Reprodu??o & Climatério最新文献

Objectives

This article aims to analyze the expectations of couples facing the diagnosis of infertility and how assisted reproduction can contribute to change this reality.

Methods

This is a systematic review of the scientific literature about the possibilities of a couple to conceive a child or not. We decided to focus scientific periodicals indexing, querying Periodic CAPES and virtual health library, using the databases Scielo, Lilacs and Medline.

Results

They were analyzed three categories of the phenomenon: Infertility in women, men and couples, assisted reproduction and the psychological impact of infertility experience in the couple. Infertility is a problem that affects men and women age and other factors are responsible for often non‐completion of a dream to create a life.

Conclusions

The assisted reproduction is a field of knowledge pertinent to think about change and progress which advances Science and technology offer numerous resources for the treatment of human infertility and that can make a difference in the lives of individuals seeking parenting.

Objectives

To verify that sexual dysfunction is more common in this population, the climacteric determines loss of sexual activity; which of the domains assessed more influence female sexual response; which assessed areas can pose risks of sexual dysfunction; have urogynecological physiotherapy.

Material and methods

Qualitative and quantitative cross‐sectional study, conducted with 21 volunteers employees of the Hospital, included in the survey apparently healthy women between 35 and 61 years old, hospital employees, who agreed to answer the questionnaire Female Sexual Function Index (FSFI) and They signed an informed consent form (ICF), excluded women who had urinary tract infection in the past four weeks, disabling disease that affects the sexual act, cognitive changes, recent puerperium tumors.

Results

99% of women are sexually active, 28.6% had hypoactive sexual desire, where the areas that offer rich potential dysfunctions are hypoactive sexual desire averaging 54.76 64.67 excitement and lubrication 63.33 65.08 orgasm sexual desire domain can be a major influencer in sexual response.

Conclusion

The climacteric with their biopsychosocial changes has repercussions directly in the woman's sex life and physical therapy has been an effective means to help menopausal women to experience this phase with better quality of sexual life.

Endometriosis is a progressive and chronic disease characterized by the presence of endometrial tissue outside the womb location. The main symptoms are dyspareunia, dysmenorrhea and infertility, and affects mainly women in fertile age. It causes numerous problems in various social, psychological and emotional levels. Its incidence ranges from 5 to 15% in the female population of reproductive age. The aim of the study is to describe the women's quality of life with endometriosis and related factors. It is about a systematized review study conducted in electronic databases SciELO and PubMed. The descriptors used were “endometriosis” and “quality of life”, using the advanced search strategy with the Boolean AND. The research period was from March to October 2015. The inclusion criteria were extended to articles published in the last five years in Portuguese and English. The exclusion criteria involved non-original studies, case series, commentaries and editorials. The search resulted in 18 articles divided into three categories. The results indicate that women with endometriosis have quality of life affected, either in the physical, social or mental level. Understanding family members and partner represents an improvement in this confrontation, being, therefore, a specific intervention to improve the quality of life of women with this disease.

Aims

Evaluate the effects of a multidisciplinary process of health education (HE) on quality of life (QoL) of climacteric women.

Methods

A quasi‐experimental research with 14 women between 40 and 65 years old was carried out. Seven comprised the control group (CG) and the others formed the experimental group (EG), subjected to the HE. Six weekly sessions of 90 minutes each were performed, with a total of nine hours. To assess the QoL of the participants, it has been used the WHOQOL‐bref ‐ elaborated by the World Health Organization ‐ for pre and post‐tests. This instrument assesses four domains (Physical, Psychological, Social Relationships and Environment) and global QoL.

Results

There was a significant difference between groups in the Social Relationships domain, causing an increase of this factor in the EG and decrease in the CG.

Conclusions

Although positive, this result reveals the importance of assessing whether the HE processes promote QoL in their various domains. Due to its preventive and health promotion character, the HE should be the subject of constant research in order to develop and improve educational technologies to promote health of the climacteric women, especially QoL.

Aims

To evaluate the epidemiological profile of patients undergoing heterologous artificial insemination (HAI), establish the rate of pregnancy and multiple pregnancy and recognize the prevalence of homosexual couples as an indication element for the procedure.

Methods

A descriptive, retrospective and quantitative study conducted from January 2009 to October 2014, in the Fertile Clinic ‐ Human Reproduction assessing the HAI procedures.

Results

We analyzed 67 patients who underwent 156 cycles of treatment with an average of 2.3 procedures per patient. The most prevalent age group was among 18 and 35 representing 55.2%. The main indication for the procedure was the male factor (70.1%). In most prevalent standard sperm concentration was between 1 and 5 million sperm/ml (53.9%) The cycle for pregnancy rate was 17.3%. Seven obtained multiple pregnancies (4.48%) and 5 of these were twins (3.2%) and 2 triplets (1.28%). Of the 67 patients, nine sought to HAI for being homosexual couples representing a rate of 13.5% of patients.

Conclusion

The epidemiological profile was represented as follows: age among 18 and 35, the main indication was the male factor and the spermatic standard donated semen was between 1 and 5 million. The cycle for pregnancy rate was 17.3% with a rate of multiple pregnancies of 4.48%, 3.2% were twins and 1.28% triplets. The prevalence of homosexual couples during the study was 13.5%.

