Fertility History Research Articles

Impact of Viruses on Prokaryotic Communities and Greenhouse Gas Emissions in Agricultural Soils.

Viruses are abundant and ubiquitous in soil, but their importance in modulating greenhouse gas (GHG) emissions in terrestrial ecosystems remains largely unknown. Here, various loads of viral communities are introduced into paddy soils with different fertilization histories via a reciprocal transplant approach to study the role of viruses in regulating greenhouse gas emissions and prokaryotic communities. The results showed that the addition of viruses has a strong impact on methane (CH4) and nitrous oxide (N2O) emissions and, to a minor extent, carbon dioxide (CO2) emissions, along with dissolved carbon and nitrogen pools, depending on soil fertilization history. The addition of a high viral load resulted in a decrease in microbial biomass carbon (MBC) by 31.4%, with changes in the relative abundance of 16.6% of dominant amplicon sequence variants (ASVs) in comparison to control treatments. More specifically, large effects of viral pressure are observed on some specific microbial communities with decreased relative abundance of prokaryotes that dissimilate sulfur compounds and increased relative abundance of Nanoarchaea. Structural equation modeling further highlighted the differential direct and indirect effects of viruses on CO2, N2O, and CH4 emissions. These findings underpin the understanding of the complex microbe-virus interactions and advance current knowledge on soil virusecology.

Deciphering the active bacteria involving glucose-triggered priming effect in soils with gradient N inputs

The soil priming effect, which refers to the alteration of soil organic matter (SOM) decomposition due to labile carbon (C) inputs, is widely acknowledged for its impact on C storage in terrestrial ecosystems. However, the impact of chronic nitrogen (N) fertilizer on soil priming effect, particularly in agroecological systems, remains unclear. Here, we utilized soils subjected to varying levels of N fertilization (0, 140, 280, 470, and 660 kg N ha−1 y−1), which were collected from a long-term experimental site. Enzyme activity related to C, N, and phosphorus (P) acquisition was measured using the fluorometric method. Additionally, DNA-based stable isotope probing with 13C-labeled glucose was conducted to explore the role of active bacterial communities (16S rRNA gene analysis) on the priming effect in soils with different N fertilization histories. Glucose addition enhanced the decomposition of native SOM and induced positive priming effects in all soils, which were amplified by the historical N application level. Activity of C-related enzymes essential for soil C decomposition increased following glucose addition, which was positively correlated with the soil priming effect. Active bacterial taxa, primarily Firmicutes, Actinobacteria, and Proteobacteria, were capable of assimilating exogenous glucose-C or native SOM-C. Notably, bacteria assimilating glucose exhibited higher abundance-weighted average ribosomal RNA gene operon copy number than those assimilating SOM, indicating the role of r-strategists in accelerating SOC turnover and increasing C loss. These findings highlight the role of active microbial community attributes on the soil priming effects. This study provides new insights into the intricate processes of C transformation in soils subjected to long-term N management in agroecosystems.

Mapping domains of early life determinants of future multimorbidity across three UK longitudinal cohort studies

Many studies use a reductionist approach to isolate the influence of one factor in childhood on multimorbidity rather than consider the combined effect of wider determinants. We explored how potential multiple early life determinants of multimorbidity can be characterised across three UK cohort studies. We used the National Child Development Study (NCDS), the 1970 British Cohort Study (BCS70), and the Aberdeen Children of the 1950s Study (ACONF) to identified early life variables that fit into 12 conceptualised domains of early life determinants of multimorbidity. Variables were assigned into 12 domains; principal component analysis reduced the dimensionality of the data and structured variables into subgroups. The data audit identified 7 domains in ACONF, 10 domains in NCDS and 12 domains in BCS70. Dominant components included maternal fertility histories within the prenatal, antenatal and birth domain, long-term illnesses within the child health domain, educational ability within the child education and health literacy domain, ethnicity within the demography domain, parental health behaviours within the transgenerational domain, housing within the socioeconomic domain and parental-child interactions within the parental-family domain. We demonstrated that if multiple large scale longitudinal studies are used, there is enough data available for researchers to consider conceptualising early life risk factors of multimorbidity across groups or domains. Such conceptualisation can help challenge the existing understanding of disease aetiology and develop new ideas for prevention of multimorbidity.

