Experience Of Infertility Research Articles

Infertility in the Capital Region of Denmark: Prevalence and population characteristics

Abstract Background Infertility is a disease defined by failure to achieve a pregnancy within 12 months of trying. Infertility has-until now-not been monitored in Denmark for three decades. The aim of this study was to assess the prevalence of infertility in persons aged 25-44 years in the Capital Region of Denmark, and to describe characteristics of persons with infertility. Methods Life-long experience of infertility was assessed in the Danish Capital Region Health Survey 2021, including 56,245 participants from the general population aged ≥16 years (response rate 54.9%). In this study, only persons aged 25-44 years who had tried to have children (thus knowing their fertility) were included, resulting in 8,203 participants. Characteristics of persons with infertility were assessed using national registries (socio-demographics) and questionnaire data (health status). Descriptive analyses and multivariate logistic regression models weighted for survey design and non-response were performed. Results Among persons aged 25-44 years, who had tried to have children, 20% had experienced infertility. Among those, 44% did not achieve the children they wanted. Infertility was most common among women (22%) and persons aged 35-44 years (21%). No associations were observed between infertility and ethnicity, education, and employment status. Persons with infertility were more likely to have poor physical health, have higher level of stress symptoms and have obesity compared with persons in same age group, who had tried to have children but not experienced infertility. Conclusions Infertility is very common in the general population and is associated with unmet fertility desires as well as poor physical health and high stress level. These findings highlight the importance of focusing on and prioritizing treatment and prevention of infertility and emphasize the need for further research in and continued monitoring of infertility. Key messages • Infertility is very common in the general population and associated with unmet fertility desires and poor health highlighting the importance of prioritizing treatment and prevention of infertility. • Continuous monitoring of infertility in the general population is essential as well as further research into risk factors and consequences of infertility.

A Comprehensive Theological and Scientific Study of Gestational Surrogacy

With advancements in science and in response to the desire of childless individuals, surrogacy has emerged as a contemporary method of treating infertility. Intriguingly, due to its novelty, this topic has sparked considerable legal and jurisprudential debate. In essence, this medical procedure involves fertilizing a woman's egg with a man's sperm outside the womb. Subsequently, due to the woman's inability to carry the pregnancy, the embryo is implanted into another woman's uterus. Surrogacy, in fact, is a means for infertile couples to have a child. Through assisted reproductive technologies, an embryo created via in vitro fertilization is transferred to a gestational carrier, who carries the pregnancy to term and then relinquishes the child to the intended parents. In Iran, assisted reproductive technologies are employed when couples, or either partner, experience infertility. In these procedures, the sperm and egg of the legal and marital couple are fertilized in a laboratory, and the resulting embryo is donated to another legal and marital couple. A crucial issue in this context is the determination of the child's parentage, especially maternal lineage. Due to the silence of the law, this matter must be resolved by examining the Constitution of the Islamic Republic of Iran and relevant jurisprudential opinions, as well as the perspectives of legal experts. In this regard, determining the maternal lineage, which involves the biological mother and the gestational carrier, presents a challenge and requires further exploration. The conclusion of this paper is that, based on Quranic verses, hadiths, the principle of freedom of will, the intentions of the parties involved, the best interests of the child, customary practices, and legal principles, the gestational carrier is considered the legal mother of the child.

Efektivitas Edukasi Kesehatan Tentang Polycystic Ovary Syndrome (PCOS) Melalui Media Sosial Terhadap Pengetahuan dan Sikap Remaja Putri di Madrasah Aliyah Laboratorium Jambi

Polycystic Ovary Syndrome (PCOS) is one of the main causes of infertility in reproductive age women. Around 17.5% of the adult population, 1 in 6 worldwide experience infertility. This research aims to analyze the effectiveness of health education about PCOS using social media on the knowledge and attitudes of young women at the Madrasah Aliyah Laboratorium Jambi. Quantitative research with a Quasi Experimental design, Pre-test and Post-test Non-Equivalent Control Group design. The total sample was 25 people, with 14 people in the Instagram social media intervention group and 11 people in the Facebook intervention group. The social media Instagram and Facebook are effective in increasing knowledge of young women before and after on Instagram (p=0.000) and Facebook (p=0.000). On the attitudes of young women before and after on Instagram (p=0.001) and Facebook (p=0.009). Meanwhile, there is no significant difference in effectiveness between Instagram and Facebook in PCOS health education on knowledge (p=0.513) and attitudes (p=0.057) of young women at Madrasah Aliyah Laboratorium Jambi. There were differences in knowledge and attitudes before and after the Instagram and Facebook intervention, and there was no significant difference in effectiveness between Instagram and Facebook in PCOS health education on the knowledge and attitudes of young women at Madrasah Aliyah Laboratotium Jambi. Young women are advised to be more concerned about reproductive health because information can be obtained in various media, especially social media. Keywords: PCOS, Instagram, Facebook, Knowledge, Attitude

Measuring non-events: infertility estimation using cross-sectional, population-based data from four countries in sub-Saharan Africa.

