Fertile Age Research Articles

Knowledge differences on the impact of age on fertility among fertile and subfertile women.

To explore the knowledge concerning the impact of age on fertility in Thai women among fertile and subfertile women. A cross-sectional study was conducted at Maharaj Nakorn Chiang Mai Hospital, Thailand. The questionnaires consisted of sociodemographic questions and knowledge pertinent to the impact of age on fertility. Both fertile and subfertile women completed the same questionnaire anonymously. A total of 500 women were included in the study, with two hundred and fifty in each group. The majority of women in both the fertile and subfertile group correctly identified the most fertile age of women (84.8% vs. 84.4%, p=0.902) and the impact of age on infertility treatment (73.2% vs. 84.0%, p=0.003). However, only one-fifth of the participants in both groups correctly identified the age that their fertility starts to decline, show a marked decline and ends. Most women in both groups chose the answer that overestimates their fertility potential. Moreover, 10.8% of subfertile women believed that fertility is not dependent on age and 16.0% believed that age does not affect the success rate of infertility treatment. The overall knowledge of women regarding the impact of age on fertility is relatively poor with no difference between fertile and subfertile women. These findings may indicate an urgent need to increase this area of knowledge in the population.

Pathophysiology of Maternal Obesity and Hypertension in Pregnancy

Obesity is one of the biggest health problems in the 21st century and the leading health disorder amongst women of fertile age. Maternal obesity is associated with several adverse maternal and fetal outcomes. In this group of women, the risk for the development of hypertensive disorders of pregnancy (HDPs), such as gestational hypertension (GH) and pre-eclampsia (PE), is increased. In fact, there is a linear association between an increase in pre-pregnancy body mass index (BMI) and PE. Excessive weight gain during pregnancy is also related to the development of PE and GH. The role of obesity in the pathophysiology of HDP is complex and is most likely due to an interaction between several factors that cause a state of poor maternal cardiometabolic health. Adipokines seem to have a central role in HDP development, especially for PE. Hypoadiponectinemia, hyperleptinemia, insulin resistance (IR), and a proinflammatory state are metabolic disturbances related to PE pathogenesis, contributing to its development by inducing a state of maternal endothelial dysfunction. Hypertriglyceridemia is suggested to also be a part of the disease mechanisms of HDP. Therefore, this review seeks to explore the scientific literature to assess the complications of maternal obesity and its association with the development of HDP.

Unmet need in fertile age couples based on PK-21 data at stunting locus in Tapin Regency

Background: Unmet need for family planning remains a significant public health issue, particularly in regions with high population growth and stunting prevalence. Tapin Regency in South Kalimantan Province experiences challenges in achieving family planning targets, with unmet need contributing to elevated fertility rates and population growth. Objective: This study aims to analyze the unmet need for family planning among fertile age couples in stunting locus sub-districts of Tapin Regency, focusing on the distribution of unmet need for spacing and limiting, and identifying potential areas for targeted intervention. Method: A descriptive survey design was employed using secondary data from the PK-21 (Pendataan Keluarga 2021 [En: Family Cencus – 2021]) database provided by the National Population and Family Planning Board (BKKBN). The study analyzed data from 12 sub-districts identified as stunting loci in Tapin Regency. The data included total unmet need, unmet need for spacing, and unmet need for limiting, which were quantitatively processed and presented as percentages. Results: The analysis revealed that the total unmet need in Tapin Regency reached 9.5%. The unmet need for limiting (65.1%) was significantly higher than for spacing (34.8%). Among the sub-districts, Binuang recorded the highest total unmet need (19.2%), while South Candi Laras had the lowest (3.5%). Sub-districts with higher unmet need were found to have greater challenges in family planning program implementation, necessitating targeted interventions. Conclusion: Unmet need for limiting dominates the family planning challenges in Tapin Regency, particularly in sub-districts with high fertility rates. Addressing these unmet needs requires tailored strategies, including enhancing awareness, accessibility, and cultural sensitivity of family planning programs.

