Female Reproductive Age Research Articles

Impact of cancer during reproductive age on the probability of livebirth after cancer: a register-based cohort study among Danish women aged 18-39 with and without cancer.

This register-based study investigates the probability of a livebirth after cancer during the female reproductive age. The study population, derived from the DANAC II cohort, included women aged 18-39 diagnosed with cancer between 1978 and 2016, matched with 60 undiagnosed women each from the general population. Primary outcome was a livebirth after cancer with follow-up until death, emigration, or end of follow-up. Hazard ratios (HR) were calculated using multivariable Cox regression analyses. The population included 21,596 women with cancer and 1,295,760 without. The 20-year cumulative incidence of livebirth after cancer/study entry was lower among women with cancer (0.22 [95% CI 0.22-0.22]) compared to those without (0.34 [95% CI 0.34-0.34]). The HR of a livebirth after cancer was 0.61 [95% CI 0.59-0.63]; highest at age 18-25 (HR = 0.72 [95% CI 0.68-0.76]); and lowest at age 33-39 (HR = 0.50 [95% CI 0.47-0.54]). Nullipara women had higher HR of a livebirth than those with children (HR = 0.72 [95% CI 0.69-0.75] vs. HR = 0.48 [95% CI 0.46-0.51]). HR was lowest for women with breast, gynecological, central-nerve-system cancer, and leukemia. Women with/without cancer were comparable in assisted reproductive technology initiation after cancer/study entry, but HR was higher among nullipara than in those with prior children. Cancer during reproductive years significantly and negatively impacts HR of a livebirth after cancer, particularly as age at diagnosis increases. Low HR of livebirth is observed in specific cancer groups. Results underscore the importance of oncofertility counseling at diagnosis, referral to fertility specialist before treatment, and follow-up after cancer, focusing on cancer type, parity status, and age at diagnosis.

Role of Basti in Artavshaya w.s.r. to Lean and Obese Polycystic Ovarian Syndrome

Polycystic ovarian syndrome is common endocrine, metabolic and lifestyle disorder for female reproductive age. Women with PCOS may not ovulate, have high level of androgens and have multiple cysts in the ovaries. PCOS can cause absent or irregular menstrual periods, excess hair growth, acne, infertility and weight gain. In Ayurveda, it can be correlated with Artavakshaya and Pushpaghani Jatharini. In the event of deficiency or loss of Artava, the menstruation does not appear in its appropriate time or is delayed (intermenstrual period is prolonged), is scanty and does not last for three days. There is also pain in vagina. This pain is due to aggression of Vayu caused by loss of Artava which fills this region, in modern context the treatment is based on hormonal preparation only which have may hazardous effect like weight gain, cysts in reproductive organ and chances of OHSS (ovarian hyper stimulation syndrome) and carcinoma. PCOS has two phenotypes, overweight/obese and lean, the latter being a much less common presentation of the syndrome. Lekhana Basti as a form of Niruha Basti which possesses Shodhana and Lekhana properties. Lekhana means scraping or scratching, this property helps to eliminate morbid Dosha and Lekhniya dravya removed increased Mala by their scraping action. PCOS is considered under Yonivyapad and Artava Dusthi and this Yoniroga cannot occur without vitiation of Vata dosha for this in Ayurveda, Basti (medicated enema) is the best therapy along with oral medications, in this article, we want to focus mainly on Basti therapy for both lean and obese PCOS, as customized approach.

