High Birth Rates Research Articles

Place-Based Strategies Addressing Neighborhood Environments to Improve Perinatal and Preterm Infant Outcomes.

Preterm birth (defined as birth <37 weeks of gestation) is a significant health concern globally, with lasting implications for individuals, families, and society. In the United States, high preterm birth rates among Black and low-income populations likely result from differences in environmental exposures. Structural racism and economic disadvantage have led to unequal distribution of polluting industrial sites and roadways across society as well as differential access to health-promoting resources which contribute to preterm birth risk. Once born, preterm infants remain at risk for numerous environmentally responsive adverse health outcomes that affect growth and development throughout childhood and adulthood. In this commentary, we describe associations of neighborhood environments with pregnancy and preterm infant health outcomes and propose strategies to address harmful exposures that affect families across the lifespan.

Analyses of Fiscal and Current Account Balances: Do Deficits Matter in Lower and Middle-Income Countries?

This research investigates the nexus between current and fiscal account deficits in selected lower and middle-income countries (LMC) by applying panel data from 2000 to 2020. Autoregressive Distributed Lag (ARDL) is applied to check the long-run (LR) and short-run (SR) affiliation between selected variables. The findings revealed that REER, GDPPCG, and trade affect CAB positively, while FD and GFCF influence the CAB negatively in the LR. The SR estimation results show that FD and GFCF are significant in positively affecting CAB. Moreover, this paper proved that the Theory of Ricardian-Equivalence-Hypothesis (REH) is more appropriate for LMC. From the policy perspective, the authorities should follow policy measures such as raising taxes, declining government expenditures, and promoting economic growth to decline the current account deficit. Similarly, the Government of LMC should also improve the investment rate by controlling the high birth rate, inflation rate, and poverty.

Spontaneously hatching human blastocyst is associated with high development potential and live birth rate in vitrified-warmed single blastocyst transfer: A retrospective cohort study.

To investigate the effect of hatching status on predicting pregnancy outcomes in single vitrified-warmed blastocyst transfer (SVBT) by objectively subdividing pre-implantation blastocysts according to hatching status. This retrospective study included 817 SVBT cycles performed between January 2016 and December 2017. Transferred embryos were categorized according to their hatching status as follows: group I (n = 147), non-hatching blastocysts; group II (n = 484), hatching blastocysts; and group III (n = 186), completely hatched blastocysts. Hatching blastocysts (group II) were then classified based on the ratio of the blastocystic diameter outside and inside the zona pellucida into early (n = 185), mid- (n = 103), and late (n = 196) hatching stages. Implantation rate (IR), clinical pregnancy rate (CPR), live birth rate (LBR), multiple pregnancy rate (MPR), miscarriage rate, and neonatal outcomes were evaluated. For groups I, II, and III, respectively, the results were as follows: IR (28.6%, 43.6%, and 53.8%; P < 0.001), CPR (27.9%, 42.8%, and 53.2%; P < 0.001), and LBR (23.1%, 32.0%, and 42.5%; P < 0.001). Group III had better IR, CPR, and LBR. Among hatching blastocysts, late-hatching blastocysts had the highest IR (33.5%, 46.6%, and 51.5% for early, mid-, and late hatching, respectively; P = 0.002) and CPR (33.0%, 45.6%, and 50.5%; P = 0.002), with a tendency for a higher rate of LBR. Neonatal outcomes were not influenced by the hatching status. Advanced hatching status is positively associated with a higher rate of clinical pregnancy and live birth with no negative effects on neonatal outcomes. Additionally, the quantitative classification of hatching status was found to be predictive of pregnancy outcomes.

