Aspects Of Reproductive Health Research Articles

Exploring the determinants of fertility rates in Ethiopia: a decomposition analysis using count regression models with a focus on urban and rural residence, based on the 2019 Ethiopian demographic health survey

IntroductionFertility refers to the biological capacity to reproduce and have children. It is a key aspect of reproductive health influenced by various factors. Therefore, this study aims to explore the determinants of fertility rates based on urban and rural settings in Ethiopia.MethodA stratified two-stage cluster sampling approach was used, employing data from the 2019 Ethiopian Mini Demographic and Health Survey (https://dhsprogram.com). The study comprised 8,885 women aged 15 to 49 years. The study employed Stata 17, and the data was described using descriptive statistics. Associations were examined using decomposition analysis and negative binomial regression. The Incidence Rate Ratio and p-value were used to determine the statistical significance of the variables examined.ResultsThe negative binomial regression found that factors such as maternal age (IRR, 1.08, P-value,0.00), living in rural (IRR,1.09, P-value,0.00), being Muslim (IRR,1.13, P-value,0.00), being from other religious groups (IRR,1.16, P-value,0.00), having six up to nine household members (IRR,1.24, P-value,0.00), having greater than nine household member(IRR,1.14, P-value,0.04), having one child under five year (IRR,1.35, P-value,0.00), having two children under five year (IRR,1.77, P-value,0.00), and having more than two under five years (IRR,1.99, P-value,0.00), being currently pregnant (IRR,1.08, P-value,0.00), use of contraceptive(IRR,1.13, P-value,0.00) are positively associated with bearing more children. On the other hand, completing primary education (IRR,0.84, P-value,0.00), secondary education (IRR,0.61, P-value,0.00), being from the richest household (IRR = 0.94, P-value,0.00), and being single/divorced and widowed (IRR,0.49, P-value,0.00) are negatively associated with having more children because their IRR is less than one. The decomposition analysis also demonstrated that marital status has a stronger negative correlation with fertility in rural compared to urban settings. Additionally, the number of children under five exerts a greater influence on fertility in urban areas.Conclusionthe study found significant rural-urban differences in the factors shaping fertility in Ethiopia. While demographics like maternal age, education, and wealth influenced fertility in both settings, the relationships varied in nature and magnitude. To address this, Policymakers should develop targeted fertility programs that address the unique needs and challenges faced by rural and urban populations.

Impact of Obesity on Dysmenorrhea and Lower Urinary Tract Symptoms in Adenomyosis Patients

Obesity poses a substantial health challenge globally, affecting various aspects of reproductive health, including adenomyosis. Adenomyosis, characterized by the presence of endometrial tissue within the myometrium, commonly affects women during their reproductive years, leading to symptoms such as dysmenorrhea and lower urinary tract symptoms (LUTS). This study aimed to investigate the influence of obesity on dysmenorrhea and LUTS severity in adenomyosis patients, considering demographic factors such as age and educational levels as potential moderators. Forty-four adenomyosis patients participated in a cross-sectional study at Dr. Moewardi General Hospital in Surakarta City of Indonesia, between April and September 2023. Diagnosis was confirmed using 2D Transvaginal Ultrasound (2D-TVUS). Obesity was defined using Body Mass Index (BMI) categories, and dysmenorrhea and LUTS were assessed using the Numerical Rating Scale (NRS) and modified International Prostate Symptom Score (IPSS) questionnaire, respectively. Statistical analyses included Pearson correlation. Results indicated a significant positive correlation between obesity and dysmenorrhea (rho = 0.256, P = 0.049) and LUTS (rho = 0.292, P = 0.029). Age and educational level did not significantly moderate these relationships, emphasizing the independent influence of obesity on symptom severity. In conclusion, obesity significantly impacts the severity of dysmenorrhea and LUTS in adenomyosis patients, highlighting the need for tailored management strategies that address both hormonal and inflammatory pathways.

Nutritional Deficiencies and Subfertility: A Comprehensive Review of Current Evidence.

