 study). Infertility was lower in women who received laparoscopic surgery compared to open restorative proctocolectomy at 12 months (RR 0.70, 95% CI 0.38 to 1.27; 37 participants; 1 study).We are very uncertain of the effect of IBD surgery on pregnancy-related outcomes, including miscarriage (OR 2.03, 95% CI 1.14 to 3.60; 776 pregnancies; 5 studies), use of ART (RR 25.09, 95% CI 1.56 to 403.76; 106 participants; 1 study), delivery via Caesarean section (RR 2.23, 95% CI 1.00 to 4.95; 20 pregnancies; 1 study), stillbirth (RR 1.96, 95% CI 0.42 to 9.18; 246 pregnancies; 3 studies), preterm birth (RR 1.91, 95% CI 0.67 to 5.48; 194 pregnancies; 3 studies), low birth weight (RR 0.61, 95% CI 0.08 to 4.83), and small for gestational age (RR 2.54, 95% CI 0.80 to 8.01; 65 pregnancies; 1 study).Studies comparing infertility before and after IBD-related surgery reported numerically higher rates of infertility at six months (before: 1/5, 20.0%; after: 9/15, 60.0%; 1 study), at 12 months (before: 68/327, 20.8%; after: 239/377, 63.4%; 5 studies), and at 24 months (before: 14/89, 15.7%; after: 115/164, 70.1%; 2 studies); use of ART (before: 5.3% to 42.2%; after: 30.3% to 34.3%; proportions varied across studies due to differences in which women were identified as at risk of using ART); and delivery via Caesarean section (before: 8/73, 11.0%; after: 36/75, 48.0%; 2 studies). In addition, women had a longer time to conception after surgery (two to five months; 2 studies) than before surgery (5 to 16 months; 2 studies). The proportions of women experiencing miscarriage (before: 19/123, 15.4%; after: 21/134, 15.7%; 3 studies) and stillbirth (before: 2/38, 5.3%; after: 3/80: 3.8%; 2 studies) were similar before and after surgery. Fewer women experienced gestational diabetes after surgery (before: 3/37, 8.1%; after: 0/37; 1 study), and the risk of preeclampsia was similar before and after surgery (before: 2/37, 5.4%; after: 0/37; 1 study). We are very uncertain of the effects of IBD-related surgery on these outcomes due to poor quality evidence, including confounding bias due to increased age of women after surgery.We rated evidence for all outcomes and comparisons as very low quality due to the observational nature of the data, inclusion of small studies with imprecise estimates, and high risk of bias among included studies. AUTHORS' CONCLUSIONS: The effect of surgical therapy for IBD on female infertility is uncertain. It is also uncertain if there are any differences in infertility among those undergoing open versus laparoscopic procedures. Previous surgery was associated with higher risk of miscarriage, use of ART, Caesarean section delivery, and giving birth to a low birth weight infant, but was not associated with risk of stillbirth, preterm delivery, or delivery of a small for gestational age infant. These findings are based on very low-quality evidence. As a result, definitive conclusions cannot be made, and future well-designed studies are needed to fully understand the impact of surgery on infertility and pregnancy outcomes.


Assuntos
Infertilidade Feminina/etiologia , Doenças Inflamatórias Intestinais/cirurgia , Taxa de Gravidez , Proctocolectomia Restauradora , Bolsas Cólicas/efeitos adversos , Feminino , Humanos , Infertilidade Feminina/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Gravidez , Resultado da Gravidez , Proctocolectomia Restauradora/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Técnicas de Reprodução Assistida
13.
Int J Gynaecol Obstet ; 146(2): 200-205, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31162639

RESUMO

OBJECTIVE: To determine the prevalence of Chlamydia trachomatis infection and the correlates of tubal pathology among Ghanaian women undergoing hysterosalpingography for suspected tubal factor infertility. METHODS: A cross-sectional study was conducted among 189 women with infertility who underwent hysterosalpingography at Korle Bu Teaching Hospital, Ghana, from September 1 to November 30, 2016. Demographic data; obstetric and gynecologic history; and hysterosalpingography findings were collected using a structured questionnaire. Endocervical swabs were tested for the presence of Chlamydia trachomatis using a rapid antigen-based diagnostic kit. Associations between the variables were assessed using bivariate analysis. RESULTS: Positive test results for Chlamydia trachomatis were recorded among 15 participants, giving an overall prevalence of 7.9% (95% confidence interval [CI] 4.1%-11.7%). In all, 67 (35.4%) participants had abnormal findings on hysterosalpingography, with 40 (21.2%) displaying bilateral tubal occlusion. The remaining 122 (64.6%) women had normal findings on hysterosalpingography. Eight participants with normal tubal appearance tested positive for Chlamydia trachomatis (prevalence 6.6%, 95% CI 2.2%-11.0%), whereas seven participants with abnormal tubal appearance tested positive (prevalence 10.4%, 95% CI 3.1%-17.7%; P=0.402). No associations were found between participant characteristics and tubal pathology. CONCLUSION: The prevalence of Chlamydia trachomatis did not differ by hysterosalpingography findings.


