Women

Research

11 pages, 582 KiB

Open AccessArticle

by Mubarick Nungbaso Asumah, Qorinah Estiningtyas Sakilah Adnani, Edem Kojo Dzantor, Mirza Adil Beig, Gifty Mary Wuffele, Doreen-Remember Donkor, Abdul-Malik Abdulai, Wisdom Klutse Azanu, Ali Davod Parsa, Russell Kabir and Abdulai Abubakari

Women 2023, 3(4), 497-507; https://doi.org/10.3390/women3040038 - 1 Nov 2023

Viewed by 3762

Abstract

Menstruation-related school absenteeism significantly affects girls’ academic progress and general wellbeing. This study aimed to assess menstruation-related school absenteeism in an urban population in the Northern Region of Ghana. A school-based cross-sectional study was conducted to determine the prevalence of school absenteeism among [...] Read more.

Menstruation-related school absenteeism significantly affects girls’ academic progress and general wellbeing. This study aimed to assess menstruation-related school absenteeism in an urban population in the Northern Region of Ghana. A school-based cross-sectional study was conducted to determine the prevalence of school absenteeism among girls using a structured questionnaire, which was pretested. The data were analyzed using Stata 16. Descriptive and inferential statistics, including cross-tabulation, the chi-square test, and binary logistic regression, were performed. The majority (59%) was between the ages of 15 and 19 years. Approximately one fifth of all respondents missed school during menstruation. Reasons assigned to missing school were menstrual pains (57%), stained clothes (43%), heavy bleeding (40%), and self-stigmatization (2%). The majority (95%) of respondents used some form of materials to absorb menstrual blood. About 88% of respondents used sanitary pads, 11% used cloth, and 1% used tissues to absorb their menstrual blood. The multivariable analysis showed that school girls < 15 years old (AOR: 3.69, 95% CI: 2.02–6.73), first year of Junior High School (AOR: 4.68, 95% CI: 2.14–10.22), and public school (AOR: 3.57, 95% CI: 1.83–6.94) were associated with increased odds of menstruation-related school absenteeism. Menstruation-related school absenteeism is considered high and could affect girls’ educational attainment. School absenteeism due to menstruation, particularly in public schools, warrants attention by the Ghana Education Service. Full article

(This article belongs to the Special Issue Research Gaps and Misperceptions in Reproduction and Their Impact on Women’s Health)

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6 pages, 198 KiB

Open AccessCommunication

The Effects of a Recent Major Hurricane on a Reproductive Medicine Clinic

by Catherine Rault, Stefanie U. Braun and Nicole D. Ulrich

Women 2022, 2(2), 115-120; https://doi.org/10.3390/women2020013 - 12 May 2022

Viewed by 2479

Abstract

Natural disasters and major weather events can have a large impact on fertility treatment in the affected area through unplanned clinic closures leading to cancelled cycles, severe weather endangering cryopreserved embryos and gametes, and long delays in the resumption of care related to [...] Read more.

Natural disasters and major weather events can have a large impact on fertility treatment in the affected area through unplanned clinic closures leading to cancelled cycles, severe weather endangering cryopreserved embryos and gametes, and long delays in the resumption of care related to infrastructure damage. The cessation of fertility treatment in these circumstances can lead to increased stress, anxiety, and trauma for patients and staff. As major weather events are expected to increase as a result of our warming planet, both the immediate effects of unplanned clinic closures and the long-term impacts on the success of assisted reproductive technology (ART) and pregnancy outcomes call for a closer evaluation of the effects of these events on the field of reproductive medicine. Research on developing new strategies to mitigate potential negative effects and improving our disaster preparedness is needed. Full article

(This article belongs to the Special Issue Research Gaps and Misperceptions in Reproduction and Their Impact on Women’s Health)

8 pages, 243 KiB

Open AccessArticle

Obstructive Sleep Apnea: Another Condition to Screen for in Women with Infertility

by Leeann M. Bui, Mihaela Bazalakova, Kathleen M. Antony and Laura G. Cooney

Women 2022, 2(1), 56-63; https://doi.org/10.3390/women2010006 - 25 Feb 2022

Viewed by 3456

Abstract

Women with obstructive sleep apnea (OSA) are at increased risk of poor pregnancy outcomes such as fetal growth restriction, hypertensive disorders of pregnancy, and gestational diabetes mellitus. Given this increased risk, we aimed to study the screening prevalence of OSA in women seeking [...] Read more.