Subfertility, a condition marked by a reduced capacity to conceive naturally, affects a significant proportion of couples globally. Nutrition is a fundamental aspect of reproductive health, with various nutrients essential in maintaining optimal reproductive function. This comprehensive review explores the intricate relationship between nutritional deficiencies and subfertility. It examines key micronutrients such as vitamins D, E, C, and B12, as well as minerals such as zinc, iron, selenium, and magnesium, and their impacts on fertility. The review also considers macronutrients and the importance of a balanced diet in supporting reproductive health. Drawing on an extensive body of clinical evidence and studies, this review highlights how deficiencies in these nutrients can lead to hormonal imbalances, impaired gametogenesis, and suboptimal pregnancy outcomes. It discusses the efficacy of nutritional interventions, including dietary supplements and lifestyle modifications, in improving fertility. Furthermore, it addresses the emerging research on personalized nutrition and its potential to enhance reproductive outcomes. The review underscores the necessity for healthcare providers to assess and address the nutritional status of patients with subfertility. It provides practical recommendations for developing nutritional plans, counseling patients, and integrating nutritional interventions into fertility treatments. By offering a comprehensive synthesis of current evidence, this review aims to inform clinical practice and promote further research into the role of nutrition in enhancing fertility.

O-067 An update from the international reproductive health education collaboration

Abstract Most people want children, but many do not achieve their parenthood goals. Research shows that both men and women have limited knowledge about fertility and the factors that affect it. This includes poor knowledge about the impact of age, the most important determinant of the chance to conceive and have a healthy baby. As age at first birth is increasing in many countries, people increasingly seek assisted reproductive technology (ART) treatment due to age-related infertility. To allow people to make informed decisions about if and when to have children and to avoid age-related infertility, they need evidence-based and accessible information about fertility. Fertility awareness is defined by the World Health Organisation as ‘the understanding of reproduction, fecundity, fecundability, and related individual risk factors (e.g. advanced age, sexual health factors such as sexually transmitted infections (STIs), and lifestyle factors such as smoking, obesity) and non-individual risk factors (e.g. environmental and workplace factors); including the awareness of societal and cultural factors affecting options to meet reproductive family planning, as well as family building needs’. In 2019, an international collective of reproductive health researchers and health professionals convened to promote fertility education for the public, teachers, and health professionals. Initially called the International Fertility Education Initiative (IFEI), in 2022 the group integrated into ESHRE. In 2023, the group rebranded as the International Reproductive Health Education Collaboration (IRHEC) (www.eshre.eu/IRHEC) to reflect a life course perspective that goes beyond childbearing and includes education about all aspects of reproductive health, from puberty to menopause. The mission statement of the IRHEC is ‘To increase reproductive health awareness using the life course approach, in order to improve reproductive health and facilitate decision-making in family planning among adolescents, people of reproductive age, primary healthcare, education professionals, and policymakers through development, evaluation and dissemination of inclusive educational resources.’ We aim for our website to be a repository for a range of reproductive health educational resources for the public, health and education professionals, and researchers. This includes some resources developed by the group. In this first IRHEC report to the ESHRE conference we will describe the committee structure, the processes for joining the IRHEC Network and for nominations and elections of committee members and introduce current IRHEC committee members. We will also provide updates on completed resources to be launched during 2024 and on current and potential future projects including: • An updated fertility education poster for young people. It is based on a poster developed in 2019 which has been redesigned in response to research conducted with young people in Denmark, Sweden, and the UK. The poster is available in many different languages on the IRHEC website. • Twelve information leaflets with more in depth information on various aspects of reproductive health which have been co-designed with young people. These are also available and free to download from our website. • After years of working with schools, and a public consultation last year, IRHEC has developed a resource to help teachers deliver reproductive health education to students. It is freely available to all teachers around the world and can be used in full or in part depending on teachers’ needs. • Preparations are underway to seek funding to evaluate the teachers’ resource. We plan to use qualitative research in the first instance to explore teachers’ views on the usefulness of the resource, what parts they would use, and whether the topics covered, and the level of detail are appropriate. • We are also examining how social media can be used to deliver reproductive health education. Through this work we want to empower everyone with evidence-based education on reproductive health.

