Fertility Of People Research Articles

Preserving Fertility in People With Rheumatic Diseases.

Rheumatology patients historically were told they "can't" or "shouldn't" become pregnant. Improved rheumatic diagnostics and treatments have led to decreased morbidity and mortality and increased quality of life resulting in an opportunity to focus on fertility and its preservation. In the same vein as rheumatic disease care, assisted reproductive technology (ART), which includes freezing of egg and sperm as well as in vitro fertilization, has made considerable strides in the recent past. ART is safe for those with rheumatic diseases and has comparable outcomes to the general public, but may take additional effort due to optimal timing, rheumatic medications, and other nuances. In a specialty that treats chronic inflammatory diagnoses using teratogens and gonadotoxins, it is important to address family building desires with patients so their goals can be met.Rheumatologists have little knowledge of ART and how it impacts or applies to their patients; however, patients want their rheumatologist to be the source of knowledge for this information (Arthritis Rheumatol. 2022;74:suppl 9). Many barriers to ART exist and will be explored, with the financial burden being paramount (Glob J Health Sci. 6;1:181-191). Future efforts to examine the future fertility of rheumatology patients in an era of biologics and "treat-to-target" are needed to better understand who would most benefit from this costly and not without risk medical treatment. Given the changing landscape of financial support for ART due to insurance mandates, rheumatologists should not modify counseling based on the anticipated ability of patients to afford care. Preservation should also be broached with patients without partners and those from the LGBTQAI+ community. In addition to expanding the education of rheumatologists regarding this topic and its incorporation into clinical care, advocacy for ART access and insurance coverage is a much-needed future direction.

Pregnancy and fertility in people with cystic fibrosis following lung transplantation.

The purpose of this review is to summarize available data on fertility, fertility preservation, pregnancy and parenthood following lung transplantation for people with cystic fibrosis (pwCF). In the era of cystic fibrosis transmembrane conductance regulator (CFTR) modulator use, oral therapies that positively impact fundamental CFTR protein abnormalities, the number of pregnancies has increased dramatically with a concomitant decrease in lung transplantation. Nonetheless, some pwCF still require lung transplantation as a life-saving measure, and a fraction of those individuals desires parenthood. Cystic fibrosis (CF) providers infrequently discuss fertility preservation with pwCF, and pwCF feel uneducated about their fertility options posttransplant. However, because the immunosuppression required to successfully maintain lung allografts may impact future fertility, pwCF should receive genetic and reproductive counseling prior to lung transplantation. While pregnancies posttransplantation are high-risk, selected females with CF may be able to pursue this path to parenthood. Although there is a paucity of data specific to pwCF who have undergone lung transplantation, recently developed general guidelines should inform discussions regarding fertility, pregnancy and parenthood in pwCF who desire parenthood following lung transplantation for optimal shared decision-making.

Explaining uncertainty in women's fertility preferences

People's fertility preferences are often considered an important determinant of fertility. What is often neglected in studies of preferred fertility, is the uncertainty that people may have about their preferences. In this study, using data on Dutch women through the Longitudinal Internet studies for the Social Sciences (collected early 2018), we examined women's fertility preferences and asked detailed questions about the certainty of these preferences. We also examined whether women agreed with their partner on preferred family size, and to what extent partner (dis)agreement shaped uncertainty. We show that Dutch women expressed much uncertainty about their fertility preferences, with only one-third feeling strongly about their preferences. Uncertainty strongly increased when women preferred higher numbers of children, whereas already having children reduced it. Women who wanted no children were most certain about their preference. Higher preferred family sizes also led to more disagreement with the partner about these preferences, and greater partner disagreement, in turn, led to more uncertainty. These findings imply that people are more likely to downgrade their fertility preferences than to increase them, as women are more certain about their preferences for lower numbers of children and are more open to family sizes below than above their preferred choice. Partner disagreement is often resolved by not having (more) children, lowering realised fertility. Hence, these findings provide another explanation for why many people have fewer children than desired.

Ketogenic diet improves fertility in patients with polycystic ovary syndrome: a brief report.