Mapping domains of early-life determinants of future multimorbidity across three UK longitudinal cohort studies.

ObjectivesMany studies use a reductionist approach to isolate the influence of one factor in childhood on multimorbidity rather than consider the combined effect of wider determinants. We aimed to explore how potential multiple early-life determinants of multimorbidity can be audited and characterised across three UK cohort studies. ApproachWe used the 1958 National Child Development Study (NCDS), the 1970 British Cohort Study (BCS70), and the Aberdeen Children of the 1950s Study (ACONF) to identify and categorise early-life variables that fit into 12 previously conceptualised domains of early-life determinants of multimorbidity. A data audit manually assigned variables into the domain they best represented. Principal component analysis (PCA) reduced the dimensionality of the data and structured variables into subgroups. Important PCA components defined as the component that contributed the greatest proportion of the overall variance were identified. ResultsSeven domains were characterised by 74 variables in ACONF, ten domains by 143 variables in the NCDS, and twelve domains by 289 variables in the BCS70. PCA analysis reduced the dimensionality of ACONF variables from 74 to 41, from 143 to 73 in the NCDS, and from 289 to 149 in the BCS70. Important PCA components included maternal fertility histories, long-term illnesses, educational ability, ethnicity, housing status and parental-child interactions. Conclusions and ImplicationsConceptualising the risk of future multimorbidity as lifecourse domains composed of multiple factors can help challenge the existing understanding of disease aetiology and inform strategies for the prevention of multimorbidity.

High-risk factors for massive haemorrhage in medical abortion patients with missed miscarriage

BackgroundRecently, the incidence of missed miscarriage has gradually increased, and medical abortion is a common method to terminate a pregnancy. In the process of medical abortion, massive vaginal bleeding takes place, leading to emergency surgical haemostasis. Emergency surgery may produce infection and organ damage. Our study aimed to investigate the high-risk factors for massive haemorrhage during a medical abortion.MethodsA total of 1062 missed miscarriage patients who underwent medical abortion participated in this retrospective study. According to the amount of bleeding, the patients were divided into a massive haemorrhage group and a control group. By comparing the general conditions of the two groups, such as fertility history, uterine surgery history, uterine fibroids, etc., the high-risk factors for massive haemorrhage during medical abortion were identified.ResultsRelative to the control group, the massive haemorrhage group exhibited a higher proportion of patients with a previous artificial abortion (51.9% vs. 38.1%, P = 0.001). Additionally, the massive haemorrhage group had a lower percentage of first-time pregnant women (32.1% vs. 40.4%) and a higher proportion of women with shorter pregnancy intervals (44.9% vs. 33.1%, P = 0.03). Furthermore, there were notable differences between the two groups regarding maximum fibroid size, the duration of amenorrhea, and gestational week (P < 0.05).ConclusionIn this study, we determined that a history of artificial abortion and an amenorrhea duration of > 11 weeks represented high-risk factors for massive vaginal bleeding during medical abortion in missed miscarriage patients.

Model Predicting the Risk of Endometrial Hyperplasia Developing into Endometrial Cancer.

This study retrospectively analyzed the medical records of 200 patients with endometrial hyperplasia to predict the risk of concurrent endometrial cancer. Patients were categorized into either the endometrial cancer group or the endometrial hyperplasia group based on post-hysterectomy pathology. The investigation compared general information, tumor indices, fertility history, preoperative endometrial sampling methods, comorbidities, and clinical symptoms between the groups to identify risk factors for endometrial hyperplasia complicating endometrial cancer. (1) Of the 200 patients, 68 (34.0%) were diagnosed with concurrent endometrial cancer post-hysterectomy. Among these, 60 (88.24%) had endometrioid adenocarcinoma, while 8 (11.76%) had other types. Stage I was identified in 58 patients (85.29%) and Stage II in 10 patients (14.71%). High differentiation was observed in 57 cases (83.82%), moderate differentiation in 7 cases (10.29%), and poor differentiation in 4 cases (5.89%), indicating that most endometrial cancers complicated by hyperplasia were early-stage, well-differentiated endometrioid carcinomas; (2) Univariate analysis revealed statistically significant differences in age, menopausal status, length of menopause, and preoperative endometrial pathology of severe atypical hyperplasia between the groups; (3) Multivariate analysis indicated significant differences for age ≥ 53.5 years (OR: 4.307, 95% CI: 2.018-9.192, p < 0.05), menopausal status (OR: 5.250, 95% CI: 2.449-11.252, p < 0.05), and severe atypical endometrial hyperplasia (OR: 4.817, 95% CI: 1.260-18.419, p < 0.05); (4) Significant differences were observed among patients with endometrial hyperplasia when stratified by the presence of zero, one, two, or three high-risk factors. In conclusion, patients aged ≥ 53.5 years, those who are menopausal, and those with severe atypical endometrial hyperplasia preoperatively are at higher risk for endometrial cancer. The risk increases with the number of high-risk factors present in patients with atypical endometrial hyperplasia.

