Implications For Reproductive Health Research Articles

Impact of the COVID-19 Pandemic on Chlamydia and Gonorrhea Screening in the U.S.

IntroductionThis study evaluates the impact of the COVID-19 pandemic on testing for common sexually transmitted infections. Specifically, changes are measured in chlamydia and gonorrhea testing and case detection among patients aged 14–49 years during the COVID-19 pandemic.MethodsU.S. chlamydia and gonorrhea testing and positivity were analyzed on the basis of >18.6 million tests (13.6 million tests for female patients and 4.7 million tests for male patients) performed by a national reference clinical laboratory from January 2019 through June 2020.ResultsChlamydia and gonorrhea testing reached a nadir in early April 2020, with decreases (relative to the baseline level) of 59% for female patients and 63% for male patients. Declines in testing were strongly associated with increases in weekly positivity rates for chlamydia (R2=0.96) and gonorrhea (R2=0.85). From March 2020 through June 2020, an expected 27,659 (26.4%) chlamydia and 5,577 (16.5%) gonorrhea cases were potentially missed.ConclusionsThe COVID-19 pandemic impacted routine sexually transmitted infection services, suggesting an increase in syndromic sexually transmitted infection testing and missed asymptomatic cases. Follow-up analyses will be needed to assess the long-term implications of missed screening opportunities. These findings should serve as a warning for the potential sexual and reproductive health implications that can be expected from the overall decline in testing and potential missed cases.

Domestic violence among women attending ante natal care in a tertiary health facility in south-south Nigeria

Background: Domestic violence is a preventable public health problem that is under reported and under diagnosed. Women are usually the most affected and presents with serious psycho-social, physical and reproductive health implications. It violates the fundamental human right of victims and associated with perinatal and maternal morbidity and mortality.Methodology: The study was a cross sectional descriptive study, conducted among pregnant women attending ante-natal care (ANC) at the ante natal care clinic of the department of Obstetrics and Gynecology (O and G), university of Port Harcourt Teaching Hospital. All eligible pregnant women who visited the ANC clinic were enlisted for the study until the required sample size was attained. Study instrument included a pretested, adapted, interviewer administered, questionnaire which was prepared in English language. Results were presented in simple frequency distribution table while data was analyzed using SPSS version 22.0. Categorical data were analyzed using chi-square test. Ethical clearance was granted by the hospitals ethical committee while permission for the study was also derived from the department of O and G and the Hospital Management.Result: Results from the study revealed a statistically significant association between alcohol, cigarette ingestion and domestic violence. Results also shows associated risk factors to domestic violence such as low income, religion, poor educational background and unemployment.Conclusion: Domestic violence is a breach of fundamental human right of those abused. It is significantly associated with alcohol and cigarette ingestion, while it is associated with young age of couple, cohabitation, poor educational background and duration of marriage. Improving women empowerment and education could help curb this social vice.

Prenatal exposure to maternal stressful life events and earlier age at menarche: the Raine Study.