Polycystic ovary syndrome (PCOS) affects up to 20 % of reproductive-age individuals and is strongly linked to obesity. The impacts of ketogenic diet on fertility in people with PCOS are unknown. This study aims to determine the effect of a ketogenic diet on restoration of regular menstrual cycles and fertility. After approval from the Institutional Review Boards of Cleveland Clinic, a retrospective analysis was conducted using the electronic health record system. We analyzed data from thirty patients (n = 30) with polycystic ovary syndrome who followed a ketogenic diet for at least 3 months at the Cleveland Clinic, Cleveland, Ohio, USA. Main outcomes were percentage of women with restoration of regular menstrual cycles and pregnancy rate. All women (n = 30) had restoration of regular menstrual cycles. The overall pregnancy rate of women desiring pregnancy (n = 18) was 55.6% (n = 10). Pregnancy rate was 38.5% for women on metformin and 100% for those who were not (P = 0.036). Pregnancy rate was 62.5% for women using ovulation induction agents and 50.0% for those who did not (P = 0.66). Percent weight change between the pregnant and non-pregnant groups did not significantly differ [-8.1 ± 6.2, vs -6.4 ± 8.4, P = 0.64, respectively]. This study reports a higher rate of pregnancy with the ketogenic diet in women with PCOS compared to existing literature.

Trans-disciplinary learnings from lived experience: person-centred integrated infertility care.

Introduction: Infertility is a stigmatising condition with profound psychosocial impacts. It is estimated it affects 48.5 million couples globally (Mascarenhas et al., 2012) and in the UK, one in seven couples have problems conceiving (NHS, 2020). Rates of infertility are increasing in both genders (Sun et al, 2019).
 Aims: To explore the lived experience of patients with infertility to identify opportunities for improvements in care and education of healthcare professionals (HCPs), and to investigate the potential of nutrition and lifestyle medicine as an adjunct to care.
 Methods: Critical reflections on a trans-disciplinary portfolio of seven publications about infertility authored or co-authored by a researcher with personal experience of infertility. These were published from 2015, and include peer-reviewed research articles, a case report, a textbook, a performance, creative artefacts including poems and a story. All embed patient voice as a fundamental element. The overall methodological framework adopted reflects a multi-lens interpretive, phenomenological, heuristic inquiry informed by a relativist ontology. Synthesis connectivity has been used to analyse the works, this approach is recommended by both Grant (2011) and Smith (2015). 
 Findings: Three research questions and findings were identified.
 1.How to improve care / outcomes? 
 Explored in publications 1, 2, 3, 4, 6, 7. Findings were optimal nutritional status and weight management supports fertility in both men and women, so nutrition care should be an integral part of care. Additionally, understanding the lived experience of infertility better facilitates effective care/counselling and improves patient experience. 
 2.How lived experience of infertility can shape clinical education/research?
 Explored in publications 2, 3, 4, 4a, 4b, 4c, 5, 6, 7. Findings were that co-creation of educational resources with people experiencing infertility, narratives of lived experience and interdisciplinary approaches have the potential to improve HCP & medical education; however, this needs to be aligned with involvement and engagement within research and curricula design.
 3.The role of gluten (a protein in grains) in infertility?
 Considered in publications 1,2,3,4,6,7. Gluten can negatively affect fertility in people diagnosed with coeliac disease, but fertility can also be affected in women with non-coeliac gluten sensitivity and more education is needed as professional awareness of the fertility implications of both coeliac disease and gluten sensitivity is low.
 Conclusions: Person-centred integrated infertility care needs to take account of the psycho-social impacts associated with infertility, include psycho-therapeutic support and also nutritional and lifestyle medicine. Where there is unexplained infertility or recurrent miscarriage, the potential role of gluten should be considered. Lived experience of infertility can be used as tool in HCP and medical education and socially to lessen stigmatisation and improve communication about infertility. Involvement needs to be aligned across the entirety of healthcare delivery, from clinical settings, through to both education and research (a 3-dimensional model called PRISM has been developed to triangulate involvement).

How does environmental quality perception influence people's fertility intention? Evidence from China

AbstractThe ongoing population aging and few children are major challenges for human sustainable development in the 21st century. While the external environment is a crucial factor determining people's behaviour, the potential effects of subjective environmental quality on an individual's fertility decision‐making remain poorly understood. Using data from the Chinese General Social Survey, this research has examined the relationship between environmental quality perception and fertility intention in China. Results reveal that an increase in environmental quality perception can significantly promote people's fertility intention. Our study proposes and verifies two pathways through which environmental quality perception affects fertility intention, namely, well‐being and future expectation. This facilitating effect is greater for people with poor socio‐economic conditions. The findings indicate that policymakers should coordinate environmental protection and population policies to promote sustainable development and design various tools targeted based on people's socio‐economic background.