Tropical cyclones and fertility: New evidence from developing countries

Does exposure to tropical cyclones affect fertility? This paper addresses this question by constructing a panel dataset from geolocated micro-data about the fertility history of mothers along with their local exposure to tropical cyclones for a sample of six developing countries for the 1985–2015 period. We then estimate the causal effect of tropical cyclone shocks on women’s likelihood of giving birth. We find evidence that tropical cyclone exposure has a significantly negative effect on motherhood. A cyclonic wind exposure between 60 and 117 km/h (resp. at least of 118 km/h) decreases the probability of giving birth by 7.8 (resp. 7.0) points a year after exposure. We also observed that the magnitude of the effect varies with the degree of cyclonic exposure associated with the mothers’ living environment and the number of children ever born. In particular, the fall in the likelihood of giving birth is lower for mothers living in cyclone-prone areas and for those who already have children. Alternative specifications of our baseline model provide further insights: (i) recent past exposure to cyclones was associated with a lower decrease in fertility when exposed once again; and (ii) no evidence of non-linearities was observed in the effect.

P-066 A multi-bioassay approach to identify male gamete fertilization dysfunction

Abstract Study question Can a multi-bioassay approach identify a specific male gamete dysfunction often overlooked by a standard semen analysis? Summary answer In cases of persistent fertilization failure, additional testing may assist in pinpointing underlying factors contributing to compromised sperm embryo developmental competence and tailor treatment. What is known already Conventional semen analysis, while informative, ineffectively captures the complete spectrum of male gamete dysfunction. Despite adequate sperm concentration and motility, some couples may still experience fertilization failure with Intracytoplasmic Sperm Injection (ICSI). This highlights the complexity of male infertility, that extends beyond standard parameters. In addressing sperm-related fertilization challenges, various assisted oocyte activation (AOA) methods have been proposed to trigger intracellular Ca2+ release, leading to calcium spikes and meiosis initiation. Study design, size, duration In the past 10 months, we identified couples (n = 50) with a history of poor ICSI fertilization, exhibiting suboptimal head morphology. Screening for acrosomal dysfunction involved assessing the presence of PLCxand related gene mutations. We measured the degree of chromatin compaction by histone-to-protamine ratio and evaluated sperm chromatin fragmentation (SCF). To correct for eventual acrosomal dysfunction, couples were counseled to undergo subsequent ICSI cycles with AOA. Clinical outcome was compared between historical and treatment cycles. Participants/materials, setting, methods Fifty men with a history of poor ICSI fertilization were included. A standard semen analysis was conducted according to WHO guidelines. The presence of PLCx was measured through immunofluorescent staining (normal threshold, ≥ 30%), corroborated by gene mutation detection though DNA-seq. Sperm histone-to-protamine ratio was evaluated by Aniline Blue (normal threshold, &amp;lt;15% histone retention). SCF was assessed utilizing the TUNEL assay (normal threshold, ≤15%). AOA was performed using ionomycin or recombinant PLCx protein. Main results and the role of chance Fifty men experienced a poor clinical outcome following ICSI with a fertilization of 7.4% (48/647), embryo implantation of 6.6% (1/15), clinical pregnancy of 6.6% (1/15), and pregnancy loss rate of 100% (1/1). Their semen analysis, interestingly, revealed the following semen parameters: 3.0±1 mL volume, 50.0±20 x106/mL concentration, 41.4±21% motility, and 1.9±1% normal morphology. Nonetheless, PLCx content was diminished, with values ranging from 2-27%. Genomic assessment confirmed mutations in PLCx, DPY19L2, SPATA16 and PICK1 genes, all implicated in sperm nuclear remodeling and acrosome formation. An elevated histone content at 29.7% was positively correlated with an increased SCF at 18.0% (R2=0.6, P&amp;lt;0.001). In subsequent cycles employing AOA, the normal fertilization increased to 42.3% (305/721), the embryo implantation reached 13.0% (9/69), the clinical pregnancy rose to 21.1% (8/38), and the delivery rate was 21.1% (8/38), without any pregnancy loss. (P&amp;lt;0.001). Limitations, reasons for caution While this study affirms the effectiveness of a multifaceted assessment in pinpointing specific sperm dysfunctions and customizing treatment, it is still a retrospective observation requiring independent validation in a larger population. Wider implications of the findings Semen analysis alone fails to address specific aspects of male gamete dysfunction. Incorporating additional bioassays to assess chromatin structure, integrity, and acrosomal function offers valuable insights for fertility management in tailoring personalized treatments. This comprehensive approach enhances the understanding of male reproductive health, maximizing the potential for successful clinical outcome. Trial registration number not applicable