Chemotherapy drug combinations induced maternal ovarian damage and long-term effect on fetal reproductive system in mice

With the postponement of female reproductive age and the higher incidence of cancer in young people, fertility preservation has become increasingly important in childbearing age. Chemotherapy during pregnancy is crucial for maternal cancer treatments and fetal outcomes. It is a need to further study ovarian damage caused by chemotherapy drug combinations and long-term effects on offspring development, and a detailed understanding of side effects of chemotherapy drugs.In this study, chemotherapy drug combinations significantly impacted on ovarian function, especially epirubicin/cyclophosphamide (EC) combination led to an unbalance in the development of the left and right ovary. Exposure to EC and cisplatin/paclitaxel (TP) increased the number of progenitor follicles while decreased the count of antral follicles and corpora luteum. As to the estrus cycle, EC exposure resulted in a longer estrus period and diestrus period, while TP exposure only extended the diestrus period. EC and TP affected steroid biosynthesis by reducing the expression of SF1 and P450arom.γ-H2AX was detected in both EC and TP exposure groups.As to the impact on the offspring from 4T1 tumor-bearing pregnant mice injected with EC, no significant difference was observed in the physical and neurological development compared to the control, but the ovarian weights, estrus cycles of the offspring were significantly different. Chemotherapy drug combinations exhibit ovarian toxicity, not only causing direct damage on the follicle cells but also disrupting steroid biosynthesis. The reproductive system of offspring from maternal tumor-bearing mice exposed to chemotherapy drugs was observed disorder, but the concrete mechanism still needs further exploration.

Ketogenic diet for ovarian disorders - promising nutritional approach in polycystic ovarian syndrome and ovarian cancer

Introduction and purpose:
 Polycystic ovary syndrome (PCOS) is the most common endocrine disease in the female reproductive age. As treatment guidelines include lifestyle changes, various diet types are being evaluated in terms of efficacy among them ketogenic diet (KD) which was also assessed in terms of its influence on another ovarian related disease - ovarian cancer. The aim of this paper is an analysis of the available scientific data in respect of the role of the KD as a part of the therapy of ovarian related disorders. The search was conducted using PubMed and Google Scholarship databases.
 Brief description of the state of knowledge:
 Ketogenic diet demonstrates favorable effects in the hormonal profile of PCOS-affected women. It was also noticed that its administration results in the reduction of BMI and the improvement in glycemic parameters. Most of the research was conducted by linking the ketogenic diet with the caloric restriction. In the matter of ovarian cancer the results are unclear; some of the research states the improvement of the quality of life of the participants, but there is some alarming data of the possible role of KD in enhancing the tumor growth.
 Conclusions:
 Ketogenic diet merits further research as a possible factor in the treatment of PCOS as foregoing results are pointing to its efficacy. Nevertheless, still more data is needed to determine its role as studies were conducted within a short period of time with relatively small research groups. There are also other limitations such as the lack of comparison with other dietary patterns with the caloric deficit which makes it difficult to deduce the main profitable factor. When it comes to ovarian cancer the results of the current data are also unclear and unambiguous with the possible negative effects.

Is creeping abandonment of human cancer defences evolutionarily favoured?

Among observed animal species, humans exhibit a remarkably elevated lifetime cancer risk (over 38%), in stark contrast to less than 10% seen in other observed species (excluding those affected by environmental pollution). Peto's paradox suggests that these observations defy explanation through mathematical models treating cancer genesis as a stochastic process, with risks resulting from lifespan and body mass. For instance, whales, despite longer lifespans and roughly 30 times the size of humans, maintain consistent cancer risk throughout life, differing from the pronounced increase after female reproductive age observed in humans. It is well-documented in the literature that species-specific tumor suppression mechanisms allow for large lifespan and body mass. Examination of data from chimpanzees, a closely related species, suggests—without definitive evidence—a major difference between chimpanzee and human cancer risk. This leads to the conjecture that vulnerability of cancer defence mechanisms in humans might have emerged due to the unique evolutionary trajectory of the genus _Homo_. Given that this vulnerability emerges after reproductive years, a prevailing hypothesis attributes it to antagonistic pleiotropy. However, considering _Homo's_ historical existence in small tribes throughout much of evolution, we suggest that natural selection may have also operated at the tribal level. Consequently, our hypothesis, "Is creeping abandonment of human cancer defences evolutionarily favored?" arises from two alternative speculative scenarios. One proposition rests on the notion that diminishing tumor suppression activities could confer a calorie-saving advantage, particularly beneficial for tribes with limited food resources. The other proposition suggests that creeping abandonment of cancer defences might promote genetic diversity.