Comprehensive program development for congenital heart disease in the United Arab Emirates and in Singapore

Background/Objective. Establishment and development of tertiary-care centres for congenital heart disease (CHD) face multiple challenges as they need to be accessible, affordable/sustainable and provide the best possible outcomes. We report our experience of foundation a new tertiary-care CHD centre in the United Arab Emirates (UAE) and program development in Singapore.&#x0D; Methods. Prevalence and incidence of CHD in the context of local sociocultural environment was reviewed. Having established program elements of team, premises and workflow, quality assurance system was established. Outcome analysis, continuous audit modified internal therapeutic policies in accordance to international databases.&#x0D; Results. Consanguinity, segregated pattern of the population, high birth rate and low prenatal screening rate increased the incidence/prevalence and complexity of CHD in the UAE. Higher complexity/redo presentation and presence of associated anomalies were prevalent in Singapore at a lower birth rate. Increasing patient-load, strict professional working environment, strong governmental financial mandate for care nominated our centre into a market-leading position in the UAE. Singapore has a highly-developed, regulated, still competitive healthcare infrastructure that represents challenges for program development. Additional surgical activity from underserviced regions could provide the adequate CHD patient-pool that is critical to achieve team-expertise and ensure the best possible patient and program outcomes.&#x0D; Conclusion. CHD has significant public health aspects, however, new and/or developing centres face different challenges depending on the sociocultural and economic environment they function in. External demographic factors, case-load, complexity, referral patterns, health-care financing structure are difficult to adjust; internal factors: program structure, quality assurance, professional working framework are subjects for improvement.

Climate Change and Urban Migration in Sub-Saharan African Cities: Impacts and Governance Challenges

Abstract Urban informal settlements are rapidly expanding in countries around the world. This is due partly to high birth rates, but also because of growing in-migration driven by climate change impacts affecting rural populations. Urban informal settlements struggle with degraded and sometimes nonexistent infrastructure (such as water, sewage, and drainage systems) and service provision (health, education), and these shortcomings are aggravated by urban climate-related hazards like flooding and heat spikes. As informal settlements expand, their already overburdened infrastructure can lead to urban disasters such as flooding and landfill collapse. These challenges increase the governance and financial problems already faced by cities and create significant problems for climate resilience planning processes. Policy responses at both the national and city levels promise much but deliver little. This article reviews what is known about the environmental problems of informal settlements, particularly those in African cities, and how city governments have responded to those problems. We focus on two inland cities: Addis Ababa, Ethiopia, and Kampala, Uganda. We find that city climate adaptation plans do not incorporate the perspective of migrants, who are both particularly vulnerable to climate change and play a role in exacerbating environmental challenges in cities.

Understanding the Dynamics of Multi-Dimensional Poverty Index: BIMARU States: An Econometrics Approach

The research study analyzes multidimensional poverty in seven states of India, namely Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, and Uttar Pradesh. The study focuses on three key dimensions of poverty: infant mortality rate, birth rate, and educational dropout rates at both primary and upper primary levels. Additionally, the study examines the availability of basic amenities such as clean cooking fuel, improved sanitation facilities, and safe drinking water. By calculating the Multidimensional Poverty Index (MPI), the study ranks the states based on their performance in these dimensions. Madhya Pradesh emerges as the top-performing state with the lowest MPI score of 0.310745, followed by Uttar Pradesh, Rajasthan, Chhattisgarh, Odisha, Bihar, and Jharkhand. The study reveals that despite having relatively low MPI scores, Madhya Pradesh and Uttar Pradesh still struggle with high infant mortality rates and birth rates. This indicates the need for targeted interventions to improve healthcare and family planning services in these states. Additionally, the study highlights the importance of education in poverty reduction. It identifies Jharkhand and Chhattisgarh as states with the highest primary and upper primary education dropout rates. This emphasizes the need for improving the quality of education and implementing strategies to encourage school completion. It also states the importance of addressing issues related to healthcare, education, and basic amenities in order to reduce poverty and improve overall well-being. The normalized index approach used in this study provides a comprehensive and objective measure of poverty, enabling policymakers and stakeholders to make informed decisions and allocate resources effectively.