Does the prevalence of 12-month infertility in Burkina Faso, Côte d'Ivoire, Kenya, and Uganda differ between women trying to conceive and the broader population of women exposed to unprotected sex, and how are prevalence estimates affected by model assumptions and adjustments? Estimates of 12-month infertility among tryers ranged from 8% in Burkina Faso to 30% in Côte d'Ivoire, increasing substantially among a larger population of women exposed to unprotected intercourse. While having a child is a fundamental human experience, the extent to which women and couples experience infertility is a neglected area of research, particularly in sub-Saharan Africa. Existing estimates of infertility in this region vary widely from 2% to 32%, however, potential impacts of variability in study populations and model assumptions have not been well-examined. We used cross-sectional nationally representative survey data from Burkina Faso, Côte d'Ivoire, Kenya, and Uganda. We employed a multi-stage cluster random sampling design with probability proportional to the size selection of clusters within each country to produce representative samples of women aged 15-49. Samples ranged from 3864 in Côte d'Ivoire to 9489 in Kenya. We created two analytic samples in each country-tryers and a broader sample of women exposed to unprotected sex-exploring differences in population characteristics and estimating the period prevalence of 12-month infertility using the current duration (CD) approach. We also examined the impact of several model assumptions within each of the two analytic samples, including adjustments for recent injectable contraceptive use, unrecognized pregnancy, infertility treatment, underreported contraceptive use, and sexual activity. Employing the CD approach among tryers produced an overall 12-month infertility prevalence of 7.9% (95% CI 6.6-12.7) in Burkina Faso, 29.6% (95% CI 15.3-100.0) in Côte d'Ivoire, 24.5% (95% CI 16.5-34.6) in Kenya, and 14.7% (95% CI 8.1-22.4) in Uganda. Results among women exposed to unprotected intercourse indicated much higher levels of infertility, ranging from 22.4% (95% CI 18.6-30.8) in Uganda to 63.7% (95% CI 48.8-87.9) in Côte d'Ivoire. Sensitivity analyses suggest infertility estimates are particularly sensitive to adjustments around pregnancy recognition timing and sexual activity, with little impact of adjustments for recent injectable contraceptive use, infertility treatment, and underreporting of traditional and coital dependent contraceptive use. There was substantial digit preference in responses at 12 months, particularly among the tryers, which could introduce bias. Data quality concerns in the reproductive calendar may impact the accuracy of the CD approach among the broader sample of women exposed to unprotected sex, particularly with regard to underreported contraceptive use, induced and spontaneous abortions, and unrecognized pregnancies. Lastly, we lacked information on postpartum amenorrhea or abstinence. Understanding the inconsistencies in definition and analytic approach and their implications for infertility estimation is important for reliably monitoring population-level infertility trends, identifying factors influencing infertility, improving prevention programs, and ensuring access to quality treatment and services. This study was supported by grants from the Bill & Melinda Gates Foundation (INV009639) and the National Institute of Child Health and Human Development (K01HD107172). The funders were not involved in the study design, analyses, manuscript writing, or the decision to publish. The authors have no conflicts of interest to declare. N/A.

Medically Assisted Reproduction and Partnership Stability

AbstractDespite the increasing use of medically assisted reproduction (MAR) in modern societies, there is limited evidence on whether conceiving with MAR or remaining involuntarily childless after MAR is associated with partnership stability. While older age, the more advantaged socioeconomic position of women undergoing MAR and their strong fertility intentions could lead to higher partnership stability, the experience of infertility and undergoing MAR may have an opposite effect, especially if couples remain involuntarily childless. Using data on Finnish nulliparous couples from 1995–2017 (N = 149,884) and event‐history models, we compare the risk of separation of couples who remained childless after MAR (N = 3871), who conceived through MAR (N = 14,474), who conceived naturally without MAR (N = 167,962) or with a prior history of MAR (N = 2273). Couples who remained childless after MAR had a higher risk of separation than couples who conceived with MAR or naturally. The higher risk of separation decreased over time since the discontinuation of treatments but persisted over the longer term. There were no differences in the risk of separation between couples who conceived with MAR or naturally. The results suggest that involuntary childlessness after MAR is associated with an increased risk of separation while undergoing MAR/experiencing infertility does not seem to play a role.