Clinical characteristics and pathologic complete response (pCR) rate after neoadjuvant chemotherapy in postpartum women with breast cancer

PurposeBreast cancer (BC) is currently the leading cause of death in women worldwide. Studies have confirmed that pregnancy is an independent factor affecting the survival of BC patients. BC found during pregnancy, lactation, or shortly after delivery is what we used to think of as pregnancy-associated breast cancer (PABC). The current expert definition of this concept is not uniform; however, there is growing evidence that postpartum breast cancer (PPBC) differs from other types of BC in terms of both biological features and prognosis, with a slightly different focus on diagnosis and treatment. With the increase of female reproductive age population and changes in fertility policies in China, patients with PPBC are receiving increasing attention. Here, we systematically analyzed the clinicopathological characteristics and chemotherapeutic response of patients with PPBC. We retrospectively analyzed the clinicopathological data, molecular subtypes, chemotherapy regimens, and pathological complete remission (pCR) rates of 1343 patients with non-metastatic BC at Harbin Medical University Cancer Hospital from January 1, 2012 to May 31, 2023. The categorical data were compared by chi-square test and Fisher exact test using logistic regression model. Predictor variables with P < 0.05 in the univariate analysis were included in the multivariate regression analysis to investigate the relationship between different age groups and pCR.ResultsA total of 714 patients were eligible for analysis in this study, and 667 patients had a history of pregnancy, 40 (5.6%) of whom were PPBC patients. When diagnosed with BC, patients with PPBC were younger, more likely to undergo breast-conserving surgery (BCS), and more likely to achieve pCR (P < 0.05). In molecular typing, human epidermal growth factor receptor 2 (HER-2)-positive and triple-negative breast cancer (TNBC) were more frequent. In the entire cohort, HER-2 expression and delivery status were independent predictors of pCR rates in BC patients after neoadjuvant chemotherapy (NAC).ConclusionOur findings suggest that postpartum status is an independent predictor of pCR attainment in BC patients. PPBC is more sensitive to chemotherapy than other patients.We need to pay more attention to this group and achieve individualized treatment, which will help us treat BC better and provide new targets and blueprints for our clinical therapy.

Is creeping abandon of human cancer defences evolutionarily favoured?

Among the animal species on which observations are available, humans have a uniquely high lifetime risk to suffer from cancer - over 38%, compared to less than 10% for all observed other species (except species suffering from environmental pollution). Peto's paradox shows that this cannot simply be explained by mathematical models which view cancer genesis as a stochastic process, with resulting risks polynomial in lifespan and body mass - whales have a longer lifespan and about 30 times the human body mass, however their cancer risk remains constant throughout their life rather than increasing sharply after female reproductive age as observed in humans. Rather, it is well documented in the literature that species-specific tumour suppression mechanisms allow for large lifespan and body mass. Data which was examined on chimpanzees, being closely related to humans, make it likely that there is a major difference between chimpanzee and human cancer risk, and hence the weakness of human cancer defence is likely to have resulted from the specific development of Homo sapiens. As this weakness appears past the reproductive years, a prominent hypothesis blames it to antagonistic pleiotropy. However, Homo sapiens having lived in small tribes during most of its development, natural selection is likely to also have acted at the level of tribes, which lets us derive our hypothesis, _is creeping abandon of human cancer defences evolutionarily favoured?_ from two alternative speculative scenarios. One of them is based on that lowering tumour suppression activities might save calories and hence benefit tribes with limited food production, the other one suggests that creeping abandon of cancer defences benefits genetical diversity.

