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2.
Fertil Steril ; 116(4): 1128-1138, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34325920

RESUMO

OBJECTIVE: To explore early disparate impacts of the COVID-19 pandemic on fertility preferences DESIGN: Cross-sectional study SETTING: Online survey questionnaire PATIENT(S): A total of 440 female participants who were trying to conceive (TTC) in the past year or currently are TTC. INTERVENTION(S): No interventions administered. MAIN OUTCOME MEASURE(S): Change in fertility preference RESULT(S): Approximately 1 in 3 participants reported changing their fertility preferences because of the COVID-19 pandemic. Of those that reported changing their fertility preferences, 23.9% reported TTC earlier and 61.6% reported TTC later. Preliminary findings show the odds of changing fertility preferences in black or African American women were 5.45 (95% confidence interval [CI], 1.50-19.90) times that of white women and in nonheterosexual women were 2.76 (95% CI, 1.41-5.42) times that of heterosexual women. Furthermore, every 1 unit increase in state anxiety and depressive symptoms was associated with a 26% (95% CI, 3%-54%) or 17% (95% CI, 5%-31%) increase in odds of pushing back TTC, respectively. CONCLUSION(S): This exploratory study highlights how the fertility preferences of racial and ethnic minorities, sexual minorities, and those experiencing mental health issues may be disparately influenced by the pandemic. Research is needed to examine further the disparate effect of the COVID-19 pandemic on fertility preferences.


Assuntos
COVID-19/etnologia , Fertilidade/fisiologia , Infertilidade Feminina/etnologia , Infertilidade Feminina/terapia , Minorias Sexuais e de Gênero , Inquéritos e Questionários , Adulto , COVID-19/psicologia , Estudos Transversais , Feminino , Humanos , Infertilidade Feminina/psicologia , Minorias Sexuais e de Gênero/psicologia , Estados Unidos/etnologia
3.
Reprod Biol Endocrinol ; 18(1): 82, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787884

RESUMO

BACKGROUND: Previous studies have shown that there is an association between FMR1 CGG repeats and ovarian dysfunction. The aim of this study is to assess the association between the number of CGG repeats in FMR1 in Chinese patients with premature ovarian insufficiency (POI) and diminished ovarian reserve (DOR). METHODS: This is a cross-sectional, case-control study, which enrolled 124 patients with POI, 57 patients with DOR and 111 normal menopausal controls. The demographic details along with other clinical data were recorded. The FMR1 CGG repeats were analyzed by polymerase chain reaction and microfluidic capillary electrophoresis. RESULTS: We could detect two premutation carriers in the POI group (1.6%) and one in the control group (0.9%). No premutation carriers were identified in the DOR group. The frequency of FMR1 premutations was not different between POI or DOR and controls. The most common CGG repeat was 29 and 30, and the repeat length for allele 2 had a secondary peak around 36-39 repeats. The CGG repeats were divided into groups of five consecutive values, and the distribution of allele 1 in the POI group was different from that in the control group (P < 0.001). No statistically significant differences were found for allele 1 between DOR group vs. controls, and for allele 2 between three groups (P > 0.05). CONCLUSIONS: The study shows that the frequency of FMR1 premutations is relatively low (1.6%) in Chinese women with POI. The distribution of allele 1 CGG repeat in patients with POI showed difference from that in healthy women.


Assuntos
Proteína do X Frágil de Retardo Mental/genética , Infertilidade Feminina/genética , Reserva Ovariana/genética , Repetições de Trinucleotídeos/genética , Adulto , Grupo com Ancestrais do Continente Asiático/genética , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Estudos de Casos e Controles , China/epidemiologia , Estudos Transversais , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/etnologia , Insuficiência Ovariana Primária/epidemiologia , Insuficiência Ovariana Primária/genética , Adulto Jovem
4.
Reprod Biomed Online ; 40(1): 105-112, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31899124