Cancer is not unusual neither incurable: in USA 85% of patients under 45 years diagnosed in 2002 survived more than 10 years. The highest survival rates occur in young patients with breast, testicular and hematologic cancer. However, these tumors are treated with drugs wich most affect fertility and there is evidence that the discussion of preserving fertility is of great importance. Moreover, hematologic and autoimmune diseases may also require the use of potentially gonadotoxic drugs for their control. The ethics committee of the American Society for Reproductive Medicine believes that “there are strong arguments for the preservation of fertility in young patients with treatable cancers”. It is up to the physician (oncologist, hematologist, surgeon, internist) to decide the best treatment to the patient evaluating the risk of ovarian/testicular failure; the prognosis and the timing to start treatments. Moreover, the specialist in reproductive medicine should develop strategies to preserve gametes/embryos according to: age; time to treatment; type of cancer; marital status and risk of infertility, with the proposed therapy. The ongoing collaboration between these specialists, including patients and partners in the discussion, is the key to making decisions that allow the preservation of reproductive function after control of the primary disease.

Objectives

To compare direct and indirect costs of the levonorgestrel‐releasing intrauterine system (LNG‐IUS), thermal balloon endometrial ablation (TBEA) and hysterectomy in the treatment of women with abnormal uterine bleeding (AUB).

Methods

88 patients treated for AUB by LNG‐IUS (n = 30), TBEA (n = 28) and hysterectomy (n = 30) were retrospectively evaluated. All procedures, medical appointments and tests involved in the treatment of patients were considered for a period of five years, as well as all costs arising from failures of the treatments used. The costs for the Unified Health System (SUS) and the private health care system were estimated. Differences between groups were evaluated by the test t of Student or ANOVA.

Results

The cost of the treatment of AUB with TBEA was significantly higher versus LNG‐IUS and hysterectomy after a five‐year follow‐up in both SUS and private health care system (p <0.001). In SUS, the treatment with the LNG‐IUS represented 38.2% of the hysterectomy cost in the first year (R$ 769.61 vs. R$ 2,012.21, p <0.001) and 45.2% after five years (R$ 927.83 vs. R$ 2,052.21, p <0.001). As for the private health care system, this difference was even more significant. In this context, the cost of LNG‐IUS represented 29.1% of the hysterectomy cost in the first year (R$ 1,551.92 vs. R$ 5,324.74, p <0.001) and 37.4% after five years (R$ 2,069.35 vs. R$ 5,538.74, p <0.001).

Conclusions

The use of LNG‐IUS results in lower direct and indirect costs versus TBEA and hysterectomy in the treatment of women with AUB. The cost‐effectiveness of LNG‐IUS, together with the reversibility and also by this being an outpatient procedure, highlights its role in the treatment of women with AUB, both in SUS perspective as in private health care system's.

Objective

This research aimed at calculating the prevalence of women with induced and unsafe abortion and spontaneous abortion as well as the sociodemographic characteristics associated to them in a low income population.

Method

It consists of a cross-sectional study, with a random sample of women in fertile age from 15 to 49 years of age, living in Favela México 70, in São Vicente-SP, performed in the last quarter of 2008. The method used for the analysis of the data was the Multiple Multinomial Logistic Regression in order to determine the main independent variables associated to the occurrence of induced abortion, with CI = 95% and p < 0.05. The statistical analyses were performed with the help of the SPSS software, version 17.0.

Results

Among the 860 women from 15 to 49 years of age living in this community, it was observed a median of 2 pregnancies for women without abortions and, for women who reported induced abortion, 51 women, a median of 4 pregnancies. It was also observed a mean of 2.53 live born children/women in the studied population. In the final Multiple Multinomial Logistic Regression model, there remained the following categorized independent variables: “number of live born children > 2″ (OR = 4.0), showing that women with 2 or more children have a 4-time-higher chance of inducing an abortion and “accepting abortion by lack of economic conditions” (OR = 11.5), which indicates that women without economic conditions of continuing pregnancy and/or raising one more child present an 11.5-time-higher chance of inducing an abortion.

Conclusions

It may be concluded that, by lack of an efficient contraception system and family planning, women with low income up to now, after 20 years of the International Conference on Population and Development, Cairo, 1994, resort to induced and unsafe abortion in order to diminish their own fertility and family size, in face of an unintended, unwanted or inopportune pregnancy.

Objective

Identify the role of induced abortion on reproductive behavior of young slum Mexico 70 compared to results obtained in previous investigation in the slum Inajar de Souza, 2007.

Method

This survey was designed to interview all young people 15‐24 years old, living in the slum Mexico 70, in the municipality of São Vicente in Sao Paulo. The vast majority of young people (94%) agreed to answer the questionnaire. Altogether they were interviewed 455 women and 339 men. Among them, they had started sex life 327 and 253, respectively. The analysis, at first, refers to the total number of interviewees and then only to those with an active sexual life. In determining the differential behavior by sex, appealed to the chi‐square test for qualitative variables and the Student t test for quantitative. Has set itself a p < = 0.05.

Results

Having as reference another survey in the same methodological manner in Inajar slum Souza in 2007, among other important, the most important findings, were the low prevalence of women with induced abortion and a high rate of recurrence of emergency contraception.

Conclusion

It is essential to develop studies to deepen knowledge of the effects arising from the self‐medication of contraceptives, including emergency contraception, even if these contribute to the reduction of induced abortions.