Search Results (21)

Introduction: Perinatal mortality is labeled as the loss of fetuses at or beyond 22 weeks of gestation, deaths during labor and delivery, as well as early neonatal deaths. Appropriate medical care provided in the perinatal period is an integral indicator of high-quality medical care. Although developed countries managed to decrease perinatal mortality, it remains high in the developing world. This study aims to perform a confidential audit of perinatal mortality (CAPM) across Kazakhstani maternity hospitals. Methods: A descriptive, observational cross-sectional study was conducted from January 2024 to December 2024. The structure of the underlying causes of mortality in the antenatal, intranatal, and early neonatal periods among different maternity hospitals of the Republic of Kazakhstan was analyzed. Results: A total of 116 cases were assessed: 34 antenatal deaths, 6 intranatal, and 76 early neonatal. Most deaths occurred on the second day post-delivery. The analysis revealed that 93% of cases fell into categories indicating substandard or potentially inadequate care (categories 2 and 3). Intraventricular hemorrhage and sepsis emerged as leading causes of neonatal death. Among antenatal and intranatal deaths, significant proportions were associated with comorbid maternal conditions, insufficient antenatal visits, and inadequate perinatal support. Conclusions: CAPM proves to be a critical tool for identifying systemic gaps and guiding improvements in maternity services without attributing blame to health professionals. Findings underscore that many perinatal deaths could have been avoided with timely, evidence-based interventions across antenatal and neonatal care. Broader implementation and institutionalization of CAPM in Kazakhstan could lead to measurable reductions in perinatal mortality and improvements in maternal/newborn care outcomes. Factors such as preconception planning, improving the health of reproductive-age women, administration of folic acid, and reducing primary cesarean sections could assist in achieving the reduction in the perinatal mortality rate. Full article

In Chile, lesbian-parent families have faced legal and social advancements as well as challenges, generating new dynamics through assisted reproduction. The reproductive justice framework allows for an analysis of the inequities and injustices experienced by LGBTIQA+ people in relation to their reproductive rights. Objective: To analyze the narratives of lesbian-parent families who have accessed parenthood through assisted reproduction techniques within the Chilean healthcare system, identifying barriers and facilitators in the process, as well as possible instances of discrimination. Methodology: This research adopted a qualitative approach with a descriptive scope and was based on a constructivist paradigm, utilizing a narrative design and analysis. Four lesbian-parent families participated, selected through purposive or convenience sampling. Results: The findings revealed that the main barriers were related to health insurance coverage and social and geographical factors. Among the key facilitators were support networks, educational level, and healthcare professionals’ guidance. Discussion: The study highlighted the presence of inequalities affecting the exercise of parenthood and the right to form a family, shaped by institutional and social barriers from a reproductive justice framework. Conclusions: The study underscores the need to advance inclusive public policies and systemic changes that recognize and protect family diversity in Chile. Furthermore, it highlights the role of narratives as a tool to make visible and challenge the inequalities surrounding lesbian parenthood. Full article

Background/Objectives: Most of the research in assisted reproduction has focused on the stressful situation experienced by women or couples looking for a desired pregnancy; however, the stress experienced by assisted reproduction professional teams is seldom studied. The present study aims to evaluate burnout and its relationship with workplace stressors among assisted reproduction professionals. Methods: A cross-sectional design was used to conduct an online self-assessment national survey, sent to all members of the Spanish Association for Fertility. The questionnaire contained sociodemographic and occupational questions about stressors in the workplace and the Maslach Burnout Inventory (MBI-HSS) to assess the three subscales of burnout: emotional exhaustion, depersonalization and personal accomplishment. Results: The percentages showing high emotional exhaustion and depersonalization in the whole sample were 41.8% and 43.2%, respectively. Additionally, low personal accomplishment was displayed in 42.6% of the respondents. Embryologists stand out for presenting the highest percentages of burnout (emotional exhaustion = 72.1%; depersonalization = 48.1%; low personal accomplishment = 48.1%), whilst psychologists showed the lowest percentages in high emotional exhaustion (32.3%) and depersonalization (24%), and gynecologists in low personal accomplishment (28.5%). Working under pressure was the stressor most experienced by the sample (76.6%) and the one that better predicted the three subscales of burnout. Conclusions: This study highlights the close relationship between high levels of burnout and workplace stressors and shows the need to reduce workplace stressors to improve the well-being of professionals working in assisted reproduction, and, consequently, that of the patients they look after. Full article