O-109 Reproductive health education: collaborative design of a learning platform for secondary school education involving reproductive health experts, pupils, and teachers

Abstract Study question Which reproductive health information do pupils miss in their education and what is the optimal way of building a learning platform to close that gap? Summary answer Teachers and students alike would welcome a novel fertility education platform. Ideally, the platform should organize information based on the educational objectives for enhanced usability. What is known already Research on fertility awareness in the general population reveals lack of understanding among young people regarding crucial aspects of reproductive health, for example the age-related impact on fertility. Literature suggests that this knowledge gap should be addressed through diverse channels, including schools. Presently, school sexual education predominantly concentrates on preventing unwanted pregnancies and sexually transmitted diseases. Notably, the updated educational objectives in Flemish Secondary Education have recently incorporated the influence of lifestyle factors on fertility. Consequently, teachers have been urged to create novel instructional materials centered on this crucial theme. Study design, size, duration This mixed-method observational study encompassed a baseline measurement with open and closed questions among 1700 third-grade secondary education pupils. Additionally, it involved focus group discussions with 6 teachers and 24 pupils. The baseline measurement occurred between February and April 2022, while the focus group interviews took place in April and May 2022. Participants/materials, setting, methods A baseline measurement examined the knowledge of secondary school pupils aged between 15 and 19 years in Flanders (Belgium), explored current sexual education topics, their evaluations, and preferences for future reproductive health education. Focus group discussions investigated optimal delivery methods and structural frameworks for fertility learning materials. Main results and the role of chance Survey results revealed that most pupils desired more information on reproductive issues, with some expressing a preference for a dedicated weekly course. Over 50% noted the absence of discussions about infertility, IVF, and egg freezing topics in school and expressed a desire for more information, a sentiment that was echoed in the focus groups with pupils. Teachers, in their focus groups, favored an online platform with structured teaching materials aligned with learning goals. With anticipated new learning goals by September 2023, teachers welcomed fertility-specific learning materials. Their preference went out to versatile resources (videos, quizzes, infographics) rather than ready-made courses or presentations, providing flexibility in lesson integration. Considering these insights, the following platform was developed: www.allesovervruchtbaarheid.be/en. Ongoing refinement occurred through workshops where teachers provided feedback for further enhancements to meet their instructional needs. Limitations, reasons for caution A limited number of motivated teachers participated in the focus group discussions. Structured feedback collection has not taken place yet but is scheduled for February 2024. Wider implications of the findings Implementing fertility education in secondary schools poses challenges due to an overloaded curriculum. The introduction of new learning goals, including one on the impact of lifestyle on fertility, provided an opportune momentum to integrate a fertility education learning platform. Trial registration number not applicable