Gottman's sound relationship house and relational resilience through infertility for couples.

Some couples report that their relationship satisfaction increases through the experience of infertility. Few studies exist which explain how this phenomenon occurs through specific variables. We hypothesized that John Gottman's constructs of friendship and intimacy as well as shared meaning could explain how couples can achieve increased relationship satisfaction. We examined a regression analysis of cross-sectional retrospective individual data for couples who are either experiencing infertility currently or have done so in the recent past. In our nonclinical sample (n = 903), mediation analyses indicated significant influencing pathways for the Gottman shared meaning system, indicating that this construct may explain how couples achieve greater emotional bonding and couple satisfaction through infertility. These findings provide couple therapists with potential areas of focus for couples navigating infertility through the lens of Gottman Method Couple Therapy, including ways to encourage deeper mutual shared meaning amidst the infertility experience.

The effect of endometriosis on the fertility of women

Endometriosis is defined by the presence of ectopic endometrial tissue outside the uterus, frequently located on pelvic organs such as the fallopian tubes and ovaries, and occasionally beyond the pelvic region. This condition manifests as dysmenorrhea, chronic pelvic pain, dyspareunia, and subfertility. Despite extensive research, the etiology and pathogenesis of endometriosis remain unclear, with laparoscopy being the definitive diagnostic method. The association between endometriosis and infertility has been extensively debated. Endometriosis can impair fertility by disrupting embryo implantation, altering hormone levels, and compromising oocyte quality. This literature review aims to examine the effects of endometriosis on female fertility. The review encompasses documents from clinical trials with control groups involving 196 to 22,416 reproductive-age participants (25-42 years), and case studies published over the past thirty-seven years from various regions (USA, Australia, Turkey, Africa, and Europe. Reputable databases such as BMJ, NEJM, Elsevier, AJR, Medline, and PubMed were utilized, with references compiled in the bibliography. A risk-benefit analysis indicates that up to 50% of women with endometriosis experience infertility. Consensus on treatment options remains elusive. The relationship between endometriosis and infertility is supported by studies of both fertile and infertile women, animal studies, donor sperm studies, and in vitro fertilization outcomes. Diagnostic methodologies based on endometrial changes are providing insights into potential mechanisms of infertility, especially in women with milder disease. However, clinical management of endometriosis-related infertility has not shown conclusive success beyond in vitro fertilization.

Exposure of women undergoing in-vitro fertilization to per-and polyfluoroalkyl substances: Evidence on negative effects on fertilization and high-quality embryos

In April 2023, the World Health Organization (WHO) reported that 17.5% of the global adult population experience infertility. What may be the contribution of per-and polyfluoroalkyl (PFAS) to this global public health problem?This study explored the associations between in vitro fertilization (IVF) outcomes and plasma concentrations of individual PFAS and PFAS mixtures in women undergoing in vitro fertilization and embryo transfer (IVF-ET) and how these exposures might affect IVF outcomes. We analyzed 8 PFASs in plasma samples from women (N = 259) who underwent IVF treatment. In multivariable generalized linear mixed models, there were statistically significant associations of higher plasma concentrations of PFNA with reduced numbers of total retrieved oocytes [12.486 (95%CI: 0.446,25.418), p trend = 0.017], 2 PN zygotes [6.467(95%CI: 2.034,14.968), p trend = 0.007], and cleavage embryos [6.039(95%CI: 2.162,14.240), p trend = 0.008]. Similarly, there was a continuous decline in the numbers of retrieved 2 PN zygotes and cleavage embryos with increasing concentration of PFOS [6.467(95%CI: 2.034,14.968), p trend = 0.009 and 6.039(95%CI: 2.162,14.240), p trend = 0.031,respectively] and a negative association between PFHxS concentrations and clinical pregnancy during the initial cycles of frozen ET [0.525(95%CI:0.410,0.640), p trend = 0.021]. To investigate the joint effect of PFAS mixtures, a confounder-adjusted BKMR model analysis showed inverse relationship between PFAS mixtures and the number of high-quality embryos, 2 PN zygotes and cleavage embryos, to which the greatest contributors to the mixture effect are PFDeA and PFBS, respectively. It demonstrated that PFAS exposure might exert negative effects on oocyte yield, fertilization and high-quality embryo in women undergoing IVF. These findings suggest that exposure to PFAS may increase the risk of female infertility and further studies are needed to uncover the potential mechanisms underlying the reproductive effects associated with PFAS.