Late-Onset Lupus Nephritis: Clinical-Epidemiological, Histological, Prognostic, and Therapeutic Implications: A Single-Center Experience from Northeastern Spain

Introduction: Systemic lupus erythematosus (SLE), as an autoimmune disease, and lupus nephritis (LN), are typically diagnosed in women at fertile age. Late-onset SLE is defined as a disease onset over 45–50 years. Our main objective was to analyze the clinical, histological, prognostic, and therapeutic features related to LN in our late-onset SLE population. Methods: A single-center and retrospective study was performed comparing clinical-demographic, histological, prognostic, and therapeutic features of 45 LN patients from 1994 to 2023. We divided the study population according to the age of onset of LN into classic onset (<45 years) and late onset (≥45 years). Results: Late-onset LN patients showed a higher association with Sjögren’s and antiphospholipid syndrome, more cardiovascular comorbidities at presentation, poorer renal function at diagnosis, and higher Systemic Lupus Damage Index (SDI) score. Histology showed more nonproliferative LN classes (II and V). Late-onset LN responders, compared to those with classic onset, achieved response later. Nonresponsive patients had a higher incidence of acute kidney injury (AKI), more glomerulosclerosis and interstitial fibrosis-tubular atrophy (IFTA) at presentation, and a higher frequency for renal replacement therapy (RRT) at diagnosis and during follow-up. The main independent variables associated with relapse were younger age at SLE diagnosis and initial partial renal response (PRR). Conclusions: Late-onset LN is often accompanied by other systemic autoimmune diseases such as Sjögren’s and antiphospholipid syndrome. These patients have major cardiovascular comorbidities, poor estimated glomerular filtration rate (eGFR) at diagnosis, and increased chronicity index in histology. A tailored approach in this fragile population in order to avoid unnecessary immunosuppression is of critical interest.

The impact of systemic sclerosis on women's health evaluated with an ad hoc-developed patient-reported questionnaire.

The impact of disease on women's health-related quality of life has become increasingly important in patients with rheumatic diseases (RDs). Systemic sclerosis (SSc) mostly affects women with a broad spectrum of clinical presentations and severity, and a variable impact on daily living. The objective of the present study was to specifically address "women's health" in systemic sclerosis patients through a dedicated questionnaire. An anonymous self-reported questionnaire (only in Italian) was developed in collaboration with obstetricians and gynecologists and subsequently revised and approved by five patient representatives. The questionnaire was administered to SSc patients during scheduled visits in an outpatient Rheumatology SSc Clinic. Between April 2021 and March 2023, 168 patients accepted to participate; among them, 44.1% had received their SSc diagnosis during reproductive age (<45 years). The questionnaire was composed of 44 questions and included 5 sections encompassing different topics. A high rate of adherence to female cancer screening programs was recorded (86.9% for cervix and 93.6% for breast cancer), while a non-regular gynecological follow-up was observed in 36.4%, mostly in patients with more severe disease phenotype. Only 42.3% accepted to compile the Female Sexual Function Index (FSFI), which indicated a sexual dysfunction (score ⩽ 26.55) in 66.2% of patients. A worse sexual function was shown to be associated with different disease manifestations, including digital ulcers. More than 90% of patients who expressed a desire for pregnancy after diagnosis received medical pre-conception counseling and were satisfied with the information provided. In contrast, discussion about contraception occurred in 37.8% of patients who had been diagnosed during fertile age. Family planning still represents an unmet need, as 43.6% of patients did not achieve their desired family size, mainly due to concerns about their capacity to care for their children. The newly developed questionnaire provides a unique opportunity to comprehensively assess the experience of women with SSc. Disease burden was shown to negatively impact sexual function and adherence to regular gynecological visits. Furthermore, receiving a diagnosis during reproductive age may increase the likelihood of a reduced family size. Clinicians who take care of women with SSc should implement these domains into routine management, thus improving the health literacy of their patients.

Reduced childbirth rates in multiple sclerosis from the prodromal phase: Evidence from a population-based cohort study.