Assuntos
Infecções por Chlamydia/epidemiologia , Doenças das Tubas Uterinas/diagnóstico , Histerossalpingografia , Infertilidade Feminina/cirurgia , Adulto , Anticorpos Antibacterianos/sangue , Infecções por Chlamydia/diagnóstico , Chlamydia trachomatis/isolamento & purificação , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/patologia , Gravidez , Prevalência
14.
MSMR ; 26(6): 20-27, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31237765

RESUMO

This report presents the incidence and prevalence of diagnosed female infertility among active component service women. During 2013-2018, 8,744 active component women of childbearing potential were diagnosed with infertility for the first time, resulting in an overall incidence of 79.3 cases per 10,000 person-years (p-yrs). Compared to their respective counterparts, women in their 30s, non-Hispanic blacks, those in healthcare and pilot/air crew occupations, Army personnel, and those who were married had the highest incidence rates. The incidence of diagnosed female infertility decreased from 85.1 per 10,000 p-yrs in 2013 to 63.6 per 10,000 p-yrs in 2018 despite a concurrent increase in the rate of fertility testing. During the surveillance period, the average annual prevalence of diagnosed female infertility was 1.6%. Of the service women who were diagnosed with infertility for the first time during the surveillance period, 1,808 (20.7%) delivered a live birth within 2 years after the incident infertility diagnosis. Current findings indicate that the prevalence of diagnosed female infertility among active component service women is lower than estimates of self-reported infertility from surveys of U.S. civilians and service women.


Assuntos
Infertilidade Feminina , Saúde Reprodutiva/estatística & dados numéricos , Saúde da Mulher/estatística & dados numéricos , Adulto , Feminino , Humanos , Incidência , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/epidemiologia , Militares/estatística & dados numéricos , Vigilância da População , Estados Unidos/epidemiologia
15.
Nutrients ; 11(7)2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31252555

RESUMO

Obesity plays an important role in human fertility in both genders. The same is true for vitamin D, for which accumulating evidence from observational human studies suggests a key role for both male and female fertility. In the latter case, however, robust data from relevant interventional studies are currently lacking. It is also not clear whether obesity and vitamin D deficiency, besides their independent effect on human infertility, act in synergy. Several pathogenetic mechanisms may be proposed as a linkage between vitamin D deficiency and obesity, with respect to infertility. In any case, the independent contribution of vitamin D deficiency in obese infertile states needs to be proven in interventional studies focusing on either vitamin D supplementation in obese or weight loss strategies in vitamin D-deficient infertile patients.


Assuntos
Fertilidade , Infertilidade Feminina/epidemiologia , Infertilidade Masculina/epidemiologia , Obesidade/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/sangue , Animais , Biomarcadores/sangue , Suplementos Nutricionais , Feminino , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/fisiopatologia , Infertilidade Feminina/terapia , Infertilidade Masculina/sangue , Infertilidade Masculina/fisiopatologia , Infertilidade Masculina/terapia , Masculino , Obesidade/sangue , Obesidade/fisiopatologia , Obesidade/terapia , Gravidez , Prognóstico , Técnicas de Reprodução Assistida , Medição de Risco , Fatores de Risco , Vitamina D/uso terapêutico , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/fisiopatologia
16.
Gynecol Endocrinol ; 35(8): 661-664, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31106610

RESUMO

To evaluate the preterm delivery and other obstetrics complications similar in singleton pregnancies achieved through IVF compared to spontaneous pregnancies. Retrospective case-control study included 1663 women with singleton pregnancies following IVF-ICSI (study group) and 3326 women with singleton spontaneous pregnancies (control group) who delivered between January 2015 and January 2018 at the Peking University Third Hospital. The control group matched 1:2 by age, BMI, parity, and gravidity. Maternal outcomes included preterm delivery and complications. There was significantly higher incidence of gestational diabetes, hypertensive disorders, and placenta previa in IVF-ICSI pregnancies versus controls (p < .05). IVF-ICSI resulted in significantly higher rate of preterm birth than in spontaneous pregnancies (p < .05) and the difference remained significant for deliveries that occurred before 28, 32, and 34 weeks gestation (p < .05). Multivariate logistic regression analysis revealed that female-factor infertility, hypertensive disorder, placenta previa, and PROM were significant prognostic factors associated with increased risk of prematurity. IVF-ICSI is associated with increased risk of obstetric complications including preterm delivery in singleton pregnancies. Female-factor infertility is an independent prognostic factor for preterm birth. This information is important for patient counseling and helps to refine the recommendation to optimize maternal health before embarking on fertility treatments.