P-484 Infertility stigma, openness with others, and their relationship to depression and meaning in life among men and women experiencing infertility

Abstract Study question Does infertility-related stigma and being open with others relate to depression and meaning in life among men and women experiencing infertility? Summary answer Higher infertility stigma was related to higher depression and search for meaning, whereas higher openness was related to lower depression and higher presence of meaning. What is known already For men experiencing infertility, there is relatively scarce knowledge about the relationship between infertility stigma, openness, depression, and meaning in life. For women, previous studies have found that higher levels of infertility stigma are associated with higher levels of hopelessness (Kaya & Oskay, 2020). Studies have also found that the presence of meaning in women is associated with the use of more adaptive coping strategies for infertility, while the search for meaning is associated with higher levels of depression (Morse & Steger, 2019). Men who reported greater openness with others about infertility, reported lower depression (Babore, et al., 2017). Study design, size, duration The design was a cross-sectional survey where participants completed demographic and infertility information along with validated measures of meaning in life, depression, openness, and perceptions of stigma regarding their infertility. Participants were recruited via announcements on infertility discussion listservs and social media accounts in the United States. Data were collected in November-December of 2023. Participants were 89 men and 458 women who reported an infertility diagnosis. Eighty-one percent of participants were from the United States. Participants/materials, setting, methods The key outcome variables were the 10-item Center for Epidemiological Studies-Depression measure (Zhang et al., 2012) and the Meaning in Life measure, which consists of two 5-item subscales, Presence of Meaning and Search for Meaning (Steger et al., 2006). Along with demographic and infertility factors, key psychological variables were measured including infertility stigma (Fu et al., 2015) and openness with others and their partner about their infertility experience (Babore, 2017). Participants mean age was 33. Main results and the role of chance Multiple linear hierarchical regression models explained substantial variance (adjusted R-squared) for depression (48% men; 29% women), presence of meaning (28% men; 27% women), and search for meaning (22% men; 16% women). Men and women who reported higher levels of personal infertility stigma had higher levels of depression (Betas = .23 men and .24 women; ps < .05), as well as higher levels of searching for meaning (Beta = .26 men, p = .051; Beta = .16 women, p = .016). Higher stigma was also associated with lower presence of meaning in women (Beta = -.233, ps <.001). Men and women who reported higher levels of openness with others about infertility reported substantially lower levels of depression (Betas = -.51 men and -.32 women; ps <.001), and greater presence of meaning in life (Betas = .29 men and .22 women; ps < .05). Openness with others was also associated with lower search for meaning among women (Beta = -.127, p = .011). Women who were currently in treatment reported more depression compared to both women who were never in treatment (Beta = -.245, p = .019), and women who had previously been in treatment (Beta = -.244, p = .031). Limitations, reasons for caution This study provided the rare opportunity to examine infertility and mental health among men, but caution is necessary when interpreting these results due to the relatively small sample size. The correlational findings do not allow for inferences of causality, and testing the generalizability of findings is an important next step. Wider implications of the findings The study highlights that higher infertility stigma and lower openness with others are key factors in understanding men and women’s mental health and worldview perceptions. Encouraging individuals with infertility to share their experiences with others may reduce feelings of depression, while also increasing one’s sense of meaning in life. Trial registration number not applicable

P-455 Exploring the impact of fertility care on the modern workforce: key research findings