New, more efficient ways to accomplish objectives are key to improving the ability of zoological and conservation organizations to protect the animals they study and care for. Here, we describe an ovocesarean procedure, a novel task to assist the hatching of larval anurans in cases when allowing for hatching to occur naturally presents a risk to the survival of the progeny. This study focuses on two clutches of La Palma Glass Frogs (Hyalinobatrachium valerioi) where the eggs were not laid over a water body for the tadpoles to drop into upon emergence from the egg. A simple, three-step procedure that can be performed in just a few minutes resulted in a 95% success rate in emergence and led to increased survivability in the tadpoles that were assisted. Procedures that assist hatching of embryos and neonates are discussed in many circles of animal care but have not been described in detail to provide assistance to those that are not in a situation where they can learn it from a professional. This description of the ovocesarean procedure assigns a definitive, technical term to assisted hatching and can easily be extrapolated to other oviparous animals. Although the focal species here is of a Least Concern conservation status, this procedure can be key in improving reproductive success in other, more threatened species of anurans. Full article

Adequate vitamin D (VD) intake during pregnancy is needed for fetal development and maternal health maintenance. However, while there is no doubt regarding its importance, there is not a unified recommendation regarding adequate intake. The main aim of our study was to measure the VD serum level of studied women, together with its potential influencing factors: demographic (i.e., age, level of education, relationship status and type of residence), conception and pregnancy related factors. Results are based on secondary data analyses of a retrospective case–control study of 100 preterm and 200 term pregnancies, where case and control groups were analyzed together. Data collection was based on a self-administered questionnaire, health documentation, and maternal serum VD laboratory tests. VD intake was evaluated by diet and dietary supplement consumption. According to our results, 68.1% of women took some kind of prenatal vitamin, and only 25.9% of them knew about its VD content. Only 12.1% of included women reached the optimal, 75 nmol/L serum VD level. Higher maternal serum levels were associated with early pregnancy care visits (p = 0.001), assisted reproductive therapy (p = 0.028) and advice from gynecologists (p = 0.049). A correlation was found between VD intake and serum levels (p < 0.001). Despite the compulsory pregnancy counselling in Hungary, health consciousness, VD intake and serum levels remain below the recommendations. The role of healthcare professionals is crucial during pregnancy regarding micronutrients intake and the appropriate supplementation dose. Full article

Infertility affects around 20% of couples of reproductive age; however, in some societies, as many as one-third of couples are unable to conceive. Different factors contribute to the decline of male fertility, such us environmental and professional exposure to endocrine disruptors, oxidative stress, and life habits with the risk of de novo epigenetics dysregulation. Since the fantastic development of new “omes and omics” technologies, the contribution of inherited or de novo genomes and epigenome disorders to male infertility have been further elucidated. Many other techniques have become available to andrology laboratories for the investigation of genome and epigenome integrity and the maturation and the competency of spermatozoa. All these new methods of assessment are highlighting the importance of genetics and epigenetics investigation for assisted reproduction pathology and for supporting professionals in counselling patients and proposing different management strategies for male infertility. This aims to improve clinical outcomes while minimizing the risk of genetics or health problems at birth. Full article

Cancer Predisposition Syndromes (CPSs), also known as Hereditary Cancer Syndromes (HCSs), represent a group of genetic disorders associated with an increased lifetime risk of developing cancer. In this article, we provide an overview of the reproductive options for patients diagnosed with CPS, focusing on the emerging role of Preimplantation Genetic Testing for Monogenic disorders (PGT-M). Specifically, we conducted a literature review about the awareness and acceptability of its application to CPSs. Based on the available data, the awareness of the applicability of PGT-M for CPSs appears to be limited among both patients and physicians, and a heterogeneous set of factors seems to influence the acceptability of the procedure. Our findings highlight the need for increasing education about the use of PGT-M for CPSs. In this context, guidelines developed by professional or institutional bodies would represent a useful reference tool to assist healthcare professionals in providing proper preconception counseling. Full article