Patriarchy Without Masculinity in Homa-Bay County of Kenya (1894-2022)

Purpose: The purpose of this treatise is to justify the existence of patriarchy without masculinity because of the existence of patriarchal shell as evidenced in the male failure to meet the societal expectation of a functioning masculinity. This study is premised in the pre-colonial belief that in patriarchal society men made far-reaching decisions, they were the breadwinners and wielded exclusive authority and power.&#x0D; Methodology: The study used historical research design of Gottschalk Louis to collect, verifies, and synthesizes evidence from the past to establish facts that defended the existence of patriarchy without masculinity in Homa Bay. Purposive and snowball sampling techniques were used to identify the individuals and gender groups informants during the primary data collection. Primary data was also gathered from the National Archives to triangulate oral and secondary data. Secondary data were collected from, thesis, journal articles, books, and other publications from the internet, university, and other libraries.&#x0D; Findings: The data collected is given thematic content analysis based on study question. Primary and secondary data sources were corroborated to attain the validity and reliability of findings. The publication utilizes patriarchal theory of Robert Filmer which highlights the role of culture on gender performance roles and explains the role of patriarchal ideology in elevating men and making woman to depend on them for survival. In this study masculinity is viewed as a quality or set of habitual performed roles which were stereotypically connected with male gender as opposed to inherent in male. Contrary to the above, this study established that men still claim to have socio-economic and political entitlement in Homa Bay but the level of degeneration and reduction on the same is below expectation. Such degeneration makes patriarchy a shadow of its original reality. This premised in the study findings that there exists a widening masculine gap between the pre and postcolonial men of Homa Bay. The evidence in Homa Bay shows that most men fail to meet the societal expectation in their performances but grapple with vulnerability as they helplessly stare at the systematic loss of pre-colonial socio-economic and political patriarchal authority.&#x0D; Unique Contribution to Theory, Policy and Practice The existence indicators of the decline of patriarchal dominance in Homa Bay such as long-life expectancy among women, high birth rate among baby girls and the socioeconomic and political degeneration, make patriarchal; theory to be rethought. This paper shows that in the pre-colonial society, there was a concept of valorized hegemonic masculinity which men strived to emulate that consequently established patriarchy. Therefore, the policy makers, governments and the non-governmental organizations should reorganize their strategies to save masculinity from extinction for the purpose of gender egalitarian societies.

Business research methods: A perspective of street traders in the informal economy

Many people, despites being educated or not, struggle to find decent jobs in the formal economy. Some end-up working in the informal economy as self-employed/own-account workers. Informal economy is the largest employer with more potentials, employing approximately 61 percent of the global labour force. Despite different forms of occupations, street trading is the most visible occupation in the informal economy. There is a research gap between formal and informal economy, with most research done in the formal economy. It is recommended that micro-level individuals must be included in research to broaden knowledge. The informal economic activities are not reported in government statistics. It is odd because the informal economy is the largest global employer and street trading is found in both developed and developing economies. Informal economic activities are however associated with lack of growth and social security, money laundering, and financing of terrorist activities. The study was conducted to determine work engagement of street traders using the Utrecht Work Engagement Scale (UWES). The UWES is validated and used for quantitative studies in the formal economy. The instrument was pretested and piloted for quality appraisal purposes for validation and use in the informal economy. The general lack of credible records of street trading activities, makes it difficult for researchers to conduct studies using different methodologies in the informal economy. The convenience sampling strategy, a nonprobability sampling startegy, was used in choosing participants, and was most valid for solving the problem of the study, choosing participants accidentally on availability. Most quantitative studies involving street traders are restricted to using nonprobabiliity sampling, which is a concern. The high birth and/or mortality rate of street trading businesses make the database inconsistent to use as some do not report when exiting or entering. The lack of credible records/database of street trading activities, and over reliance on nonprobability sampling strategy, restrict the holistic generation of knowledge. The street traders’ activities must be registered to develop from knowledge generated through research.

Effectiveness of Perceiving and Opinion of the Compass Model in Monitoring the Toddlers’ Growth

Introduction: In comparison to other countries, Indonesia has higher birth rates. Chronic malnutrition, which results from inadequate dietary intake over a long period of time due to improper feeding practises, causes a condition known as stunting. This research aims to understand the perception and opinion of the compass model through its effectiveness in monitoring toddler growth. Methods: In this research, the qualitative method is used. The qualitative data is collected by conducting interview sessions with informants. Results: The result was obtained from an interview with experts. With all the benefits and ease of using Compass, mothers could be aware of and care for their children’s growth and development. Conclusion: The Compass Model is helpful as a new tool for mothers to monitor the growth of their children because it is easy to use and understand for midwives and mothers, who can read the result of the change.