Abstract Study question Is there a need for a fertility revolution to accommodate the modern workforce, and how canit be safely and effectively implemented? Summary answer Offering care to employees facing fertility issues is vital as access to reproductive healthcareis more needed and more of a challenge than ever before. What is known already The UK faces a fertility care crisis as NHS struggles and private insurance premiums soar,prompting employees to seek support from employers. Challenges include an ageing parent demographic, falling fertility rates, and a global decline in sperm quality. Employees demand healthcare support, with 55% wanting fertility assistance, and 1 in 3 considering job change due to inadequate fertility or baby loss support. Financial concerns further delay fertility journeys for 56% of employees, impacting mental well-being. While high-cost fertility benefits emerge, the call is for holistic, early-stage support to mitigate stress and improve overall fertility outcomes for employees. Study design, size, duration During September 2023, a survey was conducted to explore and make the link between the personal / human experience of infertility and the corporate impact / responsibility in supporting someone through it. The survey was disseminated to 1031 employees, 511 of which were struggling with fertility issues and 508 were trying to conceive or considering future fertility. Participants/materials, setting, methods An online survey anonymously gathered responses from UK employees across various sectors, posing 22 targeted multiple-choice questions on fertility, pregnancy loss, and miscarriage. The survey sought to understand the intricate connections between theseaspects and the provision of employer-based support and benefits, shedding light on the current landscape of fertility-related concerns within the workforce. Main results and the role of chance The survey shows that 28% reported personal fertility experiences, and 37% faced challenges themselves or through partners. 55% desire increased employer support during their fertility journey, peaking at 66% among BAME individuals. Importantly,30% prioritise fertility benefits over a condensed work week, with Gen Z (37%) emphasising this more than Gen X (28%). Attrition concerns are evident, with 21% contemplating job changes due to fertility struggles, higher among BAME (31.54%) and LGBTQ + (25.62%) individuals. Productivity is impacted for 30%, with LGBTQ+ individuals experiencing a higher impact (38%). workplace relationships suffer for 25%, while 24% believe their workplace poorly support those facing fertility challenges.Taking time off for fertility-related issues is prevalent, with 64% having done so, and 22% believe more employer support could have reduced their time off. Workplace policies appear lacking, as 39% find them non-inclusive, with BAME (44%) and LGBTQ + (49%) individuals expressing higher dissatisfaction. Attraction and retention are influenced by fertility support, as 47% of Gen Z and 47% of BAME respondents prioritise it when considering new roles. Limitations, reasons for caution No limitations identified. Male, female and gender neutral/ non-binary respondents were included in the survey, along with those who identified as single or were in heterosexual same sex relationships. People from BAME communities were also included in the survey. Wider implications of the findings The survey underscores a growing need for employer support in fertility challenges. Attrition concerns and productivity impacts reveal potential economic ramifications for organisations neglecting fertility support and inclusive strategies. Findings position comprehensive fertility support and emotional wellbeing support as a competitive advantage for talent attraction. Trial registration number not applicable

O-161 #Infertility: a systematic review of information available on social media platforms

Abstract Study question How accurate, credible, reliable and readable is online information obtained from social media content in relation to the diagnosis and management of fertility problems? Summary answer Information available on social media regarding infertility often uses language that is inappropriate for a lay audience and lacks sufficient accuracy, credibility and reliability. What is known already Social media has become a popular source of information for people seeking guidance, advice and educational resources related to their own fertility journey. Social media can provide free and easily accessible information and can act as a space for community support to share real-world experiences. Many of the platforms delivering this information have not been verified and there is a growing concern regarding the accuracy of the content on these posts. A variation in expertise among content creators and the rapid spread of anecdotal experiences may contribute to the unreliability of information. Study design, size, duration Using real-time analytics software, the #infertility was tracked prospectively during National Infertility Awareness Week, an annual campaign organised by the National Infertility Association (USA) to raise awareness around infertility, on Twitter and Instagram platforms. During this one-week period, a total of 28,612 posts containing the #infertility was posted on Twitter and Instagram. Posts containing non-English language, commercial advertising and content related solely to the lived experience of infertility, for example, a patient’s blog, were excluded. Participants/materials, setting, methods Once screening was completed, 673 posts (310 on Twitter and 363 on Instagram) were identified as containing information pertaining to the diagnosis and management of fertility problems. Two independent researchers screened the included posts. Posts were evaluated using validated instruments across four domains, including assessments of 1) credibility (White Paper instrument) 2) quality (adapted DISCERN instrument) 3) accuracy (assessed by prioritized criteria developed in consultation with healthcare professionals and researchers) and 4) Readability (Flesch-Kincaid instrument). Main results and the role of chance A total of 28,612 posts, with a reach of 285,826,087 people were identified. Once screening had been completed, there were 310 posts on Twitter containing information pertaining to infertility, with 20,136 engagements and an overall reach of 75,184,476. For Instagram, 363 posts were identified as containing information pertaining to infertility, with 46,443 engagements. The most discussed topics included: 1) lifestyle interventions including nutrition and supplements, 2) polycystic ovarian syndrome, 3) endometriosis and 4) infertility in relation to COVID and the COVID vaccination programme. Only 87 Twitter posts (28%) had clear demonstration of credibility and of those posts the information contained within them was accurate 92% of the time. Of the remaining 72% of Twitter posts, no clear credentials were displayed, and the accuracy of those posts dropped to 34%. 139 Twitter posts (45%) appeared to have an undeclared Trial registration number Not applicable

Cervical intraepithelial neoplasia and fecundability: a prospective cohort study.

