Contraceptive Methods Research Articles

Post abortion contraception: A follow up study in women undergoing first and second trimester abortion at a tertiary care centre

: Worldwide 75 million women need post abortion care (PAC) services each year following safe or unsafe induced abortions and miscarriages. Majority of them do not wish to conceive in near future and are receptive towards using contraception. Contraceptive counselling and basket of choices should be made available to all women undergoing abortion and her right to decline or postpone this care should be respected while recognizing that each woman has a unique unmet need of contraception.: To compare the acceptance and continuation of various contraceptive choices offered after first and second trimester abortion. : A retrospective study was conducted at a tertiary care hospital in which women who underwent first and second trimester abortion over a period of one year were interviewed regarding their acceptance and continuation of the contraceptive method till six months post abortion.: A total of 378 women underwent first and second trimester abortions over one year, of which 61.3% had resulted from failure of contraception. Women were grouped into Group A for those undergoing first trimester and Group B for women undergoing second trimester abortion for study purpose. Average age of women in group A was 28.9 years and in group B was 26.5 years. Mean period of gestation of pregnancy in group A was 7.5weeks and in group B was 19.5 weeks. In group A 96% parous women had conceived as a result of failure of contraception of which 90% were using natural method (Coitus Interruptus). Group B majority (76.3%) women were nulliparous and early parous (P1, P2) and indication for termination of pregnancy in them were gross congenital anamolies (GCA) in fetus while in rest of multiparous were due to failure of contraception. With group A 53.1% nulliparous women did not opt for any contraception whereas 48.6% primiparous and second parous opted for long acting reversible contraception(LARC) –Intrauterine contraceptive device(IUCD) in contrast to 66% multiparous opting for permanent sterilization at the time of abortion. In group B 45.3% nulliparous and early parous opted for depot medroxy progesterone acetate (DMPA) and 64.2% multigravidas underwent permanent sterilization. : Post abortion care must include counselling and choice of contraceptive basket. Women with future reproductive plans preferred LARC after first trimester abortion whereas DMPA was most acceptable method of contraception after second trimester abortion. Women were most satisfied with LARC and permanent methods compared to methods that required daily intake of pills. There is need of effective contraceptive choices according to the reproductive plans of the women to reduce the burden, morbidity and mortality associated with abortions.

Trends in and Correlates of Short-Acting Contraceptive Stock-Outs: Multicountry Analysis of Performance Monitoring for Action Agile Platform Data.

Understanding trends in contraceptive stock-outs, as well as their structural and demand-side correlates, is critical for policymakers and program managers to identify strategies to further anticipate, reduce, and prevent stock-outs. We analyzed trends as well as supply- and demand-side correlates of short-acting contraceptive method stock-outs by using data from multiple rounds of Performance Monitoring for Action Agile surveys. These data longitudinally measured contraceptive availability over 2 years (between November 2017 and January 2020) across 2,134 public and private service delivery points (SDPs) from urban areas of 5 countries (Burkina Faso, Democratic Republic of the Congo [DRC], India, Kenya, and Nigeria). For each country, we analyzed the trends and used multilevel mixed-effect logistic regression to model the odds of short-acting contraceptive stock-outs, adjusting for key structural and demand-side factors of the SDPs. Stock-outs in short-acting contraceptive methods were common in health facilities and varied markedly, ranging from as low as 2.9% (95% confidence interval [CI]=1.7%, 5.1%) in India to 51.0% (95% CIs=46.8%, 56.0%) in Kenya. During the observation period, stock-out rates decreased by 28% in the SDP samples in India (aOR=0.72, P<.001) and 8% in Nigeria (aOR=0.92, P<.001) but increased by 15% in DRC (aOR=1.15; P=036) and 5% in Kenya (aOR=1.05, P=003) with each round of data collection. Correlates of stock-out rates included the facility managerial authority (private versus public), whether the facility was rated high quality, whether the facility was at an advanced tier, and whether there was high demand for short-acting contraceptives. In conclusion, stock-outs of short-acting contraceptives are still common in many settings. Measuring and monitoring contraceptive stock-outs is crucial for identifying and addressing issues related to the availability and supply of short-acting contraceptives.