Deaths associated with electric shock injuries in children and adults: A 10-year retrospective examination in Şanlıurfa, Southeast Turkey (2012-2022).

Electric shock injuries (EIs) have high rates of morbidity and mortality in both children and adults. The aim of this study was to examine autopsy cases resulting from EIs and to compare pediatric and adult groups with respect to sociodemographic data, clinical characteristics, location of the incident, electricity entry-exit wound characteristics, current direction, pathological effects of the electric shocks on the body, and cause of death. A total of 8075 autopsies conducted between 2012 and 2022 were retrospectively examined. Şanliurfa is a city in the southeast of Turkey with the highest birth rate in the country. Of 123 cases of death resulting from EIs in Şanliurfa, 58 (47.2%) were children (age < 18 years). In the majority of children (81%), a low-voltage injury resulted from a domestic appliance while the children were playing at home in a rural area. In the vast majority of adults, a high-voltage injury (HVI) resulted from a workplace accident due to working with HVI materials in an area outside the home. The manner of death was accidental in all the electric shock injuries. The electricity entry and exit wounds formed as a result of EIs had similar characteristics in both children and adults, with no significant difference identified. In the province of Şanliurfa, Turkey, which borders Syria and where the main occupation is agricultural activities, there is a need to increase electrical safety precautions within the home, educate parents, and increase electrical safety conditions and worker education in the workplace.

FAKTOR-FAKTOR YANG MEMPENGARUHI AKSEPTOR KB DALAM PEMILIHAN KONTRASEPSI MKJP DI TEMPAT PRAKTEK MANDIRI BIDAN JABA KELURAHAN KESIMAN DENPASAR TIMUR

&#x0D; &#x0D; One indicator of the success of a country's development is determined based on the quality of Human Resources (HR). This is indicated by the still high birth rate every year. The fast rate of population growth will slow down the achievement of ideal conditions between the quality and quantity of a person with inadequate carrying capacity and environmental capacity, making it difficult to increase and distribute people's welfare (BKKBN, 2019).&#x0D; . The decision-making role relates to the selection of contraceptives (Astuti and Holidi, 2015). Sources of information regarding the type or means of contraception can be obtained from community leaders, health workers, mass media and families who have an important role for couples of childbearing age (PUS) (Rachmayani, 2015). The role of health workers is related to the selection of contraceptives because they are considered to play a very important role in the final stage of choosing contraceptives (Andrianasti, 2014). The role of health workers is related to the selection of contraceptives because they are considered to play a very important role in the final stage of selecting contraceptives (Wulandari et al., 2016)&#x0D; The purpose of this study was to determine the factors that influenced family planning acceptors to choose KB MKJP at BPM JABA, Kesiman Village, East Denpasar. This type of research is a descriptive study with a cross sectional design.&#x0D; The results showed that the determinant factors (education, knowledge, husband's support) influence a person's attitude in making a decision to determine the choice of contraception to be used. The choice of contraception is influenced by economic factors, because the economy is related to the availability of funds in obtaining services for contraceptives that are chosen appropriately according to needs and desires.&#x0D;

Correlation between Anthropometric Measurement and Kidney Function in the Elderly to Detection of Chronic Kidney Disease