The impact of narratives of the future on fertility intentions in Norway

AbstractObjectiveThis study examines the effect of exposure to different economic narratives of the future on fertility intentions of Norwegian couples.BackgroundFertility patterns should not only be interpreted in relation to economic uncertainty conceptualized as objective constraints. One should also consider that subjective narratives of economic uncertainty may have a significant role in fertility decision‐making.MethodData were collected from a controlled laboratory experiment of both partners in heterosexual couples in fall 2019 in Oslo, Norway (N = 838). The participants were randomly assigned to read either a negative or a positive future economic scenario, while a control group was not assigned to any scenario.ResultsThe economic scenarios influenced couples' fertility intentions, with the negative scenario causing a clear decrease in fertility intentions and the positive scenario causing an increase in fertility intentions. Men and women responded in similar ways to the scenarios. The effect of exposure to the scenarios is not moderated by objective measures such as couple employment status and income, except in one case.ConclusionOur experimental setting demonstrates that people's fertility intentions are shaped by their subjective view of the future economic situation.

Evaluation of inactivated COVID-19 vaccine on semen parameters in reproductive-age males: a retrospective cohort study

During the coronavirus disease (COVID-19) epidemic, there have been concerns about the impact of vaccines on people's fertility, including the fertility of those who are currently preparing for pregnancy and those who might become pregnant in future. However, there is still a lack of research on the effect of the COVID-19 vaccine on male fertility, and it is not surprising that couples and donors have concerns regarding vaccination. In this study, a retrospective cohort study was conducted to examine semen quality before and after receipt of the inactivated COVID-19 vaccine. There were no statistically significant changes in semen parameters (volume, sperm concentration, progressive motility, and total progressive motile count) after two doses of vaccine (all P > 0.05). In summary, our study updates the most recent studies on the effects of the COVID-19 vaccine on male fertility, and the information from this study could be used to guide fertility recommendations for assisted reproductive technology (ART) patients and donors.

Fertility Deisire and Associated Factors Among People on Antiretroviral Treatment at a Public Health Facility in Hawassa City, Southern Ethiopia

Background: Fertility desire is the plan of people to have a child or more children in the face of being diagnosed with HIV and plan to a commitment to implement the desire.Increasing quality of life for patients leads to a desire for fertility in people living with HIV/AIDS and fertility desires were increased due to easy accessibility and availability of antiretroviral treatment drugs. Objectives: To assessed fertility desire and associated factors among people living on ante-retro viral treatment at Hawassa city southern Ethiopia, 2019. A study was conducted in Hawassa city public health facilities from May 09 –July 07/07/2019 Methods: An institutional-based cross-sectional study was conducted in Hawassa city public health facilities from May 09 – July 07/07/2019. Four hundred (400) study participants were selected using a simple random sampling technique. Data were collected by using interviewer-administered pre-tested structured questionnaires and chart review. The collected data were entered into EPI data version 3.1 software and then transported to SPSS version 20 for cleaning and data analysis.Bivariate and multivariate logistic regression was used to identify associated factors at p<0.05 was taken as a significant value with a 95% confidence level. Results:A total of 400 clients were included in the study giving a response rate of 97%. The overall fertility desire was 53.6% (95%CI: 48.7%, 58.2%). Age, sexual practice in the last six months, and discussed reproductive health with antiretroviral treatment providers were significantly associated with fertility desire.Younger age was positively associated with fertility desire, age group (18-29), [Adjust odds ratio =5.75 95%CI (2.85, 11.57)] , age group(30-39), [Adjust odds ratio= 4.71 95%CI:(2.55, 8.71)] Sexual practice in the last six months [Adjust odds ratio = 3.00 95%CI(1.46, 6.16)]and counseling reproductive health withantiretroviral treatment provider[Adjust odds ratio = 3.10 95%CI:(1.86,5.15)]. Conclusion: The prevalence of fertility desire in this study was higher than in previous studies while factors associated with fertility desire were age, sexual practice in the last six months, and discuss reproductive health with antiretroviral treatment providers. Keywords: Antiretroviral treatment, Fertility Desire, Hiv/Aids