Prevalence of different variations of non-consented care during the childbirth process in Mexico by geographical regions: comparing ENDIREH survey data from 2016 to 2021

IntroductionNon-consented care, a form of obstetric violence involving the lack of informed consent for procedures, is a common but little-understood phenomenon in the global public health arena. The aim of this secondary analysis was to measure the prevalence and assess change over time of non-consented care during childbirth in Mexico in 2016 and 2021, as well as to examine the association of sociodemographic, pregnancy-, and childbirth-factors with this type of violence.MethodsWe measured the prevalence of non-consented care and three of its variations, forced sterilization or contraception, forced cesarean section, and forced consent on paperwork, during childbirth in Mexico for 2016 (N = 24,036) and 2021 (N = 19,322) using data from Mexico’s cross-sectional National Survey on the Dynamics of Household Relationships (ENDIREH). Weighted data were stratified by geographical regions. We performed adjusted logistic regression analyses to explore associations.ResultsThe national prevalence of non-consented care and one of its variations, pressure to get a contraceptive method, increased from 2016 to 2021. A decrease in the prevalence was observed for forced contraception or sterilization without knowledge, forcing women to sign paperwork, and non-consented cesarean sections nationally and in most regions. Women between the ages of 26 and 35 years, married, cohabiting with partner, living in urban settings, who do not identify as Indigenous, and who received prenatal services or gave birth at the Mexican Institute of Social Security (IMSS) facilities experienced a higher prevalence of non-consented care. Being 26 years of age and older, living in a rural setting, experiencing stillbirths in the last five years, having a vaginal delivery, receiving prenatal services at IMSS, or delivering at a private facility were significantly associated with higher odds of reporting non-consented care.ConclusionWhile a decrease in most of the variations of non-consented care was found, the overall prevalence of non-consented care and, in one of its variations, pressure to get contraceptives, increased at a national and regional level. Our findings suggest the need to enforce current laws and strengthen health systems, paying special attention to the geographical regions and populations that have experienced higher reported cases of this structural problem.

Signs and symptoms: Adverse events associated with a sterilization device

Sterilization is now the most common contraceptive method used by women of in the U.S., and sterilization devices have played an important role in its increased popularity. This mixed methods study examines a random sample of 2500 U.S. Food and Drug Administration (FDA) adverse event reports made between 2006 and 2017 about Essure, a sterilization device. Quantitative coding was used to examine patient problems; pain and bleeding were reported most frequently. Qualitative coding analyzed impacts of symptoms on patients' everyday lives and patients' healthcare experiences, including intimate relationships, mothering, and paid employment. Findings suggest that some patients struggled when their reported “subjective” symptoms didn't result in “objective” clinical signs of problems, and when physicians dismissed or deflected their concerns in diagnostic encounters. This paper raises important issues regarding the symptoms patients associated with Essure, the diagnosis of device-driven disease and injury, and the FDA's regulation of medical devices.

Identification of latent contraceptive ideational profiles among urban women in Senegal: Transitions and implications for family planning programs