Chronic Kidney Disease (CKD) is a very common clinical problem in elderly patients and is associated with increased morbidity and mortality. The proportion of the elderly is predicted to further rise to 20% by the year 2030 caused by the demographic change from a pattern of high birth rates and high mortality to low birth rates. Delayed mortality has contributed to the rise in the elderly population. The aging process involves physiological and nutritional changes that will affect the nutritional status of the elderly, leading to malnutrition and overweight. Aging is associated with considerable changes in body composition, higher BMI is associated with improved survival in patients with CKD and very low BMI levels have been consistently associated with high all-cause mortality in the elderly. The changes in Body Fat Percentage (BFP) in the elderly will affect the estimated Glomerular Filtration Rate (eGFR) in the elderly. This study aimed to determine the correlation between anthropometric measurement and kidney function in the elderly population. this research is an analytic observational study with a cross-sectional design, which involved 42 elderly people with age &gt; 60 years in Guguak District, West Sumatera, Indonesia. Anthropometric measurement using the Waist-to-Height-Ratio (WHtR) method, Waist-to-Hip Ratio (WHR), Waist Circumference (WC), and Body Mass Index (BMI) and eGFR were calculated using the Cockcroft and Gault formula. The results of this study showed that the mean age of the elderly was 68±7.58 years, which consisted of 29.3% male and 70.7% female. The Pearson correlation test between WHR and eGFR obtained p&lt;0.05 with r= 0.439 and the Pearson’s correlation test between BMI and eGFR obtained p&lt;0.05 with r= 0.425. There was a moderate correlation between WHR with eGFR and BMI with eGFR in the elderly population.

Global variation and outcomes of expectant management of CSP.

The incidence of Cesarean scar pregnancies (CSPs) is rising globally. Ultrasound criteria for the diagnosis of CSPs have been described by the International Society of Ultrasound in obstetrics and gynecology and appear to be well used in various centers around the world. There is no guidance on best practices for expectant management of CSP, and there is considerable variation in how this is offered globally. Many studies have reported significant maternal morbidity in cases of CSP with fetal cardiac activity managed expectantly, largely relating to hemorrhage and cesarean hysterectomy from placenta accreta spectrum. However, high live birth rates are also reported. Literature describing the diagnosis and expectant management of CSP in low-resource settings is lacking. Expectant management in selected cases where no fetal cardiac activity is present is a reasonable option and can be associated with good maternal outcomes. Standardization in reporting different types of CSPs and correlating these with pregnancy outcomes will be an important next step in developing guidance for expectant management of this high-risk pregnancy with a high burden of complications.

ХАРАКТЕРИСТИКА ДЕМОГРАФИЧЕСКИХ ПРОЦЕССОВ В ЧУКОТСКОМ АВТОНОМНОМ ОКРУГЕ

Current: a comparative analysis of demographic processes in the Arctic regions of Russia adjacent to the Northern Sea Route allows us to determine the main areas of improvement and development. The aim of this study was estimation of demographic prospects of the territory of the Chukotka Autonomous Okrug based on the results of the analysis of birth and death rates. Materials and methods: The main demographic indicators in the Chukotka Autonomous Okrug from 2012 to 2022 were analyzed. A dynamic observation was carried out, as well as a comparison with the average statistical values for the Russian Federation. The main source of information was the database sites of the Unified Interdepartmental Information and Statistical System and the Federal State Statistics Service. The results of the study and their discussion. During the last 20 years, there has been a downward trend in the population. In the Chukotka Autonomous Okrug, despite the relatively high birth rate, the population decline is at a fairly high level in comparison with the data on average for the Russian Federation. It is associated with the migration outflow of the population, high morbidity and mortality from various causes. One should pay special attention to the mortality rate in working age; in the Chukotka Autonomous Okrug it is much higher than the average in Russia. The peak of mortality in the Chukotka Autonomous Okrug was observed from 2017 to 2019. Significant demographic losses are also caused by high mortality from tuberculosis, sudden external causes (suicide, murder). The main factors adversely affecting demographic indicators are the peculiarities of behavior mainly associated with alcoholism, as well as a decrease in the social, physical and psychological well-being of the population of the Chukotka Autonomous Okrug. Conclusion. The high and long-lasting infant mortality rate in the Chukotka Autonomous Okrug in comparison with that in the Russian Federation requires a thorough study of the causes and the development of programs to improve the situation in the region.