P-467 Fertility preparedness and influencing factors in women undergoing fertility treatment: Turkish sample

Abstract Study question What is the level of fertility preparedness among women undergoing fertility treatment and what factors influence this preparedness? Summary answer The readiness of the participants to undergo fertility treatment was found to be high. Factors that increase and decrease women’s prepareadiness were also identified. What is known already It is a common problem in practice to stop and not continue infertility treatment, which has a long physical, emotional and financial burden. Although there are many reasons for this, it has been found that couples move from one treatment process to another without feeling ready. In addition to the stress of infertility and treatment, couples drop out of treatment due to low readiness. Therefore, measuring the readiness of couples prior to fertility treatment and determining the factors that influence readiness may be effective in the continuation and success of treatment. Study design, size, duration It was a descriptive and cross-sectional study conducted on 375 Turkish-speaking women in a virtual environment using the Google survey technique. Infertile women who received treatment in fertility clinics of any hospital or private IVF centers worldwide and spoke Turkish constituted the population of the research. The data were collected between February 2021 and January 2022. Participants/materials, setting, methods A total of 375 women with primary infertility who agreed to be part of the study were included. Data were collected by ‘Descriptive Information Form’, ‘Fertility History Form’ and ‘Fertility Preparedness Scale for Women Receiving Fertility Support’ measurement tools. The cut-off value of the Fertility Preparedness Scale (FPS) is 56 points (min 23 - max 115) and a score of less than 56 points indicates that the participant was not sufficiently prepared for fertility treatment. Main results and the role of chance In the present study, the mean score was X¯ = 83.01 (min 39-max115). Most of the participants (94.67%) were above the cut-off value. This showed us that 94.67% of the women had a high level of prepareadiness. Factors such as advancing age, prolongation of infertility, increase in number of treatments, female factor of infertility were negative factors related to fertility preparedness. Besides increased education level, increased income, secondary infertility, feel less pressure from their families and being able to share with the social circle about the treatment were positive factors that increased the woman’s prepareadiness for treatment.According to the results fertility prepareadiness it has a very important place in starting and continuing fertility treatment. There are many factors that influence fertility prepareadiness. If a woman/couple starts well prepared in this expensive and stressful treatment process, financial loss can be prevented, treatment success can be improved and treatment discontinuation can be reduced. Limitations, reasons for caution The fact that the study was conducted online and the possibility of participation of people at different stages of treatment (beginning, while waiting for a pregnancy test, etc.) may have affected the fertility prepareadiness results. Wider implications of the findings There is a need for an experimental randomized controlled trial with objective assessment of fertility prepareadiness. It would also be useful for health professionals to measure the prepareadiness of women/couples through pre-treatment assessment in clinics. Assessment of prepareadiness and identification of influencing factors is important to provide appropriate support. Trial registration number non-clinical trials

