Frontiers in reproductive health最新文献

Background: Primary dysmenorrhea is a common gynecological problem characterized by recurrent, periodical, and cramping pain in the lower abdomen that occurs before or during menstruation, usually without pelvic disease. Its magnitude has not been well studied; some of the associated factors are inconclusive. Therefore, the goal of this study was to fill gaps on the magnitude, and associated factors of primary dysmenorrhea among female high school students in Nekemte town.

Objectives: To assess the magnitude of primary dysmenorrhea, its associated factors among high school students in Nekemte town, East Wallaga, Western Oromia, Ethiopia, 2023.

Methods: An institutional-based cross-sectional study was conducted among high school students in Nekemte town from June 05 to 19, 2023. The calculated total sample size was 534, and data were collected from four governmental high schools and one private high school that were selected by multistage stratified sampling. The collected data were entered into Epi Info version 3.1 and analyzed using SPSS version 25. Binary and multivariable logistic regressions were used to find associations between dependent and independent variables.

Results: The magnitude of primary dysmenorrhea was 68.4% (95% CI = 64.3%, 72.0%). Anxiety (AOR = 2.41, 95% CI = 1.31, 4.43), family history of primary dysmenorrhea (AOR = 4.64, 95% CI = 2.74, 7.86), sexual intercourse (AOR = 0.34, 95% CI = 0.21, 0.55), drinking tea <4 cups per day (AOR = 0.38, 95% CI = 0.22, 0.60), and physical activity (AOR = 0.06, 95% CI = 0.03, 0.11) were factors associated with primary dysmenorrhea.

Conclusion: The magnitude of primary dysmenorrhea was high among high school students in the study area. Sexual intercourse, physical activity, drinking tea, anxiety, and family history of primary dysmenorrhea were significantly associated with primary dysmenorrhea.

Introduction: Infertility has significant implications on health. It affects physical, emotional, and social wellbeing. In Morocco, about 12% of couples or live with infertility. In 2013 the first public Assisted Reproductive Technology (ART) Center was established at the Maternity and Reproductive Health Hospital les Orangers in Rabat, Morocco. This qualitative study explores the experiences of infertility among couples who have benefited from diagnosis and treatment at ART center. The study represents a part of the overall evaluation of this first public ART centre in Morrocco.

Methods: Data were collected through in-depth patient interviews. A semi-structured interview guide was used to elicit the perspectives and experiences couples with infertility. Data collection occurred between January and March 2023. Inductive thematic analysis was conducted to explore the experiences of infertility among the couples.

Results: The study showed that couples with infertility were exposed to negative experiences such as (i) biomedical experiences (diagnostic delays, fragmented care, multiplicity of treatments), (ii) social experiences (gendered social pressures, stigma, discrimination, marital challenges, isolation and disrupted social routines), (iii) mental experiences (anger, anxiety, depression, and mood changes) as well as (iv) financial limitations (out of pocket payments and financial indebtedness). Solutions addressing these challenging experiences were suggested by interviewed couples including continued quality and respectful care to enhance biomedical experiences; public education campaigns to educate the public and destigmatize infertility to improve social experience, inclusion of psychosocial services as part of fertility integrated care to enhance psychological experiences, and enhanced financial protection, and service decentralisation to mitigate negative financial pressures.

Conclusion: Couples with infertility are exposed to various challenges in the biomedical, social, psychological, and financial domains. A health system strengthening approach is essential to address those challenges, and multiple strategies are needed to improve the experiences of couples with infertility in Morocco. Given interconnectedness between biomedical, social, psychological, and financial divers of experiences, a holistic approach is required to comprehensively improve the experiences of infertile couples and address all the issues faced by couples during their treatment journey.

Introduction: Community health volunteers (CHVs) are fundamental in many health systems across the globe. In Kenya, CHVs were essential in providing sexual and reproductive health (SRH) services during the COVID-19 pandemic. The study highlights challenges experienced by community health volunteers in Kenya while providing SRH services during the COVID-19 pandemic.

Method: The study utilized a qualitative research design to explore challenges experienced by CHVs in offering SRH services in Dagoretti North and South sub-counties in Nairobi and Khwisero sub-county in western Kenya during the COVID-19 pandemic period. We conducted 17 in-depth interviews, 7 focus group discussions, and 1 group discussion with CHVs. The data was collected in different periods: in Khwisero, November 2022-August 2023, and in Nairobi, February-April 2023.

Results: The study's findings show that CHVs experienced several challenges while providing SRH services. The challenges included distrust by the community as a result of the interaction between anti-COVID-19 measures and other past and present health interventions such as vaccines for other diseases, insufficient personal protective gear and equipment (PPEs), limited human and financial resources to address community needs, limited and poor training on response to misinformation that led to vaccine hesitancy, and mental strain from stigma and burnout.