Is cervical intraepithelial neoplasia (CIN) associated with reduced fecundability, defined as the probability of conceiving per menstrual cycle? Overall, we observed no meaningful association between CIN and fecundability, regardless of surgical status, although a recent diagnosis of moderate or severe CIN might be associated with slightly reduced fecundability for 2 years after diagnosis. About 15% of couples experience infertility. Few studies have examined the influence of CIN on fertility, and the results have been inconsistent. No study has investigated the association between fecundability and pathologist-reported CIN diagnoses, particularly with respect to the recency of the specific CIN diagnoses. This prospective cohort study included 9586 women trying to conceive. The women were enrolled from 1 June 2007 to 3 February 2020. Women were invited to complete a baseline questionnaire and bimonthly follow-up questionnaires for up to 12 months or until pregnancy occurred. Data on cervical cytologies and biopsies were retrieved from The National Pathology Registry (DNPR), which holds records of all cervical specimens examined in Denmark. Women were categorized based on their most severe diagnosis of CIN: no lesion, other cervical changes, mild CIN (CIN1), or moderate/severe CIN (CIN2+) with or without surgery. To investigate the association between CIN and fecundability, we computed fecundability ratios (FR) and 95% confidence intervals (CI) using a proportional probabilities regression model. We adjusted for age at study entry, partner age, body mass index, smoking status, timing of intercourse, parity, education, number of sexual partners, and household income. Compared with no lesion, the adjusted FRs (95% CI) for the association between CIN and fecundability were: other cervical lesions, 0.97 (0.91-1.04); CIN1, 1.04 (0.96-1.13); CIN2+ no surgery, 1.00 (0.82-1.22); and CIN2+ with surgery 0.99 (0.89-1.10). The FRs (95% CI) for a recent diagnosis (<2 years) of CIN were 0.98 (0.86-1.11) for other cervical lesions; 1.13 (0.99-1.29) for CIN1; 0.89 (0.62-1.26) for CIN2+ no surgery and 0.91 (0.75-1.10) for CIN2+ with surgery compared with the no lesion group. In the analyses, we adjusted for several covariates related to the women. However, we had little information on the male partners which could lead to unmeasured confounding as fecundability is a couple-based measure of fertility. Furthermore, a CIN diagnosis may not be constant as it may regress or progress spontaneously; therefore, it is possible that we have misclassified some women, especially women categorized as having normal cells or CIN1. Our results contribute important knowledge to women who are concerned about their future fertility after receiving a CIN diagnosis. This study was funded by The Danish Cancer Society (R167-A11036-17-S2). The overall cohorts were funded by the National Institute of Child Health and Human Development (R01-HD086742 and R03-HD094117). The authors report no competing interests. N/A.

Am I Broken?: A mixed-method analysis of an ethnotheatrical performance about women’s experiences with infertility and friendship

ABSTRACT Background This study evaluated an ethnotheatrical performance about infertility to bring awareness to the health condition and its impact on friendships. Methods After each performance (N = 2), attendees participated in a talkback session to express thoughts and ask questions about the production; then, they completed a survey describing their overall experience. Analyses included descriptive statistics for Likert questions and a thematic analysis for open-ended responses. Results Eighty-six percent of attendees found the performance informative about the challenges infertility imposes on everyday life, and more than 60% gained new information and advice on how to talk about infertility. The thematic analysis revealed three themes: learn about the complexities of infertility experiences, develop empathy towards individuals with infertility, and respond appropriately to individuals coping with infertility. Conclusion The performance offered a safe environment for attendees to learn, understand, and process infertility’s complex nature. Creating awareness influenced participants’ perceptions and communicative behaviors.

Development of Marketing Strategies with Digital Enhancements to Increase Patients’ Buying Decision in a Fertility Center

Infertility is a significant global concern, affecting a substantial portion of the adult population. Defined as the inability of a married couple to achieve pregnancy after 12 months of regular unprotected intercourse, its prevalence is increasing worldwide. According to the World Health Organization’s 2023 data, one in six adults experiences infertility, with notable variations across income brackets. Indonesia also faces this issue, affecting 10–15% of reproductive-age couples. This research examines the critical role of marketing strategies, specifically the 7Ps marketing mix (Product, Price, Place, Promotion, People, Physical Evidence, and Process), in influencing consumer buying decisions in fertility centers. The study aims to identify key factors that significantly impact patient choices and propose strategic improvements to enhance patient acquisition and retention. Utilizing Partial Least Squares Structural Equation Modeling (PLS-SEM), this research evaluates the relationship between marketing mix components and patient decisions. The findings highlight the importance of competitive pricing, effective promotion, high-quality staff, and efficient service processes in attracting patients. Additionally, it underscores the need for facility improvements, continuous service quality enhancement, and ensuring access to fertility centers. Furthermore, the role of digitalization in enhancing marketing strategies is critical. Incorporating digital tools and AI can significantly improve patient engagement, streamline administrative processes, and provide personalized care. By leveraging digital platforms for promotions, virtual consultations, and patient follow-ups, fertility centers can enhance their reach and service efficiency. This integration of digital solutions is crucial for staying competitive in a rapidly evolving healthcare market. This study provides actionable insights for fertility centers to refine their marketing strategies, including digitalization to improve patient acquisition and retention.