Background Latent ideational segmentation is an important technique that can enhance family planning (FP) communication campaigns by providing insight into prototypical “profiles” of women among heterogenous populations based on shared ideational characteristics that underpin contraceptive decision-making. This can improve the development of responsive, tailored content and help programs connect with intended audiences. In Senegal, 24% of married women who want to avoid pregnancy are not using modern contraceptive methods and in 2020, the Government of Senegal fell short of reaching its goal of increasing the modern contraceptive prevalence to 45%. Social, cultural, and cognitive factors are probable deterrents to contraceptive use. The objective of this study was to identify and interpret meaningful contraceptive ideational profiles (CIPs) among urban Senegalese women and examine how and why CIP structure, interpretation, and membership changed over time. Methods Using longitudinal data from 4,047 urban, in-union Senegalese women of reproductive age in 2011 and 2015, we applied latent transition analysis to identify and interpret prototypical profiles of women based on their contraceptive awareness, beliefs, self-efficacy, partner FP acceptance, partner communication, and community support. Results We identified four longitudinal CIPs and labeled them “CIP1: Lowest efficacy and FP awareness, highest misconceptions, unsupported,” “CIP2: Low efficacy and FP awareness, rejects misconceptions, unsupported,” “CIP3: Moderate efficacy, high FP awareness, high misconceptions, moderate support,” and “CIP4: Highest efficacy and FP awareness, fewest misconceptions, most supported.” At endline, more women were in higher-order CIPs compared to baseline. Exposure to FP communication via TV, radio, religious leaders, and health workers was associated with lower odds of membership in lower-order CIPs at endline, as was exposure to messages about FP and birth spacing. Conclusions This study demonstrated the potential of latent CIP methodologies to enhance current social and behavior change approaches by identifying and responding to unique and complex ideational attributes.

Sexual behaviour among women using intramuscular depot medroxyprogesterone acetate, a copper intrauterine device, or a levonorgestrel implant for contraception: Data from the ECHO randomized trial.

Contraceptive use has complex effects on sexual behaviour and mood, including those related to reduced concerns about unintended pregnancy, direct hormonal effects and effects on endogenous sex hormones. We set out to obtain robust evidence on the relative effects of three contraceptive methods on sex behaviours, which is important for guiding contraceptive choice and future contraceptive developments. This is a secondary analysis of data from the Evidence for Contraceptive Options and HIV Outcomes (ECHO) randomized trial in which 7,829 HIV-uninfected women from 12 sites in Eswatini, Kenya, South Africa and Zambia seeking contraception were randomly assigned to intramuscular depot-medroxyprogesterone acetate (DMPA-IM), the copper intrauterine device (Cu-IUD) or the levonorgestrel (LNG) implant. Data collected for 12 to 18 months using 3-monthly behavioural questionnaires that relied on recall from the preceding 3 months, were used to estimate relative risk of post-baseline sex behaviours, as well as sexual desire and menstrual bleeding between randomized groups using modified Poisson regression. We observed small but generally consistent effects wherein DMPA-IM users reported lower prevalence of specified high risk sexual behaviours than implant users than Cu-IUD users (the '>' and '<' symbols indicate statistically significant differences): multiple sex partners 3.6% < 4.8% < 6.2% respectively; new sex partner 3.0% < 4.0% <5.3%; coital acts 16.45, 16.65, 17.12 (DMPA-IM < Cu-IUD); unprotected sex 65% < 68%, 70%; unprotected sex past 7 days 33% <36%, 37%; sex during vaginal bleeding 7.1%, 7.1% < 8.9%; no sex acts 4.1%, 3.8%, 3.4% (DMPA-IM > Cu-IUD); partner has sex with others 10% < 11%, 11%. The one exception was having any sex partner 96.5%, 96.9% < 97.4% (DMPA-IM < Cu-IUD). Decrease in sexual desire was reported by 1.6% > 1.1% >0.5%; amenorrhoea by 49% > 41% >12% and regular menstrual pattern by 26% <35% < 87% respectively. These findings suggest that women assigned to DMPA-IM may have a modest decrease in libido and sexual activity relative to the implant, and the implant relative to the Cu-IUD. We found more menstrual disturbance with DMPA-IM than with the implant (and as expected, both more than the Cu-IUD). These findings are important for informing the contraceptive choices of women and policymakers and highlight the need for robust comparison of the effects of other contraceptive methods as well.

Contraception after childbirth: current achievements and prospects: A review

The article presents modern methods of contraception after childbirth, including their impact on the mother and child, the main advantages and disadvantages. Special attention is paid to barrier methods of contraception, spermicides, and their advantages according to the "Acceptance Criteria" of the World Health Organization (2015) and the "National Acceptance Criteria" (2023), their features and prospects for use.

