Reduced Fertilization Rates Research Articles

The impact of COVID-19 on the number of births in Yucatan, Mexico.

To analyze the impact of COVID-19 on the number of births in Yucatan, Mexico during 2020 and 2021. A total of 470 651 live births occurred in Yucatan from January 1st, 2008, to December 31st, 2021, and were included in the analysis. The monthly number of births observed during January 2008-February 2020 was used to describe pre-pandemic trends. Time-series analysis was applied to examine whether the number of births observed from December 2020 (9 months after the beginning of the pandemic) to December 2021 differed from the expected values. Trends in the number of births according to maternal age, parity and education were examined to identify changes differentiated by sociodemographic characteristics. The number of births in 2021 decreased by 18% (5869 births) compared with 2019, which represents a reduction from 12.89 to 12.48 per thousand inhabitants. The observed number of births from December 2020 to July 2021 was significantly lower than the figure expected. April (expected=2863 vs. observed=1722), May (expected=2948 vs. observed=1990), and June (expected=2997 vs. observed=1978) 2021 showed the largest differences between expected and observed values. Then, from August to December 2021, the observed number of births fell within the expected range. Birth decline was slightly more pronounced among mothers between 20 and 29 years of age and in those without previous offspring. We provide evidence of birth decline in Yucatan during the COVID-19 pandemic. Birth rate reduction in Yucatan doubled the world average and young women without children were the most affected.

FAKTOR -FAKTOR YANG MEMPENGARUHI PEMILIHAN ALAT KONTRASEPSI PADA AKSEPTOR KELUARGA BERENCANA

The strategy to reduce fertility rates is through contraception to prevent pregnancy, but not all contraceptives are suitable for the physical health condition of the wearer. Active family planning participants in Metro City in 2020 amounted to 21917 (72.73%). The coverage of intrauterine contraceptive users in Metro City is 3439 (15.%), and the lowest is in the Karangrejo Health Center working area, which is 10.61% (106 out of 999 acceptors). This study aimed to determine the factors that influence the selection of contraceptives in family planning in Karangrejo Village. Methods: Quantitative research with a cross-sectional design, the population of family planning acceptors is 1374 family planning acceptors. With the results of the calculation of the sample size obtained, a sample of 94 respondents—was sampled with a simple random sampling technique. The data was collected using a questionnaire, and the analysis used univariate, bivariate, and multivariate multiple regression analysis. Results: The results of the bivariate test conducted on nine variables related to the use of IUD contraception only five variables, namely knowledge (p=0.03), occupation (p=0.002), economy (p=0.041), husband's support (p= 0.000) and health status during family planning (p= 0.000) while the other four variables were not related because the p-value was more than 0.05, namely education (p=0.210), number of children (p=0.670), history of the hereditary disease (p= 1,000) and confidence (p=1,000). In the multivariate analysis of variables, because the husband's support and maternal health status during family planning were constant, they were not included in the modeling. The final result of modeling obtained knowledge (p=0.07, 95% CI: 0.35 - 0.597) and occupation (p=0.12, 95% CI: 1.493 - 25,631). Conclusion: Results The most dominant factor is the husband's support factor, followed by maternal health during family planning, knowledge of contraceptives, and mothers who do not work / homemakers. Suggestion: In promoting the family planning program, the first step is to approach and educate the husbands of prospective acceptors. It is necessary to increase knowledge about family planning contraceptives, especially for wives who do not work or are homemakers.