The Science of Vegetation with Reference to India

Pt. I Vegetation is the sum total of plant population covering a region and its descrete units circumscribed by characteristic environment, are communities. The species content is the flora. The physical and the biological surroundings characterise the environmental complex. Both plants and their environment are dynamic systems interacting within and with each other. The amplitude of variations in the environment is generally met with synchronised adaptive responses of the plants in time and space. Differentiation of ecads and ecotypes within the plastic species is the result. However, many forms and invaders may get eliminated also if the situation goes beyond their range of tolerance set by the genetic organisation as the factors may become critical at different stages of the life-cycle. The species around provide the genetic material for recruitment and ecesis within the community.pt. II Migration of species involving mobility of disseminules, their germination, aggregation, competition and final ecesis-ever continuing processes lead to colonisation and invasions. All these plant phenomena react upon the environment introducing changes therein. Thus newer community-environment-complex equilibria are set up in the dynamic system. The whole process is called, succession in relation to time and the series of succeeding communities for a given area, a sere. When it happens ‘de novo’ with no trace of plant present originally in the area, it is prisere as a result of primary succession and subsere with disturbed communities in which secondary succession is the rule. The mechanism of succession is driven by the reacting and changing environment consequential largely either to the plant processes themselves or to extraneous forces succession is autogenic in the former and allogenic in the latter case. In every case succession terminates into a more stable climax community generally dependant upon the climate and soil. The taxa used for classifying communities differ widely among ecologists but association is the basic unit accepted by all, though with varying concepts. The concept of ecosystem in relation to energy and matter within the community is the most acceptable basis for comprehending;vegetation types in India.Pt. III Since vegetation evolves out of the flora floristic regions of India should form the basis of its main divisions. For this purpose three main latitudinal belts viz. (1) Eastern and Western Himalayas, (2) Assam, Gangetic Plains and Rajasthan, and (3) Deccan and Malabar are recognised. The seven provinces with their distinct climate including photoperiod can be individually considered for the description of vegetation types along gradients of altitude, humidity-aridity, history and proximity of human settlements and soil fertility. Along these gradients closed, open and desert types of structure within forests, scrub and grass can be described with their combinations wherever necessary. Physiognomy, structure, function, composition, dynamics, habitat relations and history are the important diagnostic criteria of vegetation types. Size, texture and seasonal behaviour of leaves of dominant species may also be given. The hydrophytes can be described in each place as floating, suspended, submerged anchored, floating-leaved anchored and emergent anchored.

Fertility history and intentions of married women, China.

To estimate the proportion of married women in China who intend to become pregnant given the country's pronatalist population policy and to investigate fecundity, with an emphasis on the influence of socioeconomic factors. A nationally representative survey of 12 815 married women aged 20 to 49years (mean: 36.8years) was conducted during 2019 and 2020. All completed questionnaires, 10 115 gave blood samples and 11 710 underwent pelvic ultrasound examination. Fertility intention was the desire or intent to become pregnant combined with engagement in unprotected sexual intercourse. We defined infertility as the failure to achieve pregnancy after 12months or more of unprotected intercourse. We considered an anti-Müllerian hormone level < 1.1ng/mL and an antral follicular count < 7 as indicating an abnormal ovarian reserve. Fertility intentions were reported by 11.9% of women overall but by only 6.1% of current mothers (weighted percentages). Fertility intention was significantly less likely among women in metropolises (odds ratio, OR: 0.38; 95% confidence interval, CI: 0.31-0.45) and those with a higher educational level (OR: 0.74; 95% CI: 0.62-0.88). Overall, 18.0% had experienced infertility at any time and almost 30% had an abnormal ovarian reserve on assessment. An abnormal ovarian reserve and infertility were less likely in women in metropolises (P < 0.05) but more likely in obese women (P < 0.05). The willingness of Chinese married women to give birth remained low, even with relaxation of the one-child policy.

U.S. Fertility in Life Course Context: A Research Note on Using Census-Held Linked Administrative Records for Geographic and Sociodemographic Subgroup Estimation

Fertility is a life course process that is strongly shaped by geographic and sociodemographic subgroup contexts. In the United States, scholars face a choice: they can situate fertility in a life course perspective using panel data, which is typically representative only at the national level; or they can attend to subnational contexts using rate schedules, which do not include information on life course statuses. The method and data source we introduce here, Census-Held Linked Administrative Records for Fertility Estimation (CLAR-FE), permits both. It derives fertility histories and rate schedules from U.S. Census Bureau–held data for the nation and by state, racial and ethnic subgroups, and the important life course status of parity. We generate three types of rates for 2000–2020 at the national and state levels by race and ethnicity: age-specific rates and both unconditional and conditional parity- and age-specific rates. Where possible, we compare these rates with those produced by the National Center for Health Statistics. Our new rate schedules illuminate state and racial and ethnic differences in transitions to parenthood, providing evidence of the important subgroup heterogeneity that characterizes the United States. CLAR-FE covers nearly the entire U.S. population and is available to researchers on approved projects through the Census Bureau's Federal Statistical Research Data Centers.

