Assessment Of Reproductive Health Research Articles

Clinical health outcomes of Ebola virus disease survivors eight years post recovery: a cross-sectional study in Sierra Leone.

The West African Ebola virus disease (EVD) epidemic that occurred between 2013-2016 resulted in >28,000 confirmed cases and >11,000 fatalities. Thousands of survivors necessitate an understanding of the long-term health effects and future medical needs of these patients. A cross-sectional study of 595 EVD survivors from Sierra Leone and 403 close contacts (n=998). An in-person survey conducted between November 2021 and March 2022 included demographics, clinical health symptomology assessment of each organ system and a reproductive health assessment including sexual dysfunction question sets. The frequency of each disorder was examined and the association of each disorder with EVD survival was assessed. Of 12 number of symptom types, five were reported by >50% of EVD survivors (Ocular, Neurological, Constitutional, Genitourinary, Dermatological), and all but one were reported by >40% of EVD survivors. Symptom types associated with EVD survival included ENT symptoms (AOR: 8.75, 95% CI: 5.63 - 13.60, p < 0.001), ocular symptoms (AOR: 7.18, 95% CI: 5.02 - 10.25, p < 0.001), dermatological symptoms (AOR: 4.16, 95% CI: 3.06 - 5.65, p < 0.001) and cardiovascular symptoms (AOR: 2.96, 95% CI: 2.12 - 4.13, p < 0.001). The West Africa EVD epidemic resulted in a high prevalence of persistent health issues among disease survivors. Continued support for survivor services in West Africa is crucial, and future outbreak response planning should include dedicated funding to ensure adequate care for survivors, both during the acute phase of infection and throughout the post recovery period.

Reproductive Health Assessment and Reports of Fertility Counseling in Pediatric and Adolescent Patients with Sickle Cell Disease After Hematopoietic Cell Transplantation

Conditioning regimens for hematopoietic cell transplant (HCT) in patients with sickle cell disease (SCD) place patients at risk for reproductive health issues. The purpose of this study was to assess reproductive health and reports of fertility counseling in patients with SCD who received a transplant. This was a secondary analysis of gonadal hormone production, future infertility risk assessment, and parent-proxy/patient reports of fertility counseling in SCD transplant recipients who are currently pubertal and were enrolled in the Atlanta sites of the Sickle Cell Transplant Evaluation of Long-term and Late Effects Registry (STELLAR) between May 2017 and October 2023. Clinical information was abstracted from medical records and reproductive health survey data from the STELLAR database. Descriptive statistics were reported as median (interquartile range [IQR]) or percentages. There were 20 females and 12 males in the study population. Females were median (IQR) 19.6 (9.4) years old and males 20.8 (11.4) years old at the time of the study. Transplants most commonly occurred in the decade 2010 to 2019 at 10.7 (4.8) years old for females and 11.1 (4.1) years old for males. Most participants received bone marrow stem cells (95.0% females, 100.0% males) from matched sibling donors (90.0% females, 100.0% males). Participants received one of seven HCT conditioning regimens with cyclophosphamide equivalent doses ranging from 3388 to 9706 mg/m2. The majority of females (90.0%) had diminished ovarian reserve with low anti-Mullerian hormone levels, and 61.1% had premature ovarian insufficiency with two follicle-stimulating hormone levels (FSH) ≥40 mIU/mL post-HCT. All males had normal testosterone levels, but 63.6% had elevated FSH levels suggestive of impaired spermatogenesis post-HCT. Parent proxies (for patients <18 years old) and patients ≥18 years old completed surveys 9.0 years (5.2) and 7.9 years (9.3) since HCT in females and males respectively. Twenty-five percent of parent proxies and 45% of patients reported that they had not been informed by a healthcare provider of the risk of infertility post-transplant. There are high rates of gonadal dysfunction post-HCT, but many parent proxies and patients do not recall being told of the risk for future infertility. More effective methods of education are warranted to ensure SCD patients and their families clearly understand the risk for reproductive health issues post-HCT.

Integrative Assessment of Seminal Plasma Biomarkers: A Narrative Review Bridging the Gap between Infertility Research and Clinical Practice.