Factors that influence fertility intentions of Chinese youth: a discussion of issues raised by Volsche and Jankowiak's "Chinese women's autonomy: parenthood as a choice"

In recent decades, China's childbearing-age young people's fertility intentions and attitudes have changed, influenced by widespread social change and general improvement of women's status. At the same time, research on intentions concerning fertility has been expanding. Volsche and Jankowiak's article, "Chinese women's autonomy: parenthood as a choice" provides a new discussion concerning college students' preferences about intended fertility and contrasts the culture of filial piety culture with new interest in personal choice about fertility. This discussion cites many sources in current research literature to their review through examining changes in the dimensions of changes in Chinese childbearing age, young people's intention concerning fertility, their ideal number of children, gender preference, and ideals about time for first birth and between pregnancies, as well as other related factors influencing their ideas about fertility.

The Protective Effects of L-Carnitine and Zinc Oxide Nanoparticles Against Diabetic Injury on Sex Steroid Hormones Levels, Oxidative Stress, and Ovarian Histopathological Changes in Rat.

Diabetes mellitus is a common chronic metabolic disorder. This study aimed to investigate the effects of co-treatment with L-carnitine (LC) and zinc oxide nanoparticles (ZnONPs) on serum levels of sex hormones, oxidative stress, and ovarian histopathology in streptozotocin (STZ)-induced diabetic rats. Female Wistar rats (n = 56, 180-220g) received a single intraperitoneal (IP) injection of STZ (65mg/kg). They were randomly assigned into the following groups: diabetic group (Dia), Dia+Met group (100mg metformin/kg/day), Dia+LC group (200mg/kg/day), Dia+ZnONPs group (10mg/kg/day), and Dia+LC+ZnONPs group (200mg LC/kg/day and 10mg ZnONPs/kg/day). Control group (Ctl) received the same volume of STZ solvent. After 21days of treatment, blood serum was centrifuged for sex hormone assays. The right ovary was used for biochemical analysis, and the left ovary was fixed in 10% neutral buffered formalin for histological assessment. The levels of estradiol, progesterone, FSH, and LH significantly increased in the Dia+ZnONPs+LC group (P < 0.001) compared with the Dia group. Co-treatment with LC and ZnONPs reduced malondialdehyde and carbonyl protein and increased glutathione, catalase, and superoxide dismutase activities in ovarian tissue compared with the Dia group (P < 0.05). Moreover, the number of all ovarian follicles significantly increased in this group compared with the Dia group (P < 0.05). The results of this study indicated that co-treatment with LC and ZnONPs could preserve ovarian function by increasing sex hormones levels and antioxidant activity and decreasing lipid peroxidation in diabetic rats. Therefore, this compound supplementation may improve ovulation and fertility in people with diabetes mellitus.

Fertility intentions among couples in Shanghai under COVID-19: A cross-sectional study.

ObjectiveTo evaluate fertility intensions among couples in Shanghai under the novel coronavirus infection (COVID‐19) pandemic against the backdrop of persistently low fertility.MethodsA cross‐sectional study was carried out using data from studies conducted before the COVID‐19 pandemic. Data were collected regarding sociodemographic characteristics, history of reproduction and gynecology, fertility intention before and after the COVID‐19 pandemic, female psychological state, and the impact of the COVID‐19 pandemic on daily life.ResultsUnder the influence of COVID‐19, 296/447 (66.2%) participants did not change their original fertility intention to have children, while 151/447 (33.8%) of participants were affected by the outbreak. Participants who believed in government and hospital control policies were less likely to change their intention to become pregnant (P < 10–3, P < 10–3). In contrast, concerns about the impact of COVID‐19 on female and fetal health led participants to cancel their original pregnancy plans (P < 10−3).ConclusionThree in ten couples of childbearing age, who originally expressed their intention of becoming pregnant, canceled their pregnancy plans after the COVID‐19 outbreak. The COVID‐19 outbreak has brought new challenges to people’s physical and mental health. Effective policies and measures can help to improve people’s fertility intentions with respect to having children.