The age of multiple sclerosis (MS) onset coincides with fertile age, and both improved prognosis and treatment may influence birth rates in people with MS (pwMS). To investigate birth rates over time in pwMS compared with controls. This cohort study included pwMS from three hospitals in the southeast of Norway. Clinical data were collected prospectively. Statistics Norway provided year of live births and marital status in pwMS and controls matched for age, sex, and place of residence at age 16. We included 1599 pwMS (1118 women with MS (wMS) and 481 men with MS (mMS)) and 23,855 controls. The mean number of live births was 1.5 (standard deviation (SD) 1.2) for pwMS versus 1.8 (SD 1.2) for controls (p < 0.001). Birth rates in wMS declined significantly starting 3 years before onset, with 4.5% giving birth versus 8.4% of controls 2 years before onset (p = 0.046). Birth rates were also lower 1 year after onset (p = 0.002). mMS showed a dip 2 years before onset (p = 0.002), but otherwise had rates similar to controls. There were no differences in marital status. wMS have reduced rates of childbirth compared with controls. This is significant already in the prodromal phase.

THE INFLUENCE OF EDUCATION THROUGH BOOKLET MEDIA ON KNOWLEDGE ABOUT LONG TERM CONTRACEPTION METHODS IN WOMEN

The long -term contraceptive method is the most effective contraceptive method for reducing birth rates but its users are only 20.3%. The National Family Planning Program prioritizes the use of Long -Term Contraception Methods, but the scope of long-term contraception is still low. This study aims to analyze the effect of education through media booklets on knowledge of long -term contraceptive methods in women of childbearing age in the village of Kajoran Klaten Selatan. The type of research is a quantitative research, with the Without Control Design pretest-post approach with the research sample is a woman of fertile age in Kajoran Village, amounting to 52 women of childbearing age. The study was conducted in May 2024. Statistic test using descriptive statistics and Wilcoxon test. The results showed that there was there an increase in the average knowledge value of respondents before and after being given education through booklets. From 73.8 to 84.3 with an increase in score of 10,5. the effect of providing education through booklets on the knowledge of women of childbearing age about the long -term contraceptive method with p value 0,000 (&lt;0.05).

Novel biomarkers in bone pathophysiology: Establishing reference intervals and biological variations estimates for serum leptin, sclerostin, lipocalin-2, osteoprotegerin, resistin and Dickkopf-related protein-1 from the European biological variation study (EuBIVAS) populations.

Novel biomarkers in bone pathophysiology: Establishing reference intervals and biological variations estimates for serum leptin, sclerostin, lipocalin-2, osteoprotegerin, resistin and Dickkopf-related protein-1 from the European biological variation study (EuBIVAS) populations.

Environmental, social, and governance investing and sustainability of pension funds: Evidence from the Organisation for Economic Cooperation and Development countries

Environmental, social, and governance investing and sustainability of pension funds: Evidence from the Organisation for Economic Cooperation and Development countries

Factors Influencing Fertile Age Couples in the Use of Long-Term Contraceptive Methods (MKJP)

The success of the National Family Planning (KB) Movement in encouraging increased community participation in building increasingly independent small families must be considered and even improved because this achievement is not evenly distributed. Likewise, what happened in the Patiluban Mudik Health Center work area where the number of Fertile Age Couples using KB was only a portion of the total number of Fertile Age Couples recorded up to May 2023, which was 514 PUS. The purpose of the study was to determine the factors that influence fertile age couples in terms of the use of Long-Term Contraceptive Methods (MKJP) in the Patiliuban Mudik Health Center Work Area, Natal District, Mandailing Natal Regency in 2023. The research method is quantitative research with a cross-sectional study design approach. The study was conducted in the working area of ​​Patiluban Mudik Health Center with a sample size of 92 people. The analysis used was Chi Square. The results showed a significant relationship between knowledge and the use of MKJP (P value = 0.018 &lt;0.05), there was a significant relationship between family support and the use of MKJP (P value = 0.0033 &gt; 0.05). There was a relationship between parity and the use of MKJP (P value = 0.011 &lt;0.05), The results of this study recommend that Patiluban Mudik Health Center be more intensive in providing counseling about MKJP so that the number of KB users, especially MKJP, can be increased and to find factors that influence PUS not to be willing to use the MKJP method.