Infertility represents a significant global health challenge impacting millions of couples worldwide. Approximately half of all infertile couples exhibit compromised semen quality, indicative of diminished male fertility. While the diagnosis of male infertility traditionally relies on semen analysis, its limitations in providing a comprehensive assessment of male reproductive health have spurred efforts to identify novel biomarkers. Seminal plasma, a complex fluid containing proteins, lipids, and metabolites, has emerged as a rich source of such indicators. Reproduction depends heavily on seminal plasma, the primary transporter of chemicals from male reproductive glands. It provides a non-invasive sample for urogenital diagnostics and has demonstrated potential in the identification of biomarkers linked to illnesses of the male reproductive system. The abundance of seminal proteins has enabled a deeper understanding of their biological functions, origins, and differential expression in various conditions associated with male infertility, including azoospermia, asthenozoospermia, oligozoospermia, teratozoospermia, among others. The true prevalence of male infertility is understated due to the limitations of the current diagnostic techniques. This review critically evaluates the current landscape of seminal plasma biomarkers and their utility in assessing male infertility. Βy bridging the gap between research and clinical practice, the integrative assessment of seminal plasma biomarkers offers a multimodal approach to comprehensively evaluate male infertility.

Exploring the impact of polystyrene microplastics on human health: unravelling the health implications of polystyrene microplastics (PS-MPs): a comprehensive study on cytotoxicity, reproductive health, human exposure, and exposure assessment.

This investigation explores the various impacts that polystyrene microplastics (PS-MPs) have on human health. As most of the plastic materials affect human health when they release leachable toxic substances that affect human health, this causes a negative effect that determines poor health conditions and leads to health hazards associated with plastic toxins routed in the human body, such as: Polychlorinated Biphenyls, Polybrominated Biphenyls etc. The study includes micro-plastic exposure assessment on testicular structure analysis, and cytotoxicity evaluations of different human cell types. The findings clarified the possible dangers of PS-MPs exposure from food, medications, and common products, emphasising the necessity of standard specimen handling procedures for precise biomonitoring.

Diagnostic Approaches in Nuclear Medicine for Reproductive Health Assessment: Hysterosalpingography in Radiology versus hysterosalpingoscintigraphy.

Infertility is a significant aspect of reproductive health and evaluating degree of tubal pathology is essential for determining appropriate management plans. To assess the role of hysterosalpingoscintigraphy (HSSG) as a tubal patency test in nuclear medicine and compare it with hysterosalpingography (HSG) in radiology in infertile women and study pain perception in both tests as well. A prospective study was conducted on 50 infertility patients undergoing infertility evaluation at a tertiary care hospital. Both HSG and HSSG procedures were performed during proliferative phase of menstrual cycle. Our study demonstrated the potential of HSSG as a tool for evaluating tubal patency in infertility workup. It showed good accuracy in detecting tubal patency compared to HSG. HSG is a radiological procedure valued for its ability to provide detailed anatomical information of uterus and patency of fallopian tubes. In contrast, HSSG provides dynamic information on the functional aspects of the reproductive system using nuclear medicine techniques. Both HSG and HSSG are vital tools in the diagnostic armamentarium for assessing female reproductive health, offering complementary information that aids in comprehensive patient management.

Development and psychometric properties of the Reproductive Health Assessment in Systemic Lupus Erythematosus: Mixed-Methods study.

Systemic lupus erythematosus (SLE) with a high morbidity rate (7% in general and 325/100.000 in reproductive period) was known as "the mother of autoimmune diseases." But healthcare providers hadn't reliable scales to measure the effectiveness of interventions to improve reproductive health. Women with systemic lupus erythematosus (SLE) express concern about a significant gap in their reproductive and sexual health during medical care due to the lack of a specific scale to measure this concept. This study developed psychometrically specific scale to evaluate this concept in Iranian women. The study utilized a sequential-exploratory mixed-methods design, wherein the concept of reproductive health was clarified during the qualitative phase using conventional content analysis (inductive-deductive) to create a pool of RHASLE (Reproductive Health Assessment in SLE) items. During the psychometric process, the face, content, and construct validities of the RHASLE were checked with 650 individuals (320 using exploratory factor analysis [EFA] and 330 using confirmatory factor analysis [CFA]) through interviews and completion of the questionnaire. Convergent and divergent validities were then checked, and the reliability was assessed through stability and internal consistency. Finally, the measurement error, responsiveness, and interpretability of the scale were evaluated and confirmed. The study's findings revealed that the RHASLE consisted of 5 factors (33 items): physical-psychological disorder (13 items), relaxing feeling (6 items), spirituality (3 items), high-risk pregnancies (5 items), and sexual satisfaction (6 items). These factors explained a total of 99.97% of the variance in the concept of reproductive health. Confirmatory factor analysis confirmed the good model fit, and its validity and reliability were deemed acceptable. The RHASLE consisted of 27 items with high internal consistency, stability, responsiveness, and interpretability. That was able to get approval of Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Based on the results, RHASLE is a valid and reliable multidimensional scale that encompasses various aspects of reproductive health (physical, sexual, psychological, social, and spiritual).