Study on Population Structure Change and Policy Development Based on Leslie Model

With the overall-two-child policy been fully opened, as the important influence factor of economic development and social life, population structure is more worthy of study. In order to get the more intuitive result of the policy for relief the China's ageing population, this paper uses the Leslie model to predict the future population and the age structure change. Based on census data of Henan province, this paper divided the people's fertility wishes into high, medium and low, proposed four kinds of fertility strategies, and qualitative analysis the total fertility rate and birth population sex ratio of three different fertility wishes. Firstly, this paper predicts the total population size and the age structure under different fertility strategies during 2011-2050. Secondly, based on the total population, the elderly population coefficient and the total population dependency ratio, this paper analyzed the optimal fertility strategy under different fertility wishes. Finally, the conclusion is as follows, when the fertility wishes is low, medium and high respectively, the fertility strategies should be chosen as IV, III and II respectively, that is to say, in the early period, a woman had less than two children and later each woman had 2.1 children, which fully accords with the concept of population sustainable development.

The Flexibility of Fertility Preferences in a Context of Uncertainty.

The Flexibility of Fertility Preferences in a Context of Uncertainty.

Bisphenol AF negatively affects oocyte maturation of mouse in vitro through increasing oxidative stress and DNA damage

Bisphenol AF (BPAF) is commonly used in industry production as a substitute for Bisphenol A (BPA). Many studies showed that BPAF negatively affect some physiological processes in humans and animals. However, the effects of BPAF on oocyte maturation and its possible mechanisms are sparsely understood. In the present study, we found that 100 μM BPAF exposure affect oocyte maturation with a decreased first polar body extrusion (PBE) rate. Immunofluorescence study displayed that BPAF exposure disrupt the spindle morphology through affecting the function of microtubule organizing centers (MTOCs), which was confirmed by the dysfunction of γ-tubulin and phosphorylated mitogen-activated protein kinase (p-MAPK). As shown by reactive oxygen species (ROS) accumulation, BPAF exposure also induced oxidative stress. Moreover, DNA damage was significantly increased after BPAF exposure, which may be caused by oxidative stress. In addition, histone modification statuses were changed after BPAF exposure, as shown by western blot with decreased expression of H3K9me3 and H3K27ac. Collectively, our current work demonstrated the possibility of BPAF to negatively impact female fertility and revealed the mechanisms that BPAF disrupted mouse oocyte maturation by affecting cytoskeletal dynamics, inducing oxidative stress, increasing DNA damage, and changing the status of epigenetic modifications. This finding can help develop the potential therapies to alleviate oxidative damage to preserve fertility in people who are often exposed to BPAF environment.

Dimercapto-1-propanesulfonic acid (DMPS) induces metaphase II mouse oocyte deterioration

In light of the recent lead contamination of the water in Flint, Michigan and its potential adverse outcomes, much research and media attention has turned towards the safety profile of commonly used chelators. Dimercapto-1-propanesulfonic acid (DMPS) typically used in the treatment of lead, mercury and arsenic poisoning also displays a high affinity towards transition metals such as zinc and copper, essential for biological functioning. It is given in series of dosages (0.2–0.4g/day) over a long period, and has the ability to enter cells. In this work, we investigated the mechanism through which increasing concentrations of DMPS alter oocyte quality as judged by changes in microtubule morphology (MT) and chromosomal alignment (CH) of metaphase II mice oocyte. The oocytes were directly exposed to increasing concentration of DMPS (10, 25, 50, 100 and 300μM) for four hours (time of peak plasma concentration after administration) and reactive oxygen species (mainly hydroxyl radical and superoxide) and zinc content were measured. This data showed DMPS plays an important role in deterioration of oocyte quality through a mechanism involving zinc deficiency and enhancement of reactive oxygen species a major contributor to oocyte damage. Our current work, for the first time, demonstrates the possibility of DMPS to negatively impact fertility. This finding can not only help in counseling reproductive age patients undergoing such treatment but also in the development of potential therapies to alleviate oxidative damage and preserve fertility in people receiving heavy metal chelators.

Adolescents' sexual and reproductive health: an ecological perspective.

