Effect of anxiety and depression levels on pregnancy outcome

SUMMARY OBJECTIVE: The aim of this study was to determine the effect of anxiety and depression on pregnancy outcome in couples receiving in vitro fertilization treatment. METHODS: A total of 102 couples (102 females and 102 males) with unexplained infertility were included in the study. Personal Information Form was used to collect data, Case Follow-up Form to record the treatment process, and Spielberger's State-Trait Anxiety Inventory and Beck Depression Inventory to measure the anxiety and depression levels of couples. Couples were measured twice: before treatment and on oocyte pickup day. RESULTS: There was no statistically significant difference between the anxiety and depression levels and oocyte count of women (p>0.05). There were statistically significant differences between State-Trait Anxiety Inventory level and sperm count and between BID level and sperm motility (p<0.05). There was no statistically significant difference between the anxiety and depression levels and pregnancy outcomes of women (p>0.05). CONCLUSION: Anxiety and depression had no effect on pregnancy outcome. More studies are needed to investigate the effect of anxiety and depression on pregnancy outcome in unexplained infertility.

Staged Treatment with Chinese Herbal Medicine in a Controlled Ovarian Hyperstimulation of In Vitro Fertilization-Embryo Transfer Programme / 中医杂志

It is believed that kidney deficiency is the fundamental pathogenesis while liver constraint and spleen deficiency， and disharmony of chong （thorough vessel， 冲脉）and ren （conception vessel， 任脉） is the key pathogenesis of infertility patients who adopted controlled ovarian hyperstimulation of in vitro fertilization-embryo transfer （IVF-ET） programme. Therefore， the method of tonifying the kidneys dominantly and treating the liver and spleen simultaneously is proposed， and Chinese herbal medicine is suggested to be used in adjuvant treatment of staged IVF-ET controlled ovrian hyperstimulation. In the regulation stage， modified Liuwei Dihuang Pill （六味地黄丸） can be used to tonify kidney and supplement essence， fortify spleen and nourish liver； in the ovulation promotion stage， modified Wenjing Decoction （温经汤） should be used to warm kidney and assist yang， dispel stasis and nourish blood； in the pre-transplantation endothelial preparation stage， modified Shenling Baizhu Powder （参苓白术散） is suggested to fortify spleen and replenish qi， invigorate blood and resolve stasis； after the transplantation stage， modified Shoutai Pill （寿胎丸） or Taiyuan Decoction （胎元饮） can be taken to fortify spleen and tonify kidney， benefit qi and nourish blood.

Transcriptomic Analysis of Wuzi Yanzongwan on Testicular Spermatogenic Function in Semi-castrated Male Mice / 中国实验方剂学杂志