O-068 Educating young people about reproductive health

Abstract Comprehensive sex and reproductive health education is crucial for promoting overall health and wellbeing, as it plays a vital role in dispelling misinformation, fostering positive attitudes toward reproductive health, and empowering informed decision-making among young people. Despite its recognised importance by global entities such as the World Health Organisation (WHO) and the United Nations Educational, Scientific and Cultural Organisation (UNESCO), comprehensive sex and reproductive health education remains insufficient worldwide. This inadequacy is a multifaceted issue, stemming from various factors, including governmental policies, social norms, cultural beliefs, inadequate curriculum, and insufficient teacher training. Schools, as primary providers of reproductive health education, often prioritise pregnancy prevention over other important reproductive health topics, leading to significant gaps in students' knowledge, further prompting young individuals to seek supplementary knowledge from external sources, like the internet or social media. To address this disparity and to promote reproductive health awareness, the International Reproductive Health Education Collaboration (IRHEC) was established in 2019 and aims to provide educational resources for the public, teachers and health professionals. The IRHEC have created a teaching guide specifically for teachers to cover all aspects of reproductive health, to be used in schools globally. To develop this resource, it has been essential to determine what is taught in schools and the attitudes of teenagers to reproductive health education and family building. In the UK, we examined the curriculum in the four nations and huge gaps were identified in reproductive health education. Subsequently, a survey was conducted with 931, 16–18-year-olds in England and pupils were asked their views on their education, if they had been taught about a list of reproductive health topics in school and their attitudes to these topics. They reported that topics around pregnancy prevention were taught, such as contraception (90%), and sexually transmitted infections (90%) but key subjects such as fertility (30%) endometriosis (3%) and PCOS (2%) were not taught. This survey has been repeated in Belgium, Greece and Japan and similar patterns observed. Teenagers in the UK (21%) and Belgium (18%) rated their school sex and reproductive health education to be either poor or very poor compared to teenagers in Japan (3%). In the UK, Belgium, and Japan, young people have similar future parenthood intentions. Most young people in the UK (64%), Japan (60%), and Belgium (60%) want to have children in the future. A higher percentage of young people in Japan (70%) expressed a desire for two children compared to those in Belgium (60%), Greece (53%) and the UK (49%). To ensure comprehensive sex and reproductive health education, efforts must be tailored to the needs of each community and demographic. Collaboration among policymakers, educators, healthcare professionals, and communities is essential to enhance school curricula to include a broader spectrum of reproductive health topics and promote culturally sensitive educational approaches. By doing this, we can empower young people with the knowledge and skills necessary to navigate their reproductive health journey with confidence. There is an urgent need for a concerted action to bridge knowledge gaps and ensure that young people receive comprehensive sex and reproductive health education.

Premature ovarian insufficiency

Key content: Premature ovarian insufficiency (POI) is a clinical syndrome involving ovarian follicle depletion and defined by loss of ovarian function before 40 years of age. The diagnostic workup in women with suspected POI is in two steps: confirming the diagnosis and establishing its cause; it is important to understand the rationale for performing each diagnostic test, how to interpret results and appropriate multidisciplinary team involvement. Treatment options include various regimens and preparations of hormone replacement therapy (HRT), monitoring and surveillance, induction of puberty in those with very early POI, complimentary treatment and fertility treatment. Management of POI requires a comprehensive and personalised strategy that addresses not only the physical symptoms and disease risks, but also the psychosocial and reproductive health aspects, and it is important that women receive adequate counselling. Learning objectives: To raise awareness of early diagnosis of POI. To be able to discuss the implications of POI for the health of women affected and their families, as well as for different hormonal and non‐hormonal treatment options. To understand various fertility treatment options for POI. Ethical issues: It is important to consider the reproductive and diagnostic implications for women with chromosomal or genetic problems (e.g. Turner syndrome, Fragile X mutation carriers) and for their family members. A diagnosis of POI may have differing implications based on social and cultural factors, and healthcare providers should consider a patient's values, beliefs, cultural background and preferences.

EROS: Engendering reproductive health within oncologic survivorship—ECOG-ACRIN E1Q11 paradoxical provision of reproductive health.

11123 Background: For the 10% of women diagnosed with cancer in the reproductive age, reproductive health (RH) is a critical component of oncologic survivorship. RH includes oncocontraception (OC), oncofertility (OF) and sexuality. Guidelines segregate these components resulting in fragmented reproductive health care management. Methods: The EROS trial is a clustered randomized trial performed at 17 NCI Community Oncology Research Program (NCORP) sites (including 8 NCORP sites and 9 Minority/Underserved NCORP sites) from 2016-2023. Eligible subjects included reproductively capable women aged 15-55 with new cancer diagnosis. Intervention included RH didactics and decision aids. Childbearing interest was dichotomous, not completed childbearing (including either pregnant or future childbearing interest) or completed childbearing. The objective of this study is to determine provision of OC and OF referral by providers at the baseline visit based on patient’s self-reported childbearing interest at study entry. Chi-square tests were used to compare distribution differences in the referral status (receipt: yes vs. no) between treatment arms. Results: The EROS study enrolled 420 subjects. Of the 63.6% (267/420) completed childbearing, 62.4% (58/93) in the intervention arm and 40.2% (70/174) in the non-intervention arm received an OC referral (p=0.0006), whereas 98.9% (92/93) in the intervention arm and 93.7% (163/174) in the non-intervention arm received an OF referral (p=0.0487). Of the 36.4% (153/420) not completed childbearing, 48.3% (28/58) in the intervention arm and 33.72% (32/95) in the non-intervention arm received an OC referral (p=0.0729), while 77.6% (45/58) in the intervention arm and 70.5% (67/95) in the non-intervention arm received an OF referral (p=0.3388). Conclusions: While the intervention increased the rates of provision of oncocontraception and oncofertility for patients with completed childbearing, our study shows provision of oncofertility referrals at a markedly higher rate than oncontraception. Referral patterns were inconsistent with patient need particularly in completed (receiving OF referral) or delayed childbearing (not receiving OC referral) interest of the patient. The bias favoring oncofertility referral may reflect oncology guidelines emphasizing this aspect of reproductive health despite comprehensive needs of patient.

