Unprotected Sexual Intercourse Research Articles

Pharmacist recommendations for emergency contraception in Belgium: a simulated user study

Background Emergency contraception reduces the risk of unintended pregnancy, after unprotected sexual intercourse or contraceptive failure. In Belgium, emergency contraception is available without a prescription and pharmacists play therefore a crucial role in dispensing emergency contraception. Aim This study assesses the dispensing practices of emergency contraception by pharmacists in two regions of Belgium. Method and design Simulated patient study, using a predefined scenario, evaluating a request for emergency contraception. The scenario involves a 25-year-old woman not using contraception, who had unprotected sexual intercourse 84 h (3.5 days) ago. Her last menstrual period was 10 days ago. Population 260 pharmacies were randomly selected. Principal outcome: proportion of pharmacists who deliver the adequate emergency contraception. We considered the following responses as adequate: Prescribing ulipristal acetate or redirecting to another pharmacy, in case of unavailability, or referring for a copper IUD Results We analysed the data obtained in 216 pharmacies (216/260 = 83.1%). In 64% of cases, adequate dispensing of emergency contraception (dispensing of ulipristal acetate or referral for intrauterine device insertion) occurred. There was an association between correct dispensing and asking appropriate questions, such as the date of the last menstrual period and the date of the risky sexual intercourse. Conclusion More than one-third of visited pharmacies did not distribute appropriate emergency contraception, underlining the need for improvement. We hypothesise that this may be achieved with appropriate training, use a dispensing checklist.

Complementary information concerning the suspected interindividual transmission of GW1516, a substance prohibited in sport, through intimate contact: a case report.

Inadvertent and/or unknowing exposure to drugs and drug residues has been frequently debated in situations of so-called adverse analytical finding (AAF) in the context of sports drug testing programs. Transfer of drug residues via unprotected intercourse is a conceivable scenario but scientific data and authentic case reports are scarce. Herein, investigations into two AAFs with the peroxisome proliferator-activated receptor delta (PPARδ) agonist GW1516 are reported and discussed. To probe for a contamination scenario involving sexual intercourse, two assays were used to determine semenogelin in human urine, with one employing an immunochromatographic lateral flow approach and another based on liquid chromatography-tandem mass spectrometry. Further, drug-residue testing using patients' ejaculate was conducted by utilizing liquid chromatography in conjunction with a triple quadrupole mass spectrometer, followed by re-analysis of suspect samples (i.e., samples indicating the presence of relevant compounds) using high resolution/high mass accuracy mass spectrometry. In one case, but not the other, the possibility of intimate contact as the source of the AAF was confirmed after a thorough investigation of potential contamination scenarios. Subsequent research revealed analytical evidence for the presence of seminal fluid in one of the female athlete's doping control urine samples, and the analysis of clinical ejaculate specimens provided first data on an authentic concentration level of GW1516 and its metabolites in human seminal fluid. The combined facts substantiate the possibility of an AAF caused by unprotected sexual intercourse and the plausibility of the case-related arguments.

Facteurs associés aux dermatoses infectieuses au Centre Hospitalier Universitaire Départemental du Borgou/Alibori, Bénin

Background: Infectious dermatoses are widespread in sub-Saharan Africa and are influenced by many factors. The aim was to study the epidemiological and clinical characteristics of infectious dermatoses and their associated factors in the Dermatology-Venerology Department of CHUD-B/A. Material and Methods: This was a descriptive and analytical cross-sectional study, with retrospective data collection, over a 12-year period from January 1, 2009 to December 31, 2020. The sample consisted of all patients with infectious dermatoses whose records could be used. Data were analyzed using Epi info 7.2.3.1 software. Results: A total of 1,512 records were collected for patients with at least one infectious dermatosis during the period. The mean age was 27.68 ± 15.9 years. There were almost as many men as women, with a sex ratio of 1.04. The most frequent reason for consultation was pruritus (64.55%). Mycotic dermatoses (59.46%) predominated, followed by viral dermatoses (22.75%). Unprotected sexual intercourse was a factor associated with bacterial dermatoses, multiple sexual partnerships a factor associated with viruses, and female sex a protective factor for cutaneous parasitoses. Conclusion: Infectious dermatoses play an important role in dermatological consultations, with a predominance of mycotic dermatoses. The factors associated with their occurrence are varied.