Root‐zone enrichment of soil organic carbon and nitrogen under grazing and other land uses in a humid‐temperate region

AbstractGrazing lands can be considered a conservation land use providing value to farmers and society. An underappreciated value of these lands may be in C and N storage and cycling. However, soil organic C (SOC) and total soil N (TSN) storage under humid‐temperate zone pastures have not been well characterized. A survey of 31 farms in Virginia USA characterized SOC and TSN depth distributions under a diversity of grassland management scenarios, as well as in comparison with long‐term no‐till cropland and woodland uses on the same farms. Root‐zone enrichment calculations separated management‐controlled SOC and TSN stocks from a baseline condition characterized at 30‐cm depth. Total stock of SOC at 0–30‐cm depth varied from 46 to 88 Mg C ha−1 (5%–95% range from 304 soil profiles) across all land uses. Root‐zone enrichment of SOC was maximized under mature pastures (≥20 years old) at 38.3 ± 1.6 Mg C ha−1, which was not different from that under woodland (39.8 ± 1.2 Mg C ha−1), but was greater than under no‐till cropland (28.3 ± 1.3 Mg C ha−1) and conventional‐till cropland (15.1 ± 5.1 Mg C ha−1). Root‐zone enrichment of TSN was optimized at stocking rate of ~1 Mg live weight ha−1, but was not affected by stocking method, N fertilization history, or low levels of hay feeding. These results suggest that grazed pastures in Virginia are storing significant amounts of SOC and TSN, with at least half due to management‐induced compared with pedogenic‐controlled accumulation.

Biological Interactions Mediate Soil Functions by Altering Rare Microbial Communities.

Soil microbes, the main driving force of terrestrial biogeochemical cycles, facilitate soil organic matter turnover. However, the influence of the soil fauna on microbial communities remains poorly understood. We investigated soil microbiota dynamics by introducing competition and predation among fauna into two soil ecosystems with different fertilization histories. The interactions significantly affected rare microbial communities including bacteria and fungi. Predation enhanced the abundance of C/N cycle-related genes. Rare microbial communities are important drivers of soil functional gene enrichment. Key rare microbial taxa, including SM1A02, Gammaproteobacteria, and HSB_OF53-F07, were identified. Metabolomics analysis suggested that increased functional gene abundance may be due to specific microbial metabolic activity mediated by soil fauna interactions. Predation had a stronger effect on rare microbes, functional genes, and microbial metabolism compared to competition. Long-term organic fertilizer application increased the soil resistance to animal interactions. These findings provide a comprehensive understanding of microbial community dynamics under soil biological interactions, emphasizing the roles of competition and predation among soil fauna in terrestrial ecosystems.

Sex differences in cognitive function trajectories and their determinants in older adults: Evidence from the Chinese longitudinal healthy longevity survey.

To examine sex differences in the cognitive trajectories of a nationally representative sample of older people living in China and to explore potential determinants of these trajectories. The study included 2230 women and 2171 men who were cognitively healthy and aged over 60 at the first observation from the Chinese Longitudinal Healthy Longevity Survey based on the 2008-2018 cohort. Cognitive function was measured using the Chinese version of the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to identify potential heterogeneity of longitudinal changes over the 10years in each gender. Logistic regression was used to investigate associations between baseline characteristics (age, education, fertility history, sleep length, physical activity, and health status and behaviors) and trajectory classes. Three trajectories (labeled stable, slow decline, and rapid decline) were identified according to the changes in MMSE scores for both women and men. For the women, both the slow and rapid decline groups accounted for a larger proportion (14.7% and 11.0%, respectively) than the male decline groups (8.1% and 6.6%, respectively), and the women had a lower baseline MMSE score with a faster decline. In the multivariable logistic regression analyses, older age, less education, older age at first birth, poorer functional abilities, hearing impairment, and lower baseline MMSE scores were significantly associated with cognitive decline in both the female and male groups compared to the stable group. For the women, sleeping over 9h was also associated with a rapid cognitive decline trajectory, while current exercise and being overweight/obese were protective factors against cognitive decline. The women had an overall more serious cognitive decline than men. The potential determinants of cognitive decline identified in this study could be considered for developing specific intervention strategies aimed at promoting a healthy brain and preventing cognitive decline in different sexes, especially in low-income and developing countries.