Assuntos
Fertilização In Vitro/efeitos adversos , Fertilização In Vitro/estatística & dados numéricos , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Adulto , Estudos de Casos e Controles , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/terapia , Paridade , Gravidez , Nascimento Prematuro/diagnóstico , Estudos Retrospectivos , Fatores de Risco , Transferência de Embrião Único/estatística & dados numéricos
17.
Fertil Steril ; 112(2): 378-386, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31056309

RESUMO

OBJECTIVE: To determine the association between biomarkers of ovarian reserve and luteal phase deficiency (LPD). DESIGN: Secondary analysis of a prospective time-to-conceive cohort study. SETTING: Not applicable. PATIENT(S): Women attempting conception, aged 30-44 years, without known infertility. INTERVENTION(S): Measurement of early follicular phase serum levels of antimüllerian hormone, FSH, inhibin B, and E2. MAIN OUTCOME MEASURE(S): The primary outcome was LPD, defined by luteal bleeding (LB) (≥1 day of LB) or a short luteal phase length (≤11 days). RESULT(S): Overall, 755 women provided information on 2,171 menstrual cycles and serum for measurement of at least one biomarker of ovarian reserve. There were 2,096 cycles from 754 women in the LB cohort, of which 40% experienced LB. After adjusting for age, race, previous miscarriages, and previous pregnancies, diminished ovarian reserve (DOR) was not significantly associated with LB. Low early follicular phase FSH levels increased the odds of LB (odds ratio [OR] 1.84; 95% confidence interval [CI] 1.25-2.71), as did high early follicular phase E2 levels (OR 1.59; 95% CI 1.26-2.01). A total of 608 cycles from 286 women were included in the analysis of luteal phase length, of which 13% had a short luteal phase. After adjusting for age, there was no significant association between DOR and a short luteal phase. The risk of a short luteal phase decreased with increasing inhibin B (OR 0.61; 95% CI 0.45-0.81). CONCLUSION(S): Although DOR is not associated with LPD, hormone dysfunction in the early follicular phase may contribute to LPD in women of older reproductive age.


Assuntos
Biomarcadores/sangue , Fase Luteal/fisiologia , Doenças Ovarianas/etiologia , Doenças Ovarianas/terapia , Reserva Ovariana/fisiologia , Adulto , Hormônio Antimülleriano/sangue , Estudos de Coortes , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/etiologia , Inibinas/sangue , Doenças Ovarianas/sangue , Doenças Ovarianas/epidemiologia , Gravidez , Tempo para Engravidar/fisiologia
18.
Fertil Steril ; 112(2): 371-377, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31126712

RESUMO

OBJECTIVE: To investigate whether live birth rate (LBR) following frozen-thawed embryo transfer in letrozole-stimulated cycles (L-FET) differs from LBR after artificial-cycle frozen-thawed embryos transfers (AC-FET) in women with polycystic ovary syndrome (PCOS). DESIGN: Retrospective cohort study. SETTING: Tertiary-care academic medical center. PATIENT(S): A total of 2,664 patients with PCOS who fulfilled the inclusion criteria were enrolled in the period from 2011 to 2016. INTERVENTIONS(S): Letrozole use versus hormone replacement therapies during FET. MAIN OUTCOME MEASURE(S): LBR per embryo transfer was the primary outcome. The secondary end points included ongoing and clinical pregnancy rate, cancellation rate, endometrial thickness, and pregnancy loss rate. Multivariable logistic regression analysis was performed to adjust for potential confounders. RESULT(S): In our crude analysis, LBR per embryo transfer was similar between groups (54.4% in the L-FET vs. 50.7% for the AC-FET). The crude odds of pregnancy loss was significantly lower in L-FET compared with AC-FET (9.1% vs. 17%). Nonetheless, after adjusting for possible confounding factors, LBR was significantly higher in L-FET compared with AC-FET. Moreover, the rates of pregnancy loss remained consistently lower in the L-FET group than in the AC-FET group. CONCLUSION(S): In patients with PCOS undergoing FET, letrozole use for endometrial preparation was associated with higher LBR compared with artificial cycles, albeit after statistical adjustment for confounding factors. Future prospective randomized studies are needed to verify our findings.