Adolescence is the key time in the formation of sexual confidence and fertility in people and many risky sexual behaviors in this sensitive era are the roots of many adulthood diseases. STD and early pregnancy are among the most important issues of adolescence. This study deals with reviewing ecological factors related to the sexual and reproductive health of adolescents. As this study was a narrative review the researchers conducted their computer search in public bases such as Google Scholar and then in more specialized ones such as MEDLINE, EMBASE, Science Direct, Up-to-date, SPRINGER, SID, Magi ran, Iranmedex and Irandoc with the key words adolescents, sexual health, reproductive health and ecological from 1991 to 2015. Initially 152 articles were elicited and after a review study of the title and abstract, 80 articles entered the study. After reading the full text, 39 articles were chosen for writing the current review article. Reviewing the articles led to organizing the contents in three main classes according to Bronfenbrenner's suggestion namely ecological factors at microsystem, mesosystem and macrosystem levels which include individual predisposing factors, environmental enabling factors and social reinforcing factors. Adolescents are at a high risk of STD and early pregnancy. Many factors are considered as effective at this critical era, based on which comprehensive intervention based on ecological factors is needed to step forward toward preventing adolescence risks.

Fertility in people with childhood-onset type 1 diabetes

To assess the number of live births in a population-based, retrospective cohort of women and men with childhood-onset type 1 diabetes, and matched controls. The reproductive histories of people in a Finnish cohort of 2,307 women and 2,819 men with type 1 diabetes and two matched controls (for each case) were obtained from National Population Register data. All persons with diabetes were diagnosed with the disease in 1965-1979 at the age of 17 or under. A proportional hazards model was used to model the association between the rate of live births as a function of the age of an individual and the observed covariates (sex and age at onset of diabetes). Both women and men with diabetes had a smaller number of live births than the controls; the HR of having a first child for diabetic women compared with controls was 0.66 (95% CI 0.62, 0.71) and for men was 0.77 (95% CI 0.72, 0.83). In women, a birth cohort effect was detected; in more recent birth cohorts, the difference between diabetic women and controls as regards having children was significantly smaller than in earlier cohorts. Later age at onset of diabetes was associated with a higher rate of having a first child among men (p = 0.04) and having a second live birth among women (p = 0.002). Type 1 diabetes affects the number of live births in both women and men. The age at onset of diabetes is associated with the pattern of reproduction in both diabetic women and men.

How Grandparents Matter

Low birth rates in developed societies reflect women’s difficulties in combining work and motherhood. While demographic research has focused on the role of formal childcare in easing this dilemma, evolutionary theory points to the importance of kin. The cooperative breeding hypothesis states that the wider kin group has facilitated women’s reproduction during our evolutionary history. This mechanism has been demonstrated in pre-industrial societies, but there is no direct evidence of beneficial effects of kin’s support on parents’ reproduction in modern societies. Using three-generation longitudinal data anchored in a sample of grandparents aged 55 and over in 1992 in the Netherlands, we show that childcare support from grandparents increases the probability that parents have additional children in the next 8 to 10 years. Grandparental childcare provided to a nephew or niece of childless children did not significantly increase the probability that those children started a family. These results suggest that childcare support by grandparents can enhance their children’s reproductive success in modern societies and is an important factor in people’s fertility decisions, along with the availability of formal childcare.

Rodność i umieralność na ziemiach polskich w kontekście teorii przejścia demograficznego

An attempt was made, in the article, to explain changes of people's fertility and mortality in ln 1918–1939 in context of the demographic transition as well as to determine transition phase periods. To set the beginning and the end of the "right" demographic transition, the non-linear regression (approximation by anti-logistic function in connection with the simple substitution method) was used in case of rigid fertility and mortality rates. According to the used methodology, it was found the "right" demographic transition (decrease in the mortality outdistanced decrease in the fertility) took place about 1885 on the Polish areas. Important differences in the level and dynamic of the fertility and mortality in different Poland's districts were indicated in the study too. On the basis of estimated models for each district it was stated, i.a. that the earliest (about 1871 and 1875) distinct collapse of the mortality trend took place in the west and south areas. From the time the "right" demographic transition was done on the areas. Moreover, on the basis of mortality tables from the twenty year period between two World Wars, it was recognized the value increase of the average life expectancy as well as a minor increase of the average years number of the reproduction age of the Poland's population (total: men and women).