Is there an association between prenatal exposure to stressful life events and age at menarche, and does childhood BMI mediate this association? Girls exposed to prenatal stress had a slightly earlier age at menarche, but this association did not show a dose-response effect and was not mediated by childhood offspring BMI. Prenatal stress may impact on reproductive function in females including age at menarche, but human data are very limited. High childhood BMI is known to be associated with earlier age at menarche. Only one small study has measured the association between maternal stress and age at menarche and reported that childhood BMI mediated the association between maternal stress and earlier age at menarche. However, neither maternal stress nor age at menarche was prospectively recorded and the study was limited to 31 mother-daughter pairs. The Raine Study is a large prospective population-based pregnancy cohort study (n = 1414 mother-daughter pairs) continuously followed from prenatal life through to adolescence. In the present study, we examined the association between exposure to maternal stressful life events during early, late and total gestation and age at menarche in offspring using 753 mother-daughter pairs with complete case information. Mothers prospectively reported stressful life events during pregnancy at 18 and 34 weeks using a standardized 10-point questionnaire. Exact date of menarche was assessed using a purpose-designed questionnaire at 8, 10, 14 and 17 years of age. Complete information on exposure, outcome and confounding variables was obtained from 753 mothers-daughter pairs. Multivariate linear regression complete case analysis was used to examine associations between maternal stressful life event exposure and age at menarche. Potential selection bias was evaluated using multiple imputations (50 datasets). The mediating effects of offspring childhood BMI (ages 5, 8, or 10 years) on these associations were measured in separate sub-analyses. Most (580/753, 77%) daughters were exposed to at least one prenatal stressful life event. Exposure to maternal stressful life events during the entire pregnancy was associated with a non-linear earlier age at menarche. Exposure to one event and two or more psychological stressful events was associated with a 3.5 and 1.7-month earlier onset of puberty, respectively when compared to the reference group with no exposure maternal stressful life events. The estimates from multiple imputation with 50 datasets were comparable with complete case analysis confirming the existence of an underlying effect. No separate significant effects were observed for exposure during early or late gestation. The association between prenatal stressful events and age at menarche was not mediated by childhood BMI in the offspring. Stressful life events may have affected pregnant women in different ways and self-perceived maternal stress severity may have provided a more precise estimate of gestational psychological stress. The observed non-linear U-shape of the association between maternal psychological stress and age at menarche did not reflect a dose-response. This suggests that the first exposure to prenatal stress exerts a greater effect on fetal reproductive development. A potential mechanism is via dramatic initial activation of the hypothalamic-pituitary-adrenal (HPA) axis following the first stressful life event which is greater than that observed following subsequent exposure to two or more maternal stressful life events. Whilst we adjusted for a priori chosen confounders, we cannot exclude residual confounding or confounding by factors we did not include. Maternal age at menarche was not available so the effects of familial history/genetics could not be assessed. There was a large loss due to the number of girls with no information on date of menarche and missing confounder information implying risk of selection bias and multiple imputation analyses did not fully exclude this risk (similar direction but slightly weaker estimate magnitude). Menarche is a sentinel reproductive event and earlier age at menarche carries implications for psychological, social and reproductive health and for long-term risk of common non-communicable diseases. Understanding the factors regulating age at menarche has extensive health implications. This is the first population-based cohort study in humans to demonstrate that prenatal psychological stress might directly modify age at menarche. Dr. Bräuner and Trine Koch's salaries were supported by Doctor Sofus Carl Emil Friis and spouse Olga Doris Friis foundation, The Danish Cancer Society (Kræftens Bekæmpelse, RP15468, R204-A12636, Denmark) and The Danish Health Foundation (Helsefonden, F-22181-23, Denmark). Martha Hickey was funded by NHMRC Practitioner Fellowships. The funding bodies played no role in the design, collection, analysis, or interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. Dr. Hart has received personal fees in his function as the Medical Director of Fertility Specialists of Western Australia and received educational sponsorship grants from MSD, Merck-Serono and from Ferring Pharmaceuticals. Dr Hart has also received personal fees from Shareholders in Western IVF outside the submitted work. NA.

Assessing the effects of non-optimal temperature on risk of gestational diabetes mellitus in a cohort of pregnant women in Guangzhou, China

Previous observational studies have shown that exposure to ambient temperature and air pollution were associated with the incidence of gestational diabetes mellitus (GDM). However, the susceptible time window of non-optimal temperature on GDM is still unknown, and the interaction with air pollution has not been examined. We conducted a prospective cohort study in Guangzhou, China to investigate the windows of susceptibility of temperature extremes and variability on the risk of GDM and to explore any interaction effect with air pollution. Daily maximum (Tmax), minimum temperature (Tmin) and diurnal temperature range (DTR) were obtained from Guangdong Meteorological Service. Distributed lag non-linear models with a logistic regression were applied to assess the effect of temperature extremes and DTR in different weeks of gestation on GDM. To examine the interaction effect, relative excess risk due to interaction index, attributable proportion and synergy index were calculated. There were 5,165 pregnant women enrolled, of which 604 were diagnosed with GDM (11.7%). Compared with a reference temperature (50th percentile of Tmax), we found that extreme high temperature (99th percentile of Tmax) exposure during 21st and 22nd gestational weeks was associated with an increased risk of GDM. Extreme low temperature (1st percentile of Tmax) exposure during 14th to 17th weeks increased the risk of GDM. We observed that per 1 °C increment of DTR during 21st to 24th weeks was associated with an elevated GDM risk. No interaction effect of temperature extremes or variability with air pollution on GDM were observed. Our results suggested that non-optimal temperature is an independent risk factor of GDM. The time window of susceptibility for extreme temperatures and DTR exposure on the risk of GDM generally occurred in second trimester of pregnancy. In the context of climate change, our study has important implications for reproductive health and justifies more research in different climate zones.