Diverse impacts of female chromosomal polymorphisms on assisted reproduction outcomes: a retrospective cohort study

BackgroundThe effects of female chromosomal polymorphisms (FCPs) on various aspects of reproductive health have been investigated, yet the findings are frequently inconsistent. This study aims to clarify the role of FCPs on the outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).MethodsThis retrospective cohort study comprised 951 couples with FCPs and 10,788 couples with normal karyotypes who underwent IVF/ICSI treatment at Peking University Third Hospital between 2015 and 2021. The exposure was FCPs. The embryological outcomes and clinical outcomes were compared.ResultsThe FCPs, as a whole, compromised the oocyte maturation rate (76.0% vs. 78.8%, P = 0.008), while they did not adversely affect other IVF/ICSI outcomes. Further detailed analyses showed that every type of FCPs contributed to the lower oocyte maturation rate, particularly the rare FCPs (69.0% vs. 78.8%, P = 0.008). The female qh + was associated with a higher normal fertilization rate (63.0% vs. 59.2%, adjusted P = 0.022), a higher clinical pregnancy rate (37.0% vs. 30.7%, adjusted P = 0.048), and a higher live birth rate (27.0% vs.19.0%, adjusted P = 0.003) in couples undergoing IVF. Conversely, in couples undergoing ICSI, female qh + was found to be related to a lower normal fertilization rate (58.8% vs. 63.8%, P = 0.032), a comparable clinical pregnancy rate (25.7% vs. 30.9%, P = 0.289), and a comparable live birth rate (19.8% vs. 19.2%, P = 0.880) compared to the control group. Additionally, an increased risk of preterm birth was observed in women undergoing IVF with multiple polymorphisms (62.5% vs. 16.9%, adjusted P < 0.001) and in women undergoing ICSI with pstk+ (36.4% vs. 15.4%, P = 0.036).ConclusionsOur research unravels the diverse impacts of various FCPs on IVF/ICSI outcomes, highlighting the detrimental effects of FCPs on oocyte maturation and the risk of preterm birth.

Role of Anti-Müllerian Hormone in the Central Regulation of Fertility.

In recent years, the expanding roles of anti-Müllerian hormone (AMH) in various aspects of reproductive health have attracted significant attention. Initially recognized for its classical role in male sexual differentiation, AMH is produced postnatally by the Sertoli cells in the male testes and by the granulosa cells in the female ovaries. Traditionally, it was believed to primarily influence gonadal development and function. However, research over the last decade has unveiled novel actions of AMH beyond the gonads, specifically all along the hypothalamic-pituitary-gonadal axis. This review will focus on the emerging roles of AMH within the hypothalamus and discusses its potential implications in reproductive physiology. Additionally, recent preclinical and clinical studies have suggested that elevated levels of AMH may disrupt the hypothalamic network regulating reproduction, which could contribute to the central pathophysiology of polycystic ovary syndrome. These findings underscore the intricate interplay between AMH and the neuroendocrine system, offering new avenues for understanding the mechanisms underlying fertility and reproductive disorders.

Diagnostic Approaches in Nuclear Medicine for Reproductive Health Assessment: Hysterosalpingography in Radiology versus hysterosalpingoscintigraphy.