ObjectiveTo screen out the transcriptomes related to the intervention of Wuzi Yanzongwan on the spermatogenic function of semi-castrated male mice， and to explore its potential mechanism in the intervention of the progress of low spermatogenic function. MethodBalb/c mice were randomly divided into sham-operated group， model group， testosterone propionate group（0.2 mg·kg-1·d-1， intramuscular injection） and Wuzi Yanzongwan group（1.56 g·kg-1·d-1， intragastric administration） according to body weight， with 12 mice in each group. The right testicle and epididymis were extracted from the model group and the drug administration group to construct the semi-castrated model of low spermatogenic function， while the fur and the right scrotum of the sham-operated group were only cut and immediately sterilized and sutured. At the end of the intervention， hematoxylin-eosin（HE） staining was used to observe the histopathology of testis， enzyme-linked immunosorbent assay（ELISA） was used to detect the levels of serum testosterone（T）， luteinizing hormone（LH） and follicle stimulating hormone（FSH）. The sperm count and motility of epididymis were measured by automatic sperm detector of small animal. Transcriptomic microarray technology was used to detect the mRNA expression level of testicular tissue in each group， the transcriptome of genes related to the regulation of Wuzi Yanzongwan was screened， and three mRNAs were selected for Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） to verify the transcriptome data. Through the annotation analysis of Gene Ontology（GO） and the signaling pathway analysis of Kyoto Encyclopedia of Genes and Genomes（KEGG）， the related functions of drugs regulating transcriptome were analyzed. ResultCompared with the sham-operated group， the testicular tissue of mice in the model group showed spermatogenic injury， contraction and vacuolization of the seminiferous tubules， reduction of spermatogenic cells at all levels， widening of the interstitial space， obstruction of spermatogonial cell development and other morphological abnormalities， and serum T significantly decreased， LH significantly increased（P<0.01）， and FSH elevated but no statistically significant difference， the count and vitality of epididymal sperm significantly decreased（P<0.01）. There were 882 differentially expressed mRNAs in the testicular tissues， of which 565 were up-regulated and 317 were down-regulated. Cluster analysis showed that these differentially expressed mRNA could effectively distinguish between the sham-operated group and the model group. Compared with the model group， the damage to testicular tissue in the Wuzi Yanzongwan group was reduced， the structure of the seminiferous tubules was intact， vacuolization was reduced， and the number of spermatogenic cells at all levels was significantly increased and arranged tightly. The serum T significantly increased， LH significantly decreased（P<0.01）， and FSH decreased but the difference was not statistically significant. The count and vitality of sperm in the epididymis were significantly increased（P<0.01）. Moreover， Wuzi Yanzongwan could regulate 159 mRNA levels in the testes of semi-castrated mice， of which 32 were up-regulated and 127 were down-regulated， and the data of the transcriptome assay was verified to be reliable by Real-time PCR. GO and KEGG analysis showed that the transcriptome functions regulated by Wuzi Yanzongwan were involved in the whole cell cycle process of sperm development such as sex hormone production of interstitial cells in testis， renewal， differentiation， metabolism， apoptosis and signal transduction of spermatogenic cells， and were closely related to the biological behaviors of signaling pathways such as spermatogenic stem cell function， endoplasmic reticulum protein processing and metabolic program. ConclusionWuzi Yanzongwan can effectively improve the low spermatogenic function of semi-castrated male mice， and its mechanism may be related to the regulation of testicular transcriptional regulatory network， the synthesis of sex hormones in testicular interstitial cells， the function of spermatogenic stem cells， the whole cell cycle process of spermatogenesis， as well as the expression of endoplasmic reticulum protein processing and metabolic program related genes transcription.

Análisis molecular y filogenético del genotipo F de Chlamydia trachomatis aislados en México en 2011 / Molecular and phylogenetic analysis of the F genotype of Chlamydia trachomatis isolated in Mexico in 2011

Resumen Antecedentes: Chlamydia trachomatis es la bacteria que se detecta con mayor frecuencia en las infecciones de transmisión sexual. Se han identificado 20 genotipos de C. trachomatis mediante el gen ompA y varias genovariantes mediante el análisis de polimorfismo de un solo nucleótido (SNP). En México, el genotipo F es el más frecuente. Objetivo: Identificar la existencia de subtipos del genotipo F. Método: Se analizaron siete cepas del genotipo F de C. trachomatis aisladas en 2011, mediante secuenciación de nucleótidos y mapeo con enzimas de restricción. Resultados: El análisis de SNP mostró dos cepas con el mismo SNP en el nucleótido 288 (C288T), mientras que con enzimas de restricción se identificó una variante con diferente RFLP (polimorfismo de la longitud de fragmentos de restricción) cuando se tratan con la mezcla de enzimas HinfI y TaqI. Conclusión: En México se encuentran dos subtipos del genotipo F y solo las enzimas de restricción HinfI y TaqI pueden identificar la existencia de uno de estos genotipos F.