Organochlorine pesticide residues in Uganda’s honey as a bioindicator of environmental contamination and reproductive health implications to consumers

Honey has multifaceted nutritional and medicinal values; however, its quality is hinged on the floral origin of the nectar. Taking advantage of the large areas that they cover; honeybees are often used as bioindicators of environmental contamination. The focus of the present paper was to examine the quality of honey from within the vicinity of an abandoned pesticide store in Masindi District in western Uganda. Surficial soils (<20 cm depths) and honey samples were collected from within the vicinity of the abandoned pesticide store and analysed for organochlorine pesticide (OCP) residues using gas chromatograph coupled to an electron capture detector (GC-ECD). The mean level of ∑DDTs in all the soil samples was 503.6 µg/kg dry weight (d.w). ∑DDTs contributed 92.2% to the ∑OCPs contamination loads in the soil samples, and others (lindane, aldrin, dieldrin, and endosulfans) contributed only 7.8%. Ratio (p, p′-DDE+p, p′-DDD)/p, p′-DDT of 1.54 suggested historical DDT input in the area. In all the honey samples, the mean level of ∑DDTs was 20.9 µg/kg. ∑DDTs contributed 43.3% to ∑OCPs contamination loads in the honey samples, followed by lindane (29.8%), endosulfans (23.6%) and dieldrin (3.2%), with corresponding mean levels of 14.4, 11.4 and 1.55 µg/kg, respectively. Reproductive risk assessment was done based on the hazard quotient (HQ) and hazard index (HI) procedure. In our study, the calculated HIs for adults (102.38), and children (90.33) suggested high potential health risks to the honey consumers. Lindane, endosulfan and p, p′-DDD detected in the honey samples at levels exceeding the acute reference dose (ARfD) are known risk factors for spontaneous abortion, reduced implantation, menstrual cycle shortening, impaired semen quality, and prostate cancer in exposed individuals and experimental animal models.

‘I love my job…it’s more the systems that we work in’: the challenges encountered by rural sexual and reproductive health practitioners and implications for access to care

This paper focuses on rural aspects of sexual and reproductive health and sexuality. Disadvantage of access to practitioners with expertise in sexual and reproductive health and sexuality is compounded for rural residents. Retaining and supporting the rural sexual and reproductive health workforce is important in addressing sexual health inequities and promoting the sexual and reproductive rights of rural residents. However, little is known about the role-related challenges encountered by rurally-based sexual and reproductive health practitioners. We draw on 15 qualitative interviews with general practitioners and nurses with recognised expertise in sexual and reproductive health working in three rural regions of Victoria, Australia. Findings highlight the precarious state of sexual and reproductive health delivery in rural contexts and draw attention to the unsustainability of current systems for providing access to care in rural settings. Problems stem from cultural processes and assumptions within the health sector. Adapting organisational cultures and how sexual and reproductive health is structured within the health system are critical to improving access for rural residents. Our findings have relevance for other high-income, Eurocentric and metrocentric countries with public health systems and similar geographies.

Viral infections and implications for male reproductive health.

Viral infections have haunted humankind since times immemorial. Overpopulation, globalization, and extensive deforestation have created an ideal environment for a viral spread with unknown and multiple shedding routes. Many viruses can infect the male reproductive tract, with potential adverse consequences to male reproductive health, including infertility and cancer. Moreover, some genital tract viral infections can be sexually transmitted, potentially impacting the resulting offspring's health. We have summarized the evidence concerning the presence and adverse effects of the relevant viruses on the reproductive tract (mumps virus, human immunodeficiency virus, herpes virus, human papillomavirus, hepatitis B and C viruses, Ebola virus, Zika virus, influenza virus, and coronaviruses), their routes of infection, target organs and cells, prevalence and pattern of virus shedding in semen, as well as diagnosis/testing and treatment strategies. The pathophysiological understanding in the male genital tract is essential to assess its clinical impact on male reproductive health and guide future research.