RESUMO

RESEARCH QUESTION: To evaluate the findings of outpatient transvaginal hydrolaparoscopy (THL) in comparison with diagnostic laparoscopy combined with chromopertubation in subfertile women. DESIGN: In a retrospective study in four large teaching hospitals, all subfertile women who underwent a THL and a conventional laparoscopy as part of their fertility work-up in the period between 2000 and 2011 were studied. Findings at THL were compared with findings at diagnostic and therapeutic laparoscopies. Tubal occlusion, endometriosis and adhesions were defined as abnormalities. RESULTS: Out of 1119 women, 1103 women underwent THL. A complete evaluation or incomplete but diagnostic procedure could be performed in 989 (89.7%) and 28 (2.5%), respectively. An incomplete non-diagnostic procedure was performed in 11 (1.0%) women. Failure of THL occurred in 75 women (6.8%) and 40 of these women (3.6%) subsequently underwent laparoscopy. Laparoscopy was performed in a total of 126 patients with a median time interval of 7 weeks (interquartile range [IQR] 3-13 weeks). Of 64 patients who successfully underwent both THL and laparoscopy, concordant findings were found in 53 women and discordant results in 11 women, 6 of which were caused by tubal spasm. Sensitivity of THL in detecting abnormalities was 100% and specificity was 22.2%, with a likelihood ratio of 1.29. CONCLUSION: THL in an outpatient setting can detect anatomical abnormalities comparable to the more invasive reference standard diagnostic laparoscopy. If THL succeeds, there is no need to add a diagnostic laparoscopy in the work-up.


Assuntos
Endometriose/diagnóstico , Doenças das Tubas Uterinas/diagnóstico , Infertilidade Feminina/etnologia , Laparoscopia/métodos , Adulto , Endometriose/complicações , Doenças das Tubas Uterinas/complicações , Feminino , Humanos , Estudos Retrospectivos
5.
Maturitas ; 131: 78-86, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31787151

RESUMO

Ovarian deficiency, including diminished ovarian reserve and premature ovarian insufficiency, represents one of the main causes of female infertility. Little is known of the genetic basis of diminished ovarian reserve, while premature ovarian insufficiency often has a genetic basis, with genes affecting various processes. NR5A1 is a key gene required for gonadal function, and variants are associated with a wide phenotypic spectrum of disorders of sexual development, and are found in 0.26-8% of patients with premature ovarian insufficiency. As there is some debate about the extent of involvement of NR5A1 in the pathogenesis of ovarian deficiency, we performed an in-depth analysis of NR5A1 variants detected in a cohort of 142 patients with premature ovarian insufficiency, diminished ovarian reserve, or unexplained infertility associated with normal ovarian function. We identified rare non-synonymous protein-altering variants in 2.8 % of women with ovarian deficiency and no such variants in our small cohort of women with infertility but normal ovarian function. We observed previously reported variants associated with premature ovarian insufficiency in patients with diminished ovarian reserve, highlighting a genetic relationship between these conditions. We confirmed functional impairment resulting from a p.Val15Met variant, detected for the first time in a patient with premature ovarian insufficiency. The remaining variants were associated with preserved transcriptional activity and localization of NR5A1, indicating that rare NR5A1 variants may be incorrectly curated if functional studies are not undertaken, and/or that NR5A1 variants may have only a subtle impact on protein function and/or confer risk of ovarian deficiency via oligogenic inheritance.


Assuntos
Infertilidade Feminina/genética , Menopausa Precoce/genética , Reserva Ovariana , Insuficiência Ovariana Primária/genética , Fator Esteroidogênico 1/genética , Adulto , Grupo com Ancestrais do Continente Africano , Alelos , Estudos de Coortes , Feminino , Regulação da Expressão Gênica , Células HEK293 , Humanos , Infertilidade Feminina/etnologia , Menopausa Precoce/etnologia , Mutação , Insuficiência Ovariana Primária/etnologia
6.
Afr J Reprod Health ; 24(2): 27-39, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34077089