Contraceptive strategies for reducing the risk of reproductive cancers.

Reproductive cancers, encompassing various malignancies like endometrial, ovarian, cervical cancer, and gestational trophoblastic neoplasia, pose a significant global health burden. Understanding their patterns is vital for effective prevention and management. Contraceptives show a protective effect against some of these cancers. This clinical guidance document aims to elucidate the disease burden of reproductive cancers and the evidence supporting contraceptive methods in prevention and management. Regional disparities in incidence and mortality highlight the urgent need for targeted interventions, particularly in low-resource settings. Healthcare providers must weigh individual risk profiles and medical eligibility criteria when discussing contraceptive options. Enhanced health literacy through direct patient education is essential for leveraging low-cost behavioral interventions to mitigate reproductive cancer risks.

Emerging approaches to male contraception.

Currently, approximately half of all pregnancies worldwide are unintended. Contraceptive use significantly reduces the risk of unintended pregnancy; however, options for men are particularly limited. Consequently, efforts are underway to develop novel, safe, and effective male contraceptives. This review discusses research into emerging male contraceptive methods that either inhibit sperm production or impair sperm function. It focuses on those in the preclinical or early clinical stages of development.

Priorities for contraceptive method and service delivery attributes among adolescent girls and young women in Kenya: a qualitative study.

Despite increasing global commitment to meeting the family planning needs of adolescent girls and young women (AGYW), there is limited research on how they prioritize contraceptive method and service delivery characteristics. In this qualitative study, we examine the specific elements that drive the contraceptive choices of Kenyan AGYW, and apply our findings to the development of attributes and levels for a discrete choice experiment (DCE). Our four-stage approach included data collection, data reduction, removing inappropriate attributes, and optimizing wording. Between June-October 2021, we conducted in-depth interviews with 30 sexually-active 15-24 year-old AGYW in Kisumu county, Kenya who were non-pregnant and desired to delay pregnancy. Interviews focused on priorities for contraceptive attributes, how AGYW make trade-offs between among these attributes, and the influences of preferences on contraceptive choice. Translated transcripts were qualitatively coded and analyzed with a constant comparative approach to identify key concepts. We developed and iteratively revised a list of attributes and levels, and pre-tested draft DCE choice tasks using cognitive interviews with an additional 15 AGYW to optimize comprehension and relevance. In-depth interview participants' median age was 18, 70% were current students, and 93% had a primary sexual partner. AGYW named a variety of priorities and preferences related to choosing and accessing contraceptive methods, which we distilled into six key themes: side effects; effectiveness; user control; privacy; source of services; and cost. Bleeding pattern was top of mind for participants; amenorrhea was generally considered an intolerable side effect. Many participants felt more strongly about privacy than effectiveness, though some prioritized duration of use and minimizing chance of pregnancy above other contraceptive characteristics. Most AGYW preferred a clinic setting for access, as they desired contraceptive counseling from a provider, but pharmacies were considered preferable for reasons of privacy. We selected, refined, and pre-tested 7 DCE attributes, each with 2-4 levels. Identifying AGYW preferences for contraceptive method and service delivery characteristics is essential to developing innovative strategies to meet their unique SRH needs. DCE methods may provide valuable quantitative perspectives to guide and tailor contraceptive counseling and service delivery interventions for AGYW who want to use contraception.

Effect of various contraceptives on oocyte yield and maturation in patients undergoing planned oocyte cryopreservation