Teratogenicity and toxicity of the new BPA alternative TMBPF, and BPA, BPS, and BPAF in chick embryonic development

Bisphenol A (BPA) is a widely known, yet controversial reproductive toxin, capable of inducing reproductive, developmental, and somatic growth defects across species. Due to scientific findings and public concern, companies have developed BPA alternatives remarkably similar to BPA. However, these alternatives have had much less testing and oversight, yet they are already being mass-produced and used across industries from plastics to food-contact coatings. The newest one, tetramethyl bisphenol F (TMBPF), is the least well-studied and has never been investigated in embryological models, however it continues to be mass produced and found in various products. Here, we used the chicken embryotoxicity screening test to compare the toxicities and potencies of several BPA analogs including TMBPF. We exposed developing chicken (Gallus gallus domesticus) embryos in ovo, from embryonic day 5 to 12 (E5–12), to increasing concentrations of BPA, bisphenol S (BPS), bisphenol AF (BPAF), and TMBPF, from 0.003 to 30 μM, and analyzed their developmental and toxic effects. The bisphenols significantly impaired development, growth, and survival in a dose-dependent manner, even at low, environmentally relevant concentrations of 3–30 nM. There was severely reduced growth and developmental delay, with exposed embryos averaging half the size and weight of control vehicle-treated embryos. The most common and severe dysmorphologies were craniofacial, eye, gastrointestinal, and body pigmentation abnormalities. The bisphenols caused dose-dependent toxicity with the lowest LC50s (lethal concentration with 50% survival) ever demonstrated in chick embryos, at 0.83–2.92 μM. Notably, TMBPF was the second-most toxic and teratogenic of all chemicals tested (rank order of BPAF > TMBPF > BPS > BPA). These results underscore the adverse effects of BPA replacements on early embryo development and may have implications for reproductive health and disease across species, including pregnancy exposures in humans.

Increased Frequency and Changing Patterns of Marital Sexual Activity During COVID-19: Evidence from Longitudinal Data Prior to, During and After Lockdown in Singapore

This longitudinal study followed 409 Singaporean heterosexual married female respondents who completed a baseline survey in April-July 2018 and biweekly online surveys on exact dates of sexual activity over the next 14 weeks, an online survey in May 2020 during the COVID-19 lockdown, and an online survey in June 2020 after the lockdown was lifted. Results point to more active and flexible marital sex lives during the pandemic, with effects that persisted after the lockdown ended. The proportion who reported not having marital sex within a week fell from 54.30% in 2018 to 49.79% in 2020, while weekly sexual frequency increased from an average of 0.68 to 0.78 times. Probability of sexual activity was significantly higher on weekends prior to but not during the pandemic. Stress, fatigue and marital satisfaction was associated with probability of non-activity and sexual frequency, whereas couple’s stay-at-home status was not associated with outcomes of interest. The increase in flexibility in marital sex lives holds implications for sexual and reproductive health, including sexual satisfaction, prevalence of infertility and low birth weight associated with waiting time to pregnancy.

Internal Displacement in Nigeria: It’s Impact on Women’s Reproductive Health

Internal Displacement in Nigeria: It’s Impact on Women’s Reproductive Health Professor (Mrs.) T. U. Akpoghome Abstract In times of crisis, the ability to access good medical care is a determinant of whether the woman involved lives or dies. This paper examines the reproductive health implications arising from internal displacement in Nigeria and the laws that protect internally displaced persons. The doctrinal methodology of research was employed thus both primary and secondary sources of law relating to internal displaced persons were examined. It finds that in times of crisis, it is common place to see people flee their habitual places of residence to take up respite in temporary habitations, in order to avoid the effects of violations of their human rights. The impact of this displacement is mostly felt by women and children. The scale of internal displacement and the inevitable problems arising therefrom, in proportion to the nature of response from government have become an increasing cause for worry in contemporary times. More worrisome is the fact that the array of international legal instruments protecting internally displaced persons has not been domesticated in Nigeria, leaving a protection gap in that respect. It is therefore recommended that these Laws be domesticated and given effect in other to protect the lives and dignity of women caught up in armed conflict amongst others. Full Text: PDF DOI: 10.15640/jlcj.v9n2a8