Abstract Background: Chlamydia trachomatis is the most frequently identified bacterium in sexually transmitted infections. Twenty C. trachomatis genotypes have been determined using the ompA gene and several genovariants by single nucleotide polymorphism (SNP) analysis. In Mexico, the F genotype is the most frequent. Objective: To identify subtypes of the F genotype. Method: Seven C. trachomatis genotype F strains isolated in 2011 were analyzed by nucleotide sequencing and restriction enzyme mapping. Results: SNP analysis showed two strains with the same SNP at nucleotide 288 (C288T), while with res-triction enzymes, a variant with different RFLP (restriction fragment length polymorphism) was identified when treated with the mixture of HinfI and TaqI enzymes. Conclusion: In Mexico, there are two subtypes of F, and only with restriction enzymes HinfI and TaqI can identify one of the genovariants of the F genotype.

Sistema de Gestión Hospitalaria para la atención de la pareja infértil. Centro Territorial de Holguín, 2021

Introducción: La infertilidad es una enfermedad del sistema reproductivo que altera el equilibrio biológico, psicológico y social de las parejas. En Cuba existe un programa para el tratamiento de la pareja infértil y el Ministerio de Salud Pública incluye en sus directrices implementar las bases organizativas, sistema de trabajo, indicadores, funciones y control que garanticen el perfeccionamiento del Programa para la óptima atención de parejas infértiles, y dentro de esto se incluye confeccionar bases de datos donde se registren las parejas tratadas por este motivo. Objetivos: Implementar un Sistema de Gestión Hospitalaria para la atención de la pareja infértil, en el Centro Territorial de Holguín. Métodos: Se realizó un estudio de desarrollo tecnológico, se confeccionó sobre el sistema de base de datos relacional postgreSQL, se empleó la herramienta Odoo con el objetivo de englobar en un único software todas las prestaciones que necesita la consulta. Se utilizó el lenguaje de programación Python. Resultados: SCAPI, permite gestionar la información de los pacientes y sus historias clínicas, está compuesto por módulos relacionados: configuración general, permite crear los perfiles de usuarios y los permisos para interactuar con el sistema; SCAPI muestra y gestiona toda la información relacionada con la historia clínica digital, la agenda de turnos, medios diagnósticos (estudios de reserva ovárica, espermogramas, ecografías ováricas, estudios hormonales, técnicas de baja y alta tecnología entre otros). Conclusiones: El Sistema de Gestión Hospitalaria para la atención de la pareja infértil, contribuye al objetivo de una mayor calidad de la atención al paciente pues gestiona la información de estos y sus historias clínicas de manera rápida, oportuna y fiable.

Introduction: Biological infertility is a disease of the reproductive system that alters the psychological and social balance of couples. In Cuba there is a program for the treatment of infertile women and the Ministry of Public Health includes in its guidelines to implement the organizational bases, work system, indicators, functions and control that guarantee the improvement of the Program, including databases where couples treated for this reason are registered. Objective: To implement a Hospital Management System for the infertile couple care in the Holguín Territorial Center. Methods: A study of technological development was carried out using postgre SQL relational database system, Odoo tool, and Python programming language. Results: SCAPI allows to manage the information of patients and their medical records; it is made up of modules that are related to each other: the general configuration module which allows you to create user profiles and permissions to interact with the system; the SCAPI module which shows and manages all the information related to the digital medical history, appointment schedules, and diagnostic means (ovarian reserve studies, spermograms, ovarian ultrasound, hormonal studies, low and high technology techniques, among others). Conclusions: Hospital Management System for the care of infertile couples allows managing fast, timely and reliable information on patients and their medical records during care consultations for infertile couples with the aim of achieving a higher quality of patient care.