Association study of NAT2 rs1799931 polymorphism with male infertility

Infertility is a complex disease that is characterized by the failure to achieve pregnancy after 24 months of regular, unprotected sexual intercourse. Various factors result in male sterility, including genetic and non-genetic factors. Recently, scientists have drawn attention to the role of metabolic genes in contributing to the risk of male infertility by inducing reactive oxygen species (ROS). However, such studies about N-acetyltransferase 2 (NAT2), an enzyme that participates in phase II metabolism, remain limited. Thus, this study investigated whether the NAT2 rs1799931 variant was associated with idiopathic male sterility in Vietnam. A total of 306 DNA samples (148 cases and 158 controls) were genotyped using the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. About 20% of randomly selected samples were confirmed using an allele-specific polymerase chain reaction (AS-PCR). The results showed that genotype frequencies were consistent with Hardy-Weinberg Equilibrium. Notably, there was an association between NAT2 rs1799931 and male infertility in two genetic models: the additive model (GA genotype, OR = 0.606, 95% CI: 0.369–0.989, p-value = 0.044) and the dominant model (GA+AA genotypes, OR = 0.614, 95% CI: 0.382–0.981, p-value = 0.040). This study has enriched our knowledge about the roles of genetic factors in contributing to male infertility in the Vietnamese population.

Trends in Utilization of Emergency Contraceptives in Tanzania: A Retrospective Longitudinal Study From 2018 to 2023.

Introduction Emergency contraceptives (ECs) are a critical method for preventing unwanted pregnancies following unprotected sexual intercourse. However, Tanzania is experiencing an alarming surge in the misuse ofECs among reproductive-aged females, particularly younger girls and women. Reports of their use as regular contraceptives are a rising concern. Deviations from their intended use in emergencies may not only increase the risk of contraceptive failure but also increase the risk of adverse health events. This study aims to delineate and evaluate the utilization patterns of ECs over six consecutive years using importation data obtained from the Tanzania Medicines and Medical Devices Authority (TMDA). Materials and methods We analyzed the ECdata collected by TMDA over six consecutive years using a retrospective longitudinal design. Microsoft Power BI (Microsoft® Corp., Redmond, WA) was used to clean, organize, and aggregate the data. IBMSPSSStatistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States)was used to analyze annual trend utilization using linear regression. Results We analyzed 114 importation consignments for ECs, identifying 95.6% (109 records) as oral ECs and 4.4% (five records)as intrauterine devices (IUDs) between 2018 and 2023. This data revealed a significant increase in the volume of EC imports, with its contribution increasing from 1.9% in 2018 to 60.1% in 2023. This highlights the marked increase in EC consumption in Tanzania. In 2023, the defined daily dose per 1000 inhabitants per year (DID) peaked at 3.917826, indicating an unprecedented increase of 4,983.06% compared to the lowest DID observed in 2019 at 0.0873552. The year 2023 alone accounted for 41.63% of the total DID (9.43) over the entire study period. In 2019 and 2020, there was a decrease in EC consumption, followed by a rapid increase from 2021 to 2023. The reduction in EC consumption from 2019 to 2020 was 36.9% compared to that between 2021 and 2022. Conclusions The significant rise in EC importation and utilization in Tanzania between 2018 and 2023, marked by fluctuating consumption trends and a notable surge, highlights the urgent need for targeted educational and policy intervention. This will guide the rational and informed use of ECs, ensuring access aligns with best practices for reproductive health.