Characterization of the reproductive seasonality of Florida Native sheep ewes

The Florida Native sheep (FNS) is recognized primarily due to their natural adaptation to harsh parasitic and environmen­tal conditions which allows them to thrive on minimal input from producers. FNS have been found to possess genetic re­sistance to gastrointestinal parasitism when compared with other breeds. In general, sheep profitable production requires effective reproductive management which in turn relies on a thorough characterization of key physiological reproductive parameters of the breed. Effective reproductive management will also aid in the conservation and propagation of this endan­gered native Florida breed. Nonetheless, in the scientific litera­ture, there is a lack of information regarding FNS reproductive characteristics. The present study aims to establish FNS female reproductive seasonality and age to puberty to improve produc­tion and management practices as well as contribute to long-term genetic improvement and preservation of the FNS breed.

Assessment Biochemical Parameters Role in Women with Polycystic Ovary Syndrome (PCOS) in Nineveh Governorate

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in female reproductive age, it is associated with metabolic disorder, oxidative stress and infertility. This study amid to show the effect of PCOS and obesity on a number of biochemical parameters in serum of 70 patients which age ranged (15-45) years attending Al-khansa hospital and private laboratories in Nineveh governorate They were diagnosed as PCOS by gynecologists, obstetricians and infertility doctors, 50 of healthy female with the same ages of patient were used as a control group for comparison. The results showed significant increase (P≤0.01) in concentration of Glucose, Insulin, Insulin resistance HOMA-IR, Triglyceride, Cholesterol, Low density lipoprotein LDL, very low-density lipoprotein VLDL, with non-significant decrease in High density lipoprotein HDL compared to control group. When comparing the previously mentioned parameters in serum of obese PCOS (BMI>30) with non-obese PCOS (BMI<30) we found significant increase (P≤0.05) in these parameters in obese more than in non-obese patient.

Mesenchymal-Stem Cell-Derived Conditioned Media Versus Exosomes in the Treatment of Rat Model of Polycystic Ovary: An Attempt to Understand the Underlying Mechanisms (Biochemical and Histological Study).

Polycystic ovary syndrome (PCOS) is one of the most common endocrine and reproductive disorders throughout female reproductive age. Cell free therapy [conditioned media (CM) & exosomes (EXO)] is a promising approach in regenerative medicine. This study aimed to compare between the therapeutic effects of stem cell-derived CM and exosomes on induced animal model of polycystic ovary. Polycystic ovary (PCO) was induced in female rats (3-4 weeks old, weighing 70-80 g) by letrozole with a dose of 1 mg/kg/day dissolved in carboxymethylcellulose 1% orally once daily for 5 weeks. Animals were divided into four groups: control group, PCO group, EXO-treated group, and CM-treated group. Serum levels of testosterone hormone, leutinizing hormone, follicle stimulatimg hormone, and insulin hormone were estimated. Immunohistochemistry using anti-P53, anti-AMP-dependent protein kinase antibodies were done. Six rats/group were used for matting with adult male rats for testing fertility. The results showed that CM had significant superior therapeutic effects on exosomes in restoring the normal histological architecture of the ovary and fertility. In summary, cell free treatment is a safe approach for tissue regeneration. Stem cell-derived CM was more effective than exosomes in restoring normal histological structure of the ovaries and fertility in animal models of polycystic ovary.

2022 Winners: Kathleen Scheffler, Federica Giannini and Tom Lemonnier

2022 Winners: Kathleen Scheffler, Federica Giannini and Tom Lemonnier

A Tale of 5Ms: Massive Uterine Leiomyoma Mimicking Ovarian Malignancy along with Multiple Fibroids Displaying Multiple Degenerations

Background: Leiomyomas are by far the commonest uterine neoplasms in the female reproductive age group. Giant leiomyomas are quite scarce and when longstanding tend to undergo various degenerations owing to decreased blood supply which on imaging may simulate malignancy owing to compromised blood supply and may simulate malignancy on imaging.Case Presentation: We present a case of a 48-year-old post-menopausal multiparous woman complaining of intermittent lower abdominal pain for a month. Suspected as an ovarian tumor clinically and on ultrasound, this was seconded by raised serum CA125 levels. Histopathological examination gave a definitive diagnosis of a giant uterine leiomyoma along with multiple fibroids exhibiting multiple degenerations.Conclusion: Degenerated leiomyomas can masquerade malignancy and hence should be one of the first differentials in women of reproductive age group presenting with complex abdominopelvic masses.