Infertility is a significant aspect of reproductive health and evaluating degree of tubal pathology is essential for determining appropriate management plans. To assess the role of hysterosalpingoscintigraphy (HSSG) as a tubal patency test in nuclear medicine and compare it with hysterosalpingography (HSG) in radiology in infertile women and study pain perception in both tests as well. A prospective study was conducted on 50 infertility patients undergoing infertility evaluation at a tertiary care hospital. Both HSG and HSSG procedures were performed during proliferative phase of menstrual cycle. Our study demonstrated the potential of HSSG as a tool for evaluating tubal patency in infertility workup. It showed good accuracy in detecting tubal patency compared to HSG. HSG is a radiological procedure valued for its ability to provide detailed anatomical information of uterus and patency of fallopian tubes. In contrast, HSSG provides dynamic information on the functional aspects of the reproductive system using nuclear medicine techniques. Both HSG and HSSG are vital tools in the diagnostic armamentarium for assessing female reproductive health, offering complementary information that aids in comprehensive patient management.

Issues of contraception in rheumatic diseases: current status of the problem and perspectives

Contraception is an important aspect of reproductive health in patients with rheumatic diseases. This is primarily due to the fact that in most immuneinflammatory rheumatic diseases (IRD) pregnancy must be planned. On one hand, the presence and activity of IRD can influence the course of the pregnancy, but on the other hand, pregnancy, which is accompanied by changes in general hormonal levels, is often a factor that alters the activity of IRD. Some patients take medication with potentially teratogenic effects. Planning a pregnancy during IRD can contribute to its optimal progression and minimize the risks of exacerbation of IRD. Given the wide range of barrier and hormonal contraceptives currently in use and the introduction of new drugs into clinical practice, data on the possibility of their use are of particular importance to rheumatologists in practical healthcare.

Analysis of Risk Factors for External Genital Health of Women of Childbearing Age in Purwakarta Regency, Indonesia

Introduction: The health of women's external genitalia is an important aspect of reproductive health. This study aims to analyze the health risk factors for the external genitalia of women of childbearing age in Purwakarta Regency, Indonesia.&#x0D; Methods: This research is an analytical observational study with a cross-sectional design. The research sample was 240 women of childbearing age in Purwakarta Regency who were selected randomly. Data was collected through questionnaires and physical examination. Data analysis was carried out univariate and bivariate.&#x0D; Results: The results of the study showed that the risk factors for the health of the external genitalia of women of childbearing age in Purwakarta Regency were age, parity, and a history of sexually transmitted infections (STIs). Women aged more than 35 years have a higher risk of external genital health than women aged less than 35 years (OR = 2.65; 95% CI: 1.22-5.83). Women with parity more than 2 have a higher risk of external genital health than women with parity 1-2 (OR = 2.32; 95% CI: 1.14-4.71). Women with a history of STIs have a higher external genital health risk than women without a history of STIs (OR = 3.52; 95% CI: 1.58-8.17).&#x0D; Conclusion: Age, parity, and history of STIs are risk factors for external genital health in women of childbearing age in Purwakarta Regency.

Women's Awareness of Reproductive Health.

Background and Objectives: reproductive disorders are a serious global concern in medical, social, and demographic contexts. According to estimates, approximately 10-15% of couples around the world suffer from infertility. Numerous studies have shown that modifiable lifestyle factors, such as a high-fat diet, a postponed decision to start a family, tobacco smoking, alcohol consumption, risky sexual behavior, psychiatric diseases, and chronic stress, have a negative influence on the fertility of women. The main goal of this study is to assess the knowledge of women about reproductive health, infertility risk factors, and causes of infertility and to determine whether the level of this knowledge varies based on sociodemographic variables. Materials and Methods: a survey was conducted among 111 patients who anonymously filled in a questionnaire comprising questions regarding fertility and its deficiencies. The results were analyzed using the Chi-square test and Fisher's test. Results: the survey results indicated that women had a good or very good level of knowledge of the causes of infertility. The obtained test results were statistically significant (p < 0.05), but the studied group did not possess sufficient knowledge of the symptoms characterizing the diseases related to limited fertility (p > 0.05). The level of knowledge on the diagnosis of infertility did not depend on the age of the examined people, their educational level, or personal experience in this field (p > 0.05). The results also revealed that the awareness of women on reproductive health was poor. The studied women had a low level of knowledge of infertility risk factors, and their knowledge did not correlate with age, educational level, or personal experiences. Conclusions: information on the aspects of reproductive health should be widely disseminated through public educational campaigns, aimed at correcting erroneous convictions among women about the risk factors for infertility and assisting them in improving fertility.