Sexual and reproductive health problems among women with mental illness attending tertiary care psychiatric outpatient clinic in India: A cross-sectional study.

Sexual and reproductive health (SRH) is a vital concern among women with mental illness (WMI) due to the increased risk for unplanned pregnancy, sexually transmitted infections (STIs), and poor obstetric outcomes. Objective of the study was to explore the current use of family planning (FP) methods, symptoms of STIs and sexual dysfunction among WMI. This descriptive study involved 404 WMI of reproductive age (18-49 years) attending tertiary care psychiatric outpatient clinics in India. During face-to-face interviews, centers for disease control and prevention (CDC)-reproductive health assessment toolkit-FP questionnaire, STI questionnaire and Female sexual function index (FSFI) were used to collect the data. Of 404 WMI, 261(64.6%) were users, and 137 (33.9%) were non-users of FP methods. About 6(1.5%) WMI did not respond FP methods question. Female sterilization was the highest among the users, 244(93%). Among non-users, 100 (73%) were unaware of choosing the effective method of FP. Most of the WMI, 377(93.3%), were unaware of STIs. The symptoms of STI reported include unusual genital discharge 62(15.3%) and genital ulcers/ sores 58(14.4 %). Most of them, 76(63.3%), were not on any treatment. The most common reason for not taking treatment was feeling ashamed 70(92.1%). Female sexual dysfunction was reported in 176(43.6%). Most of the WMI had difficulties in the arousal domain 288(71.3%), followed by low desire 233(57.7%) and dissatisfaction 186(46%). Most WMI underwent sterilization. Non-users of FP methods were not aware of choosing the effective method. Awareness about STIs was poor, and feeling ashamed was the primary reason for not availing of medical help. Nearly half of the WMI reported sexual dysfunction, among which arousal difficulties, low desire and dissatisfaction were common. Health professionals need to increase awareness about FP methods and symptoms of STIs among WMIs. Women require appropriate counselling regarding SRH and treatment for sexual dysfunction.

P-463 Data from 143,251 women indicates that black women access at-home fertility testing services later in life compared to white women in the United Kingdom