Knowledge and attitude towards emergency contraceptive among undergraduate students of Kathmandu metropolitan, Nepal

Background: Emergency Contraception is the only method women can use to prevent pregnancy after they have had unprotected sexual intercourse, have experienced a contraceptive failure, have remembered too late that they have forgotten to take their birth control pills, or have been forced to have sex against their will. Unintended pregnancy poses a major challenge to the reproductive health of young adults both in developed and developing nations. Objectives: The primary objective of this study was to assess the knowledge and attitude of undergraduate students of Kathmandu Metropolitan City towards Emergency Contraceptive. Methods: An analytical cross-sectional study was conducted in which self-administered questionnaire was used. A total of 370 sample size was drawn and multi-step sampling technique was used. Quantitative research method was applied, and the data was entered and analysed using SPSS v.16 (SPSS Inc., Chicago, Ill., USA). Results: Of the total 370 participants, 42.2% were over the age of 20 years, female participants (54.3%) were slightly more than male participants (45.7%). More than half (54.1%) of the participants had adequate knowledge regarding Emergency Contraception. Age was found to be significantly associated with knowledge of the students (AOR=4.71, 95% CI: 2.02-10.95). 32.11% and they had a positive attitude towards Emergency Contraceptive. Janjati ethnicity compared to Brahmin/Chhetri (AOR=3.049, 95% CI:1.716-5.419), and BBS/BBA study program (AOR=1.962, 95% CI: 1.168-3.297) were found to be significantly associated with the attitude of the participants regarding Emergency Contraceptive. 47% of the participants responded that they will use Emergency Contraception in the future and 52% responded that they will recommend it in future. Conclusion: This study has shown that there is inadequate knowledge and negative attitude of participants towards Emergency Contraception. This study highlights the necessity of awareness campaigns regarding emergency contraception to all faculties and levels of students.

Fertility history and intentions of married women, China.

To estimate the proportion of married women in China who intend to become pregnant given the country's pronatalist population policy and to investigate fecundity, with an emphasis on the influence of socioeconomic factors. A nationally representative survey of 12 815 married women aged 20 to 49years (mean: 36.8years) was conducted during 2019 and 2020. All completed questionnaires, 10 115 gave blood samples and 11 710 underwent pelvic ultrasound examination. Fertility intention was the desire or intent to become pregnant combined with engagement in unprotected sexual intercourse. We defined infertility as the failure to achieve pregnancy after 12months or more of unprotected intercourse. We considered an anti-Müllerian hormone level < 1.1ng/mL and an antral follicular count < 7 as indicating an abnormal ovarian reserve. Fertility intentions were reported by 11.9% of women overall but by only 6.1% of current mothers (weighted percentages). Fertility intention was significantly less likely among women in metropolises (odds ratio, OR: 0.38; 95% confidence interval, CI: 0.31-0.45) and those with a higher educational level (OR: 0.74; 95% CI: 0.62-0.88). Overall, 18.0% had experienced infertility at any time and almost 30% had an abnormal ovarian reserve on assessment. An abnormal ovarian reserve and infertility were less likely in women in metropolises (P < 0.05) but more likely in obese women (P < 0.05). The willingness of Chinese married women to give birth remained low, even with relaxation of the one-child policy.

Reproductive Enhancement through Phytochemical Characteristics and Biological Activities of Date Palm Pollen: A Comprehensive Review on Potential Mechanism Pathways.

Infertility represents a significant global health challenge affecting both men and women. Despite regular unprotected sexual intercourse, approximately 15% of couples of reproductive age struggle to conceive within 12 months, with 10% of infertility cases attributed to unknown causes worldwide. As a result, numerous studies have turned their attention to exploring the use of natural products for the prevention and treatment of infertility. Among these natural remedies is date palm pollen (DPP), a male reproductive powder derived from the blossoms of the Phoenix dactylifera L. palm tree, which has a long history of use as a dietary supplement, particularly as an aphrodisiac and fertility enhancer for both men and women. This review critically examines the diverse components of DPP, including metabolites, proteins, amino acids, fatty acids, to elucidate its potential impact on human reproduction. The analysis thoroughly assesses the composition of DPP in relation to its effects on enhancing reproductive processes and delves into its traditional uses and therapeutic benefits in male fertility, such as the enhancement of sexual desire, semen quality, and hormonal equilibrium. Similarly, it explores the influence of DPP on female fertility, emphasizing its potential to improve factors such as lubrication, desire, ovulation, and hormonal balance. Overall, this review underscores the potential of DPP as a natural remedy for addressing reproductive disorders.

Stress Biomarkers Transferred Into the Female Reproductive Tract by Seminal Plasma Are Associated with ICSI Outcomes.