Inconsistent reporting of drug–drug interactions for hormonal contraception and antiepileptic drugs – Implications for reproductive health for women with epilepsy

Drug compendia are the source of safety prescribing information. We assessed the reporting concordance of drug–drug interactions between hormonal contraception and antiepileptic drugs (AEDs) among eight leading international drug compendia. Antiepileptic drugs reported to interact with ≥1 form of hormonal contraception were reviewed. Scaled concordance was quantified using linearly weighted percent agreement (wPA). Differences in interaction severity rankings between hormonal contraception forms were evaluated using the Wilcoxon signed-rank test.There was high agreement among compendia for interactions of combined hormonal contraception interactions with AEDs (wPA = 0.82–0.84), especially potent enzyme-inducing AEDs (wPA = 0.89). However, concordance was reduced for AED interactions with progestin-only contraception (wPA = 0.69–0.81). Extreme interaction reporting discrepancies were found for less potent enzyme-inducing AEDs. The greatest variability in interaction reporting was observed for injectable and intrauterine contraception (wPA = 0.69 and 0.70, respectively), which are the only hormonal contraception options currently classified as not interacting with enzyme-inducing AEDs.Drug–drug interaction reporting variability can have major clinical implications and highlights critical knowledge gaps in the care of women with epilepsy of childbearing age. Further research on AED–contraceptive interactions is needed to standardize compendia reporting and enhance evidence-based clinical guidelines for women with epilepsy.

A Review of Volatile Organic Compound Contamination in Post-Industrial Urban Centers: Reproductive Health Implications Using a Detroit Lens.

Volatile organic compounds (VOCs) are a group of aromatic or chlorinated organic chemicals commonly found in manufactured products that have high vapor pressure, and thus vaporize readily at room temperature. While airshed VOCs are well studied and have provided insights into public health issues, we suggest that belowground VOCs and the related vapor intrusion process could be equally or even more relevant to public health. The persistence, movement, remediation, and human health implications of subsurface VOCs in urban landscapes remain relatively understudied despite evidence of widespread contamination. This review explores the state of the science of subsurface movement and remediation of VOCs through groundwater and soils, the linkages between these poorly understood contaminant exposure pathways and health outcomes based on research in various animal models, and describes the role of these contaminants in human health, focusing on birth outcomes, notably low birth weight and preterm birth. Finally, this review provides recommendations for future research to address knowledge gaps that are essential for not only tackling health disparities and environmental injustice in post-industrial cities, but also protecting and preserving critical freshwater resources.

SARS-CoV-2 and its relationship with the genitourinary tract: Implications for male reproductive health in the context of COVID-19 pandemic.

The current outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, named coronavirus disease 19 (COVID-19), is not the first well-known spillover of an animal originated virus to infect humans. However, one of the few to make such a fast jump in a powerful evolutionary shortcut. The incredible pattern of aggressiveness worldwide since the beginning of the outbreak is that up to 20% of those infected need hospitalization and 5% evolve to critical conditions, not limited to respiratory-related issues, but rather to systemic involvement. This study aims to summarize the current knowledge about the effects of SARS-CoV-2 infection on the male genitourinary tract. A narrative review was carried out to identify articles on the SARS-CoV-2 infection on the male genitourinary system. Considerations were made about the molecular characteristics of SARS-CoV-2 and immune response to coronavirus. We discussed the influence of the virus on the urinary system, potential mechanisms of COVID-19- related acute kidney injury (AKI), and the role of cytokine release syndrome on the renal pathophysiology of the disease. In the male reproductive tract, it was discussed the testis' vulnerability to SARS-CoV-2 invasion and the possible adverse effects on its function and the seminal findings of COVID-19. During the COVID-19 pandemic, an international coordinated scientific effort must arise to understand the role of the urogenital system in the SARS-CoV-2 infection in the clinical setting.