Abstract Study question Does ethnicity play a role in fertility assessment-seeking behaviour of Black women in the United Kingdom (UK)? Summary answer Black women approach an at-home reproductive health and fertility assessment service later in their fertility journey than White women. What is known already Evidence from the Human Fertilisation and Embryology Authority (HFEA) shows that Black patients access fertility care two years later than the national average in the United Kingdom (UK) (36.4 vs 34.6 years). Additionally, previous research has shown different prevalences of reproductive health conditions associated with infertility amongst Black women, such as fibroids and tubal occlusion. In combination with delayed access to fertility care, this may contribute to the lower live birth rates seen in Black patients in the UK. Study design, size, duration A retrospective observational study conducted on 143,251 Hertility Health users who completed a virtual health assessment between September 2020 and January 2023. The health assessment collected self-reported data on age, ethnicity, pre-existing diagnoses of reproductive health conditions, whether they were actively trying to conceive (TTC) and the length of time they had been actively TTC. Participants/materials, setting, methods A total of 25.9% users (n = 37,170) indicated they were TTC. The majority of those TTC self-identified as White (82.9%), followed by Asian (7.4%), Mixed (3.6%), Black (4.6%) and ‘Other’ (1.5%). Summary statistics (mean ± SD and %) regarding age and prevalence of pre-existing conditions of users TTC have been reported. Additional statistical analysis of the associations of time spent TTC between ethnicities was conducted via Chi-squared test (χ2); p values &amp;lt;0.05 were considered significant. Main results and the role of chance A significant relationship was observed between time spent TTC and ethnicity; the strongest association was observed between Black and White users χ2 (16, n = 34,706)=120, p &amp;lt; 0.0001). Comparison of time spent TTC, and average age showed that fewer Black women undertook the virtual health assessment at &amp;lt; 6 months of TTC than White women (29.3%, n = 469 vs 34.1%, n = 9820) at a moderately older age (31.3±6.5 years vs 29.8±5.7 years). A higher percentage of Black women were TTC for &amp;gt;5 years compared to White women (14.2%, n = 227 vs 8.8%, n = 2544). Additionally, Black women at this time point were approximately four years older than White women (36.9 years ± 6.0 years vs 33.0 ± 5.1 years). Secondary analysis of the prevalence of reproductive health conditions associated with infertility indicated that 20.1% (n = 133) and 22.5% (n = 149) of Black women had a preexisting condition at &amp;lt; 6 months and &amp;gt;5 years of TTC, respectively, vs 22.6% (n = 1363) and 19.2% (n = 1158) of White women in the corresponding TTC length groups. Limitations, reasons for caution As the virtual health assessment data was self-reported, there is a risk of recall bias and false reporting. Data was stratified via the main ethnicities and did not take the heterogeneity within ethnic groups or mixed ethnicities into account. Wider implications of the findings This data suggests that Black women approach fertility testing services later than White women, which may contribute to the disparities between pregnancy outcomes in the UK and cannot fully be accounted for by preexisting diagnoses associated with infertility. Further investigations are needed to outline the underlying reasons for this. Trial registration number not applicable

Online Clinical Decision Support Software Reduces Time to Diagnosis of Fertility Disorders to 8 Weeks on Average [ID: 1380156

INTRODUCTION: Time to diagnosis of fertility disorders is reported to take up to 11 years and involves five to six physicians on average. Prolonged time to diagnosis is not just an immense burden on the health care system, but also means that in vitro fertilization (IVF) becomes necessary for couples who would have been able to conceive naturally had they been diagnosed sooner, often leaving these couples childless. This observational study evaluated how a clinical decision support software based on American Society for Reproductive Medicine, American College of Obstetricians and Gynecologists, and European Society of Human Reproduction and Embryology guidelines used by patients and obstetrician–gynecologists together can reduce the time to diagnosis of up to 65 conditions affecting female fertility. METHODS: One hundred eighty women aged 20–45 who had been trying to conceive for an average of 11 months were recruited to participate. Women completed a reproductive health assessment with a dynamic online questionnaire. The output of the assessment was a lab requisition with an individualized selection of female and male sex hormones, thyroid hormones, markers for glucose metabolism, vitamin deficiencies, complete blood count, as well as markers for immunology, genetics, and thrombophilia. The clinical decision support software combined the results from the online reproductive health assessment with the lab results to render recommendations for diagnosis, further diagnostics, and treatment. RESULTS: An average of four previously unknown health conditions affecting fertility were diagnosed with an average time of 8 weeks to diagnosis (range, 5–16). Diagnoses included polycystic ovarian syndrome, various forms of amenorrhea, premature ovarian insufficiency, vitamin and iron deficiency, hyperthyroidism and hypothyroidism, insulin sensitivity, and prolactinoma. CONCLUSION: An online clinical decision support tool can significantly reduce time to diagnosis of conditions affecting female fertility. It also reduces the number of patient–physician interactions and the time physicians spend on medical history and necessary patient education.