This study aimed to determine whether male stress is related to seminal stress biomarkers and pregnancy achievement in women exposed to their partner's seminal plasma (SP) in the intracytoplasmic sperm injection (ICSI) cycle. In this pilot prospective study, 20 couples undergoing ICSI, as well as 5 fertile sperm donors and 10 saliva donors, were investigated. Women were exposed to their partner's SP via unprotected sexual intercourse during the ICSI cycle and intravaginal application on the day of ovum pick-up (Day-OPU). Semen samples were collected from male partners by masturbation on the Day-OPU. Saliva and serum samples were collected prior to masturbation. Body fluids were frozen at - 80°C until assayed. Biomarkers of activity of the sympathetic adrenomedullary axis (salivary alpha-amylase and adrenaline), sympathetic neural axis (noradrenaline and dopamine), hypothalamic-pituitary-adrenal (HPA) system (cortisol), and immune system (C-reactive protein and interleukin (IL)-18) were estimated to examine their association with SP composition and clinical pregnancy achievement. The clinical pregnancy rate was 45.0%. In the unsuccessful ICSI group, blunted levels of salivary and serum cortisol were found compared to the successful ICSI group and the fertile sperm donors. With regard to seminal markers, decreased cortisol level and elevated noradrenaline, noradrenaline/cortisol ratio, and lL-18 levels were strongly associated with ICSI failure (areas under the ROC curves were, 0.813, 0.848, 0.899, and 0.828, respectively). These findings confirm that stress response systems activity affects SP composition, which in turn is associated with ICSI outcomes in women exposed to their partner's SP during an ICSI cycle.

Prevalence and Causes of Infertility: Perspectives of Married Couples in the Southern Part of Volta Region

Infertility is the inability of a couple to conceive after one year of regular unprotected sexual intercourse. This study aimed to assess the prevalence and causes of infertility among couples in the southern part of the Volta Region of Ghana. We employed descriptive cross-sectional study involving 322 married couples in the Southern Volta. Structured questionnaire was used to collect data from the respondents. Data were collected between March and April 2019. This study included couples, 18 years and above who had stayed together for at least a year, were residing in the community for at least six months ‘prior to the study and have consented to participate in the study. Of the 322 couples, 35 (10.9%) had primary infertility, and 13 (4.0%) had secondary infertility. The infertility prevalence was of 14.9%. In all, 51% of the respondents had good level of knowledge on the causes of infertility.

EXPERIMENTAL EVALUATION OF VAJIKARANA KARMA OF TILAGOKSHURA SIDDA DUGDA WITH SPECIAL REFERENCE TO APHRODISIAC ACTIVITY

Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Estimates suggest that approximately one in every six people of reproductive age worldwide experience infertility in their lifetime. Conventional management need long term therapy and are not devoid of ADR’s. Vajikarana is one among Astanga Ayurveda that deals with the preservation and amplification of sexual potency of a healthy man and conception of healthy progeny. Vajikarana yogas helpful in management of Shukra dusti and Vandytava were documented in the classics. ‘TilaGokshura Sidda Dugdha’ is one such formulation explained by Chakradatta in Vajikarana chapter indicat-ed in Shandatva (Impotency). The ingredients of yoga are Tila and Gokshura processed in Aja ksheera (Gaot milk) which are having Shukrala and Vrishya karma. Thus, yoga was selected to evaluate the Vajikarana karma. Also, an additional attempt is made to evaluate the same yoga by changing the processing agent as Go-Dugda(Cow milk) in another group. MATERIAL AND METHODS : Wister rats were grouped in to 5 groups of 6 animals each. Experimental period was 28 days study. Oligospermia was induced by administrating Metroni-dazole for initial 14 days. Group one as Normal, Group 2 as Disease control, Group 3 was treated with Clomi-phene citrate, Group 4 and Group 5 were treated with Tila Gokshura Sidda Dugda (Aja Dugda Saditha) and Tila Gokshura Sidda Dug-da (Go-Dugda Saditha) respectively for next 14 days. Sexual Behaviour Pattern, Sperm count, Serum parameters, Tissue parameters and Histopathological changes in testis tissue were Observed. DIS-CUSSIONS AND CONCLUSION : Tila Gokshura Sidda Dugda (Aja Dugda Saditha) showed effective Vajika-rana karma in experimental rats when compared to standard drug. RESULTS : The results of the experimental study reveal that TilaGokshura Sidda Dugda has significant Vajikarana karma when compared with standard drug.