Intracytoplasmic sperm injection versus conventional in-vitro fertilisation for couples with infertility with non-severe male factor: a multicentre, open-label, randomised controlled trial

Introduced in 1992, intracytoplasmic sperm injection (ICSI) was initially indicated for severe male infertility; however, its use has since been expanded to non-severe male infertility. We aimed to compare the efficacy and safety of ICSI versus conventional in-vitro fertilisation (IVF) in couples with infertility with non-severe male factor. We conducted an investigator-initiated, multicentre, open-label, randomised controlled trial in ten reproductive medicine centres across China. Couples with infertility with non-severe male factor without a history of poor fertilisation were randomly assigned (1:1) to undergo either ICSI or conventional IVF. The primary outcome was live birth after first embryo transfer. We performed the primary analysis in the intention-to-treat population using log-binomial regression models for categorical outcomes or linear regression models for continuous outcomes, adjusting for centre. This trial is registered with Clinicaltrials.gov, NCT03298633, and is completed. Between April 4, 2018, and Nov 15, 2021, 3879 couples were screened, of whom 2387 (61·5%) couples were randomly assigned (1184 [49·6%] to the ICSI group and 1203 [50·4%] to the conventional IVF group). After excluding couples who were ineligible, randomised twice, or withdrew consent, 1154 (97·5%) in the ICSI group and 1175 (97·7%) in the conventional IVF group were included in the primary analysis. Live birth after first embryo transfer occurred in 390 (33·8%) couples in the ICSI group and in 430 (36·6%) couples in the conventional IVF group (adjusted risk ratio [RR] 0·92 [95% CI 0·83-1·03]; p=0·16). Two (0·2%) neonatal deaths were reported in the ICSI group and one (0·1%) in the conventional IVF group. In couples with infertility with non-severe male factor, ICSI did not improve live birth rate compared with conventional IVF. Given that ICSI is an invasive procedure associated with additional costs and potential increased risks to offspring health, routine use is not recommended in this population. National Natural Science Foundation of China, National Key Research and Development Program, Beijing Municipal Science & Technology Commission, and Peking University Third Hospital.

Temporal Trends in Semen Quality, Hormone Levels, and Substance Use Among Infertile Men in Pre- and Post-Cannabis Legalization Eras in Canada.

Background: The Cannabis Act (Bill C-45) was enacted in 2018, to legalize and regulate the use, production, and sale of nonmedical cannabis in Canada. While public health and safety implications of cannabis legalization have yet to be elucidated, the wide availability of cannabis necessitates health care providers to be knowledgeable about therapeutic potential and side effects of use. This study aimed to examine the temporal trends over two decades and the impact of the Cannabis Act in Canada, implemented in October 2018, on substance use, semen parameters, and testosterone levels of infertile men. Methods: We conducted a retrospective cohort study from a prospectively maintained database of a single infertility clinic. Demographic, fertility, and substance use history were correlated with semen and hormone assessments. Temporal trends in cannabis use and semen quality between 2001 and 2021 were investigated and compared between pre-cannabis legalization eras (PRCL) and post-cannabis legalization eras (POCL). Results: Our cohort included 11,630 patients (9411 PRCL and 2230 POCL). Cannabis use increased by 8.4% per year (p<0.001), while alcohol and tobacco consumption declined (0.8% and 1.5% per year, p<0.05 and p=0.004, respectively). Similar trends were noticed in the POCL, with higher rates of cannabis use (22.4% vs. 12.9%, p<0.001) and decreased tobacco and alcohol intake (15.2% vs. 17.7%, p=0.005 and 50.5% vs. 55.2%, p<0.001, respectively) compared to the PRCL group. Semen concentration was lower in the POCL group (24.8±44.8 vs. 28.7±48.3 million/mL, p=0.03). Testosterone did not differ between the cohorts. Comparison between cannabis users (n=1715) and nonusers (n=9924) demonstrated a slight increase in sperm motility (25.9%±15.3% vs. 23.9%±15.0%, p=0.002) and decreased sperm concentration among users (27.6±53.5 vs. 23.9±15.0 million/mL, p=0.03). Conclusion: A nearly 10% rise in cannabis use in the POCL era was observed among men being investigated for infertility. Our data suggest cannabis use may be associated with an increase in testosterone, slightly improved sperm motility, and decreased sperm concentration.