A multi-level assessment of biological effects associated with mercury concentrations in smallmouth bass, Micropterus dolomieu

Total mercury (THg) was measured in muscle (fillet) and liver tissue of adult smallmouth bass Micropterus dolomieu collected at multiple sites in the Potomac and Susquehanna River drainages within the Chesapeake Bay watershed. Smallmouth bass in these drainages have experienced episodic mortality events, a high prevalence of skin lesions and reproductive endocrine disruption (intersex or testicular oocytes and plasma vitellogenin in males). A multi-level assessment of general and reproductive health including indicators at the organismal, organ, cellular and molecular levels was conducted on adult smallmouth bass during the spring (prespawn) season. Concentrations of THg were correlated with increased visible abnormalities, increased macrophage aggregates and tissue parasite burdens. In male bass positive correlations of THg were observed with plasma vitellogenin and hepatic transcript abundance of estrogen receptor β1 and androgen receptor α, while there was a negative association with estrogen receptors α and β2 and androgen receptors β. In female bass there was a negative correlation between THg and plasma vitellogenin as well as hepatic transcript abundance of vitellogenin, choriogenin, estrogen receptor β2 and 17β hydroxysteroid dehydrogenase. Associations of THg concentrations with various biological indicators suggest mercury may be an important environmental stressor contributing to the observed adverse effects in smallmouth bass populations.

Assessment of Reproductive Age Women Health Related Behavior Regarding Emergency Contraception Methods

Assessment of Reproductive Age Women Health Related Behavior Regarding Emergency Contraception Methods

Biomarkers of reproductive health in wildlife and techniques for their assessment

Historically, reproductive health in wildlife species has been evaluated primarily via immunoassay detection of fecal and urinary steroid hormone metabolites. This combination of sample type, biomarker category, and assay has been preferred for decades due to the ease of assessing reproductive health through the evaluation of stable compounds in easily collected biological samples using a cost-effective method. Increasingly, beginning with high performance liquid chromatography (HPLC) and more recently with convergence chromatography and ultra HPLC coupled with mass spectrometry (MS), wildlife studies are incorporating more sensitive and specific high-throughput technologies for the assessment of not only steroid hormone metabolites but proteins as well. Of note, a comprehensive health evaluation requires the measurement of biological readouts that modulate reproduction such as: glucocorticoids, leptin, insulin, thyroid hormones, melatonin, the microbiome, and markers of inflammation. Emerging modulatory biomarkers of reproductive health include acute phase proteins, microRNAs, and reactive oxygen species. Several of these biomarkers require application of newer technologies such as LC-MS/MS and sequencing, which demonstrates the need for the field of wildlife reproductive biology to diversify from its reliance on immunoassays. Importantly, endocrine disrupting chemicals adversely affect many aspects of reproductive function and evaluation of these compounds requires high throughput technology such as LC-MS/MS. The application of sequencing, particularly Next Generation Sequencing of bulk RNA (RNA-Seq) and single cell RNA-Seq, is uncommon in studies of wildlife reproductive health. However, as the cost of these methods decreases and consortiums of wildlife researchers band together to raise funds in support of studies using these technologies, their use will become more routine. Future research should focus on integration of known biomarkers of related systems into comprehensive reproductive assessments and the development of new biomarkers which are sensitive, precise, and employ non-invasive methodologies for the assessment of reproductive health of wildlife species.

Ultra-performance convergence chromatography tandem mass spectrometry analysis of adrenal and gonadal steroid hormones in southern white rhinoceros (Ceratotherium simum simum) faeces and serum