RESUMO

Due to the pronatalist orientation of the Ghanaian society and the social consequences of childlessness, infertile persons adopt several health seeking strategies in their bid to have their own children. This study therefore explored the health seeking behaviour of infertile Ghanaians and the factors that influence this behavior. The study adopted a qualitative research approach. Forty-five semi-structured in-depth interviews were used to collect data. The findings suggest that treatment seeking behaviour of infertile Ghanaians was motivated largely by perceived cause and belief in the efficacy of a treatment form. Two main treatment seeking patterns emerged from the data, hierarchical and concurrent treatment seeking behaviours. Although participants combined spiritual healing with either herbal or orthodox medicine, a combination of orthodox and herbal seemed inappropriate to them. The findings of this study should have implications for healthcare workers in general as the quest for biological parenthood and the treatment seeking behaviours employed by the infertile could be detrimental to the health of these individuals. For instance, the use of unregulated herbalists and itinerant herbal medicine sellers, as well as the over reliance on spiritual healing could have dire implications for health.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Medicina Herbária , Infertilidade Feminina/psicologia , Infertilidade Feminina/terapia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Técnicas de Reprodução Assistida , Terapias Espirituais , Adulto , Características Culturais , Feminino , Gana , Humanos , Infertilidade Feminina/etnologia , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
7.
Metab Syndr Relat Disord ; 17(10): 500-504, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31592705

RESUMO

Background: Polycystic ovary syndrome (PCOS) is classically associated with insulin resistance, metabolic syndrome, or type 2 diabetes. Infertile Afrocaribbean (AC) women with PCOS may have metabolic features that could help to better target their management. Objective: To evaluate the characteristics of PCOS in this population and their metabolic profile to target the worst metabolic parameter. Methods: A retrospective study including infertile AC women for 4 years. PCOS was diagnosed using Rotterdam criteria and compared with non-PCOS women referred consecutively for infertility during the same period. Results: Among 981 AC women evaluated for infertility, PCOS was found in 17%. PCOS women were younger than non-PCOS women. After age and body mass index (BMI) matching, only fasting blood glucose and triglyceride levels were higher in PCOS women compared with non-PCOS women. PCOS was positively correlated with triglyceride levels and negatively with vitamin D levels. PCOS women with obesity had low high-density lipoprotein-cholesterol and increased triglyceride levels compared with those without obesity. No correlation was found between lipids or glucose levels and androgen levels. Multivariate analysis showed that only triglycerides were independently related to PCOS after adjustment for age and BMI. Conclusions: In the AC population where the prevalence of obesity and diabetes is increased, the metabolic profile of infertile women with PCOS is mainly characterized by hypertriglyceridemia, with a higher risk of visceral obesity and nonalcoholic fatty liver disease. Interventional studies would be useful to evaluate the predictive value of hypertriglyceridemia on diabetes and cardiovascular diseases in this population.


Assuntos
Grupo com Ancestrais do Continente Africano , Hipertrigliceridemia/terapia , Infertilidade Feminina/sangue , Planejamento de Assistência ao Paciente , Síndrome do Ovário Policístico/sangue , Triglicerídeos/sangue , Adulto , Região do Caribe/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Hipertrigliceridemia/sangue , Hipertrigliceridemia/complicações , Hipertrigliceridemia/etnologia , Infertilidade Feminina/etnologia , Infertilidade Feminina/terapia , Obesidade/sangue , Obesidade/complicações , Obesidade/etnologia , Obesidade/terapia , Síndrome do Ovário Policístico/etnologia , Síndrome do Ovário Policístico/terapia , Prevalência , Estudos Retrospectivos , Adulto Jovem
8.
Hum Reprod ; 34(9): 1735-1745, 2019 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-31411328