Major locus on ECA18 influences effectiveness of GonaCon vaccine in feral horses

Contraceptive vaccines are used to reduce birth rates in wild and feral animal populations. While the immunocontraceptive GonaCon-Equine has proven effective in reducing fertility among female feral horses, there is individual variation in the duration of infertility following treatment. To identify genetic factors influencing the effectiveness of GonaCon-Equine, we conducted a genome-wide association study of 88 mares from a feral population genotyped using the Illumina GGP Equine 70k SNP array. Contraceptive treatment schedules and long-term foaling rates have been recorded for each individual. We used mixed linear models to control for relatedness among mares. We found a significant association (p < 5 ×10-8) with a locus on equine chromosome 18. The most likely candidate genes in this region are STAT1 and STAT4, which are both involved in immune system function. Variation in STAT function could affect the immune response to the vaccine, leading to variation in contraceptive efficacy. Additional SNPs reaching a less stringent threshold of significance (p < 5 ×10-6) were located on other chromosomes near known immune system genes, supporting the hypothesis that variation in immunocontraceptive efficacy can be attributed to genetic variation in immune response rather than fertility genes.

Căsătoriile şi divorţurile în România: dinamica demografică şi percepţii sociale

In the context of the diversification of family patterns, the reduction in birth rates and social changes in recent years, the analysis of demographic phenomena related to marriage and divorce is important especially if these phenomena are correlated with changes in the options for marriage or consensual union and the dissolution of marriage through divorce. Both marriage and divorce are determined by a combination of factors. In turn, these two social events influence other aspects of life. The study aims to provide a picture of marriages and divorces in Romania over the last ten years, in relation to developments in society: views on marriage, the dissolution of family life, the perception of divorce in society, the psychosocial consequences of divorce and perceptions of living together before marriage. It is a theoretical analysis based on official statistical sources and literature, following the evolution in recent years. The results of the study will provide not only a picture of marriages and divorces, but also an overview of the vision of marriage (family) and cohabitation today, providing support for educational and family actions or policies.

Prevalence and factors associated with the use of long-acting reversible and permanent contraceptive methods among women who desire no more children in high fertility countries in sub-saharan Africa

BackgroundThe proportion of women with family planning needs increased from 74 to 76% between 2000 and 2019, and this improvement has not transcended to a fertility rate stall or decrease in sub-Saharan Africa (SSA). In the face of a continuous increase in the fertility rate in SSA, population experts agreed that the efficient use of reliable family planning methods such as long-acting reversible and permanent contraceptive methods (LARC/PMs) could help reduce the high fertility rate and associated adverse reproductive health outcomes in the region. However, despite the effectiveness of LARC/PMs, its use remains elusive in SSA. Thus, this study examines the prevalence and factors associated with the use of LARC/PMs among women who desire no more children in high-fertility countries in SSA.MethodsSecondary datasets from the demographic health surveys conducted in 20 countries in SSA between 2010 and 2019 were included in the study. A total sample size of 46,290 sexually active women of reproductive age who desire no more children and who met the study inclusion criteria was pooled and analysed. Prevalence of LARC/PMs use was displayed using a graph whilst binary logistic regression was used to determine the associated factors, and results were presented as unadjusted odds ratio and adjusted odds ratio with a statistical significance of p < 0.05.ResultsThe prevalence of LARC/PMs use among women who desire no more children was 7.5%. Ranging from 20.9% in Senegal and as low as 0.4% in Congo. Women within the richest wealth index [aOR = 1.18, 95% CI = 1.03–1.36] and those exposed to mass media [aOR = 1.54, 95% CI = 1.41–1.68] had higher odds of LARC/PMs use among sexually active women of reproductive age who desire no more children compared to those within poorest wealth index and women with no mass media exposure.ConclusionThe study concluded that LARC/PMs use among sexually active women who desire no more children was very low, and women within the richest wealth index and those with mass media exposure were likely to use LARC/PMs. Interventions that will encourage using LARC/PMs should be prioritised to reduce fertility rates in SSA.