Stem Cells and Infertility: A Review of Clinical Applications and Legal Frameworks.

Infertility is a condition defined by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to an impairment of a person's capacity to reproduce either as an individual or with their partner. The authors have set out to succinctly investigate, explore, and assess infertility treatments, harnessing the potential of stem cells to effectively and safely treat infertility; in addition, this paper will present the legal and regulatory complexities at the heart of stem cell research, with an overview of the legislative state of affairs in six major European countries. For couples who cannot benefit from assisted reproductive technologies (ART) to treat their infertility, stem-cells-based approaches have been shown to be a highly promising approach. Nonetheless, lingering ethical and immunological uncertainties require more conclusive findings and data before such treatment avenues can become mainstream and be applied on a large scale. The isolation of human embryonic stem cells (ESCs) is ethically controversial, since their collection involves the destruction of human embryonic tissue. Overall, stem cell research has resulted in important new breakthroughs in the treatment of infertility. The effort to untangle the complex web of ethical and legal issues associated with such therapeutic approaches will have to rely on evidence-based, broadly shared standards, guidelines, and best practices to make sure that the procreative rights of patients can be effectively reconciled with the core values at the heart of medical ethics.

Homoeopathy – An Alternative to Conventional Treatment for Infertility

AbstractInfertility is a disease of reproductive system in males or females. It is defined as inability to achieve pregnancy after 12 months or more of unprotected sexual intercourse. As per the World Health Organisation, the availability, access and quality of infertility treatment are challenges in most countries especially the middle- and low-income countries. Infertility has a negative psychological and social impact for couples. The cost of conventional treatment which includes medicines and assisted reproductive techniques can be a deterrent for many. Published case reports have shown positive pregnancy outcome in infertility cases treated with homoeopathy due to both male and female causes. There is a need to make homoeopathic treatment for infertility accessible to general population through focused outpatient departments (OPDs) and also consolidate research-based evidence of efficacy of homoeopathy in infertility through well-designed comparative randomised controlled trials (RCTs). Towards this, Dr. D. P. Rastogi Central Research Institute of Homoeopathy has made effort to start weekly infertility OPD. The institute is also in process of initiating a RCT on female infertility in polycystic ovary syndrome cases with comparative arm of conventional treatment and homoeopathic treatment.

Management of Severe Asthenoteratozoospermia with Traditional Medicine: A Case Study

Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Fertility issues may represent a stressful situation to the couple’s life with important negative psychosocial effects. Ayurveda as a branch of traditional medicine developed a separate specialty for sexual dysfunction, namely Aphrodisiac Therapy (Vajeekarana Chikitsa). It deals with preservation and augmentation of sexual potency and conception of healthy progeny as well as management of defective semen, spermatogenesis along with treatment of seminal related disorders. Sperm quality is affected by various biological and environmental factors. A male patient was diagnosed with asthenoteratozoospermia, which is a combination of two conditions namely, asthenozoospermia (low sperm motility) and teratozoospermia (abnormal sperm morphology). The study patient was treated with ayurvedic medicine (shaman chikitsa) and panchakarma therapy (shodhana chikitsa) for 5 months. After completing the treatment course a semen analysis was performed and improvement was observed in his abnormal condition. The condition changed from severe asthenoteratozoospermia to normozoospermia and finally his wife had conceived successfully.

Overview of Female Infertility: Causes, Evaluation, And Management

Introduction: Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. In the female reproductive system, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among others. Infertility can be primary or secondary. Primary infertility is when a pregnancy has never been achieved by a person, and secondary infertility is when at least one prior pregnancy has been achieved. Objectives: Describe the epidemiology of female infertility. Review the most common findings of female infertility. Outline the management for known causes of female infertility. Explain the importance of improving health care coordination among the interprofessional team to enhance and improve outcomes for female infertility patients.

Retail demand for emergency contraception in United States following New Year holiday: time series study.