P0532 Exploring biomarkers of systemic oxidative stress and placental insufficiency in pregnant women with Inflammatory Bowel Disease

Abstract Background Inflammatory bowel disease (IBD) often presents during the fertile age and may affect pregnancy outcomes. Both IBD and selected pregnancy complications involve oxidative stress. Soluble FMS-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) serve as biomarkers of placental insufficiency, while free thiols (FT) reflect systemic oxidative stress. This study aimed to assess the dynamics of FT, sFlt-1, and PlGF before, during, and shortly after pregnancy, and their relationships with disease- and pregnancy outcomes in patients with IBD. Methods This retrospective cohort study included pregnant women with and without IBD (Figure 1). FTs were measured with colorimetric detection; sFlt-1 and PlGF were measured using immunofluorescent assays. Extensive clinical data were collected, including pregnancy complications and IBD parameters. Differences between groups during pregnancy were assessed using nonparametric tests. Linear mixed-effects models were used to assess longitudinal changes of biomarkers before, during, and after pregnancy. Results A total of 40 patients and 14 non-IBD controls participated, covering 57 IBD and 14 control pregnancies. Serum FT levels were significantly lower in patients with ulcerative colitis during pregnancy (p=0.007, Fig. 2A) and decreased compared to pre-conceptional levels (p=0.005, Fig. 2B), indicating increased oxidative stress. Conversely, sFlt-1/PlGF ratios were not significantly different across groups (Fig. 2C). sFlt-1/PlGF ratios were higher in patients with small-for-gestational-age infants (p=0.015, Fig. 2D). Post-pregnancy FT levels were lower in patients experiencing disease exacerbations during pregnancy (p=0.046, Fig. 2E), whereas sFlt-1/PlGF ratios were numerically higher (p=0.063, Fig. 2F). IBD severity correlated with lower FT levels, as reflected in patients with a surgical history (p=0.066, Fig. 2G) and those using biologics at time of sampling (p=0.033, Fig. 2H). Conclusion This study demonstrates increased systemic oxidative stress in patients with IBD during pregnancy, as reflected by lower FT levels compared to pre-conceptional values and non-IBD controls. This was especially pronounced in patients with higher disease activity and severity. Prospective validation is required to evaluate the utility of these biomarkers in predicting pregnancy complications and informing clinical decision-making.

Analyzing regional demographic threats in the context of economic security

Subject. This article discusses the impact of demographic factors on the economic security of Russia and its regions. Objectives. The article aims to compare federal districts of Russia by nature of demographic threats. Methods. For the study, we used the general scientific research methods. Results. The article finds that low fertility and population aging are the most serious demographic threats in almost all federal districts, and it describes the most significant differences between the Russian federal districts in various parameters. Conclusions. To overcome demographic imbalances and strengthen Russia's economic security, a set of differentiated measures of State policy is needed at the federal and regional levels.

Factors Influencing the Behavior of Visual Inspection of Acetate (VIA) Examination in Couples of Fertile Age

Factors Influencing the Behavior of Visual Inspection of Acetate (VIA) Examination in Couples of Fertile Age

Impact of Oncological Treatments on Reproductive Capacity: Alternatives to Minimize Risks and the Role of DEX Immunotherapy

Fertility preservation in cancer patients is an increasingly relevant challenge due to the gonadotoxic effects of conventional treatments, such as chemotherapy and radiotherapy. This article reviews current options for fertility preservation and explores the potential of DEX immunotherapy as a less invasive alternative. Initially, an overview of cancer incidence in fertile age and the importance of addressing reproductive concerns in this population group is presented. Subsequently, the negative impacts of conventional treatments on reproductive capacity are analyzed and strategies to minimize these risks, such as reducing treatment intensity and using cryopreservation techniques, are discussed DEX immunotherapy stands out as a promising option, with a lower risk of gonadotoxicity compared to traditional treatments. This immunological approach allows to specifically target cancer cells, reducing damage to reproductive cells and offering better fertility preservation in young patients. Finally, the article addresses future research needs and practical guidelines for clinicians, highlighting the importance of a multidisciplinary approach that integrates fertility preservation options in cancer treatment. It is concluded that, although DEX immunotherapy is a viable alternative, it is essential to promote further research and develop specific clinical protocols to maximize its effectiveness and safety in terms of long-term reproductive health

