Research Gaps and Misperceptions in Reproduction and Their Impact on Women’s Health

A special issue of Women (ISSN 2673-4184).

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 37193

Special Issue Editors


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Guest Editor
Department of Biological Sciences, University of Toledo, Toledo, OH 43607, USA
Interests: centriole; centrosome; cilium in sperm and male fertility
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA
Interests: infertility; protamine biology; obesity and fertility; assisted reproductive technologies

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Guest Editor
Department of Obstetrics & Gynecology and Psychiatry, Northwestern University, 633 Clark St, Evanston, IL, USA
Interests: infertility; trauma; psychology; counseling; LGBTQ family building

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Guest Editor
Kaiser Permanente, Oakland, CA, USA
Interests: fertility preservation treatment; treatment decision making; socioeconomic and racial disparities in access to, continuation of, and outcomes associated with fertility treatment

Special Issue Information

Dear Colleagues,

Women and men have distinct biological roles in reproduction. Both women and men provide gametes that create the embryo and the resulting fetus. Women then carry the fetus during pregnancy and provide nutrition at the beginning of life. This asymmetry in women’s and men’s biological roles has led to a spectrum of social misperceptions, medical inequalities, psychological challenges, and research gaps, which are detrimental to women’s and men’s health. In this Special Issue, we plan to publish research articles, reviews, and opinion pieces that touch directly or indirectly on women’s reproduction. We look forward to contributions from biological, medical, social, psychological, ethical, or any other relevant perspectives.

Prof. Dr. Tomer Avidor-Reiss
Dr. Samantha Beth Schon
Dr. Angela K. Lawson
Dr. Deborah Ikhena-Abel 
Guest Editors

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Keywords

  • infertility
  • sterility
  • women
  • men
  • reproduction
  • psychological distress

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Published Papers (8 papers)

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Research

Jump to: Review, Other

11 pages, 582 KiB  
Article
Menstruation-Related School Absenteeism: An Urban Centre Study in the Northern Region of Ghana
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 3770
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
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6 pages, 198 KiB  
Communication
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 2484
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
8 pages, 243 KiB  
Article
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 3460
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
12 pages, 246 KiB  
Article
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 4894
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

Review

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8 pages, 232 KiB  
Review
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 9929
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

Other

Jump to: Research, Review

11 pages, 5837 KiB  
Case 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 2157
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
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4 pages, 206 KiB  
Commentary
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 3338
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
9 pages, 254 KiB  
Commentary
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 5165
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
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