Determinants of Unmet Need for Family Planning in Sleman District, Yogyakarta Province, Indonesia

One of the things that are of great concern in future development is the population problem, the main thing is population control. The family planning program in Indonesia has been recognized nationally and internationally as one of the programs that have succeeded in reducing fertility rates. However, the high number of unmet needs for family planning is one of the problems in managing family planning programs. Based on family data collection in the year 2021, the Total Fertility Rate (TFR) fell to 2.24% after touching the figure of 2.45% in 2019. Meanwhile, the number of unmet needs in 2019 was 14.3%, increasing to 18% in the year 2021. This study aims to describe the influence of unmet needs on the population with the regression model approach. Meanwhile, to analyze the factors that influence the unmet need for family planning in Sleman District, Yogyakarta Province, Indonesia used primary data with simple random sampling which includes 2 things. First, the identity of the respondent provides an overview of the category of mother's age, mother's education level, mother's occupation, number of last children, husband's education level, husband's age category, husband's occupation, number of last living children, and total family income. Second, the experience of family planning will be described in terms of participation in family planning, reasons for not participating in family planning, desire for family planning, methods of family planning, family planning costs, family planning information, family planning socialization, and respondents' statements. The result is that unmet need has a positive effect on the population. While with primary data showed that the determinants of unmet needs in Sleman District derived from various variables that fall within the scope of the respondent's identity and various variables that fall within the scope of experience in participating in family planning.

Effects of whole-body vibration on reproductive physiology in a rat model of whole-body vibration

ABSTRACT Findings from epidemiological studies suggest that occupational exposure to whole-body vibration (WBV) may increase the risk of miscarriage and contribute to a reduction in fertility rates in both men and women. However, workers exposed to WBV may also be exposed to other risk factors that contribute to reproductive dysfunction. The goal of this experiment was to examine the effects of WBV on reproductive physiology in a rat model. Male and female rats were exposed to WBV at the resonant frequency of the torso (31.5 Hz, 0.3 g amplitude) for 4 hr/day for 10 days. WBV exposure resulted in a significant reduction in number of developing follicles, and decrease in circulating estradiol concentrations, ovarian luteinizing hormone receptor protein levels, and marked changes in transcript levels for several factors involved in follicular development, cell cycle, and steroidogenesis. In males, WBV resulted in a significant reduction in spermatids and circulating prolactin levels, elevation in number of males having higher circulating testosterone concentrations, and marked alterations in levels of transcripts associated with oxidative stress, inflammation, and factors involved in regulating the cell cycle. Based upon these findings data indicate that occupational exposure to WBV contributes to adverse alterations in reproductive physiology in both genders that may lead to reduction in fertility.

Maternal long-term inhalation exposure to perchloroethylene and prenatal teratogenicity: morphometric, hormonal, and histological study

Some commonly used chemicals have teratogenic effects. Perchloroethylene (PCE) is a liquid that is widely used in various industries and drying clothes. In this study, the teratogenic effects of PCE in rat embryos were investigated. In this experimental study, 32 adult Wistar female rats in the weight range of 230-250 g were used. Female rats were randomly divided into 4 groups (n = 8). Control group (without PCE inhalation), experimental group G(I) (exposed to PCE 18 days prior to mating), experimental group G(II) (exposed to PCE 18 days after mating) and experimental group G(III) (exposed to PCE 18 days before and 18 days after mating). Pregnant rats were anesthetized on the 18th day of gestation and then serum and embryos were removed for the required studies. Embryos were examined for number, weight, sex, morphometric parameters of organs, and tissue samples were prepared for histological studies. Serum isolated from dams were evaluated for sexual and gonadal hormones. The results of this study showed that PCE has teratogenic effects on rat embryos. Infertility and reduced birth rate were other effects of PCE in rats. PCE has teratogenic effects and impairs the reproductive system of rats.

