Global reproductive health最新文献

Evidence continues to emerge on the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) in pregnancy. Compared with previous coronavirus outbreaks (severe acute respiratory syndrome and Middle East respiratory syndrome), recent reports suggest that pregnant women who contract SARS-CoV-2 have lower rates of maternal and fetal complications; however, the incidence of preterm birth remains elevated. The potential for vertical transmission is still under investigation. Universal testing of women admitted to labor and delivery is being encouraged in most centers.

With the SARS-CoV-2 pandemic creating such a wide-reaching health crisis, it is imperative that a safe and effective vaccine be developed promptly for global availability. As such, there are several vaccine development projects currently underway aiming to meet this critical demand. However, COVID vaccine development is not immune to the inherent limitations and challenges that are encountered during vaccine clinical trials.

The novel coronavirus disease 2019 (COVID-19) has rapidly spread around the world, impacting every aspect of life. Valuable research is currently being conducted to understand disease transmission, detection, and treatment. As countries begin to relax policies aimed to reduce disease transmission, contact tracing and antibody testing will likely be incorporated to slow the spread of COVID-19. However, future research is needed to determine if the presence of COVID-19 antibodies offers immunity.

The COVID-19 pandemic has posed unique concerns and potential risks to women now pregnant or considering childbearing. Although no professional societies have issued recommendations that women avoid conception at this time, several professional organizations recommended a moratorium on infertility services including both medically assisted reproduction and assisted reproductive technology shortly after the World Health Organization declared COVID-19 infection to be a pandemic. Reasons cited for undertaking these extraordinary measures included prevention of possible complications of assisted reproductive technology and medically assisted reproduction and virus induced complications of pregnancy including potential vertical transmission to the fetus and optimization use of critical health care resources. A survey of reproductive health providers in 97 countries was undertaken to assess their response to the pandemic and recently issued guidance. Although different countries reacted differently with diverse responses and variable resources, the results suggest that the reproductive health community has largely been responsive to public health and individual patient concerns.

SARS CoV-2, otherwise known as Corona virus 2019 (COVID-19) has left >300,000 dead without a definitive cure in sight. Significant research has been conducted regarding the use of currently available pharmacotherapies and multiple clinical trials are underway to bring new treatments to market. While supportive treatment remains the standard of care, additional therapeutic regimens including antivirals, monoclonal antibodies, antibiotics, anti-inflammatories, immunoenhancers, vitamins, systemic steroids, inhalants, anticoagulants, and convalescent plasma are showing promise.

Background: Multiple Sclerosis (MS) is an immune-mediated inflammatory disease characterized by demyelination of the CNS that affects women in their child-bearing years. There has been no absolute data to suggest infertility in this population; however, women with MS may exhibit decreased fertility due to various etiologies. Furthermore, their transition into menopause presents unique aspects in patient care.

Methods: We report a case of a 38 year-old female with a diagnosis of MS with subsequent secondary amenorrhea and primary infertility. Multidisciplinary work-up with was consistent with hypothalamic hypogonadism secondary to MS affecting the pituitary stalk. She was treated for infertility in our clinic as well as management of her menopausal symptoms.

Results: The patient conceived triplets after 2 cycles of ovarian stimulation with injectable gonadotropins and intrauterine insemination. She underwent fetal reduction to twins. After completion of childbearing, she was treated for menopausal symptoms with various hormonal therapies and ultimately remained on oral conjugated estrogens with no symptoms.

Conclusion: To our knowledge, this is the first report of infertility caused by suspected MS involvement of the pituitary stalk. In this patient population, infertility treatment can be successful with gonadotropins and alleviation of menopausal symptoms can be achieved with hormone replacement.