Demographic Development and Social-Demographic Policy in Zambia

The purpose of the study was to identify trends in demographic development and features of the socio-demographic policy of the Republic of Zambia in the context of the demographic transition. The main research method is the statistical analysis of the demographic data of the current registration and population censuses of the Republic. The sources of information are demographic statistics and demographic surveys presented in the materials of national agencies and international organizations of the UN system. Zambia is on the path of the demographic transition, but so far remains one of the youngest countries in the world in terms of the average age of the population. The annual population growth rate remains significant at the level of 2.5-3%. The country maintains a high birth rate. As a large cohort of young people enter their reproductive years, the population of the Republic is expected to double in the next 25 years. The demographic situation may exacerbate some socio-economic problems, including an increase in demand for jobs, a shortage of medical care and social services. In this situation, the state socio-demographic policy of Zambia, although focused on the UN Sustainable Development Goals until 2030, has not yet fully responded to demographic changes. By 2030, the authorities of the Republic of Zambia have set the achievement of a prosperous nation with an average income as the goal of the country’s development by 2030. In this context, the health of the workforce remains an important component. It is considered that a healthy workforce will allow the country to increase productivity and gain a significant demographic dividend.

The first homosporous lycophyte genome revealed the association between the recent dynamic accumulation of LTR-RTs and genome size variation.

The contrasting genome size between homosporous and heterosporous plants is fascinating. Different from the heterosporous seed plants and mainly homosporous ferns, the lycophytes are either heterosporous (Isoetales and Selaginellales) or homosporous (Lycopodiales). Many lycophytes are the resource plants of Huperzine A (HupA) which is invaluable for treating Alzheimer's disease. For the seed-free vascular plants, several high-quality genomes of heterosporous Selaginella, homosporous ferns (maidenhair fern, monkey spider tree fern), and heterosporous ferns (Azolla) have been published and provided important insights into the origin and evolution of early land plants. However, the homosporous lycophyte genome has not been decoded. Here, we assembled the first homosporous lycophyte genome and conducted comparative genomic analyses by applying a reformed pipeline for filtering out non-plant sequences. The obtained genome size of Lycopodium clavatum is 2.30Gb, distinguished in more than 85% repetitive elements of which 62% is long terminal repeat (LTR). This study disclosed a high birth rate and a low death rate of theLTR-RTs inhomosporous lycophytes, but the opposite occurs inheterosporous lycophytes. we proposethat the recent activity of LTR-RT is responsible forthe immense genome sizevariation between homosporous and heterosporous lycophytes. By combing Ks analysis with a phylogenetic approach, we discovered two whole genome duplications (WGD). Morover, we identified all thefive recognized key enzymes for the HupA biosynthetic pathway in the L. clavatum genome, but found this pathwayincompletein other major lineages of land plants. Overall, this study is of great importance for the medicinal utilization of lycophytes and the decoded genome data will be a key cornerstone to elucidate the evolution and biology of early vascular land plants.

P-529 High Live Birth Rates After Low Dose Immunization Therapy (LIT) Pre and Post Pregnancy With Partner Lymphocytes In Patients With Recurrent Miscarriage (RM)