Steroid hormone analysis is routinely undertaken in the assessment of stress response and reproductive function in the management of both captive and free-ranging wildlife species. Faecal samples have become the preferred sample type for analysis as collection is non-invasive and easily assessable. These investigations are generally aimed at aiding successful translocations, enhanced survival outcomes in captivity and improvement of reproductive rate. Immunoassays are the most common approach in the analysis of hormones, particularly in the case of the southern white rhinoceros (Ceratotherium simum simum). Non-specificity, attributed to structural similarity of steroid metabolites impedes accurate evaluations which can be eliminated by chromatographic techniques which are more specific, selective and provide comprehensive analyses.This study developed and validated three methods using ultra-performance convergence chromatography tandem mass spectrometry for the assessment of classical androgens, progestogens and adrenal steroids, as well as the C11-oxy androgens and C11-oxy progestogens in serum and faeces from white rhinoceros. The limit of detection and quantification were determined for each steroid, parameters such as accuracy (<19.8 % RSD) and precision (<20.2 % RSD) were established with recovery, matrix effect, and process efficiency within acceptable limits. Subsequent analysis of serum and faecal samples from five white rhinoceros identified novel steroids for the first time in this species. In addition to the classical adrenal steroids, the following C11-oxy steroids were detected in faecal samples: 11α-hydroxydihydroprogesterone (168 ng/g), 11α-hydroxyprogesterone (125.9 ng/g), 11β-hydroxyprogesterone (210.2 ng/g) and 11-ketoandrostenedione (3.3–19.6 ng/g) with 11-deoxycortisol being the major glucocorticoid (24.2–67.3 ng/g) together with 21-deoxycortisone (40.7 ng/g) and deoxycorticosterone (7.6–14.6 ng/g). In serum samples 11β-hydroxyandrostenedione (0.35–2.34 ng/mL) and 11β-hydroxytestosterone (0.18–1.62 ng/mL) were the predominant androgens with cortisol (5.8–20.5 ng/mL), the predominant glucocorticoid, while corticosterone, 18-hydroxycorticosterone and aldosterone were also detected.These methods can be applied independently to assess either androgens, progestogens, or adrenal steroid panels or in combination to assess the cohort of gonadal and adrenal steroids in faeces and/or serum, in southern white rhinoceros as well as other wildlife species. Analysis would enable the accurate assessment of reproductive health and stress responses while also distinguishing between stress and distress thus contributing to the conservation of wildlife species.

PSUN373 Early Evidence for Ovarian Morphology as a Biomarker of Reproductive and Metabolic Health During the First Gynecological Year

Abstract Introduction Ovarian transabdominal ultrasonography (TAUS) is not recommended in the assessment of adolescent reproductive health. We have previously demonstrated feasibility of ovarian TAUS in adolescents with polycystic ovary syndrome (PCOS) as well as the utility of ovarian features to reflect the degree of reproductive symptomology in these older teens. Whether this feasibility and ovarian biomarker capability extends to the early post-menarcheal years is unknown. Objectives To determine the feasibility of TAUS to image ovarian morphology in early gynecological life, and to determine whether ovarian features reflect degree of metabolic or reproductive status as compared to menstrual cycle length. Methods 31 healthy adolescents are enrolled in a prospective cohort study monitoring ovarian morphology, reproductive health, and metabolic status during the first 2 years post-menarche. At 6-10 months post-menarche, all participants underwent a physical exam, TAUS and a fasting blood draw to measure reproductive hormones, lipids, and insulin. Self-recorded menstrual cycles were categorized as "irregular" if any of the three previous inter-menstrual-intervals (IMIs) were &amp;lt;21 or &amp;gt;45 days and "regular" if all three previous IMIs were 21-45 days. IMI groups were compared via Mann-Whitney U-tests. Spearman's rho correlations evaluated associations between ovarian variables, mean IMI, and reproductive and metabolic endpoints. Results Resolution of ovarian morphology was possible in all but one participant (97%). Overall image quality was judged as partially visible or excellent in 70% of the left ovaries and 80% of the right ovaries assessed. 19 participants were classified as having irregular cycles (61%), 10 as having regular cycles (32%), and 2 participants as undetermined (7%) within the first year of menarche. Reproductive, metabolic, and ovarian endpoints did not differ by cycle status (Mann-Whitney U-tests, P&amp;gt;0.05). Both the number of 2-9mm antral follicles per ovary (FNPO) and ovarian volume (OV) were positively associated with anti-Müllerian hormone (ρ=0.66, P&amp;lt;0.01; 0.55, P&amp;lt;0.01) and negatively associated with fasting insulin (ρ=-0.42, P&amp;lt;0.05; -0.51, P&amp;lt;0.01). FNPO was also positively associated with total testosterone (ρ=0.34, P&amp;lt;0.1) and negatively associated with waist-to-hip ratio (ρ=-0.32, P&amp;lt;0.1). Ovarian features were not associated with clinical measures of hyperandrogenism (hirsutism score). Unlike aspects of ovarian morphology, IMI was only significantly associated with triglycerides (ρ=-0.39, P&amp;lt;0.05). Conclusion Transabdominal ovarian imaging during the early post-menarcheal period is feasible and provides sufficient resolution to enable the identification of antral follicles and ovarian size. Unlike IMI, ovarian features in early gynecological life correspond with measures of both reproductive and metabolic health. Similar to adults, we provide evidence that ovarian morphology may represent a clinically feasible biomarker to monitor reproductive health in early gynecological life. Whether ovarian features change as reproductive dysfunction, such as PCOS manifests will be determined in follow-up studies within this longitudinal cohort. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Evaluation of Women’s Reproductive Health Status After the 2017 earthquake in Kermanshah, Iran