Investigation of Factors Related to Stillbirth.

The stillbirth rate is among the most important indicators of access to and quality of care during pregnancy. This study investigated the factors related to the stillbirth rate in the Yazd province, Iran. The current research is descriptive and cross-sectional and the results of Shahdieh city cohort study which was conducted on 4756 women were used. Data related to the history of stillbirth, demographic characteristics, fertility history and, various female diseases were extracted from the results of the cohort study. The result shows that 7.2% of studied women had a history of stillbirth. Among the multiple variables, predictor variables including education level, marriage age, age of the first conception, number of children, consanguineous marriage, Employment status, and diseases like diabetes, hypertension, and history of depression had a significant relationship with a history of stillbirth (P ≤ .05). The stillbirth rate in Shahedieh is high compared to the global stillbirth Rate, but it is comparable with the stillbirth Rate in Yazd province. Although Yazd province, as one of the industrial hubs of Iran, has relatively acceptable indicators of income, employment, and medical and health facilities and welfare compared to other provinces, this study showed that factors such as diabetes, hypertension, low level of women's education, consanguineous marriage, and women's employment status and social welfare can affect Stillbirth Rate.

Menarche age and the risk of diabetes: A cross-sectional study in South-Eastern Iran.

Diabetes is a major public health problem worldwide. This study aimed to determine the relationship between menarche age and overt diabetes in southeast Iran. This cross-sectional study was conducted on 6094 eligible women between the ages of 35 and 70 participating in the Zahedan Adult Cohort Study. Demographic and background data, fertility, anthropometry, and disease history were collected based on a questionnaire. Menarche age was classified into five categories (under 12 years, 12, 13, 14, 15 years and more). Diabetes is defined as a blood sugar of 126 or more according to the definition by the American Diabetes Association. Data analysis was done using SPSS 26 software. Descriptive analysis was performed with frequency, percentage, mean, and standard deviation; and analytical analysis using chi-square and logistic regression tests. The significance level in this study was p < 0.05. The participants' mean age was 49.41 ± 8.88, and the mean age at menarche was 13 ± 1.49. 22.8% (1389 women) of participants with diabetes and 77.2% (4705 women) did not have diabetes. The findings showed that the chance of developing diabetes in women with a menarche age <12 years was significantly higher than in women with a menarche age of 13 years (reference) (OR = 1.23, 95% CI: 0.96, 1.51). This relationship was significant after adjusting variables such as body mass index, education level, fertility factors, history of diabetes, and reproductive diabetes (OR = 1.21, 95% CI: 0.90, 1.44, p = 0.04). Our findings suggest that young age at menarche may be a risk factor for diabetes in adulthood. Further prospective studies are needed to confirm our findings. However, it is suggested to pay attention to it in diabetes screening so that, if possible, by identifying people at risk and implementing prevention programs, the adverse consequences of diabetes can be reduced.

Changing fertility patterns in China

China's recent fertility data collected from the 2020 population census and 2017 fertility survey have considerably improved in quality. Based on these, we can assess the levels and patterns of fertility with high confidence. We reconstruct China's fertility history from 1990 using these two types of data and review the trends and characteristics of fertility transitions and changing fertility patterns in China. Over the past half century, China has experienced an extraordinary fertility transition and decline, which can be described as three stepwise downward jumps in fertility that occurred in the 1970s, 1990s, and 2010s. While the tempo effect has always depressed fertility, the quantum effect became positive in the most recent fertility decline, when China made successive adjustments to its fertility policy. Age, parity, and interval patterns of fertility in China have also undergone fundamental changes influenced by changing fertility policies and rapidly expanding higher education. The recent rapid decline in fertility is driven by the increasing postponement of marriage, a large reduction in fertility for lower education groups, and a rising proportion of younger women accessing higher education.