Abstract Study question Could Lymphocyte Immunization Therapy effectively improve pregnancy and live birth rate in Unexplained Recurrent Miscarriage patients? Summary answer The use of paternal lymphocytes pre and post pregnancy significantly increases the pregnancy success and Live Birth Rate In Patients With Recurrent Miscarriage (RM) What is known already RM affects 1–2% of couples who attempt to conceive and has been defined as three consecutive pregnancy losses within 20 weeks of pregnancy confirmation. Although many potential causes have been established for RM, about 50% of these remain idiopathic and unexplained owing to immunology factors. Meta-analyses have observed better effectiveness and safety of LIT in treating couples with RM shown improvement in pregnancy outcomes. Still, results are conflicting due to different screening criteria and therapeutic protocols. Objective of present study is to evaluate effectiveness of low dose LIT in patients with uRM and Th1/Th2/Treg paradigm disorders Study design, size, duration In self-controlled, prospective study, after IEC clearance and obtaining Informed consent, 19 RM patients underwent immunization with partner lymphocytes from August 2021 to October 2022. Inclusion criteria were at least three clinical pregnancies that culminated in abortion before 20 weeks of gestation or at least three cycles of IVF/ICSI with at least two PGT+ embryos and &amp;gt;8mm endometrium during ET and no pregnancy, normal coagulation tests, autoimmune antibodies negative, normal couple karyotyping. Participants/materials, setting, methods Maternal BMI of 30 and age of 45 was the upper limit with peripheral blood Th1/Th2/Treg cells proportions and concentrations of TNF-a, IFN-g, TGF-β1, IL-2, IL-4, IL-6, IL-10, and blocking antibodies were detected using flowcytometry/ELISA as per Seragen’s Immuno profiling platform. 30-50ml paternal blood was used to purify lymphocytes which were intradermally administered to the wife before Embryo Transfer and post-pregnancy confirmation. Main results and the role of chance Proportion of Th1 cells was significantly decreased while the proportions of Th2 cells and Treg cells were significantly increased in immunotherapy patients after treatment. In addition, the concentration of TGF-β1 in serum was significantly higher after immunotherapy than before. The concentration of TNF-a, IFN-g was significantly high before therapy were significantly decreased after therapy. LIT effectively induced the production of blocking antibodies in all the patients. 16/19 (84%) uRM patients underwent ET post LIT became pregnant and 4 of the pregnant patient had delivered healthy babies (21%). 42% (8/19) of patients have reported uneventful ongoing pregnancies crossed &amp;gt;14weeks. 4 patients who were pregnant for more than 12-14 weeks had miscarriages (21%). 1 patient (5%) did not conceive. 1 patient (5%) conceived spontaneously and crossed 20 weeks of uneventful gestation. 1 patient (5%) opted to try to conceive naturally hence ET is not planned. The cumulative positive uneventful pregnancy outcome was 68%, approximately the same as the figures reported earlier. LIT is associated with high live birth rates, especially in women with RM. It not only ameliorates patient’s cellular immune function but also further increases patient’s pregnancy success rate with high safety, which is worthy of clinical application and promotion. Limitations, reasons for caution This prospective self-control study with small sample size lacks randomized control group. Beneficial effects observed in this study are in sync with published data. Larger study with patients recruited based on inclusion criteria of unexplained recurrent miscarriage due to immunological factors is proposed for recommending LIT as routine therapy. Wider implications of the findings Our study findings supports LIT as a beneficial treatment for RM/RIF in IVF patients. LIT may be considered safe and effective therapy in individual cases and based on the immunoprofiling (Th1/Th2/Treg paradigm disorders), after all other potential causes of RM or RIF have been ruled out. Trial registration number Not applicable

Outcomes of Social Egg Freezing: A Cohort Study and a Comprehensive Literature Review.

The purpose of this study is to evaluate the live birth outcome following oocyte thaw in women who underwent social egg freezing at Guy's Hospital, alongside a detailed published literature review to compare published results with the current study. A retrospective cohort study was conducted between January 2016 and March 2022 for all women who underwent egg freezing during this period. Overall, 167 women had 184 social egg freezing cycles. The mean age at freeze was 37.1 years and an average of 9.5 eggs were frozen per retrieval. In total, 16% of the women returned to use their frozen eggs. The mean egg thaw survival rate post egg thaw was 74%. The mean egg fertilisation rate was 67%. The pregnancy rate achieved per embryo transfer was 48% and the live birth rate per embryo transfer was 35%. We also noted that irrespective of age at freezing, a significantly high live birth rate was achieved when the number of eggs frozen per patient was 15 or more. Despite the rapid increase in social egg freezing cycles, the utilisation rate remains low. Pregnancy and live birth rate post thaw are encouraging if eggs are frozen at a younger age and if 15 eggs or more were frozen per patient.

Urinary Tract Infection and Associated Factors among Pregnant Women Receiving Antenatal Care at a Primary Health Care Facility in the Northern Region of Ghana.