Infertility is a global health concern, with male factors playing an especially large role. Unfortunately, however, the contributions made by reproductive urologists in managing male infertility under assisted reproductive technology (ART) often go undervalued. This narrative review highlights the important role played by reproductive urologists in diagnosing and treating male infertility as well as any barriers they face when providing services. This manuscript presents a comprehensive review of reproductive urologists’ role in managing male infertility, outlining their expertise in diagnosing and managing male infertility as well as reversible causes and performing surgical techniques such as sperm retrieval. This manuscript investigates the barriers limiting urologist involvement such as limited availability, awareness among healthcare professionals, and financial constraints. This study highlights a decrease in male fertility due to lifestyle factors like sedentary behavior, obesity, and substance abuse. It stresses the significance of conducting an evaluation process involving both male and female partners to identify any underlying factors contributing to infertility and to identify patients who do not require any interventions beyond ART. We conclude that engaging urologists more effectively in infertility management is key to optimizing fertility outcomes among couples undergoing assisted reproductive technology treatments and requires greater education among healthcare providers regarding the role urologists and lifestyle factors that could have an effect on male fertility. Full article

Objective: To review the current knowledge concerning COVID-19 vaccination and assisted reproductive techniques (ART). Methods: A systematic review in Pubmed-Medline, the Cochrane Database, the Web of Science, and the National Guideline was performed. Studies were selected if they were primary studies, included vaccinated (case) and unvaccinated (control) patients, and described fertility treatment response. Results: A total of 24 studies were selected. Outcomes related to the association between COVID-19 vaccination and ART were collected. The vast majority of studies found no statistical differences concerning oocyte stimulation response, embryo quality, implantation rates, or pregnancy outcome (clinical or biochemical pregnancy rates and losses) when comparing cases and controls. Similarly, no differences were found when comparing different types of vaccines or distinct ART (artificial insemination, in vitro fertilization, and embryo transfer of frozen embryos). Conclusions: Patients receiving ART and health care professionals should be encouraged to complete and recommend COVID-19 vaccination, as the available evidence regarding assisted reproductive outcomes is reassuring. Full article

Recurrent pregnancy loss is a complex health challenge with no universally accepted definition. Inconsistency in definitions involves not only the number of spontaneous abortions (two or three) that are accepted for recurrent pregnancy loss but the types of pregnancy and gestational age at miscarriage. Due to the heterogeneity of definitions and criteria applied by international guidelines for recurrent pregnancy loss, the true incidence of recurrent miscarriage, which is reported to range from 1% to 5%, is difficult to estimate. Moreover, the exact etiology of recurrent pregnancy loss remains questionable; thus, it is considered a polyetiological and multifactorial condition with many modifiable and non-modifiable factors involved. Even after thoroughly evaluating recurrent pregnancy loss etiology and risk factors, up to 75% of cases remain unexplained. This review aimed to summarize and critically analyze accumulated knowledge on the etiology, risk factors, relevant diagnostic options, and management approach to recurrent pregnancy loss. The relevance of various factors and their proposed roles in recurrent pregnancy loss pathogenesis remains a matter of discussion. The diagnostic approach and the management largely depend on the etiology and risk factors taken into consideration by a healthcare professional as a cause of recurrent miscarriage for a particular woman or couple. Underestimation of social and health consequences of recurrent pregnancy loss leads to compromised reproductive health and psychological well-being of women after miscarriage. Studies on etiology and risk factors for recurrent pregnancy loss, especially idiopathic, should be continued. The existing international guidelines require updates to assist clinical practice. Full article

Pregnant women presumably gather information about the coronavirus disease 2019 (COVID-19) from various sources. However, it is difficult for pregnant women who are not medical professionals to source the appropriate information because of the infodemic related to the COVID-19 pandemic. Therefore, the objective of our study was to investigate how pregnant women gathered information about COVID-19 and COVID-19 vaccination. To address this issue, we conducted an online questionnaire survey between 5 October and 22 November 2021, which was approved by the Ethics Committee of Nihon University School of Medicine. We received 4962 responses after excluding 1179 insufficient answers. Our study found that age, occupation, and infection-risk anxiety influenced the selection of media for obtaining information. Pregnant women who were older, medical professionals, public servants, or educators tended to rely on specialized medical websites, whereas housewives tended to use mass media, social media, and sources with uncertain scientific evidence. Additionally, the number of weeks of gestation and the method of conception (natural or assisted reproductive conception) affected the selection of media. The accessibility of COVID-19 information for pregnant women was determined by their social background and pregnancy status. We need to continue making efforts to ensure that appropriate information is readily available to pregnant women and their families. Full article