RESUMO

STUDY QUESTION: What are the views, experiences and healthcare needs of infertile women from a minority ethnic or religious background living in Wales? SUMMARY ANSWER: Women from ethnic and religious minority backgrounds consider that their communities have highly pronatalistic attitudes and stigmatize infertility, and express the need for more infertility education (for themselves and their communities), as well as more socio-culturally and interpersonally sensitive fertility care. WHAT IS ALREADY KNOWN: Some people from minority ethnic or religious groups perceive pressure to conceive from their communities, experience social costs when they are unable to have children and stressful interactions with the fertility healthcare system while attempting to conceive. STUDY DESIGN, SIZE, DURATION: This study was based on a one-day drawing workshop to collect visual (artwork produced by participants) and textual (all conversations and discussions during the workshop) data about the participants' views and experiences of infertility and their fertility care needs. PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were nine adult women with a minority ethnic or religious status living in Wales, UK, who were experiencing or had experienced infertility in the past. The workshop comprised five activities: (i) small and large group discussion of infertility-related drawings, (ii) lide-based lecture consisting of an introduction to the basics of drawing objects and people and (iii) thoughts and feelings, (iv) free drawing session and (v) group sharing. Audio recordings of the workshop were transcribed verbatim. Textual data was analysed with thematic analysis. Risk for bias was addressed via individual coding by two authors followed by joint presentation and discussion of results with the research team and participants. MAIN RESULTS AND THE ROLE OF CHANCE: Forty-one themes were identified and grouped into eight distinct higher order themes. These themes described the emotional, relational and social burden of infertility experienced by women, which they perceived to result from their communities' highly pronatalistic attitudes and stigmatization of infertility. Themes also captured women's adaptive coping strategies and critical attitude towards pronatalist ideologies. Lastly, themes captured their overall positive evaluation of their fertility health care, their desire for more infertility education (for themselves and their communities) and for culturally competent and interpersonally sensitive care. LIMITATIONS, REASONS FOR CAUTION: Our participants were a small, non-random sample recruited in collaboration with a local charity, which may mean that all participants were well integrated in their communities. Analysis focused on capturing commonalities in participants' experiences and this may sometimes result in homogenising diverse experiences. WIDER IMPLICATIONS OF THE FINDINGS: More education about the infertility experiences of minority ethnic and religious groups at the community and healthcare delivery level may translate into lessened negative attitudes towards infertility and more culturally competent care, which can be beneficial for women. STUDY FUNDING/COMPETING INTEREST(S): This research was funded by Welsh Crucible. The authors have no conflict of interests to declare.


Assuntos
Cristianismo/psicologia , Aconselhamento/métodos , Assistência à Saúde Culturalmente Competente/métodos , Educação/métodos , Infertilidade Feminina/etnologia , Infertilidade Feminina/epidemiologia , Islamismo/psicologia , Adaptação Psicológica , Adulto , Emoções , Grupos Étnicos/psicologia , Feminino , Humanos , Infertilidade Feminina/psicologia , Pessoa de Meia-Idade , Relações Médico-Paciente , País de Gales/epidemiologia
9.
Medicine (Baltimore) ; 98(8): e14366, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30813136

RESUMO

The aim of this study was to investigate the relationships between uterine size and volume and clinical pregnancy rate.This longitudinal study was conducted among patients undergoing assisted reproduction technology (ART) treatment at the Reproductive Medicine Center from January 2010 to May 2017, all of whom provided informed consent to participate in the study. The uterine size, for all patients, was measured by transvaginal ultrasonography before ovarian stimulation. Clinical pregnancy was diagnosed by ultrasound confirmation of at least an intrauterine gestational sac and fetal cardiac activity 4 weeks after embryo transfer.A total of 11,924 patients were enrolled in this study. Compared to patients with uterine lengths of 50 to 59 mm (referent), patients with uterine lengths ≥60 mm had a lower clinical pregnancy rate. Compared to patients with uterine widths of 30 to 39 mm (referent), patients with uterine widths of 40 to 49 mm and those with uterine widths of ≥50 mm had a lower clinical pregnancy rate. Compared with those with a uterine anteroposterior diameter of <30 mm (referent), patients with uterine anteroposterior diameters of ≥50 mm had a lower clinical pregnancy rate. Compared with those with a uterine volume of 30 to 49 mL (referent), patients with a uterine volume ≥70 mL had a lower clinical pregnancy rate.The patients with an optimal uterine length, width, anteroposterior diameter, and volume had a higher clinical pregnancy rate than those with suboptimal uterine measurements. Uterine sizes and volumes that were too large reduced the clinical pregnancy rate.


Assuntos
Infertilidade Feminina/patologia , Infertilidade Feminina/terapia , Taxa de Gravidez , Técnicas de Reprodução Assistida , Útero/anatomia & histologia , Adulto , Grupo com Ancestrais do Continente Asiático , Feminino , Humanos , Infertilidade Feminina/diagnóstico por imagem , Infertilidade Feminina/etnologia , Estudos Longitudinais , Tamanho do Órgão , Gravidez , Ultrassonografia , Útero/diagnóstico por imagem
10.
Afr J Reprod Health ; 22(3): 13-23, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30381928