HUBUNGAN PERAWATAN PAYUDARA IBU PADA MASA POST PARTUM DENGAN MENYUSUI EKSKLUSIF DI PUSKESMAS ULU MORO’O NIAS BARAT TAHUN 2022

The WHO recommends that exclusive breastfeeding for six months must be carried out worldwide because it has benefits for both mother and baby, and is the baby's right to get breast milk. This study aims to determine whether there is a relationship between maternal breast care in the postpartum period and exclusive breastfeeding at the Ulu Moro'o Health Center, West Nias. This research is a quantitative study using an analytic design with a cross-sectional approach. The number of 60 respondents is based on the Slovin formula, with a total sampling in December 2021. Data collection uses a questionnaire about characteristics and breast care. The results showed that the majority (90%) were female reproductive age 20-35 years old, household work (91.7%), multiparous (61.7%), normal delivery (90%), and breastfeeding history was not the first experience (78.3%). The results of the chi-square test showed that there was no relationship between breast care (massage p= 0.467; warm or cold compresses p= 0.601) of mothers during the postpartum period with exclusive breastfeeding, so it was concluded that breastfeeding problems could not only be overcome by breast care such as massage or breastfeeding. However, it requires the cooperation of health workers in making skin-to-skin contact and IMD which is the first step in maintaining breastfeeding. The Puskesmas is expected to provide alternatives or other methods of breast care as well as education at least twice during pregnancy to mothers according to government regulations and intensive assistance to mothers in carrying out breast care education.

Large parasitic leiomyoma mistaken for an ovarian mass: A case report

Introduction: Uterine leiomyomas, commonly known as fibroids, are benign tumors composed of uterine myometrial tissue which are the most prevalent pelvic masses during female reproductive age. Abnormal uterine bleeding is the most common symptom. When a fibroid undergoes separation from the uterus and grows extensively it can cause difficulty in making an accurate diagnosis and limit potential treatment options. Case Report: This case report discusses a large pelvic mass found in a 40-year-old female. Because of the size of the mass and inadequate diagnostic imaging, a proper diagnosis was difficult to establish, so the patient underwent surgical management. A total abdominal hysterectomy with bilateral salpingectomy and right oophorectomy was performed with additional unexpected intraoperative findings. Conclusion: Parasitic leiomyomas can cause atypical patient presentations. They can grow to occupy a great amount of space in the abdominopelvic cavity which can create obstacles during diagnostic workup. This report demonstrates how a relatively rare type of fibroid can be easily misdiagnosed and lead to limited treatment options.

State of the art in assisted reproductive technologies for patients with advanced maternal age.

According to the World Health Organization, the female reproductive age lasts up to 49 years, but problems with the realization of women's reproductive rights may arise much earlier. Significant numbers of factors affect the state of reproductive health: socioeconomic, ecological, lifestyle features, the level of medical literacy, and the state of the organization and medical care quality. Among the reasons for fertility decline in advanced reproductive age are the loss of cellular receptors for gonadotropins, an increase in the threshold of sensitivity of the hypothalamic-pituitary system to the action of hormones and their metabolites, and many others. Furthermore, negative changes accumulate in the oocyte genome, reducing the possibility of fertilization, normal development and implantation of the embryo and healthy offspring birth. Another theory of ageing causing changes in oocytes is the mitochondrial free radical theory of ageing. Taking into account all these age-related changes in gametogenesis, this review considers modern technologies aimed at the preservation and realization of female fertility. Among the existing approaches, two main ones can be distinguished: methods allowing the preservation of reproductive cells at a younger age using ART intervention and cryobanking, as well as methods aimed at improving the basic functional state of advanced-age women's oocytes and embryos.