Research questionDo the various forms of hormonal and non-hormonal contraceptives have any association with ovarian stimulation outcomes, such as oocyte yield and maturation, in patients undergoing planned oocyte cryopreservation (POC)? DesignThis retrospective cohort study included all patients who underwent POC cycles between 2011 and 2023. The use of types of contraception before a POC cycle was recorded. The study evaluated the median number of cumulus–oocyte complexes obtained after vaginal oocyte retrieval and the proportion of metaphase II oocytes that underwent vitrification among all the cohorts. ResultsA total of 4059 oocyte freezing cycles were included in the analysis. Eight types of contraceptive method were recognized in patients undergoing ovarian stimulation: intrauterine device (IUD), copper (n = 84); IUD, levonorgestrel low dose (<52 mg) (n = 37); IUD, levonorgestrel (n = 192); subdermal etonogestrel implant (n = 14); injectable medroxyprogesterone acetate (n = 11); etonogestrel vaginal ring (n = 142); combined oral contraceptive pills (n = 2349); and norelgestromin transdermal patch (n = 10). The control group included patients not using contraceptives or using barrier or calendar methods (n = 1220). Among all the cohorts the median number of cumulus–oocyte complexes retrieved during oocyte retrieval was comparable (P = 0.054), and a significant difference in oocyte maturity rate with median number of vitrified oocytes was found (P = 0.03, P < 0.001, respectively). After adjusting for confounders a multivariate analysis found no association between the type of contraceptive and proportion of metaphase II oocytes available for cryopreservation. ConclusionsAmong the various forms of contraception, none was shown to have an adverse association with oocyte yield or maturation rate in patients undergoing POC.

Prenatal depression among pregnant women attending public health facilities in Babile district, Eastern Ethiopia: a cross-sectional study

BackgroundDepression during pregnancy is a significant health concern that can lead to a variety of short and long-term complications for mothers. Unfortunately, there is a lack of information available on the prevalence and predictors of prenatal depression in rural eastern Ethiopia. This study assessed prenatal depression and associated factors among pregnant women attending public health facilities in the Babile district, Eastern Ethiopia.MethodAn institution-based cross-sectional study was conducted among 329 pregnant women attending Babile District Public Health Facilities from November 1 to December 30, 2021. Bivariable and multivariable logistic regression were used to identify factors associated with prenatal depression. The adjusted odds ratio (AOR) with a 95% confidence interval was used to report the association, and the significance was declared at a p-value < 0.05.ResultsThe prevalence of prenatal depression was 33.1% (95% CI = 28.0%, 38.2%). A lower income (AOR = 3.85, 95% CI = 2.08, 7.13), contraceptive use (AOR = 0.53, 95% CI = 0.28, 0.98), unintended pregnancy (AOR = 2.24, 95% CI = 1.27, 3.98), history of depression (AOR = 5.09, 95% CI = 2.77, 9.35), poor social support (AOR = 5.08, 95% CI = 2.15, 11.99), and dissatisfied marriage (AOR = 2.37, 95% CI = 1.30, 4.33) were the factors associated with increased prenatal depression among pregnant women.ConclusionsOne in every three pregnant women in rural eastern Ethiopia had prenatal depression. Monthly income, contraceptive use, pregnancy intention, history of depression, social support, and marriage satisfaction status were the determinants of prenatal depression. Preventing unintended pregnancies by encouraging women to utilize modern contraceptive methods is essential for mitigating and controlling the risks and burdens of prenatal depression and its negative consequences.

Discontinuation of long-acting reversible contraceptive methods and associated factors among reproductive-age women in Shashemene town, Oromia, Ethiopia.

The early termination of long-acting reversible contraceptives (LARCs) raises issues for the healthcare system and has the potential to affect public health. Long-acting reversible contraception has now become more widely available and used, although a sizable percentage of women still do not use it. Therefore, this study aims to assess the factors associated with the discontinuation of the LARC method among female users of health facilities in Shashemene town in Oromia, Ethiopia. A facility-based cross-sectional study was conducted in Shashemene town involving 410 study participants from nine facilities. The study participants were selected by using a systematic sampling method. The data were collected by using structured interviewer-administered questionnaires, entered into EpiData version 4.6.0.2, and exported to SPSS version 25 for analysis. Bivariate and multivariable logistic regressions were used to examine the association between independent variables and LARC discontinuation. The results were presented using the odds ratio at 95% CI. p < 0.05 was used to indicate statistical significance. The overall prevalence of women who discontinued the LARC method before the due date was 57.2%. Having an occupation as a housewife, desire for pregnancy, unwarned side effects, effectiveness, and dissatisfaction with the service provided were the factors positively associated with the discontinuation of the contraception. The prevalence of the discontinuation of LARCs was high. Pre-insertion, effective counseling about the benefits, follow-up care, management of side effects, and client reassurance are recommended.