RESUMO

Infertile women feel more psychological stress and pressure than their husbands, and the prevalence of anxiety and depression among them are higher. This study aimed to develop a culture-specific measurement tool to identify the strategies of infertile women in dealing with infertility-related problems. This was a scale development study. This study was carried out in three different fertility centers in the three largest cities in Turkey. The data were collected using personal information form and through the application of a Coping Scale for Infertile Women (CSIW) protocol. Ways of Coping with Stress Inventory. Cronbach's alpha, Intraclass Correlation Coefficient and Spearman's Rank correlation analyses were used to determine the reliability of the scale. The results of explanatory factor analysis and a factor structure of the Coping Scale for Infertile Women, comprising 50 items, were examined, and the data were determined to be suitable to perform factor analysis. The internal consistency of the scale was found to be 0.880. The number of factors in the scale was 10, and the internal consistency of the factors was 0.720. The results showed that the CSIW had good reliability and validity.


Assuntos
Adaptação Psicológica , Infertilidade Feminina/psicologia , Psicometria/instrumentação , Estresse Psicológico/psicologia , Inquéritos e Questionários/normas , Adolescente , Adulto , Análise Fatorial , Feminino , Humanos , Infertilidade Feminina/etnologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Cônjuges/psicologia , Estresse Psicológico/etnologia , Turquia , Adulto Jovem
11.
Med Anthropol ; 37(4): 343-357, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29308935

RESUMO

In Mozambique, involuntary childlessness triggers immediate treatment seeking, especially on the woman's side. Treatment processes involve the activation and/or creation of situational social networks that provide emotional, instrumental, and informational support. These are formed through careful processes of disclosure management, and are embedded in social relations and local moral configurations of family making, reproduction, and healing. In this article I explore social networks involving friends, family, religion, and emerging biosocial relations, some or all of which are involved in Mozambican women's and couples' therapeutic navigations in the quest for fertility.


Assuntos
Infertilidade Feminina/etnologia , Infertilidade Feminina/terapia , Mulheres/psicologia , Adulto , Antropologia Médica , Feminino , Fertilidade , Humanos , Moçambique/etnologia , Apoio Social , África do Sul/etnologia
12.
Women Health ; 58(1): 1-15, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-27922291

RESUMO

Infertility has been negatively associated with sexual satisfaction. This study aimed to estimate the relation of infertility to sexual satisfaction from a cross-cultural perspective, comparing Italian and Brazilian women. Between June 2012 and January 2013, 528 women seeking assisted reproduction technology (ART) treatment in Italy (39%) or Brazil (61%) completed self-reports of sexual satisfaction (ISS) and infertility-related stress in the marital domain (IRS). IRS was the same across countries. ISS differed, with 34.31% of the Italians and 43.52% of the Brazilians being sexually dissatisfied at a clinical level (ISS score >30). Multiple logistic regression models showed that being sexually dissatisfied at a clinical level was associated with lower education and higher IRS among Italian women, regardless of having a diagnosed cause of infertility. It was instead associated with higher IRS only among the Brazilian women who had a diagnosed cause of infertility. These findings suggest that, regardless of nationality, sexual satisfaction and infertility-related stress need to be addressed in the treatment of infertile women turning to ART. However, as factors associated with these dimensions vary across countries, interventions to promote sexual satisfaction among infertile women should be adapted to their specific socio-cultural context.


Assuntos
Infertilidade Feminina/psicologia , Casamento/psicologia , Orgasmo , Satisfação Pessoal , Qualidade de Vida/psicologia , Técnicas de Reprodução Assistida/psicologia , Comportamento Sexual/psicologia , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Infertilidade Feminina/etnologia , Infertilidade Feminina/terapia , Relações Interpessoais , Itália , Modelos Logísticos , Casamento/etnologia , Inquéritos e Questionários
13.
J Relig Health ; 57(6): 2230-2240, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29188549

RESUMO

Religion can have a significant influence on the experience of infertility. However, it is unclear how many US women turn to religion when facing infertility. Here, we examine the utilization of prayer and clergy counsel among a nationally representative sample of 1062 infertile US women. Prayer was used by 74.8% of the participants, and clergy counsel was the most common formal support system utilized. Both prayer and clergy counsel were significantly more common among black and Hispanic women. Healthcare providers should acknowledge the spiritual needs of their infertile patients and ally with clergy when possible to provide maximally effective care.


