Over half of Society for Assisted Reproductive Technology member fertility clinics included LGBT content on their websites, yet those in the Midwest and South were significantly less likely to do so. Predictive factors for having LGBT website content included location in northeastern and western regions and increasing clinic size. Further studies are needed to evaluate whether inclusion of LGBT content on clinic websites impacts use of reproductive services by the LGBT patient population.
BackgroundPharmaceutical uterotonics are effective for preventing postpartum hemorrhage and complications related to unsafe abortion. In Madagascar, however, traditional birth attendants (Matrones) commonly administer medicinal teas for uterotonic purposes. Little is known about Matrone practices and how they might coincide with efforts to increase uterotonic coverage. The aims of this study were to: 1) identify indications for presumed uterotonic plant use by Matrones, 2) explore uterotonic practices at the village level, and 3) describe the response of health practitioners to village-level uterotonic practices.MethodsTwelve in-depth interviews with health practitioners, Matrones and community agents were conducted in local dialect. All interviews were audio-recorded, transcribed, and translated into English for analysis using Atlas.ti. Medicinal plant specimens were also collected and analyzed for the presence of uterotonic peptides.ResultsWhile Matrones reported to offer specific teas for uterotonic purposes, health practitioners discussed providing emergency care for women with complications associated with use of specific teas. Complications included retained placenta, hypertonic uterus, hemorrhage and sepsis. Chemical analysis indicated the presence of cysteine-rich peptides in the Dantoroa/Denturus plant used in some Matrones’ teas.ConclusionsThe presence of uterotonic peptides in one plant used by Matrones may indicate that Matrones intend to administer uterotonics for safer childbirth. This finding, combined with practitioner reports of complications related to some medicinal teas, points to a need for availability of an evidence-based uterotonic at the village level, namely, misoprostol pills or oxytocin in the form of uniject.
and New York City. Total sperm count, average concentration and total motile count were analyzed as a whole and by region. Data was analyzed using a general estimate equation model with an exchangeable working correlation structure. RESULTS: A total of 124,107 SA specimens were analyzed. Controlling for BMI, there was a decline in total sperm count (b¼-2.9, p<0.01), concentration (b¼-1.76, p<0.01) and total motile sperm count (b¼-2.45, p<0.01) over the 11-year study. There were decreases in SA parameters in all regions except New York City, which showed no change in total sperm count, concentration or total motile sperm count. Boston showed a decline in concentration and total motile sperm count but no difference in total sperm count. CONCLUSIONS: Changes in our modern environment-chemical exposures or increasingly sedentary lifestyles-may negatively affect spermatogenesis. We demonstrated a time-related decline in semen quality. Given that donors have higher than average sperm counts, these trends would likely be magnified in the general population. If confirmed, these findings would serve as a public health warning, particularly with the simultaneous increase in other male disorders, including testicular cancer. 5 The magnitude of semen quality decline varied by region, with only samples from New York City consistent throughout the study. To further investigate geographical differences, future prospective studies should investigate potential causes for this decline. Identifying modifiable risk factors is the first step in determining how to reverse these trends.
GnRH-a trigger is a suitable option for women undergoing EOC, where even a small risk of OHSS may be unacceptable. No significant decline was seen in MR when used in normal and low responders undergoing EOC. Very-low responders had lower MR overall, regardless of trigger type. Based on these data, GnRH-a can be used reliably for the induction of maturation in EOC cycles regardless of response.
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