Urinary tract infection (UTI) is frequently encountered during pregnancy and is associated with adverse maternal, fetal, and neonatal effects. However, very little information is available on the prevalence of UTI among pregnant women in the northern part of Ghana, a region with a high birth rate. This study employed a cross-sectional analysis of the prevalence, antimicrobial profile, and risk factors associated with UTI in 560 pregnant women attending primary care for antenatal check-ups. Sociodemographic obstetrical history and personal hygiene information were obtained using a well-structured questionnaire. Afterward, clean catch mid-stream urine samples were collected from all participants and subjected to routine microscopy examination and culture. Of 560 pregnant women, 223 cases (39.8%) were positive for UTI. There was a statistically significant association between sociodemographic, obstetric, and personal hygiene variables and UTI (p < 0.0001). Escherichia coli (27.8%) was the commonest bacterial isolate followed by CoNS (13.5%) and Proteus species (12.6%). These isolates exhibited greater resistance to ampicillin (70.1-97.3%) and cotrimoxazole (48.1-89.7%) but were fairly susceptible to gentamycin and ciprofloxacin. Gram-negative resistance to meropenem was up to 25.0%, and Gram positives resistance to cefoxitin and vancomycin was up to 33.3% and 71.4% respectively. The current findings extend our knowledge of the high frequency of UTIs and associated risk factors in pregnant women with E. Coli being the predominant and usual isolate. Variation existed in the resistance pattern of isolates to various drugs, underscoring the need to perform urine culture and susceptibility before treatment.

Day after rescue ICSI: eliminating total fertilization failure after conventional IVF with high live birth rates following cryopreserved blastocyst transfer.

What is the impact of day after rescue ICSI (r-ICSI) on success of fresh and frozen embryo transfers? The use of r-ICSI can virtually allay fears of total fertilization failure (TFF) after conventional IVF (C-IVF) and achieve high live birth rates after frozen blastocyst transfer. More infertility clinics have resorted to the use of ICSI in place of C-IVF in IVF treatment owing to fear of TFF or a low fertilization rate. r-ICSI has been attempted either on the day of IVF or the day after. Day after r-ICSI has proved unsuccessful in the past. A retrospective data analysis was performed of 16 608 qualifying cases between April 2010 and July 2021 conducted at a single private academically affiliated fertility clinic. r-ICSI was performed principally on patients with >4 metaphase II oocytes, showing no signs of fertilization 18 h after C-IVF. C-IVF was performed on patients who had >4 million total motile sperm after preparation. r-ICSI was then performed 18-24 h after insemination, using the sperm sample from the previous day. r-ICSI fertilization rates, cryopreservation of cleavage and blastocysts embryos, and pregnancy rates after fresh or frozen transfer were then assessed. r-ICSI was performed on 377 patients (2.3% of eligible retrieval cycles) who had a mean (±SD) female and male age of 35.9 ± 4.5 and 38.1 ± 9.1 years, respectively. A total of 5459 oocytes were initially retrieved. Of the oocytes undergoing r-ICSI, 2389 (49.5%) fertilized normally, and 205 (54.4%) patients underwent a fresh embryo transfer. The live birth rates were 23/186 (12.3%) for fresh cleavage and 5/19 (26.3%) for fresh blastocyst stage transfers. In 145 cycles a blastocyst was frozen, and 137 transfers were performed with a 64/137 (46.7%) live birth rate. Of the 377 cycles receiving r-ICSI only, 25 of the qualifying cases failed to have any fertilization, reducing TFF to 25/16 608 (0.15%). This was a single-center retrospective study on a specific subset of patients, which may limit its generalizability to other clinics. r-ICSI allows a second opportunity to fertilize oocytes despite poor initial outcomes. Patients who had a frozen blastocyst transfer achieved high live birth rates, indicating that a resynchronization of the embryo with the endometrium can optimize r-ICSI cases. r-ICSI allays fears of TFF when using C-IVF, providing evidence that the overuse of ICSI in patients without male factor may not be warranted. The study was internally funded by Boston IVF. The authors declare that they have no conflict of interest in relation to the data published in the article. N/A.