This was a nationwide cohort study based on Danish health registers focusing on assisted reproductive technology (ART) treatments in women using donor or partner sperm from 2007 to 2017. Women using donor sperm were subdivided into groups based on relationship status: women with male partners, single women, or women with female partners. The live birth adjusted odds ratios (aORs) after the IUI treatments in women using donor sperm compared with women using partner sperm were 1.48 (95% CI: 1.38–1.59) in women with male partners using donor sperm, 1.20 (95% CI: 1.13–1.28) in single women, and 1.46 (95% CI: 1.32–1.62) in women with female partners. The live birth aORs after IVF treatments in women using donor sperm compared with women using partner sperm were 1.16 (95% CI: 1.02–1.32) in women with male partners using donor sperm, 0.88 (95% CI: 0.80–0.96) in single women, and 1.20 (95% CI: 1.00–1.44), in women with female partners. The use of donor sperm was associated with a higher chance of a live birth after the IUI treatments, but there was no difference after the IVF treatments. Our study invites healthcare professionals to increase their attention toward the different needs and fertility issues of all women attending fertility clinics. Full article

The aim of study was to understand care strategies for homeless women, focusing on aspects of sexual and reproductive health from the perspective of Street Outreach Office strategy professionals. This is a qualitative study carried out in a large city in the countryside of São Paulo, Brazil. Data were collected from December 2020 to April 2021 through semi-structured interviews, and the results were obtained through content analysis and thematic modality. Nine health professionals participated in this study, and the analysis of the interviews allowed identifying three thematic categories: (i) being female and sex on the streets (violence and oppression); (ii) gynecology as a gateway to comprehensive care for homeless women; and (iii) pregnancy, puerperium and motherhood in the context of the streets. This study contributes to the reflection of professional practices within the Street Outreach Office, allowing the understanding of challenges in assisting homeless women, aiming to raise awareness of professionals and services that make up the health care network. Full article

The prevalence of depression, stress, or anxiety in people receiving assisted reproductive technologies (ART) has been demonstrated. However, knowledge about the influence of gender norms on quality of life (QofL) during infertility treatment is limited. The main objective of this study was to confirm that patients undergoing ART present a vulnerable mental state, which may be an indicator of risk. For this purpose, a quasi-experimental cross-sectional study was carried out in the Assisted Reproduction Unit of the Hospital Politécnico Universitario de la Fe (Spain) in which a total of 438 women participated: 256 in pre-treatment and 182 in treatment. Two questionnaires were administered, FertiQol and CFNI-23, assessing self-perceived QofL and conformity to gender norms, respectively. The results showed significant differences between the pre-treatment and treatment groups on the FertiQol and its subscales. Significant associations were also found between the CFNI-23 factors and the FertiQol subscales. The results suggest that gender norms and ART interfere with women’s mental health and QofL and should be considered as possible risk indicators by professionals preventively before the prenatal or perinatal stages. Future research should design prospective studies aimed at estimating the impact of clinical and sociodemographic variables on women and other groups receiving ART. Full article

Assessing resilience response to an adverse event such as infertility requires measuring the same construct adequately and accurately by nurses. The objective of this study was to explore the validity and reliability of the Portuguese version of the Resilience Scale for adults. A cross-sectional and methodological design was used, and factor analyses were performed. The sample comprised 140 adult Portuguese individuals under fertility treatment recruited from health-related websites. The findings yielded a bad fit of the hypothesized Resilience Scale structure with the observed data. Instead, a 21-item tool with a four-factor structure revealed high internal consistency (0.94). The tool correlated positively and significantly to the Portuguese version of the Spiritual Well-Being Questionnaire and was negatively associated and lacked correlation with the Fertility Adjustment Scale. The 21-item Resilience Scale is a reliable tool suitable to measure resilience in Portuguese adults under assisted reproductive techniques. This tool offers the opportunity of early recognition by health professionals aiming to enhance patients’ coping skills effectively and promote positive psychological and mental health outcomes. Full article