Patterns of population decline following European contact and colonization: The cases of Tahiti and the Marquesas

Recent archaeological data assess that Tahiti and the Marquesas Islands were densely populated at contact with the Europeans and then experienced a tremendous decline. This phenomenon is most often attributed to epidemics, while a steady negative increase is rarely mentioned. This paper shows that the population of Tahiti was most probably around 110,000 – or even reached 180,000 – at contact, based on a retrodiction from the 1881 census using data on epidemic mortality and annual decline rates observed in the second half of the nineteenth century in Tahiti, the Marquesas, and other Eastern Polynesian islands in similar situations, according to missionary, administrative, and medical reports. Our ‘model’, or reconstitution, provides estimates on the impact of both types of mortality. Due to no exposure to childhood and other diseases common on the continents, the Polynesians had low immunity, as shown by age-specific death rates until the 1918 flu and the 1951 measles epidemics. Following the European contact, sexually transmitted diseases (STDs), tuberculosis (TB), and other introduced infectious diseases resulted in a steady population decline due to reduced birth rates and very high death rates. Health services were available for the Europeans soon after the takeover, however the natives got access to health services much later with their sporadic and fragmental provision. The constant negative increase extended far beyond the colonial period, including after effective drugs were discovered in the 1880s, becoming the main contributor to the overall demographic decline in the Marquesas, where health services were missing most of the time before 1924, mostly in the South-Eastern group.

Family Planning Counseling and Safari (IUD and Implant)

Introduction: A well-implemented family planning program can prevent maternal death through the use of contraception. The use of long-term contraceptives such as IUDs and implants is considered much more effective in reducing birth rates, but their use is still very low. The purpose of this community service is expected to be able to open insight and foster interest in fertile age couples (PUS) in making decisions to join in the use of long-term contraceptives, especially IUDs and implants. The method used is counseling to WUS and PUS who are domiciled in Loru Village, Sigi Biromaru District about IUDs and implants. The number of EFA targets in counseling was 28 people, which was then carried out on a family planning safari for counseling participants who decided to use an IUD or implant contraceptive device. The result of this community service activity is a change in attitude in choosing contraceptives after counseling, marked by 6 people deciding to use long-term IUD contraception and 9 other people deciding to use implant contraceptives. The need for contraceptive counseling that involves husbands and families, so that there are no obstacles in decision making by mothers.

P-309 Endometriosis does not compromise early embryonic development as well as live birth: a retrospective analysis of 716 standard in vitro fertilization cycles

Abstract Study question Does endometriosis compromise early embryonic development and/or clinical outcome in standard in vitro fertilization (sIVF) cycles? Summary answer Endometriosis does not compromise embryo development or clinical outcome in sIVF cycles characterised by normal semen parameters. What is known already IVF is an elective approach to overcome endometriosis-related infertility. The notion that IVF outcomes are altered in women with endometriosis the is scarce and conflicting. Different meta-analyses reached diverging conclusions concerning a possible impact of endometriosis on clinical outcome. With reference to laboratory outcomes, a reduced fertilization rate with sIVF was observed in several but not all studies. Study design, size, duration A retrospective analysis of 716 women undergoing their first sIVF cycles from 2015 to February 2021, 205 with in situ endometrioma (class IV) and 511 with tubal factor infertility. Participants/materials, setting, methods Diagnosis of endometriosis was based on ultrasound observation of cysts on at least two occasions at least two menstrual cycles apart. Women carrying atypical lesions, i.e., cysts with sonographic appearance compatible but not distinctive for endometriosis, were excluded. Multivariate analysis was conducted using the generalized estimating equation (GEE) approach, thus making it possible the analysis of variables with non-normal distribution. The primary study outcome was live birth rate. Main results and the role of chance After adjustment for maternal, paternal age, maternal body mass index (BMI), anti-mullerian hormone (AMH) and follicle stimulating hormone (FSH) we found no significant difference in fertilization rate [78,69 ± 26,16 (Endo) Vs 79,5 ± 24,01 (Tubal)], embryo quality [33,33 (0 – 57,86) endometriosis vs. 33,40 (0 – 67,70) tubal factor], blastulation rate [52,00 ± 15,01 (endometriosis) vs. 55,49 ± 14,98 (tubal factor)], top quality blastocyst [38,15 ± 18,67 (endometriosis) vs. 34,62 ± 14,77 (tubal factor)], ongoing pregnancy [OR = 0,84, 95% CI (0,54 – 1,32)], live birth [OR = 0,89, 95% CI (0,53 – 1,48)], and miscarriage rate [OR = 0,68, 95% CI (0,27 – 1,74)]. The only significantly different outcome was the percentage of embryos with ≥ 8 blastomeres on day 3 [25,00 (0 - 60,00) endometriosis Vs 40,00 (0 - 67,00) tubal factor]. Limitations, reasons for caution The retrospective design of the study and lack of data on cumulative live birth rates are additional limitations. Wider implications of the findings The results of our study suggest that in women with endometriosis fertilization rate, embryo quality, blastulation rate and live birth rate are not affected in sIVF cycles. Trial registration number N.A.