Assuntos
Transferência Embrionária/métodos , Infertilidade Feminina/terapia , Letrozol/uso terapêutico , Indução da Ovulação/métodos , Síndrome do Ovário Policístico/terapia , Adulto , Blastocisto , Criopreservação , Transferência Embrionária/estatística & dados numéricos , Feminino , Fertilização In Vitro/métodos , Fertilização In Vitro/estatística & dados numéricos , Congelamento , Terapia de Reposição Hormonal/métodos , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/etiologia , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/epidemiologia , Gravidez , Resultado da Gravidez/epidemiologia , Taxa de Gravidez , Estudos Retrospectivos , Resultado do Tratamento
19.
J Assist Reprod Genet ; 36(6): 1127-1133, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31065945

RESUMO

PURPOSE: To evaluate the relationship of clinical pregnancy rates with bone morphogenetic proteins 2-4-7 (BMP 2, 4, 7), growth differentiation factor 9 (GDF 9), and Emmprin levels in follicular fluid of intracytoplasmic sperm injection patients. METHODS: Follicular fluid of 77 patients who underwent ICSI procedure was collected during the oocyte retrieval procedure. And follicular fluid levels of BMP 2, BMP 4, BMP 7, GDF 9, and Emmprin (Basigin) were measured and compared for clinical pregnancy rates. RESULTS: Follicular levels of BMP 4 was significantly higher whereas Emmprin levels were lower in patients who had achieved clinically diagnosed pregnancy compared with those who did not achieve clinical pregnancy after ICSI procedure (P = 0.007 and P = 0.035, respectively). BMP 2, BMP 7, and GDF 9 levels were comparable for both groups. CONCLUSION: Clinical pregnancy rates after ICSI may be associated with follicular fluid levels of Emmprin and BMP 4. Follicular levels of Emmprin and BMP 4 can be used as a marker (as markers for predicting ICSI outcomes) for a better ICSI outcome.


Assuntos
Basigina/genética , Proteína Morfogenética Óssea 4/genética , Infertilidade Feminina/genética , Taxa de Gravidez , Adulto , Proteína Morfogenética Óssea 2/genética , Proteína Morfogenética Óssea 7/genética , Feminino , Fertilização In Vitro , Líquido Folicular/metabolismo , Fator 9 de Diferenciação de Crescimento/genética , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/patologia , Masculino , Recuperação de Oócitos , Oócitos/crescimento & desenvolvimento , Oócitos/metabolismo , Indução da Ovulação/métodos , Gravidez , Injeções de Esperma Intracitoplásmicas/métodos
20.
Fertil Steril ; 112(2): 258-265, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31103285

RESUMO

OBJECTIVE: To evaluate differences in euploidy rates between IVF cycles triggered with either GnRH agonist (GnRHa) or hCG. DESIGN: Retrospective cohort study. SETTING: University-affiliated fertility center. PATIENT(S): A total of 366 patients performing 539 IVF cycles utilizing preimplantation genetic testing for aneuploidy (PGT-A). INTERVENTION(S): Gonadotropin-releasing hormone agonist or hCG trigger of oocyte maturation during IVF cycles. MAIN OUTCOME MEASURE(S): Rate of euploid embryos. RESULT(S): Patients in the GnRHa trigger arm were younger, with a lower body mass index and higher antimüllerian hormone level, and they had a higher number of oocytes retrieved and embryos biopsied. Euploid rate per embryo biopsied was higher after GnRHa trigger than after hCG trigger (37.8% ± 2.1% vs. 30.3% ± 1.8%), but multivariate regression analysis controlling for potential confounding factors did not show any differences between the two groups. Moreover, the euploid rate per oocyte retrieved was not significantly different overall (GnRHa vs. hCG: 33.9% ± 2.2% vs. 28.0% ± 1.9%). The anticipated decline in the rate of euploid embryos per oocyte retrieved went from 15.8% ± 1.2% for age <35 years to 4.3% ± 0.9% for patients aged ≥41 years. There were no significant differences between the two groups after stratifying by age and controlling for PGT-A testing modality. CONCLUSION(S): Both GnRHa and hCG trigger result in comparable euploid rates. Trigger with GnRHa should therefore be considered a valid option for trigger modality in freeze-all PGT-A cycles, in view of its demonstrated effectiveness and known safety enhancement.


Assuntos
Gonadotropina Coriônica/uso terapêutico , Fármacos para a Fertilidade Feminina/uso terapêutico , Testes Genéticos/estatística & dados numéricos , Hormônio Liberador de Gonadotropina/uso terapêutico , Indução da Ovulação/métodos , Ploidias , Diagnóstico Pré-Implantação/estatística & dados numéricos , Adulto , Aneuploidia , Feminino , Fertilização In Vitro/estatística & dados numéricos , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/genética , Infertilidade Feminina/terapia , Ciclo Menstrual/efeitos dos fármacos , Oogênese/efeitos dos fármacos , Oogênese/genética , Indução da Ovulação/efeitos adversos , Indução da Ovulação/estatística & dados numéricos , Gravidez , Estudos Retrospectivos
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