Prevalence and associated factors of undiagnosed hypertension among women aged 15-49 years in India: an analysis of National Family Health Survey-4 data.

Hypertension is a major risk factor for cardiovascular disease globally. Although Indian studies have addressed the prevalence of hypertension and its associated factors, this study focuses upon women in the reproductive age group, 15-49 years, who have undiagnosed hypertension. We use NFHS-4 data for secondary analyses of prevalence and factors associated with undiagnosed hypertension among women aged 15-49 years in India. Multiple logistic regression was undertaken to identify associated factors. Our analyses showed that overall prevalence of undiagnosed hypertension was 18.69% among women aged 15-49 years in India. In rural areas, it was 17.09% compared and 21.73% inurban areas. By comparison, only 8.86% self-reported a diagnosis of hypertension. Factors associated with undiagnosed hypertension were age, less than or more than normal BMI, higher wealth quintiles, no education, religion, caste, and geographical zones. Almost one in five women aged 15-49 years in India has undiagnosed hypertension with implications for personal and reproductive health.

Mild and Asymptomatic Covid-19 Infections: Implications for Maternal, Fetal, and Reproductive Health.

OPINION article Front. Reprod. Health, 16 June 2020Sec. Reproductive Epidemiology Volume 2 - 2020 | https://doi.org/10.3389/frph.2020.00001

Associations between intrauterine exposure to polychlorinated biphenyls on neonatal ano-genital distance

Polychlorinated Biphenyls (PCBs) are widespread environmental contaminants. PCBs have endocrine disrupting properties which raises concerns regarding their effect on the developing fetus.This study aimed to examine the association between prenatal exposure to PCBs and anogenital distance (AGD) in newborns.Serum concentrations of PCB congeners -118, -138, -153 and -180 were measured in 175 pregnant women presenting to the delivery room. AGD was measured in their newborns. Regression models were used to estimate associations between maternal PCB exposure and infant anogenital measurements, controlling for possible confounding variables.Mean maternal serum concentrations were 2.95 ± 2.18 ng/g, 4.62 ± 3.54 ng/g, 7.67 ± 6.42 ng/g and 5.10 ± 3.91 ng/g for congeners -118, -138, -153 and -180, respectively. Higher maternal concentrations of PCBs were associated with reduced AGD measures in male infants. Higher maternal concentrations of PCB-138 and PCB-153 were associated with reduced ano-scrotal distances and higher maternal concentrations of all four PCB congeners were associated with reduced ano-penile distances. No significant associations were found between any PCB congener and any AGD measure in female newborns.This study demonstrates that intrauterine exposure to PCBs may be associated with reduced AGD in male newborns. More research is needed to reveal the implications for adult reproductive health.

Persistence of platinum in semen of cisplatin-treated survivors of advanced testicular cancer.

5056 Background: Cisplatin is highly curative treatment for testicular cancer. Most survivors develop azoospermia immediately after cisplatin with recovery expected in 50% at 2 years and 80% at 5 years. Platinum is a heavy metal that can be detected at low levels in serum many years after treatment, however, it is not known whether platinum also persists in semen and if platinum persistence in semen is associated with impaired fertility. Methods: Testicular cancer survivors previously treated with cisplatin were enrolled, relapsed disease treated with salvage chemotherapy was excluded. Semen samples were collected to assess semen quality. Repeat semen collections were performed if azoo- or oligospermia was noted. Serum and semen Platinum levels were determined using HPLC-tandem mass spectrometry. DNA Fragmentation Index (DFI) was measured. Results: From 11/2017 to 12/2019, 38 pts (median age 32 years; range: 19-52; median BSA 2.03; range: 1.81-2.61) were enrolled, 31 were treated with 3 cycles of Bleomycin, Etoposide, Cisplatin. Median cumulative cisplatin dose was 300 mg/m2 (range: 274-404). Median serum platinum concentration was 0.1 ng/mL (range: 0-22.6) at a median of 11 months (range 0.5-36) post treatment completion. Median semen platinum concentration was 0.5 ng/mL (range: 0.2-28.7) at a median of 14 months (range: 1.3-40) post treatment completion. Semen platinum levels were higher in semen than in blood drawn at the same time (p = 0.03). Semen platinum levels were associated with time from last cisplatin dosing (r = -0.34; p = 0.09) but not cumulative cisplatin dose (r = -0.10, p = 0.63). Sperm concentration was correlated with time from last cisplatin dosing (r = 0.58, p &lt; 0.001) but not with semen platinum level (r = -0.15, p = 0.46). DFI was associated with time from last cisplatin dosing (r = 0.55, p = 0.08) but not with semen platinum level (r = -0.32, p = 0.33). In 4 pts with serial semen samples available, semen platinum level decreased with time, sperm concentration and motility increased. Conclusions: Platinum can be detected in semen in long-term testicular cancer survivors at higher levels than matched blood samples. Our preliminary findings may have important implications for reproductive health of survivors of advanced testicular cancer, further studies are needed to assess the relationship between platinum persistence in semen and recovery of fertility post chemotherapy.