THE EXPERIENCES OF COLORECTAL CANCER SURGERY AMONG OLDER PATIENTS WHO LIVED ALONE IN TAIWAN

Abstract In Taiwan, it is a common practice that family takes care of their older adults when hospitalized. However, people who were never married or living alone would face challenges in coming up with a caregiver in the hospital. The shortage of caregiver among Taiwanese older population was due to its low fertility and high aging rate as Taiwan will enter a super-aged society in 2025. The purpose of this paper was to understand how inpatient surgical experiences on older adults who lived alone. The research methodology used qualitative interviews with structural questions followed by content analysis. Eight older adults participated to share their experiences who live alone and hospitalized for colorectal cancer surgery. The result showed that prognosis, postoperative care and Activities of daily living(ADL) were concerned. Older adults living alone were not only worried about the results of the surgery but also concerned about their reduced self-care ability and postoperative care without help. In addition to determining the recovery of digestive system function, doctors consulted rehabilitation to strengthen their mobility, taking into account the factor of living alone. Based on the results, the author suggested that it is essential to discuss postoperative care arrangements and whether the patient will be able to regain their self-care abilities after surgery. With the increasing number of people living alone, greater emphasis should be placed on the patient’s own decisions not relatives. For older patients living alone and undergoing inpatient surgery, developing in-hospital rehabilitation plans is crucial to strengthen their self-care abilities.

Edukasi Persiapan Psikologi Pada Wanita Usia Subur Untuk Masa Prakonsepsi

Data from the World Health Organization (WHO) shows that around 10% of pregnant women and 13% of new mothers experience mental disorders, especially depression. In developing countries this figure is even higher, at 15.6% during pregnancy and 19.8% after childbirth. To prevent similar cases, it is necessary to prepare for pregnancy which can be done during the preconception period, namely the treatment period before pregnancy occurs with a time span of three months to one year before conception. Therefore, Education on Psychological Preparation of Women of Fertile Age for Preconception Preparation at the Bara-Barayya Health Center through community service activities is considered necessary with the aim of changing the views of women of childbearing age and families related to psychological health and behavior that can affect it as an effort to prepare for preconception. The method used was lecture and question and answer. The participants who attended the counseling consisted of 23 people where the post-test evaluation showed the participants' better understanding of efforts to maintain mental health can help mothers prepare for pregnancy in the preconception period. Conclusion: counseling participants, namely women of childbearing age, understand the importance of psychological preparation during the preconception period

Preconceptional Reproductive Risk in women of childbearing age. Preventive, clinical and epidemiological approach

Introduction: Prevention of preconceptional maternal risk is important to avoid complications and death during the reproductive process. Methods: An observational, descriptive and cross-sectional study was carried out from 2023 to April 2024 in women of childbearing age with preconceptional reproductive risk (RRPC) residing in the community served by the Pedro Borrás Astorga Polyclinic in the municipality of Pinar del Río, in the province of the same name. The universe consisted of 5761 women of fertile age between 15 and 49 years old from the family doctor's and nurse's offices of the aforementioned polyclinic who gave their consent to participate in the research. The data collection was carried out from the controls recorded in the individual medical records and information provided by the statistics department of the center, in addition to the survey applied by the author of the research to a sample of 606 women with RRPC, with prior informed consent (Annexes 1 and 2).Results: the current trends in the development of the object of study were identified, determining irregularities that made possible the transformation of the inadequacies Conclusions: The risk factors mostly associated with RRPC in our polyclinic were determined, which will allow the establishment of future strategies in a problem yet to be solved