Impact of Women Empowerment on Fertility Preferences in Pakistan

Reproduction is an important aspect of a women's life, unfortunately in Pakistan fertility rates are quite high in comparison to other developing countries as well as in comparison to the other South Asian countries. Different studies have suggested that women empowerment can help reduce fertility rates. The present study has attempted to analyze the role of women empowerment along with other socioeconomic indicators on three different dimensions of the fertility behavior i.e. number of children born (current fertility status), ideal number of children and birth intervals (future fertility status. Data of Demographic and Health Survey (PDHS) 2012-13 has been used. The analysis consists of two levels, at level one a descriptive analysis is carried out. As three different aspects of fertility are the count data. Therefore at the next stage models will be estimated by using poison regression technique and Incidence Rate Ratios (IRR) are reported. It has been found that women’s being empowered in financial matters, seeking health care and in household decision making are helpful in reducing fertility. Furthermore, participation in job by women, living in urban areas, having secondary or higher education, access to awareness created by the media, married at higher age are also significant factors in reducing fertility. However, women facing incidence of miscarriage or death of a child tends to increase the fertility. Study had found that wealth of the household, education of husband and having sons have very limited role on the fertility behavior.

Maize root exudate composition alters rhizosphere bacterial community to control hotspots of hydrolase activity in response to nitrogen supply

Improving nitrogen (N) acquisition by crops from soil is essential to reduce fertilization rates whilst maintaining yields. Plants can adapt their nutrient acquisition strategies according to N availability, which also affects soil microbial community structure, functions and activities and relies on the supply of carbon (C) for energy. We hypothesized that N deprivation would create hotspots of N- and C-acquiring hydrolase activities in maize rhizosphere through the effects of altered root exudation on the rhizosphere bacterial community. We grew maize under three N fertilization rates and combined soil zymography with the identification of rhizosphere microbial communities and non-targeted metabolic profiling of root exudates to explore enzyme hotspot formation. The rhizosphere extents of β-1,4-glucosidase (BG) and β-N-acetylglucosaminidase (NAG) activities decreased after N fertilization, narrowing by 48% and 39%, respectively, under typical field N application rates compared to zero application. Rhizosphere extents of enzyme activities were more sensitive to altered N supply than changes in the rates of enzyme activities: BG activity decreased by ∼10%, while NAG activity was unaffected. Decreases in the activities of both hydrolases and their rhizosphere extents caused by N addition correlated with reduced abundances of oligotrophs. The relative abundances of oligotrophic bacteria (e.g., Acidobacteria) decreased, while copiotrophs (e.g., Pseudomonadota and Patescibacteria) increased under the highest N application rate. Co-occurrence networks of the rhizosphere bacterial community revealed that functional units increased with BG activity, while an efficient and denser co-occurrence network supported expansion of its rhizosphere extent. The metabolic profiles of root exudates changed according to the N application rate, suggesting that their chemistry was regulated by the plant in response to N supply. The composition of root exudates and dissolved organic C and nitrate contents explained the largest variations in NAG hotspots in the rhizosphere. In summary, maize actively adjusts the composition of root exudates to increase interactions with rhizosphere bacteria, thereby stimulating hydrolase production and activities, and altering their rhizosphere extents to mobilize N and energy (C) in a larger soil volume, under conditions of N deficiency.