Women with obstructive sleep apnea (OSA) are at increased risk of poor pregnancy outcomes such as fetal growth restriction, hypertensive disorders of pregnancy, and gestational diabetes mellitus. Given this increased risk, we aimed to study the screening prevalence of OSA in women seeking fertility treatment. We performed a cross sectional study of patients presenting to a university-affiliated fertility clinic between March-April 2021. Patients were asked to complete OSA screening (STOP-BANG), anxiety screening (GAD-7), and depression screening (PHQ-2) questionnaires. 107 women completed the surveys. Mean age was 35.1 years and mean body mass index (BMI) was 25.7 kg/m². Nine (8.4%) women screened positive for OSA using the STOP-BANG screening tool. Women who screened positive for OSA were more likely to be older (37.8 years vs. 34.7 years, p = 0.02) and have a higher BMI (42.6 kg/m² vs. 27.4 kg/m², p < 0.001). Women who screened positive for OSA were also more likely to screen positive for mild-severe depressive symptoms (22.2% vs. 3.1%, p = 0.006) and mild-severe anxiety (66.7% vs. 21.4%, p = 0.003) symptoms. 24.3% of the population had polycystic ovary syndrome (PCOS). Women with PCOS were more likely to screen positive for OSA (19.2% vs. 4.9%; p = 0.04). Despite this being a low-risk population of young women seeking fertility evaluation or treatment, 8% screened positive for OSA. Given the association between OSA and adverse pregnancy outcomes, our results underline the need to screen women seeking fertility treatment. Full article

(This article belongs to the Special Issue Research Gaps and Misperceptions in Reproduction and Their Impact on Women’s Health)

12 pages, 246 KiB

Open AccessArticle

Laboring to Conceive: Reducing Barriers to Fertility Care for Same-Sex Mothers Pursuing Parenthood

by Caroline E. Richburg, Nina Jackson Levin and Molly B. Moravek

Women 2022, 2(1), 44-55; https://doi.org/10.3390/women2010005 - 23 Feb 2022

Cited by 3 | Viewed by 4889

Abstract

Infertility clinics and providers in the United States have made efforts to become LGBTQ-inclusive, yet patients in same-sex partnerships continue to face disproportionate barriers to accessing fertility services when pursuing parenthood. This narrative case study of a same-sex couple’s “labor to conceive” illustrates [...] Read more.

Infertility clinics and providers in the United States have made efforts to become LGBTQ-inclusive, yet patients in same-sex partnerships continue to face disproportionate barriers to accessing fertility services when pursuing parenthood. This narrative case study of a same-sex couple’s “labor to conceive” illustrates some of the structural barriers to family building that lesbian mothers face when seeking fertility care, including insurance coverage of fertility treatments, federal regulations for sperm donation, and legal definitions of parenthood. Exclusionary medical and legal systems are discussed, as are the informal strategies that this same-sex couple utilized to negotiate and circumvent these barriers. A patient-centered model of advocacy that facilitates access to and protection of same-sex partners seeking (in)fertility services is presented. Intervention points at the (1) Logistical and (2) Societal levels are considered with respect to three domains of same-sex reproduction: (A) insurance; (B) sperm donation; (C) legal adoption. Full article

(This article belongs to the Special Issue Research Gaps and Misperceptions in Reproduction and Their Impact on Women’s Health)

Review

Jump to: Research, Other

8 pages, 232 KiB

Open AccessReview

Emotional Support for Infertility Patients: Integrating Mental Health Professionals in the Fertility Care Team

by Megan R. Sax and Angela K. Lawson

Women 2022, 2(1), 68-75; https://doi.org/10.3390/women2010008 - 4 Mar 2022

Cited by 9 | Viewed by 9908

Abstract

Patients seeking fertility treatment are at risk of experiencing psychological distress, with both women and men reporting higher levels of depression and anxiety during infertility treatment than patients in the general population. Multiple professional societies, fertility care providers, and patients have advocated for [...] Read more.

Patients seeking fertility treatment are at risk of experiencing psychological distress, with both women and men reporting higher levels of depression and anxiety during infertility treatment than patients in the general population. Multiple professional societies, fertility care providers, and patients have advocated for integrating mental health providers in the treatment of infertile patients in order to provide comprehensive patient-centered care. Research with other patient populations shows that embedding mental health professionals into clinics provides the greatest benefit to patients. Despite acknowledging the importance of mental health in infertility care, professional societies, such as ASRM and ESHRE, have not universally standardized recommendations or methods for imbedding mental health providers in the fertility team. This review article aims to serve as a resource for providers and patients to appraise the available literature on the importance of embedding mental health providers into the fertility treatment team and discusses feasible methods to develop this comprehensive care team. Full article

(This article belongs to the Special Issue Research Gaps and Misperceptions in Reproduction and Their Impact on Women’s Health)

Other

Jump to: Research, Review

11 pages, 5837 KiB

Open AccessCase Report

Rapid Ovarian Reserve Decline in a Woman with Pericentric Inv(9) Variant

by Leeann M. Bui, Laura G. Cooney and Aleksandar K. Stanic

Women 2023, 3(3), 421-431; https://doi.org/10.3390/women3030032 - 6 Sep 2023

Cited by 1 | Viewed by 2154

Abstract

Inv(9) is one of the most common chromosomal variants and is generally considered to be a variant of no clinical significance. We describe a case of a 35-year-old woman with a normal baseline fertility workup who presented to a university-affiliated fertility clinic after [...] Read more.