The Relationship Of The Role Of Parents In Providing Reproductive Health Education And Care Of Genital Organ Hygiene In Adolescent Women In Man Model Manado

Genital hygiene care is to prevent and control infection, prevent skin damage, increase comfort, and maintain personal hygiene. The low knowledge of adolescents regarding aspects of reproductive health in adolescents is caused by the information they obtain mostly not coming from experts in the field, but instead from information sources that are sometimes even misleading. This research aims to determine the relationship between the role of parents in providing reproductive health education and genital hygiene care for young women in MAN Model Manado. This research uses an analytical survey with a cross sectional study design. Sampling using proportionate random sampling technique was 73 people. The conclusion of this research is that the majority of respondents' parents have a poor role in caring for the cleanliness of genital organs in adolescent girls, amounting to 47 people (64.4%) and at least the parents of respondents have a good role in caring for the cleanliness of genital organs in adolescent girls. as many as 26 people (35.6%). There is a relationship between the role of parents in providing reproductive health education with genital hygiene care for adolescent girls at MAN Model Manado. With the results of the chi-square statistical test analysis, a significance level of 0.000 was obtained. Further research is needed regarding reproductive health in adolescent girls.

Connections between reproductive health and cognitive aging among women enrolled in the HCHS/SOL and SOL-INCA.

Reproductive health history may contribute to cognitive aging and risk for Alzheimer's disease, but this is understudied among Hispanic/Latina women. Participants included 2126 Hispanic/Latina postmenopausal women (44 to 75 years) from the Study of Latinos-Investigation of Neurocognitive Aging. Survey linear regressions separately modeled the associations between reproductive health measures (age at menarche, history of oral contraceptive use, number of pregnancies, number of live births, age at menopause, female hormone use at Visit 1, and reproductive span) with cognitive outcomes at Visit 2 (performance, 7-year change, and mild cognitive impairment [MCI] prevalence). Younger age at menarche, oral contraceptive use, lower pregnancies, lower live births, and older age at menopause were associated with better cognitive performance. Older age at menarche was protective against cognitive change. Hormone use was linked to lower MCI prevalence. Several aspects of reproductive health appear to impact cognitive aging among Hispanic/Latina women.

Development and psychometric properties of the Reproductive Health Assessment in Systemic Lupus Erythematosus: Mixed-Methods study.

Systemic lupus erythematosus (SLE) with a high morbidity rate (7% in general and 325/100.000 in reproductive period) was known as "the mother of autoimmune diseases." But healthcare providers hadn't reliable scales to measure the effectiveness of interventions to improve reproductive health. Women with systemic lupus erythematosus (SLE) express concern about a significant gap in their reproductive and sexual health during medical care due to the lack of a specific scale to measure this concept. This study developed psychometrically specific scale to evaluate this concept in Iranian women. The study utilized a sequential-exploratory mixed-methods design, wherein the concept of reproductive health was clarified during the qualitative phase using conventional content analysis (inductive-deductive) to create a pool of RHASLE (Reproductive Health Assessment in SLE) items. During the psychometric process, the face, content, and construct validities of the RHASLE were checked with 650 individuals (320 using exploratory factor analysis [EFA] and 330 using confirmatory factor analysis [CFA]) through interviews and completion of the questionnaire. Convergent and divergent validities were then checked, and the reliability was assessed through stability and internal consistency. Finally, the measurement error, responsiveness, and interpretability of the scale were evaluated and confirmed. The study's findings revealed that the RHASLE consisted of 5 factors (33 items): physical-psychological disorder (13 items), relaxing feeling (6 items), spirituality (3 items), high-risk pregnancies (5 items), and sexual satisfaction (6 items). These factors explained a total of 99.97% of the variance in the concept of reproductive health. Confirmatory factor analysis confirmed the good model fit, and its validity and reliability were deemed acceptable. The RHASLE consisted of 27 items with high internal consistency, stability, responsiveness, and interpretability. That was able to get approval of Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Based on the results, RHASLE is a valid and reliable multidimensional scale that encompasses various aspects of reproductive health (physical, sexual, psychological, social, and spiritual).