Effects of sociodemographic background on fertility motivation patterns in the Beni-Suef governorate, Upper Egypt

ObjectivesA comprehensive assessment of childbearing motivations in the governorate of Beni-Suef was conducted to better understand fertility patterns, and to develop appropriate familial policies and programs to reduce fertility rates and address the problem of overpopulation in Upper Egypt. Subjects and methodsA cross-sectional study was conducted from May 2019 to May 2021. A total of 1085 married women who attended any health care service in rural or urban primary health care facilities in the Beni-Suef governorate were included in the study. ResultsThe results revealed that 42.1% of participants had a positive desire for childbearing, and 45% of participants had a negative desire for childbearing; the rest of the participants (12.9%) had undecided motivations. The most prevalent positive motive for childbearing was a love of children (40.8%), whereas the most prevalent negative motive for childbearing was economic circumstances (44.7%). A statistically significant difference was observed in fertility motivations among the studied women, depending on age, education, husband's education, age at marriage, marriage duration, number of living siblings, monthly income, occupation, gravidity, parity, and chronic diseases (p = 0.001). ConclusionA great need exists to involve young couples who have not yet attained their desired family size and who do not use family planning methods, in fertility regulation interventions.

Nitrous oxide-induced reproductive risks: Should recreational nitrous oxide users worry?

Background:Nitrous oxide (N2O) is a frequently used anaesthetic. Since the year 2000, recreational use of N2O, also known as ‘laughing gas’, became popular as a recreational drug due to its mild psychedelic effect. In the 1980s, several reports warned against N2O-induced reproductive risks among healthcare personnel, questioning the occupational safety of N2O in health care.Methods:Data about the reproductive risks of N2O were collected from literature.Results:Particularly in the past, professionals working in dental and midwifery practices, operating theatres and ambulance transport were exposed to high levels of N2O. Adverse reproduction effects included congenital anomalies, spontaneous abortion and reduced fertility rates in females. Following occupational measures, like maximal exposure limits for ambient N2O, this occupational risk was considerably reduced. Recreational users of N2O, however, voluntarily and repeatedly expose themselves to (very) high doses of N2O. As such, they exceed the health exposure limits some hundred times, but they are fully unaware of the related reproductive risks.Conclusion:We advocate to increase the awareness in recreational N2O-users about its potential reproductive risks, especially in heavy users, pregnant users or those who intend to become pregnant.

A coherent functional demographic model approach for stochastic population forecasting

The present work proposed a new method for coherent mortality forecasting that incorporates forecasting interpretable product and ratio functions of rates using the functional data paradigm introduced in Hyndman and Ullah (2007). The product-ratio functional forecasting method can be applied to two or more sub-populations, incorporates convenient calculation of prediction intervals as well as point forecasts and is suitable for use within a larger stochastic population modeling framework such as Hyndman and Booth (2008). The new method is simple to apply, flexible in its dynamics, and produces forecasts that are at least as accurate in overall terms as the comparable independent method. The main aim of study is to propose the use of Coherent functional demographic model as new approach for population projection. For analysis, two datasets in age-period format required for males and females separately: central death rates (mx) = number of deaths/mid-year population, exposures to the risk of death (ie mid-year population). We compare our results to longer fitting periods by making use of the extrapolated data. Our analysis shows, the estimated average gender-specific mortality (ax), the male and female mortality are almost identical till 20-24; but for subsequent age-groups, the average female mortalities are consistently lower than the male. After analysing stochastic population forecasting by using coherent demographic model, the projected evolution of the population pyramids reveals several insightful information. There is gradual narrowing of base reflecting reduction in birth rate. The gradual bulge towards the top is reflective of reduced mortality across ages. In conclusion, the development of improved mortality forecasting methods, and by extension, fertility and migration forecasting methods, represents a step toward more reliable and automated demographic forecasting.