Factors Affecting Infertility in Women of Reproductive Age in the IVF Programme

Approximately 8-10% of couples are facing some kind of infertility problem. Infertility is defined as a couple's inability to achieve pregnancy over an average of one year without using birth control methods and while engaging in normal sexual intercourse. Primary and secondary infertility are the two types of infertility. The high percentage of female reproductive age factors influencing infertility, as well as existing studies on infertility-related factors in women, piques the researcher's interest in studying the factors that influence infertility in women. This study is an observational descriptive-analytic with a chi-square design based on secondary data collected from medical records. The majority (37,6%) of infertile women in this study were within the 31-35 age group. Most of the infertile women are primary infertile type women (81%). Indications that cause infertility include an indication of tubal damage, uterine disorders of the endometrium, and ovulation problems. In this case, researchers used these three indications to examine infertility factors in women of reproductive age. Based on the study results, 25% of indications of tubes, 21.7% of endometrial indications, and indications of ovarian problems were calculated by looking at AMH (Anti Müllerian Hormone) and AFC (Antral Follicle Count) values. In this study, the researchers looked for a correlation between increasing age in reproductive women with increasing AMH and AFC levels. Based on random sampling, there was a significant correlation between the increasing reproductive age of women and decreasing AMH and AFC values in women of reproductive age who underwent therapy at Bunda International Clinic, Morula IVF Jakarta.

Analytical Study of Suicidal Deaths in Female Reproductive Age Groups, Based on Autopsies Conducted in GGH, Mortuary

Suicidal death is nothing but ending one’s own life, which is the most daunting human tragedies and a seriouspublic health problem. As for NCRB the suicide rate has increased from 6.2% (2020) to 7.2% (2021).This study takes100 cases retrospectively for the duration of 6 months. All suicidal deaths postmortem examinations are donein the reproductive age group females from April 2022 to September 2022. Those deaths occurred on the spot,or in the GGH Guntur, while undergoing treatment. The distribution of cases based on age, geographical area,marital status, educational status, place of occurrence, history of previous attempt of suicide, hormonal status infemale, case of death and motive behind the suicide. Majority of cases belong to age group 19-29 years and 58%of urban population committed suicide with common motive behind the suicide is failure in exam. Preferredmethod for death is ingestion of poison which is seen in 46% of cases. Victims with changes in hormonal statuslike in menstruation are considerable in number. Family history of committing suicides or history of suicides inthe neighbors have provocated some people. Counselling of such identified group of people at various levelswill help the needy victims and decrease the suicide incidence.

Comparison of daily oral iron replacement therapy with every other day treatment in female reproductive age patients with iron-deficiency anemia

Iron-deficiency anemia (IDA) is accepted as the most common cause of anemia in the world. The main goals of iron replacement therapy are to normalize the hemoglobin level and to replace iron stores. Current guidelines for treating iron deficiency recommend daily divided doses of iron to increase absorption. Hepcidin is a key regulator of systemic iron balance and acts in harmony with intracellular iron metabolism. Daily dosing and divided doses may increase serum hepcidin and decrease iron absorption. In this study, it was aimed to compare the effectiveness of daily and every other day oral iron replacement therapy in women of reproductive age with iron-deficiency anemia. We included premenopausal female patients aged between 18 and 50years with iron-deficiency anemia. Forty patients were given oral iron therapy at a daily dose of 2*80mg (iron sulfate). Forty-three patients were given iron treatment at a dose of 2*80mg (iron sulfate) every other day. After 2months of oral iron therapy, there was a significant improvement in hemoglobin, mean corpuscular volume, serum iron, total iron-binding capacity, and transferrin saturation in both groups. The values of hemoglobin, serum iron, transferrin saturation, and ferritin significantly increased at the end of the treatment for both groups. Although the median hepcidin level on the 15th-day measurement in the every other day treatment group was higher than that in the daily treatment group, there was no significant difference. As a result, the patients' compliance with the treatment can be increased by offering treatment every other day instead of daily, since it provides similar treatment effectiveness.