Conclusion: During pandemics, governments should provide adequate personal protective gear and financial and human resources for CHVs' work as they deliver SRH services to the community under risky conditions. In addition, CHVs must be trained to address misinformation about relevant medical interventions during epidemics and pandemics and provided with psychosocial support to mitigate the impact of psychological distress.

Introduction: Hypospermatogenesis is a common histopathological subtype of non-obstructive azoospermia and is characterized by a decrease in the total number of germ cells within the seminiferous tubule as a result of spermatogenic failure. Determination of genetic factors before intracytoplasmic sperm injection can prevent the inheritance of these factors, as hypospermatogenesis patients gives high successful sperm retrieval rate. This study aimed to identify the structural variants associated with idiopathic hypospermatogenesis (iHS) by analyzing patient cohorts diagnosed with azoospermia using whole exome sequencing.

Methods: It is a hospital-based observational study in which patients reporting with azoospermia due to spermatogenic failure were recruited prospectively. Comprehensive clinical history, blood samples, semen analysis parameters, and reproductive endocrine evaluation reports of 51 hypospermatogenesis patients were collected. The known genetic causes were investigated using XY fluorescent in situ hybridization and Yq microdeletion for exclusion. Whole exome sequencing was performed, and the data of 42 iHS patients was analyzed to identify single nucleotide variants associated with diagnostically important male infertility genes.

Results: Genomic analysis of SNVs identified rare deleterious candidate variants in CFTR (c.1265C>T; p.Ser422Phe), CYP21A2 (c.955C>T; p.Gln319Glu), SRD5A2 (c.737G>A; p.Arg245Gln), LHCGR (c.378A>C; p.Lys126Asn) and AR (c.2179C>A; p.Arg727Ser) genes associated with 7/42 idiopathic hypospermatogenesis patients. In silico analysis of variants shows deleterious and probably damaging effects on canonical transcripts of the genes.

Discussion: This exploratory genomic analysis conducted on idiopathic hypospermatogenesis patients shows prevalence of rare deleterious candidate variants in genes associated with human male infertility. The candidate variants in idiopathic hypospermatogenesis patients are heterozygous and genotypically associated with syndromic male infertility. The symptomatic heterozygosity leading to mild spermatogenic failure resulting in hypospermatogenesis points towards a multifactorial etiology of the disease. This study justifies the importance of genetic screening of idiopathic hypospermatogenesis patients for the presence of structural variants in known human male infertility genes.

Endometriosis and adenomyosis are prevalent causes of infertility, often coexisting in a significant proportion of patients. Although endometriosis typically does not negatively impact assisted reproductive technology (ART) outcomes, the presence of coexisting adenomyosis, mainly non-severe external forms, may slightly influence IVF/ICSI success rates. However, this impact is often minimal and may result in insignificant changes in statistical analyses. Recent studies underscore the critical role of accurate diagnostic techniques, such as ultrasound or MRI, in identifying severe adenomyosis characteristics, including diffuse involvement with junctional zone participation. This precise delineation is reassuring, as it is essential for tailoring assisted reproductive technology (ART) strategies to enhance success rates and reduce the confounding effects of adenomyosis, particularly when it coexists with endometriosis. Strategic approaches, such as ultralong GnRH agonist protocols or freeze-all strategies, may provide advantages in these scenarios. However, the need for extensive research is vital to understanding the complex interactions between endometriosis, adenomyosis, and ART outcomes. This ongoing exploration is particularly important in cases where coexisting adenomyosis might not significantly influence statistical results.

Background: Today's youth are adopting a new trend: casual sex. College students are expected to engage in a range of potentially harmful sexual activities, such as casual sex. Numerous factors can lead students to engage in casual sexual encounters. However, there has been limited research on the prevalence of casual sex and related issues in higher education institutions in Ethiopia.

Objective: To assess the prevalence of casual sex and its associated factors among regular undergraduate students at Debre Berhan University in 2023.

Methods: From 15 May 2023, to 30 May 2023, regular undergraduate students from Debre Berhan University participated in a cross-sectional study. A total of 512 samples were collected using a multistage sampling technique. Subsequently, a simple random sampling technique was employed to select the students, with a proportionate allocation of samples distributed to randomly selected colleges, departments, and academic years. The data were collected using a structured, pretested, and self-administered questionnaire. Once the data were imported into Epi-data version 4.6 and exported to SPSS version 20 for analysis, frequencies, percentages, and tables were generated. Bivariate and multivariate logistic regression models were used to identify characteristics associated with casual sex.

Results: The prevalence of casual sex among regular undergraduate students at Debre Berhan University was 31.0% 95% CI (27.2-34.6). Several factors were significantly associated with casual sex. These included students from urban areas [AOR: 2.95; 95% CI (1.66-5.24)], students with poor academic performance [AOR: 2.81; 95% CI (1.51-5.22)], alcohol consumption [AOR: 4.59; 95% CI (2.60-8.12)], attending nightclubs [AOR: 2.75; 95% CI (1.47-5.16)], watching pornography [AOR: 2.59; 95% CI (1.47-5.16)], and peer pressure [AOR: 2.24; 95% CI (1.38-3.65)].