To estimate the increase in sales of emergency contraception following the New Year's Eve/New Year's Day holiday. Time series analysis using autoregressive integrated moving average (ARIMA) model. Traditional (that is, "bricks and mortar") retail outlets-grocery stores, drug stores, mass merchandisers, club stores, dollar stores, and military outlets-in the United States from 2016 to 2022. Marketing data on weekly aggregated sales of items classified as emergency contraception gathered between 2016 and 2022 (n=362). On the basis of dates, weeks were classified as following the New Year holiday (n=6) or not (n=356). Weekly sales of levonorgestrel emergency contraception per 1000 women of reproductive age in the US population. Sales of levonorgestrel emergency contraception significantly increased after the New Year holiday (0.63 (95% confidence interval 0.58 to 0.69) unit increase per 1000 women aged 15-44). Holidays that share some aspects of the elevated risks of unprotected sexual intercourse with the New Year holiday (Valentine's Day, St Patrick's Day, US Independence Day) were associated with increased sales, albeit to a lesser degree, with respective sales increases per 1000 women aged 15-44 of 0.31 (0.25 to 0.38), 0.14 (0.06 to 0.23), and 0.20 (0.11 to 0.29). Holidays without these expectations (Easter, Mother's Day, Father's Day) were not significantly associated with sales of levonorgestrel emergency contraception. Increased sales of emergency contraception following the New Year's holiday suggest that this period is associated with increased risks of unprotected vaginal intercourse compared with other holidays. Targeting behavioral risks, prevention strategies to mitigate sexual violence, and improving access to contraception around holidays may limit the risks associated with unprotected vaginal intercourse.

A Comparison of ICSI Outcomes and Reactive Oxygen Species Levels in Seminal Plasma between Normozoospermia and Sperm Abnormalities Groups for Infertile Men

Background: Social life and the healthcare systems are affected by infertility. Infertility could be primary or secondary; secondary infertility is the inability to conceive after one successful pregnancy while primary infertility is the inability to conceive at all. As sperm abnormalities cause male infertility, Intracytoplasmic Sperm Injection (ICSI) is a particular type of in vitro fertilization (IVF) used to treat severe male-factor infertility. Free radical oxygen derivatives are reactive oxygen species (ROS). Reactive oxygen species may cause 30% to 80% of male infertility. Aims of the study: the present study aims to determine the reactive oxygen species level in seminal plasma and to study the Intracytoplasmic Sperm Injection outcomes for Normospermia group and compare it with Oligozoospermia, Asthenozoospermia and the Teratozoospermia Groups. Material, and Methods: a cross-sectional study was conducted between January 2023 to June 2023 in Najaf, on a non-random sampling including 50 couples who suffered from a minimum of 12 months of primary fertility with regular unprotected sexual intercourse and who had attended the fertility center in Najaf requesting fertility treatment. A gynecological examination and assessment were done for the female participants while the urologists examined and assessed the male subjects; then, a semen analysis was carried out followed by macroscopic and microscopic examinations. After the preparation of the sample for ICSI and performing ICSI, pregnancy was assessed and the outcomes of the different groups were compared. At the same time, reactive oxygen species levels were assessed by using the Human Reactive Oxygen Species ELISA kit. Then, the SPSS version 26 was used to perform the statistical analysis. Results: Among the twenty-one patients with Normozoospermia, seven with Asthenospermic, seven with Oligozoospermia and fifteen with Teratozoospermia, there was a significant difference among the four groups regarding sperm concentration, progressive motility, and sperm normal morphology. There was no significant difference among the type of sperm, Normo, Astheno, Tearato, and Oligozoospermia, regarding birth rate and ICSI outcomes. Males with higher progressive motility showed a higher pregnancy rate. In conclusion, despite the presence of reactive oxygen species, Intracytoplasmic Sperm Injection was advantageous and effective for all four groups. reactive oxygen species had no significant effect on Intracytoplasmic Sperm Injection outcomes, however Normozoospermia was associated with greater pregnancy rates. Despite the presence of reactive oxygen species, Intracytoplasmic Sperm Injection was advantageous and effective for all four groups. ROS had no significant effect on Intracytoplasmic Sperm Injection outcomes, however Normozoospermia was associated with greater pregnancy rates.