Strategi Manajemen Informasi Iklan Layanan Masyarakat Keluarga Berencana (Studi Kasus di Dinas Pengendalian Penduduk, Pemberdayaan Perempuan dan Perlindungan Anak Kota Surabaya)

This study aims to identify and explore the information management strategy of public service advertisements about Family Planning carried out by the Department of Population Control, Women's Empowerment, and Child Protection (DP5A) of Surabaya City. This study focuses on information management strategies for Public Service Advertisements about the Family Planning program and the latest advertisements of the BKKBN about "The Importance of Independent Family Planning in a Pandemic", where BKKBN urges the public, especially couples of childbearing age to delay pregnancy in the Covid-19 pandemic era. This research was conducted at the DP5A of Surabaya City using a descriptive method, a qualitative approach. The data collection technique in this study used interviews, observations, and documentation conducted by researchers to leaders, staff employees, IMP cadres, and target communities in the Public Service Advertising family planning program in Surabaya City. The results of this study indicate that the information management strategy of Public Service Advertising of Family Planning in the DP5A of Surabaya City is made in the form of images and videos which are disseminated by utilizing the Website and Social Media such as Instagram and Youtube. Furthermore, the DP5A of Surabaya City also utilizes IMP cadres owned by DP5A of Surabaya City to reach out to people who are not active on electronic media. In addition, the production of advertising materials at the DP5A of Surabaya City begins with instructions given by the Head of the Division which is then followed up by the Chair of Sie and the Field Staff until the advertisement is declared ready to be distributed to the target community. After the advertisement is declared ready to be distributed, the Head of Division and the Head of Sie approve and determine the strategy for distributing the advertisement so that it can be well received by the target community, and after that, the IT staff disseminates the advertisement following the orders and directions given. In this era of the COVID-19 pandemic, the BKKBN provided information and messages, in particular, in the form of a video about "The Importance of Independent Family Planning in a Time of Pandemic", where this was done because it was feared that due to restrictions on social activities in the community, many female reproductive age women experienced unplanned pregnancies that resulted in pregnancy loss that will increase the safety risk to mother and child. This research is limited to a discussion of information management strategies for public service advertisements about family planning in DP5A Surabaya City so that further research needs to reveal the effectiveness of PSAs conducted by DP5A Surabaya City to know how effective it is.

Anti-Mullerian hormone concentrations are inversely associated with subclinical atherosclerosis in premenopausal women

Abstract Background Anti-Müllerian hormone (AMH) constitutes a marker of ovarian reserve and appears to have a predictive role regarding the time of menopause. Moreover, AMH is associated with adverse cardiac events. History of premature menopause and early onset of menopause have been associated with increased risk of cardiovascular (CV) disease. In addition, menopausal transition and duration of menopause have been associated with increased burden of subclinical atherosclerosis. However, the association between AMH as a marker of female reproductive age with atherosclerosis in premenopausal women is currently unknown. Purpose To investigate whether AMH concentrations are associated with markers of early atherosclerosis in healthy, normally menstruating women. Methods In a cross-sectional study, vascular structure and function were assessed by measurement of carotid and femoral intima-media thickness (IMT), lipid profile and serum AMH concentrations were assessed. Exclusion criteria were clinically overt CV disease, abnormal ovulatory cycles, polycystic ovarian syndrome, acute infection or chronic inflammatory disease, risk factors for CV disease and any medication Results Seventy premenopausal women, aged 32.7±6.5 years, were included. Mean AMH levels were lower in smokers than in non-smokers and negatively associated with total cholesterol (TC) levels. An inverse association between mean AMH concentrations and IMT in all segments was observed. No correlation with other markers of subclinical atherosclerosis or traditional CV risk factors was found. After multi-variable adjustment for traditional CV risk factors, the association between AMH concentrations combined IMT and carotid bulb IMT, remained significant. Conclusions In healthy, normally ovulating women, low AMH concentrations are associated with an adverse lipid profile and subclinical atherosclerosis, independently of traditional CV risk factors. This finding suggest a role of decreased follicular reserve with atherosclerotic disease. Funding Acknowledgement Type of funding source: None