Conclusion: The prevalence of casual sex was high among Debre Berhan University students. In order to lessen the negative effects of casual sex practices, this study found predictors that can be avoided through various interventions. Key preventative measures include improving student academic performance, providing engaging and free entertainment, restricting access to pornographic websites on university Wi-Fi, and employing peer educators.

Objectives: Limited data exists on attitudes and practices of young men in tertiary institutions towards contraception. This study assesses attitudes and practices regarding contraception among male students in a tertiary educational institution in northwestern Nigeria, identifying factors influencing these attitudes.

Methods: This cross-sectional study conducted from July to August 2021 at Kaduna Polytechnic, Nigeria, involved 160 male students chosen via multistage sampling. Structured questionnaires gathered information on socio-demographic characteristics, awareness, attitudes, and contraceptive practices. Analysis utilized SPSS version 23.0, employing descriptive statistics, bivariate, and multivariable logistic regression analyses to determine significant factors influencing contraception attitudes.

Results: Findings revealed a mean respondent age of 25.4 ± 3.5 years, with most being single (71.3%) and 51.2% sexually active. While awareness of contraceptives was high (85.6%), almost half (46.7%) exhibited negative attitudes towards contraception. Common concerns included reliability, impact on sexual pleasure, and traditional gender norms. Only 35.8% had ever used contraception, primarily using withdrawal and male condoms. Significant factors influencing positive attitudes included being aged 18-24 years compared to 26-35 years (AOR = 2.66, 95% CI: 1.22-5.82).

Conclusion: Culturally sensitive interventions are vital for improving negative attitudes and low contraceptive use among male Nigerian youth.

Introduction: Evidence suggests a new demand for vasectomies following the Supreme Court's Dobbs v. Jackson Women's Health Organization [597 U.S. 215 (2022), (Dobbs)]. Vasectomies are safer and more cost-effective than tubal sterilization. Understanding how to support men's use of this procedure is important to improving sexual and reproductive health and wellbeing (SRHW). This study is an exploration of health care providers' perspectives on the gender, cultural and political influences on vasectomies at Title X-funded clinics across all regions of the US.

Methods: Providers or health services staff (N = 21) at Title X-funded settings currently offering vasectomy services in their own clinics or via referral were recruited using list serve and email outreach. Participants took part in one-on-one or small group interviews about vasectomy procedures, patient experiences, and trends. A thematic analysis of interview transcripts through an iterative process of reviewing, note-taking, and discussing data assessed provider views on patient cultural, gender, and political vasectomy influences.

Results: Qualitative interviews yielded four themes related to participant access to services, including income challenges, language barriers, medical distrust, and societal gender roles that stressed women's responsibility for contraception. Two additional themes focused on men's fear of losing reproductive health options and desire to "step up" to do their part to prevent unplanned pregnancies.

Discussion: Interviewees stressed that vasectomy was for everyone but identified sub-groups of men who still faced logistical and social access challenges to the procedure. Providers also believed that men were concerned over reproductive justice in the US and wanted to do their part to help prevent unplanned pregnancies. They thought that the Dobbs decision may mark a turning point in reproductive care that could ultimately better public health initiatives and overall SRHW by including men in the conversation. Vasectomy education, marketing-along with policy changes that ease access, can support this goal.

Introduction: In Spain, legislation protecting women during the menopausal transition and postmenopause is still in its early stages. For public policies to be effective, it is essential that their design, implementation, and evaluation actively involve women going through this stage. Only from their experience and perspective can the impact of measures be maximized and ensure that they truly respond to their needs and realities. The goal of this article is to identify and analyze proposals for action that public organizations in Spain could undertake to improve the management of and transition through menopause. On the basis of the initiatives identified through women's narratives, this study aims to establish a solid basis for the inclusion of future governmental policies and practices in Spain. Adapting to the economic conditions and sociocultural aspects specific to each region can stimulate reflection and debate on their policies regarding menopause.

Methods: This qualitative study, which was conducted in Spain, was based on 20 semistructured interviews with women who had experienced physiological and symptomatic menopause in the last five years, were postmenopausal, and were actively employed. The interviews were audio-recorded, transcribed, and analyzed following an inductive thematic analysis.

Results: The stories of the interviewees indicate three categories of government action comprising a set of specific measures. More specifically, the categories relate to: (a) proposals for accompaniment and social awareness, (b) educational and training proposals, and (c) political and regulatory proposals.

Conclusions: This study identifies governmental proposals and specific actions to improve support for the menopausal transition and postmenopause in Spain. While its findings may be applicable to other countries, further research is needed to explore how they could be adapted to the different socioeconomic and cultural realities of those contexts. Ultimately, the proposals presented lay the groundwork for developing public policies and laws that respond to the needs of women, improving their well-being and promoting gender equity in public health.