Sperm selection with hyaluronic acid improved live birth outcomes among older couples and was connected to sperm DNA quality, potentially affecting all treatment outcomes.

Sperm selection with hyaluronic acid improved live birth outcomes among older couples and was connected to sperm DNA quality, potentially affecting all treatment outcomes.

Long-Term High-Temperature Stress Impacts on Embryo and Seed Development in Brassica napus.

Brassica napus (rapeseed) is the second most important oilseed crop worldwide. Global rise in average ambient temperature and extreme weather severely impact rapeseed seed yield. However, fewer research explained the phenotype changes caused by moderate-to-high temperatures in rapeseed. To investigate these events, we determined the long-term response of three spring cultivars to different temperature regimes (21/18°C, 28/18°C, and 34/18°C) mimicking natural temperature variations. The analysis focused on the plant appearance, seed yield, quality and viability, and embryo development. Our microscopic observations suggest that embryonic development is accelerated and defective in high temperatures. Reduced viable seed yield at warm ambient temperature is due to a reduced fertilization rate, increased abortion rate, defective embryonic development, and pre-harvest sprouting. Reduced auxin levels in young seeds and low ABA and auxin levels in mature seeds may cause embryo pattern defects and reduced seed dormancy, respectively. Glucosinolates and oil composition measurements suggest reduced seed quality. These identified cues help understand seed thermomorphogenesis and pave the way to developing thermoresilient rapeseed.

Inflammatory Bowel Disease and Reproductive Health: From Fertility to Pregnancy-A Narrative Review.

Despite the fact that knowledge on obstetrical management of Inflammatory Bowel Diseases (IBDs) has greatly improved over the years, many patients still actively avoid pregnancy for fear of adverse maternal or neonatal outcomes, of adverse effects of pregnancy on the disease activity, of eventual IBD inheritance, or of an increased risk of congenital malformations. Indeed, though data prove that fertility is hardly affected by the disease, a reduced birth rate is nevertheless observed in patients with IBD. Misconceptions on the safety of drugs during gestation and breastfeeding may influence patient choice and negatively affect their serenity during pregnancy or lactation. Moreover, physicians often showed concerns about starting IBD medications before and during pregnancy and did not feel adequately trained on the safety of IBD therapies. IBD-expert gastroenterologists and gynecologists should discuss pregnancy and breastfeeding issues with patients when starting or changing medications in order to provide appropriate information; therefore, pre-conception counselling on an individualized basis should be mandatory for all patients of reproductive age to reassure them that maintaining disease remission and balancing the eventual obstetrical risks is possible.

Dinamika fertilitas dan prevalensi kontrasepsi di Indonesia

The fertility dynamics are related to the direction of population policies and socio-economic conditions of the community. From the 1970s to 1990, Soeharto had succeeded in reducing fertility rates. Unfortunately, population control had weakened in 2000 when the government adopted regional autonomy. Consequently, population control was no longer a priority due to the merger of institutions with the full authority of population and family planning. In addition, improving the socio-economic conditions of society poses challenges to population control efforts. This paper aims to analyze fertility and contraceptive prevalence rate trend in Indonesia based on the 2017 Indonesia Demographic and Health Survey data. The data were analyzed using inferential statistics. The results indicate socio-economic conditions affect people’s mindset in deciding the use of contraception and pregnancy. People are aware of birth control but tend not to use modern contraception and move to traditional contraception. The socio-economic improvement of women, which causes negative child value, is sufficiently a sufficient condition to maintain or reduce fertility. Other factors such as improvement of maternal education, maternal participation in work, and increased family welfare that is important to keep fertility at a low level.