Stable and transient structural variation in lemur vaginal, labial and axillary microbiomes: patterns by species, body site, ovarian hormones and forest access.

Host-associated microbiomes shape and are shaped by myriad processes that ultimately delineate their symbiotic functions. Whereas a host's stable traits, such as its lineage, relate to gross aspects of its microbiome structure, transient factors, such as its varying physiological state, relate to shorter term, structural variation. Our understanding of these relationships in primates derives principally from anthropoid studies and would benefit from a broader, comparative perspective. We thus examined the vaginal, labial and axillary microbiota of captive, female ring-tailed lemurs (Lemur catta) and Coquerel's sifakas (Propithecus coquereli), across an ovarian cycle, to better understand their relation to stable (e.g. species identity/mating system, body site) and transient (e.g. ovarian hormone concentration, forest access) host features. We used 16S amplicon sequencing to determine microbial composition and enzyme-linked immunosorbent assays to measure serum hormone concentrations. We found marked variation in microbiota diversity and community composition between lemur species and their body sites. Across both host species, microbial diversity was significantly correlated with ovarian hormone concentrations: negatively with progesterone and positively with estradiol. The hosts' differential forest access related to the diversity of environmental microbes, particularly in axillary microbiomes. Such transient endogenous and exogenous modulators have potential implications for host reproductive health and behavioral ecology.

The interaction between pubertal timing and childhood maltreatment on the risk of human papillomavirus infection among adolescent girls and young women

PurposeThe goal of this study was to evaluate the effect of pubertal timing, and its interaction with prior childhood maltreatment, on the risk of cervical human papillomavirus (HPV) among sexually active adolescent minority female adolescents and young adults. MethodsThis cross-sectional study includes 842 adolescent girls and young women (aged 12 to 20 years; predominately Black and Hispanic) enrolled in an HPV vaccine surveillance study at a large adolescent health clinic in New York City between 2007 and 2016. Pubertal timing was assessed by self-reported age at menarche at baseline, with “early” and “late” defined as one standard deviation below (<11 years) or above (>13 years) the mean. Childhood exposure to abuse (sexual, physical and emotional) and neglect (physical and emotional) was assessed using the Childhood Trauma Questionnaire. Over 40 types of HPV infection were detected using the polymerase chain reaction in cervical Pap specimens. ResultsResults from multivariable logistic regression showed that early and late pubertal timing were marginally associated with a higher risk of HPV infection, adjusting for demographic and health covariates. Childhood maltreatment moderated the association between early pubertal timing and HPV infection: early pubertal timing was associated with a higher risk for HPV infection among maltreated girls (OR = 3.32, 95%CI:1.61–6.85), but not among non-maltreated girls (OR = 0.96, 95%CI:0.61–1.50; p-interaction<0.01). ConclusionsVariation in the timing of puberty and history of childhood maltreatment may have implications for adolescent sexual and reproductive health. Findings suggest that clinicians need to assess the biological and psychosocial risks in caring for youth.

Prevalence and associations of prescribing of long-acting reversible contraception by general practitioner registrars: a secondary analysis of ReCEnT data

ObjectiveLong-acting reversible contraception (LARC) is the most effective form of contraception but use in Australia is low. Uptake of LARC prescribing by early-career general practitioners (GPs) has important implications for...