Background: Women are at higher risk of death during disasters due to physical, biological, psychological, and cultural differences. After a disaster, they experience more miscarriages, premature births, inadequate fetal growth, low birth weight, sexual violence, and unwanted pregnancies. This study aims to investigate the reproductive health status of women affected by the 2017 earthquake in Kermanshah, Iran. Materials and Methods: This descriptive cross-sectional study was conducted in 2018. The study population consists of women aged 15-49 years (Mean age=31.7 years) living in Sarpol-e Zahab, Javanrood, and Thalas Babajani towns in Kermanshah city affected by the earthquake in 2017. The questionnaire used for assessing the status of reproductive health in women was the Reproductive Health Assessment Questionnaire for Women of Reproductive Age, which has already been localized in Iran and its reliability and validity have been confirmed. Native Kurdish language experts completed the questionnaires on behalf of 396 participants. Descriptive statistics were used to describe the variables. Results: It was found that 42.4% of women complained of abnormal menstruation and 34.09% of limited menstrual hygiene materials. Sixty women were pregnant at the time of the earthquake, all of whom gave birth in hospital; two had miscarriages, two had premature births, and one had stillbirth. Urinary tract infection was the most common problem (21%) in pregnant women. Moreover, 48% of women used contraceptive methods after the earthquake, the most commonly used method was the use of contraceptive pills (23%). Access to contraception methods was difficult for 14.4% of them after the earthquake. Furthermore, 25% had experienced violence after the earthquake; of these, 30 reported physical violence, 86 verbal violence, and 13 sexual violence. Conclusion: The control of pregnancy and safe delivery in earthquake-affected areas of Kermanshah is relatively acceptable; however, the provision of reproductive health services seems to be challenging. It is recommended to pay attention to the menstrual hygiene of women and regular distribution of contraceptives (despite the current population growth plan), address sexual acts of violence, and develop a protocol to support the victims.

Sexual and Reproductive Health Assessment in a Group of Female Renal Transplant Recipients

Fertility and sexual health are impaired in individuals with chronic kidney disease and can be restored after a successful renal transplant. This is a single-center prospective study about the sexual and reproductive health (including contraceptive methods and gynecologic cancer screening) in renal transplant recipients. Female renal transplant recipients, aged 18 to 49 years at transplant, were interviewed about their gynecologic history, sexual health, and use of contraceptive methods. Ninety-one patients fulfilled the inclusion criteria. The majority of women maintained menstrual cycles during dialysis therapy, being almost 60% of the women in an irregular rhythm. Pregnancies were reported for 51 women, 20% after transplant, and associated with low-weight newborns. The incidence of spontaneous abortion was 12.5%. Thirty-one patients were denied contraceptive methods due to the vasectomy of the partner (n=16) or the belief that they would not become pregnant (n=15). The most common contraceptive method was a condom, and the use of an intrauterine device was rare. Gynecologic assessment and cancer screening were out-of-date in almost one-third of patients. In this study, the majority of women were from low-income areas and had low levels of education. Despite access to public universal health care, adherence to yearly screening tests and use of contraceptive methods were lower than expected.

Development and psychometric evaluation of Sexual and Reproductive Health Assessment Scale for women with educable intellectual disability (SRH-WIDS): a sequential exploratory mixed-method study