A conceptual review on Vitap Marma

The term Marma (vital point) is defined as “Maryanti iti Marmani” that spot when injured kills the person. The Vitap Marma is considered as Snayu Marma by Acharya Sushruta and Sira Marma by Acharya Vagbhata with dimension of one Angula. The effect of injury in Vitap Marma is infertility or deformities in spermatogenesis and Oogenesis. According to WHO infertility is defined as failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility affects millions of people of reproductive age worldwide and has an impact on their families and communities. Estimates suggest that between 48 million couples and 186 million individuals live with infertility globally. Vitap Marma is situated between pelvis and scrotum. Vitap Marma should be identified as inguinal canal consisting of spermatic cord.

Sex, Age, and Risk Group Variations among Individuals Infected with HIV, HTLV-1, and HTLV-2: Review of Data Records (1983–2017) from a Public Health Laboratory in São Paulo, Brazil

The inaugural AIDS Program in Brazil was established in São Paulo in 1983, with the Instituto Adolfo Lutz appointed for laboratory assistance. Subsequently, research on HIV infections and HIV/HTLV (HIV/HTLV-1 and HIV/HTLV-2) co-infections was conducted. This narrative review focuses on studies from the Immunology Department (1983–2017) that significantly influenced AIDS diagnosis or provided epidemiological data such as prevalence rates, sex, age, and risk factors. Twelve studies, encompassing over 8000 individuals, are discussed. During 1983–1985, nearly all AIDS cases were attributed to homosexual/bisexual men aged 31 years old. Subsequently, heterosexual men and women emerged as risk groups owing to intravenous drug use (IDU) and/or unprotected sexual intercourse with AIDS patients or multiple partners per year. From 1985 onwards, vertical transmission led to child infections. HIV/HTLV co-infection rates decreased over time, initially associated with male IDU, and in the 2010s with female IDU, and individuals aged &gt;40 years. Trends in HIV and HIV/HTLV co-infections among younger men and women (&lt;30 years of age) were observed from 2015 to 2017. The changing characteristics and risk groups for HIV and HIV/HTLV co-infections over the years underscore the necessity for ongoing public policies to prevent retrovirus transmission, particularly among adolescents and young adults.

How Far Should We Investigate the Male Causes in Unexplained Infertility?

According to a recent report by the Guideline Development Group of the ESHRE, the definition of Unexplained Infertility (UI) is ‘infertility in couples with apparently normal ovarian function, fallopian tubes, uterus, cervix and pelvis, age [Formula: see text]40 years and with adequate coital frequency; and apparently normal testicular function, genito-urinary anatomy and a normal ejaculate.’ This is anchored with the ICMART definition of infertility, where couples should have at least 12 months of regular, unprotected sexual intercourse before investigations are initiated. Since Unexplained Infertility is a diagnosis by exclusion, apart from evaluating female causes, it seems important that in evaluating male contributions to the UI, all necessary tests need to be carried out. Unfortunately, there are no robust standardized methods for establishing etiologic diagnosis in the male partner and that in some patients, underlying sperm dysfunction may not be detected during a routine assessment of the ejaculate, which may appear to be normal using the 2021 WHO standards. It is possible that some adverse reproductive outcomes that have been identified during medical and reproductive history examination may require the use of further tests procedures specified in the latest WHO manual to assess sperm function. However, these tests have a research status only or are not regarded for routine use in clinical practice until sound evidence is developed. These tests include testicular imaging, anti-sperm antibodies, sperm DNA fragmentation, sperm chromatin condensation, sperm aneuploidy screening, serum hormone testing, semen HPV testing, and semen microbiology testing all of which were found not routinely indicated based on current evidence when semen was found to be normal using the WHO 2021 semen standards. In summary, in evaluating male causes in unexplained infertility, there are no robust data to support the recommendation that additional tests about the male reproductive function may routinely be carried out when semen analysis based on the 2021 WHO standard is normal. However, additional tests may be carried out when adverse reproductive outcomes and findings in the medical and reproductive history may require the use of these further tests especially when there are no findings on the female side.