Assessing the Factors That Affect the Use of Modern Contraceptive Methods Among Youth and Adolescents in Traditional Authority Chimwala, Mangochi District

Assessing the Factors That Affect the Use of Modern Contraceptive Methods Among Youth and Adolescents in Traditional Authority Chimwala, Mangochi District

Multidimensional Analysis of Adolescent Fertility in Latin America: Trends and Determinants

Adolescent pregnancy in Latin America constitutes a complex issue with significant consequences. High pregnancy rates among individuals under 20 years old impact education, personal development, and future opportunities. It is imperative to pay closer attention to sexual education, access to contraceptive methods, and reproductive health services to prevent unintended pregnancies and ensure the well-being of both adolescents and their children. The study aimed to elucidate the determinants influencing the adolescent fertility rate, thus providing an academic contribution for the formulation of public policies in Latin America. The period covered was 1990-2019, and the analyzed data were sourced from the World Population Prospects 2019 report. The main findings indicate that the adolescent pregnancy rate is alarming, attributed to the absence of effective public policies for control and prevention in response to this phenomenon. Received: 10 February 2024 / Accepted: 27 April 2024 / Published: 5 May 2024

Confidence in adolescent contraceptive counseling among residents and fellows training at the University of Texas Southwestern in Dallas, Texas

ObjectivesEvaluate trainees’ perceptions of past training and confidence in counseling about five contraceptive methods. Study DesignTrainees completed an online survey in 2020. Logistic regressions evaluated the relationship between participant characteristics and confidence. ResultsAmong 227 respondents (63% response rate), pediatric trainees reported the least confidence in counseling across each contraceptive method. Past training and confidence were associated. ConclusionsGaps in training should be addressed to improve confidence in contraceptive counseling among pediatricians in reproductively restricted states.

Knowledge Regarding Contraception and Previous Practices of Contraception Among Antenatal Women

Introduction: Contraceptive methods or devices are used to prevent pregnancy. Contraception enables women to realize their human rights and to choose whether or not to have children, as well as helps people achieve their desired family size. Currently, short-term family planning methods are available at levels of the health sector, but long-term methods are available at all levels. Objectives: To assess the knowledge regarding contraception and previous practices of contraception among antenatal women at term pregnancy attending gynaecology OPD. Methodology: An exploratory cross-sectional study was conducted. The total enumeration sampling technique was used, and 120 study participants were enrolled for the study. Data was collected by interviewing participants as per an interview schedule. Results: The study findings showed that a majority (76.6%) of the antenatal women had poor knowledge regarding contraception and 23.3% antenatal women had average knowledge. A majority (81.07%) of participants had previously practiced contraception. The most commonly used contraceptives were condoms and the calendar method. Conclusion: In the present study, more than half of the participants (antenatal women) had poor knowledge regarding contraception. It indicates the need for awareness regarding contraception and the appropriate use of contraceptive methods when required.

Association between knowledge and use of contraceptive among women of reproductive age in sub-Saharan Africa.