BackgroundWomen with Intellectual disability have many problems in their sexual and reproductive health due to their special mental and physical conditions caused by disability. This study aimed to develop and evaluate the psychometric properties of Sexual and Reproductive Health Scale for Women with Educable Intellectual disability.MethodsThis sequential exploratory mixed-method study was conducted at two qualitative and quantitative stages in Tehran, from 2018 to 2020. At the qualitative stage, in-depth and semi-structured interviews were conducted with 21 parents and caregivers of women with intellectual disability to explain the concepts and to generate items. Thereafter, the item pool was formed based on the concepts and themes extracted from the qualitative phase as well as the review of literature. At the second stage, psychometric properties of the scale were assessed. Finally, responsiveness, interpretability, and feasibility of the scale were determined.ResultsAn item pool containing 95 items was produced at the first stage. At the second stage, the final version of scale was developed. The psychometric properties of this final version were then assessed and the results showed that the instrument has good validity and reliability. The results of exploratory factory analysis showed that the instrument contains seven factors. Accordingly, these factors explained 53% of the total variance of the instrument variables.ConclusionsThe results show that the SRH-WIDS with 25 items has sufficient validity and reliability, so it could be easily used by caregivers to assess the sexual and reproductive health of Women with Educable Intellectual disability.Ethical code: IRI.TUMS.VCR.REC 1397.340.

The Status, Policies, and Programs of Preconception Risk Assessment in Iran: A Narrative Review

Introduction: Preconception care is defined as a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman’s health or pregnancy outcome through risk assessment, health promotion, and medical and psychosocial interventions. This study aimed to review the status, policies, and programs of preconception risk assessment in Iran.Methods: We searched scientific databases including Medline, PubMed, Web of Science, Scopus, CINAHL, Magiran, Iran Medex, SID, Iran Doc, Science Direct, and Google Scholar using key words such as "preconception care", "pre-pregnancy care", "instruction", "guideline", "risk assessment", "program", "policy", "Iran" and their combinations. No time limit was considered in searching the databases and all studies were published until February 1, 2020. Our search strategy resulted in the retrieval of 66 articles and guidelines, of which nine articles met the inclusion criteria and entered the study. Results: Multiple guidelines have been designed to assess the general health of women and men of childbearing age, with pay little attention to the reproductive health assessment in Iran. Assessment of reproductive health is specific to the integrated maternal health care program, which the reproductive health risk assessment from pre-pregnancy to postpartum period. The preconception care is a component of integrated maternal health care program that is faced in its content and faces challenges in implementation. Conclusion: Several strategies have been developed in the field of risk assessment for general health in Iran, but risk assessment in pre-pregnancy period is only exclusive to preconception care program that is moderate in performance.

Reproductive health status of adolescent mothers in an Iranian setting: a cross-sectional study

BackgroundIn low and middle-income countries (LMICs), where millions of women give birth before the age of 18, the reproductive health status of married adolescent mothers, including family planning, sexual, psychosocial, and maternal health, remains a significant and recurring phenomenon. As a result, the purpose of this study was to assess the reproductive health status of married adolescent mothers who sought treatment at Ardabil health care centers in 2019.MethodsA cross-sectional study was carried out in five health centers in Ardabil, Iran. This research included 312 married adolescent mothers who were under 19 years old. Health workers who asked questions of each participant completed a demographic questionnaire and the Reproductive Health Assessment Scale for Married Adolescent Women, and all data were self-reported. Univariate and multivariate linear regressions were used to determine risk factors associated with reproductive health scores. The data was examined using statistical software (SPSS version 20).ResultsThe mean age (years) of the respondents was 16.41 ± 0.85, the mean age of their husbands was 24.18 ± 2.29, and the mean age of their marriage was 15.06 ± 1.15. In this study, adolescent mothers had an average reproductive health score of 63.78 ± 11.06. There was a significant association between reproductive health status and age, education, husband’s age and education, and contraceptive methods among married adolescent mothers (p < 0.05).ConclusionThe research findings indicated that adolescent mothers had an average level of reproductive health. Several socio-demographic characteristics, including age, education, gravida, and contraception, were linked to reproductive health scores. Programmers and policymakers should prioritize improving the reproductive health of adolescent mothers through education and increasing women’s and spouses’ knowledge and awareness.

A Workshop To Develop Nurse Practitioner Competencies in Women’s Reproductive Health

Reproductive health is a central component of nurse practitioner education. Training opportunities in reproductive health have been limited by multiple factors. This article reviews the background on women’s reproductive health assessment and the outcomes of an intensive workshop to give students opportunity to demonstrate competence in sexual health history taking, pelvic examination skills, and clinical analysis of common reproductive health concerns. Students overwhelmingly reported that the workshop increased their competence and confidence in reproductive health skills. This reproducible workshop fits well into the emergence of competency-based nurse practitioner education.