Evaluating associations of bisphenol and phthalate exposure with time to pregnancy and subfecundity in a New York City pregnancy cohort

It is important to understand the impact of consumer chemical exposure and fecundity, a couple's measure of probability of successful conception, given approximately 15% of couples experience infertility. Prior research has generally found null associations between bisphenol and phthalate exposure and fecundability, measured via time to pregnancy (TTP). However, this research has not been updated with current chemical exposures and have often lacked diversity in their study populations. We evaluated the associations between common bisphenol and phthalate chemical exposure groups and TTP as well as subfecundity (TTP>12 months) in the New York University Children's Health Study, a diverse pregnancy cohort from 2016 onward. Using first-trimester spot-urine samples to measure chemical exposure and self-reported TTP from first-trimester questionnaires, we observed a significant adverse association between total bisphenol exposure and certain phthalate groups on TTP and odds of subfecundity. Furthermore, in a mixtures analysis to explore the joint effects of the chemical groups on the outcomes, we found evidence of a potential interaction between total bisphenol exposure and low-molecular weight phthalates on TTP. Future research should continue to update our knowledge regarding the complex and potentially interacting effects of these chemicals on reproductive health.

Women’s emotional roller coasters during pregnancy as a consequence of infertility: a qualitative phenomenological study

Women experiencing infertility tend to experience distinct emotions during pregnancy following infertility. Individuals in this population often struggle with psychological and social challenges during pregnancy. This qualitative phenomenological study determines how infertility experiences affect mothers’ mental well-being during pregnancy as well as their experiences and emotions after becoming pregnant. A face-to-face, in-depth interview with 15 women with infertility was conducted between November 2022 and May 2023. The study adhered to ethical guidelines, with informed written consent obtained prior to interviews and voice recordings. The COREQ checklist is applied to follow the EQUATOR guidelines for reporting research and the data were coded using MAXQDA.20 software. A thematic analysis revealed four main themes and 15 codes. Main themes included “Over Emotional Burden,” “Overprotection,” “Overthinking,” and “Social Activity Changes.” Pregnancy after infertility is a unique and emotionally charged experience for women, encompassing a spectrum of feelings that can be difficult to express. The importance of caring for these women and receiving support from their partners, families, and healthcare providers should not be overstated. Healthcare providers should be aware of these emotional challenges so they can provide better support and counselling to improve women’s overall pregnancy experience. It is believed that empathetic communication and tailored support can significantly improve the psychological well-being of this population. Psychologists, psychiatrists, and midwives should also be more attentive to mothers’ emotional challenges and integrate comprehensive emotional support and provide coping mechanisms in perinatal care programs.

Identification of a new mutation in the ACTL9 gene in men with unexplained infertility.

Infertility is defined as the failure to achieve pregnancy after one year of unprotected intercourse within a marital relationship. Approximately 10%-15% of couples worldwide experience infertility issues, with nearly half of these cases attributed to male factors. Among men with unexplained infertility, genetic mutations have been identified as a potential cause. Studies have indicated that mutations affecting the function of the protein encoded by the ACTL9 gene may play a role in male infertility. The purpose of this research was to identify mutations in the ACTL9 gene associated with male infertility in a sample of 40 infertile men with unknown causes. Genomic DNA extraction and PCR amplification were carried out on samples from each individual. The genetic material was then analyzed using Sanger sequencing, followed by bioinformatics and segregation analysis to determine the potential effects of the observed variations. A novel genetic variant, c.376G>A (p.Glu126Lys), was identified in an infertile male individual, representing a previously unreported finding that was validated through segregation analyses. This specific variant induces a change from glutamate to lysine at the amino acid level by replacing the nucleotide G with A in the genomic DNA sequence, consequently impacting the secondary structure and function of the protein. The conclusive analysis of the procedure indicated that this alteration has the potential to interfere with the process of fertilization, ultimately resulting in the complete failure of fertilization (TFF) and causing male infertility.