Assuntos
Clero , Grupos de Populações Continentais/estatística & dados numéricos , Aconselhamento , Infertilidade Feminina/etnologia , Religião , Espiritualidade , Adulto , Grupos de Populações Continentais/etnologia , Estudos Transversais , Feminino , Humanos , Infertilidade Feminina/psicologia , Pessoa de Meia-Idade , Gravidez , Inquéritos e Questionários
14.
Med Anthropol ; 37(2): 101-116, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29182369

RESUMO

When combined, primary and secondary infertility affects up to 21 percent of Indonesian couples. Based on ethnographic fieldwork with married heterosexual couples, I explore how intra-family adoption represents a culturally and religiously acceptable pathway to family formation for couples without access to assisted reproductive technologies. I examine how kinship is central to the negotiation of adoption, and to maintaining ethnic and religious continuity within adoptive families. I reveal how adoption can enable infertile women and birth mothers to achieve or escape the dominant expectations of heteronormativity, and discuss intra-family adoption by infertile couples in relation to reproductive stratification and leveling.


Assuntos
Adoção/etnologia , Antropologia Médica , Infertilidade Feminina/etnologia , Feminino , Humanos , Indonésia/etnologia , Masculino
15.
J Obstet Gynaecol Can ; 40(3): 293-298, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29132967

RESUMO

OBJECTIVE: The aims of this study were to examine the prevalence of Celiac disease (CD) in Canadian women with unexplained infertility versus women with an identifiable cause of infertility and to assess the sensitivity of the point-of-care Biocard Celiac Test Kit versus standard serum serologic testing. METHODS: In this prospective cohort study, women aged 18 to 44 who were evaluated for infertility between February 2010 and May 2012 at a tertiary academic care fertility clinic in Toronto, ON, were invited to participate. They were categorized as having unexplained infertility (Cases) or infertility secondary to a known cause (Controls). Women on a gluten-free diet or previously diagnosed with CD were excluded. Outcome measures were the Celiac Questionnaire, serum testing for tissue transglutaminase IgA antibody (anti-tTG IgA), serum IgA levels, and Biocard Celiac Test Kit. RESULTS: Of 685 women approached, 1.2% (4/326) with unexplained infertility and 1.1% (4/359) with an identifiable infertility cause were newly found to have CD. Biocard testing revealed the same results as standard serologic IgA and anti-tTG IgA testing. CONCLUSION: CD was not more common in women with unexplained infertility than those with an identifiable cause of infertility. These results do not support the routine screening of Canadian women with infertility for CD.


Assuntos
Doença Celíaca/complicações , Infertilidade Feminina/complicações , Adulto , Doença Celíaca/sangue , Doença Celíaca/diagnóstico , Doença Celíaca/etnologia , Feminino , Humanos , Infertilidade Feminina/etnologia , Ontário/epidemiologia , Testes Imediatos , Estudos Prospectivos
16.
Women Health ; 58(10): 1081-1093, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29240537

RESUMO

Infertility is prevalent and stigmatized in sub-Saharan Africa. Self-rated health, a subjective indicator that has been consistently related to objectively measured health, may be useful in evaluating the relationship between women's infertility and health. Data were from surveys conducted from July 2014 to January 2015 with women aged 15-39 years (n = 915) as part of the initial assessment in a cohort study in Lilongwe district, Malawi. We first assessed correlates of self-reported infertility among women in rural Malawi. We then used multiple logistic regression to examine associations between infertility and self-rated health. Of women surveyed, 20 percent had a history of infertility. Compared to women who had not experienced infertility, women with a history of infertility were older (p = 0.05), less educated (p = 0.01), and more likely to report depressive symptoms (p = 0.02) and forced first intercourse (p = 0.02) and to have been previously diagnosed with a sexually transmitted infection (p = 0.05). However, women with a history of infertility were not significantly more likely to report poor self-rated health (adjusted odds ratio: 1.69; 95 percent confidence interval: 0.70-4.07). Infertility was prevalent in our sample of Malawian women but was not significantly related to self-rated health, an instrument widely used in public-health research.