The Effect of the Reproductive Health Self-Care Educational Booklet on the Self-Care Ability of Female University Students.

Reproductive health during youth is considered one of the pivotal aspects of sustainable development. In this regard, students are more exposed to reproductive health problems and risks. Accordingly, the aim of this study was to determine the effect of the reproductive health self-care educational booklet on the self-care ability of female university students. This study was a quasiexperimental research in which a reproductive health self-care educational booklet designed based on needs assessment was provided to 75 newly admitted female university students at Isfahan University of Medical Sciences in 2018-2019 who were selected by quota sampling method from all faculties. Using a researcher-made questionnaire on reproductive health self-care ability (knowledge, attitude, practice), data were collected before, immediately after, and 6 weeks after the intervention. Data analysis was performed using descriptive and analytical statistics in SPSS version 20. As the results showed, the mean score of self-care ability (F = 208.46, p < 0.001), knowledge (F = 130.88, p < 0.001), attitude (F = 76.09, p < 0.001), and practice (F = 89.76, p < 0.001) of the subjects immediately and 6 weeks after the intervention was significantly higher than before the intervention. However, no significant difference was observed in these scores, between immediately after and 6 weeks after the intervention. The results indicated that the designed self-care educational booklet led to a relatively constant promotion of the reproductive health self-care ability of female students. Thus, this booklet seems to be useful in meeting the educational needs of female students in various aspects of reproductive health.

Reproductive Health Among Those with Schizophrenia Spectrum Disorders: An Overview of Considerations Related to the Premenopausal Period, Pregnancy and Postpartum, and the Menopausal Transition, with a Focus on Recent Findings.

Schizophrenia spectrum disorders (SSD) impact many aspects of reproductive health for women and non-binary and transgender individuals assigned female at birth. In this narrative review, we highlight considerations and recent research related to (1) the premenopausal period, (2) pregnancy and postpartum, and (3) the menopausal transition. Most recent research has focused on pregnancy and the postpartum period, and specifically on elucidating perinatal risk factors, adverse obstetrical and neonatal outcomes (and modifiable contributors such as smoking), long-term child health, and psychotropic medications (with reassuring results related antipsychotic-associated gestational diabetes mellitus and neurodevelopmental outcomes). Much less recent focus has been on menstruation and menopause, although some research has highlighted the relative worsening of illness peri-menstrually and peri-menopausally. Despite the many important reproductive considerations for those with SSD, many aspects including menstruation and menopause have received very little attention. Further research is needed on how to best support women, non-binary, and transgender people assigned female at birth with SSD throughout the lifespan.

Health Promotion Model through Peer Group Education on Health Behavior Change

Adolescence is also a period of mental change that can fluctuate. This pandemic results in changes in any behavior related to adolescents. The psychological condition of adolescents, who are generally still vulnerable and easily disturbed, is further exacerbated by conditions in the surrounding environment that do not support them in carrying out their usual activities. The purpose of the study was to determine the effect of the health promotion model through the peer group education method on changes in health behavior intentions in adolescents during the Covid-19 pandemic in Medan City. The research method used a quasi-experimental pretest and post-test design with one control group with a sample of 65 adolescents aged 13-18 years using purposive sampling technique. Data analysis was carried out using the Paired t test (p = 0.000). The results of the analysis stated that there was an effect of providing education using the peer group education method given to adolescents on changes in adolescent behavior during the covid 19 pandemic which was seen from the aspect of reproductive health, adolescent psychological disorders and the impact of using gadgets that must be supervised by parents