Seroprevalence and infection by human parvovirus B19 in pregnant women from Córdoba, Argentina, 2021-2022

parvovirus B19 (B19V) infection during pregnancy can be transmitted to the fetus and cause serious complications such as fetal hydrops and stillbirth. The preexistence of specific IgG prevents vertical transmission. Seroprevalence in fertile age is variable (50-70%) and depends on the region/viral circulation, in addition to factors such as maternal age and frequent exposure to children. to determine seroprevalence for B19V in pregnant women at Hospital Universitario de Maternidad y Neonatología (HUMN), analyze its association with predictive factors and describe cases of B19V infection. observational, cross-sectional study. Patients treated at HUMN during 2021-2022 were included and compatible demographic and clinical data were recorded. Specific IgG was quantified and its association with predictive factors was analyzed by bivariate analysis (p<0.05). In cases with signs/symptoms associated with B19V, specific IgM and viral DNA were also determined. Results: 317 cases were studied and anti-B19V IgG was detected in 214/317 (67.5%). No association was found between seroprevalence and maternal age, multiparity, cohabitation with children under 15 years of age, or presence of maternal/fetal signs/symptoms. Ten cases (10.4%) of B19V infection were identified, all of them with anemia and one with fetal hydrops and VDRL+. in the population studied, B19V seroprevalence for was 67.5% and independent of the predictive factors, leaving 32.5% without evidence of exposure to the virus (susceptible to contracting the infection in the future). The detection of infection in symptomatic cases indicates the importance of investigating B19V in this group.

A Ketogenic Diet Followed by Gradual Carbohydrate Reintroduction Restores Menstrual Cycles in Women with Polycystic Ovary Syndrome with Oligomenorrhea Independent of Body Weight Loss: Results from a Single-Center, One-Arm, Pilot Study.

Background/Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of fertile age. Some studies suggest that a ketogenic diet (KD) may have a role in treating PCOS. We aimed to demonstrate the long-term effectiveness of a KD in PCOS. Methods: Eighteen patients with PCOS phenotype A were enrolled: 28% were of normal weight, 28% were overweight, and 44% had obesity. All participants followed a KD without meal replacements for 45 days. After this period, patients underwent gradual carbohydrate reintroduction over 45 days, and thereafter healthy eating indications were given. Twelve patients completed the study. The patients were assessed at baseline and after 6 months. Anthropometric data, body composition, pelvic ultrasound, blood chemistry, hirsutism, and menstrual cycles frequency were recorded; Results: Besides improvement in anthropometric parameters, menstrual cycles (p 0.012), ovarian volume (p 0.029), FSH (p 0.05), LH (p 0.037), and progesterone (p 0.017) improved independently of weight or fat loss. However, testosterone and hirsutism improvements were influenced by weight and fat mass reduction. Conclusions: Our study showed that a KD followed by gradual carbohydrate reintroduction in PCOS has beneficial effects medium term, mostly independent of body weight loss, even in normal-weight women, suggesting that nutritional ketosis exerts beneficial effects per se.

Contraception Use in Cancer Survivors, Clinical Practice and Patients' Preferences.

Current literature suggests that emergency contraception, defined as a therapy aimed at preventing an unwanted pregnancy after unprotected or insufficiently protected intercourse, is used more by cancer survivors than by the general population. This may be related to reduced use of contraception in women after cancer diagnosis and, when it is used, to a choice of less effective methods, even in the absence of contraindications to hormonal options. The purpose of this review is to analyze the use of contraception in these patients, its predictors and the preferred methods, as well as to try to define timing and characteristics of an effective contraception counseling. Factors identified as predictors of contraception usage were younger age, having a partner and better sexual function, having children, past use and having received contraception counseling by a gynecologist, especially in the previous year. Contraception counseling should start before oncological therapies, together with information regarding fertility and sexual health, preferably by the gynecologist of the oncofertility unit, with a specific expertise in dealing with cancer patients. Increased awareness of oncologists and family medicine doctors is fundamental to optimize contraception use and compliance with the prescribed method. Major guidelines regarding oncological care in women of fertile age already recommend contraception counseling, but optimal timing and mode of the consultation(s) options should be further researched, to be better detailed in all relevant documents.