Assuntos
Nível de Saúde , Infertilidade Feminina/etnologia , Adolescente , Adulto , Feminino , Humanos , Infertilidade Feminina/etiologia , Malaui/epidemiologia , Prevalência , População Rural , Adulto Jovem
17.
Kaohsiung J Med Sci ; 33(11): 558-566, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29050673

RESUMO

This study investigated the relationship between the CYP19 alleles, rs727479A/C, rs700518A/G, and rs700519C/T, and pregnancy outcome after assisted reproductive technology (ART) in patients with polycystic ovary syndrome (PCOS). Between January 2012 and September 2015, 293 PCOS patients undergoing ART were randomly selected for the study. According to pregnancy outcome after ART, the patients were assigned to pregnancy and non-pregnancy groups. CYP19 rs727479A/C, rs700518A/G and rs700519C/T genotypes were determined using the denaturing high-performance liquid chromatography (DHPLC) method. Haplotype frequencies of the CYP19 alleles rs727479A/C, rs700518A/G and rs700519C/T were estimated using the SHEsis platform. Logistic regression analysis was employed to analyze the factors influencing the pregnancy outcome after ART. The frequency of the AC + CC genotype of rs727479A/C was higher in the pregnancy group than in the non-pregnancy group. The frequency of the CT + TT genotype of rs700519A/G was also higher in the pregnancy group than in the non-pregnancy group. Haplotype analysis indicated that the AAC and AGT haplotypes both exhibited unfavorable influence on the pregnancy outcome after ART. The AAT and CGT haplotypes were favorable to the pregnancy outcome after ART. Logistic regression analysis suggested that the rs727479A/C AA genotype, the rs700519C/T CC genotype and body mass index (BMI) might exert unfavorable influence on the pregnancy outcome after ART for PCOS patients. These findings indicated that the CYP19 alleles rs727479A/C and rs700519C/T might be associated with the pregnancy outcome after ART in patients with PCOS.


Assuntos
Aromatase/genética , Predisposição Genética para Doença , Infertilidade Feminina/terapia , Síndrome do Ovário Policístico/genética , Polimorfismo de Nucleotídeo Único , Técnicas de Reprodução Assistida , Adulto , Alelos , Grupo com Ancestrais do Continente Asiático , Sequência de Bases , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Expressão Gênica , Frequência do Gene , Técnicas de Genotipagem , Haplótipos , Humanos , Infertilidade Feminina/etnologia , Infertilidade Feminina/genética , Infertilidade Feminina/patologia , Síndrome do Ovário Policístico/etnologia , Síndrome do Ovário Policístico/patologia , Gravidez , Resultado da Gravidez
18.
Thyroid ; 27(9): 1194-1200, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28810821

RESUMO

BACKGROUND: While screening of thyroid peroxidase antibody (TPOAb) has been recommended in women with primary ovarian insufficiency, the relationship between thyroid autoimmunity (TAI) and ovarian reserve remains undetermined. Because the TAI prevalence was reported to be different between different ethnic/racial groups, this study aimed to investigate the TAI prevalence in Chinese women with variable ovarian reserve. METHODS: This is a cross-sectional study conducted in a university infertility clinic between October 2013 and March 2016. Among patients at their first entry to the infertility clinic, a total of 1044 patients with available results of anti-Müllerian hormone (AMH), thyrotropin (TSH), TPOAb, and thyroglobulin antibody (TgAb) were enrolled. The TSH levels and the prevalence of positive TPOAb and positive TgAb were compared between patients with low, normal, and high ovarian reserve categorized with age-specific AMH levels. RESULTS: For the whole study population, the TSH levels, TPOAb positivity, and TgAb positivity were comparable between patients with variable ovarian reserve. However, after patients with known causes compromising ovarian reserve (iatrogenic or genetic) were excluded, only TPOAb positivity became significantly different between patients with low (22.7%), normal (14.0%), and high ovarian reserve (10.3%; p = 0.012). The TPOAb levels were not significantly correlated to AMH levels (Spearman's ρ = -0.027; p = 0.413). For the infertile subgroup, TPOAb positivity was significantly associated with idiopathic low ovarian reserve in unexplained infertility (low ovarian reserve: 28.6%; normal: 15.7%; high: 9.5%; p = 0.020). CONCLUSIONS: Idiopathic low ovarian reserve was associated with more frequent positive TPOAb rather than thyroid function or TgAb positivity in Chinese women.