A Biallelic Mutation in CCDC103 Impairs Sperm Motility due to the Absence of Dynein Arms

Primary ciliary dyskinesia (PCD) is a rare genetic condition characterized by destructive respiratory disease and laterality abnormalities due to randomized left–right body asymmetry. In men, PCD is also often associated with infertility due to immotile sperm owing to a malfunction of the sperm flagella. Pathogenic mutations have been found in more than 50 genes. Nonetheless, not all patients with PCD experience infertility. Therefore, to better understand the impact of PCD-associated mutations on male fertility, it is necessary to clarify the role of these genes in spermatogenesis. The CCDC103 p.His154Pro mutation has a high prevalence in PCD. Here, we present the identification and functional analysis of a biallelic mutation in CCDC103 identified in a familial case of PCD associated with male infertility. The biallelic CCDC103 mutations, NM_213607:c.161_162del(p.His55Serfs ∗9) and NM_213607:c.461A &gt; C (p.His154Pro), were identified by whole-exome sequencing. Sanger sequencing validation was performed on all available family members, and the mutation was recessively separated with an infertility phenotype. The c.161_162del mutation breaks the reading frame of the protein and, therefore, is predicted to produce a nonfunctional protein. The tertiary structure of CCDC103-mutated protein indicated a significant conformational change that likely affected protein function. Transmission electron microscopy of spermatozoa showed that both the mid and principal regions of the flagellum lacked dynein arms, which was confirmed via immunofluorescence staining. Using the method of laser-assisted immotile sperm selection combined with intracytoplasmic sperm injection, the patient’s wife has a successful clinical pregnancy. These results extend the phenotype spectrum of the CCDC103 mutation in PCD.

A scoping review of infertility research conducted in the Republic Of Ireland

Background Approximately 25 million citizens in Europe experience infertility. Until September 2023, the Republic of Ireland (RoI) was the only state in the European Union that did not offer any state-funded access to Assisted Reproductive Technology (ART). As research supports the understanding, and improvement, of care delivery, and research activity is associated with healthcare performance, it seems timely to develop an understanding of infertility research to-date in RoI. The aim of this scoping review was to examine the extent and nature of research on infertility conducted in RoI. Methods A protocol for this scoping review was published through the Open Science Framework (https://doi.org/10.17605/OSF.IO/H8F4Y) in March 2023. The search strategy was comprised of electronic searches, review of reference lists, grey literature searches, and screening of publications from the European Society of Human Reproduction and Embryology and the International Committee for Monitoring Assisted Reproductive Technologies. Studies focused on infertility or infertility care that were conducted in RoI were included. Deductive content analysis was used to cluster studies. Results In total, 105 studies were included and published between 1951 and 2023, with a marked increase from 2010. Studies most frequently considered Success Rates of ART (31.4%), Service Description and Evaluation (12.4%), and Optimising Treatment Regimes or Protocols (11.4%). Conclusions The sizable body of research is congruent with the increasing burden of infertility. However, the literature is limited by a predominant focus on ART success rates, a dearth of qualitative studies, limited engagement with healthcare providers, and limited exploration of the quality of care provision. This review may offer a useful model for researchers in other countries. The variability in availability, and outcomes, of ART across Europe conveys the necessity of understanding and advancing research within individual countries and health systems as well as internationally.

Microfluidics as an emerging paradigm for assisted reproductive technology: A sperm separation perspective.

Millions of people are subject to infertility worldwide and one in every six people, regardless of gender, experiences infertility at some period in their life, according to the World Health Organization. Assisted reproductive technologies are defined as a set of procedures that can address the infertility issue among couples, culminating in the alleviation of the condition. However, the costly conventional procedures of assisted reproduction and the inherent vagaries of the processes involved represent a setback for its successful implementation. Microfluidics, an emerging tool for processing low-volume samples, have recently started to play a role in infertility diagnosis and treatment. Given its host of benefits, including manipulating cells at the microscale, repeatability, automation, and superior biocompatibility, microfluidics have been adopted for various procedures in assisted reproduction, ranging from sperm sorting and analysis to more advanced processes such as IVF-on-a-chip. In this review, we try to adopt a more holistic approach and cover different uses of microfluidics for a variety of applications, specifically aimed at sperm separation and analysis. We present various sperm separation microfluidic techniques, categorized as natural and non-natural methods. A few of the recent developments in on-chip fertilization are also discussed.