Inv(9) is one of the most common chromosomal variants and is generally considered to be a variant of no clinical significance. We describe a case of a 35-year-old woman with a normal baseline fertility workup who presented to a university-affiliated fertility clinic after eight months of attempting conception. She underwent a rapid decline in anti-Mullerian hormone (AMH) from 10.0 ng/mL to 0.5 mg/mL and cycle day 3 (CD3) antral follicle count (AFC) from 58 to 4 total follicles during 18 months of follow-up. Her karyotype demonstrated a reportedly benign 46XX, Inv(9)(p11q13) variant. During follow-up and fertility treatment, she achieved pregnancy three times, but they all ended in chemical pregnancies. A systematic review of the literature identified 24 publications evaluating the association between infertility or recurrent pregnancy loss (RPL) and Inv(9). We report the prevalence of Inv(9) in women with infertility and the prevalence of infertility or RPL in women with Inv(9) mutation. Although Inv(9) has previously been considered to be a normal variant, several publications support the possible correlation between Inv(9) with reproductive failure. There has been limited literature regarding this association, and future studies should consider higher-resolution genomic detection methods to identify Inv(9)-related chromosomal rearrangements in couples presenting with infertility. Full article

(This article belongs to the Special Issue Research Gaps and Misperceptions in Reproduction and Their Impact on Women’s Health)

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4 pages, 206 KiB

Open AccessCommentary

A Costly Choice? In Vitro Fertilization and Those That Terminate: Working towards an Understanding in a Post-Roe America

by Julie Bindeman

Women 2022, 2(3), 176-179; https://doi.org/10.3390/women2030018 - 21 Jul 2022

Cited by 1 | Viewed by 3337

Abstract

Abortion continues to be a hotly debated topic in the United States, despite the majority of the populace endorsing it as a legal right. The June 2022 ruling from the Supreme Court turned the legal question about abortion back to the states, which [...] Read more.

Abortion continues to be a hotly debated topic in the United States, despite the majority of the populace endorsing it as a legal right. The June 2022 ruling from the Supreme Court turned the legal question about abortion back to the states, which will drastically reduce abortion services in the country and confine abortion access mainly to the coasts. The intersection between abortion and a pregnancy achieved using assisted reproductive technology is one that lacks understanding. While presumed to be rare, as data is not collected in the US about abortions, this intersection exists but is understudied. This paper illuminates the little that we know to date about this intersection as well as where our knowledge is profoundly lacking. Creating a better sense of understanding will enable clinics to counsel patients appropriately when the intersection arises. Full article

(This article belongs to the Special Issue Research Gaps and Misperceptions in Reproduction and Their Impact on Women’s Health)

9 pages, 254 KiB

Open AccessCommentary

Body Size, Fertility, and Reproductive Justice: Examining the Complex Interplay between BMI, Reproductive Health, and Access to Care

by Breonna Slocum, Adrienne Shami and Samantha B. Schon

Women 2022, 2(2), 93-101; https://doi.org/10.3390/women2020011 - 14 Apr 2022

Cited by 6 | Viewed by 5156

Abstract

The relationship between obesity and reproduction is highly complex. While there are clear obstetrical and fertility risks associated with elevated BMI, it is less clear how weight loss impacts these outcomes. Increasingly, patients considered obese according to BMI are being denied access to [...] Read more.

The relationship between obesity and reproduction is highly complex. While there are clear obstetrical and fertility risks associated with elevated BMI, it is less clear how weight loss impacts these outcomes. Increasingly, patients considered obese according to BMI are being denied access to fertility care, thus leaving them without treatment options for their disease (infertility). Notably, BMI cutoffs disproportionately affect historically marginalized populations in the United States and people of lower socioeconomic status (SES). This paper uses a reproductive justice framework to discuss access to reproductive healthcare based on BMI. In doing so, we connect obesity to larger systems of structural inequalities. We conclude that rather than strict BMI cutoffs, a more holistically patient-centered approach is appropriate taking into account the overall health of the individual, available scientific data, clinical capabilities, and the patient’s value system. This will ultimately make reproductive medicine more accessible to all patients. Full article

(This article belongs to the Special Issue Research Gaps and Misperceptions in Reproduction and Their Impact on Women’s Health)

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