Assuntos
Autoanticorpos/análise , Autoimunidade , Infertilidade Feminina/etiologia , Reserva Ovariana , Glândula Tireoide/fisiopatologia , Tireoidite Autoimune/fisiopatologia , Adulto , Hormônio Antimülleriano/sangue , Grupo com Ancestrais do Continente Asiático , Biomarcadores/sangue , China/etnologia , Estudos Transversais , Feminino , Hospitais Universitários , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/etnologia , Infertilidade Feminina/imunologia , Pessoa de Meia-Idade , Ambulatório Hospitalar , Índice de Gravidade de Doença , Taiwan , Glândula Tireoide/imunologia , Tireoidite Autoimune/sangue , Tireoidite Autoimune/etnologia , Tireoidite Autoimune/imunologia , Tireotropina/sangue
19.
Fertil Steril ; 107(4): 868-877, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28366413

RESUMO

Across the reproductive spectrum, obesity is associated with greater risks for adverse health outcomes, including higher rates of infertility, subfertility, early pregnancy loss, fetal deaths and stillbirths, congenital anomalies, and pregnancy complications. The excess reproductive morbidity associated with obesity may increase with longer duration, making the current trends among children and young adults particularly critical in terms of their future reproductive potential. Obese women have a lower chance of pregnancy following in vitro fertilization (IVF), require higher dosages of gonadotropins, and have reduced rates of implantation, clinical intrauterine gestation, and live birth rates and increased rates of pregnancy loss, as well as greater risks for prematurity and preeclampsia even when stratified by plurality. Racial and ethnic differences by overweight and obesity in IVF outcomes have been reported. Compared with normal-weight women, failure to achieve a clinical intrauterine gestation is significantly more likely among obese women overall, normal-weight and obese Asian women, normal-weight Hispanic women, and overweight and obese Black women. Among women who do conceive, compared with normal-weight women, failure to achieve a live birth is significantly more likely among overweight and obese women overall, and among overweight and obese Asian women, overweight and obese Hispanic women, and normal-weight and obese Black women. Although weight loss should theoretically be the first line of therapy for obese women, other lifestyle factors, such as regular physical exercise, elimination of tobacco use and alcohol consumption, and stress management, may be of more immediate benefit in achieving conception.


Assuntos
Fertilidade , Infertilidade Feminina/etnologia , Obesidade/etnologia , Saúde Reprodutiva/etnologia , Adiposidade/etnologia , Feminino , Estilo de Vida Saudável , Humanos , Infertilidade Feminina/fisiopatologia , Infertilidade Feminina/terapia , Estilo de Vida , Obesidade/fisiopatologia , Obesidade/terapia , Gravidez , Complicações na Gravidez/etnologia , Técnicas de Reprodução Assistida/efeitos adversos , Fatores de Risco , Comportamento de Redução do Risco , Resultado do Tratamento
20.
Med Anthropol Q ; 31(1): 23-39, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27353387

RESUMO

This article reappraises the link between fertility and women's status by examining changing means and meanings of reproduction in India. It is based on data gathered during and after 16 months of ethnographic fieldwork conducted between 2005 and 2007 in Lucknow, Uttar Pradesh, India, on social and cultural contexts of infertility. Lucknow is the capital city of Uttar Pradesh, India's most populous state. Historical views of population and fertility control in India and perspectives on the contemporary use of assisted reproductive technologies (ARTs) for practices such as surrogacy situate the ethnographic perspectives. Analysis of ARTs in practice complicates ideas of autonomy and choice in reproduction. Results show that these technologies allow women to challenge power relations within their marital families and pursue stigmatized forms of reproduction. However, they also offer new ways for families to continue and extend an old pattern of exerting control over women's reproductive potential.


Assuntos
Infertilidade Feminina , Técnicas Reprodutivas , Antropologia Médica , Anticoncepção , Serviços de Planejamento Familiar , Feminino , Humanos , Índia/etnologia , Infertilidade Feminina/etnologia , Infertilidade Feminina/psicologia , Infertilidade Feminina/terapia , Pais/psicologia , Gravidez , Reprodução , Cônjuges/psicologia , Mães Substitutas
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