The use of contraceptives has been considered relevant in reducing unintended pregnancies in sub-Saharan Africa (SSA). However, despite evidence of knowledge of contraceptives, their use remains low in SSA. This study examined the association between knowledge of contraceptive methods and the use of contraceptives in SSA. Data for the study were extracted from the Demographic and Health Surveys of 21countries in SSA spanning from 2015 to 2021. A weighted sample of 200,498 sexually active women of reproductive age were included in the final analysis. We presented the results on the utilization of contraceptives using percentages with their respective 95% confidence intervals (CI). We examined the association between knowledge of contraceptive methods and the use of contraceptives using multilevel binary logistic regression analysis. Overall, 24.32% (95% CI: 24.15-24.50) of women in SSA used contraceptives. Chad had the lowest prevalence of contraceptive use (5.07%) while Zimbabwe had the highest prevalence (66.81%). The odds of using any method of contraception were significantly higher for women with medium [Adjusted odds ratio (AOR) = 1.89; 95% CI = 1.80-1.98] and high [AOR = 2.22; 95% CI = 2.10-2.33] knowledge of contraceptive methods compared to those with low knowledge, after adjusting for all covariates. Our study has shown that the use of contraceptives among women in SSA is low. Women's knowledge of any contraception method increases their likelihood of using contraceptives in SSA. To improve contraceptive use in SSA, targeted interventions and programmes should increase awareness creation and sensitization, which can improve women's knowledge on methods of contraception. Also, programmes implemented to address the low uptake of contraceptives should consider the factors identified in this study. In addition, specific subregional strategies could be implemented to narrow the subregional disparities.

Current strategies using 3D organoids to establish in vitro maternal-embryonic interaction.

The creation of robust maternal-embryonic interactions and implantation models is important for comprehending the early stages of embryonic development and reproductive disorders. Traditional two-dimensional (2D) cell culture systems often fail to accurately mimic the highly complex in vivo conditions. The employment of three-dimensional (3D) organoids has emerged as a promising strategy to overcome these limitations in recent years. The advancements in the field of organoid technology have opened new avenues for studying the physiology and diseases affecting female reproductive tract. This review summarizes the current strategies and advancements in the field of 3D organoids to establish maternal-embryonic interaction and implantation models for use in research and personalized medicine in assisted reproductive technology. The concepts of endometrial organoids, menstrual blood flow organoids, placental trophoblast organoids, stem cell-derived blastoids, and in vitro-generated embryo models are discussed in detail. We show the incorportaion of organoid systems and microfluidic technology to enhance tissue performance and precise management of the cellular surroundings. This review provides insights into the future direction of modeling maternal-embryonic interaction research and its combination with other powerful technologies to interfere with this dialogue either by promoting or hindering it for improving fertility or methods for contraception, respectively. The merging of organoid systems with microfluidics facilitates the creation of sophisticated and functional organoid models, enhancing insights into organ development, disease mechanisms, and personalized medical investigations.

Sterilization Surgery Trends in Texas After Passage of the Texas Heartbeat Act [ID 2683648

INTRODUCTION: On September 1, 2021, abortion became illegal in Texas once electric embryonic cardiac activity can be detected. Before that, elective abortions were allowed up to 20 weeks postfertilization. In order to primarily avoid unwanted pregnancy, a trend for younger women to seek a definite contraception method has been observed; however, this has not been studied yet. The aim of this study was to compare the characteristics of women requesting surgical sterilization before and after the Texas Heartbeat Act went into effect. METHODS: This is a retrospective study including all women who underwent bilateral salpingectomy for surgical sterilization between May 2020 and November 2022. Women who underwent surgery 15 months before the new laws (controls) were compared to women who underwent surgery 15 months after the change (study group). Demographic, clinical characteristics, operative, and postoperative data were collected from women's medical files. RESULTS: Two hundred five women met inclusion criteria, of them 131 (64%) in the study group and 74 (36) controls. The rate of women with managed care insurance was significantly higher in the study population (P=.04). Median age was similar between the groups (P=.98). Parity was significantly higher in the controls (P=.004); however, the rate of nulliparous women more than doubled in the study population (37 [28%] versus 8 [11%]; P=.004). Surgery as first contraception method was reported in 63 (48%) and 41 (19%) of the women in the study and control groups, respectively (P=.58). Complication rate was found higher for the study group, but the difference did not reach significance [4 (3.1%) versus 0 (0); P=.13]. CONCLUSION: Since the passage of the Texas Heartbeat Act, more women with managed care insurance were undergoing surgical sterilization. Although the mean age to undergo the surgery did not change compared to the period before the change in the law, the rate of nulliparous women preferring this method for contraception significantly increased.