Infertilidade, justiça reprodutiva e pandemia de COVID-19: reflexões sobre acesso e barreiras / Infertility, reproductive justice and the COVID-19 pandemic: reflections on access and barriers / Infertilidad, justicia reproductiva y la pandemia de COVID-19: reflexiones sobre acceso y barreras

Objetivo: refletir sobre o acesso a serviços de saúde para infertilidade e reprodução humana assistida durante o período da pandemia de COVID-19, na perspectiva da justiça reprodutiva. Metodologia: utilizou-se dados do inquérito online da pesquisa Pandemia de COVID-19e práticas reprodutivas de mulheres no Brasil, que obteve 8.313 respostas de mulheres residentes em todas as regiões do país, de 18 anos ou mais. O questionário autoaplicável circulou entre julho e outubro de 2021, contendo questões fechadas e abertas. A análise descritiva das respostas objetivas de 242 mulheres que referiram buscar atendimento para infertilidade contou com o cálculo de frequências simples das variáveis. Já os textos escritos nos espaços abertos do questionário foram submetidos à análise temática. Resultados: o estudo verificou a existência de barreiras institucionais e não institucionais para os cuidados da infertilidade, ambas incrementadas pela pandemia. Conclusão: recomenda-se a efetivação de política pública que garanta acesso pleno a todas as pessoas, haja vista que o tratamento para infertilidade e reprodução assistida tende a se restringir a mulheres cisgênero, de camadas médias e altas, mais escolarizadas e majoritariamente brancas.

Objective: to critically examine access to health services for infertility and assisted human reproduction during the COVID-19 pandemic, emphasizing the perspective of reproductive justice. Methods: data for analysis were derived from the online survey titled COVID-19 Pandemic and Women's Reproductive Practices in Brazil, garnering 8,313 responses from women aged 18 years or older residing in all regions of the country. The self-administered questionnaire circulated from July to October 2021 and comprised both closed and open-ended questions. Descriptive analysis of the objective responses obtained from 242 women actively seeking infertility care involved the calculation of simple frequencies for relevant variables. Responses provided in the open-ended sections of the questionnaire underwent thematic analysis. Results: revealed the presence of both institutional and non-institutional barriers to infertility care, with a notable exacerbation during the pandemic. Conclusion: given that infertility and assisted reproduction treatment predominantly cater to cisgender women from middle and upper socio-economic strata, characterized by higher education levels and mostly white, there is a compelling need for the implementation of public policies that ensure equitable access for all individuals.

Objetivo: reflexionar sobre el acceso a los servicios de salud para la infertilidad y la reproducción humana asistida durante el período de la pandemia de COVID-19, desde la perspectiva de la justicia reproductiva. Metodología: se utilizaron datos de la encuesta en línea de la Pandemia de COVID-19y prácticas reproductivas de las mujeres en Brasil, que obtuvo 8.313 respuestas de mujeres residentes en todas las regiones del país, con edad igual o superior a 18 años. El cuestionario autoaplicado circuló entre julio y octubre de 2021, conteniendo preguntas cerradas y abiertas. El análisis descriptivo de las respuestas objetivas de 242 mujeres que relataron buscar atención por infertilidad implicó el cálculo de frecuencias simples de las variables. Los textos escritos en los espacios abiertos del cuestionario fueron sometidos a análisis temático. Resultados:el estudio verificó la existencia de barreras institucionales y no institucionales para la atención de la infertilidad, ambas aumentadas por la pandemia. Conclusión: se recomiendala implementación de una política pública que garantice el pleno acceso a todas las personas, dado que el tratamiento de la infertilidad y reproducción asistida tiende a estar restringido a mujeres cisgénero de clase media y alta, con mayor educación y en su mayoría blancas.

Diagnóstico y tratamiento del síndrome de ovario poliquístico

El síndrome de ovario poliquístico es un trastorno endocrino-genético-ginecológico que afecta principalmente a mujeres en edad fértil, con manifestaciones de hiperandrogenismo e infertilidad en etapas tempranas de la vida. Este trabajo tiene por objetivo describir el diagnóstico y tratamiento del síndrome de ovario poliquístico. cuya fisiopatología no ha sido del todo comprendida, de ahí que su diagnóstico continúe siendo por exclusión. Los criterios del consenso de Rotterdam han logrado mejorar la uniformidad diagnóstica; sin embargo, se hace necesario un diagnóstico individualizado, en el cual debe incluirse el estudio de la morfología de los ovarios. Aunque la literatura sugiere la asociación de esta entidad con la presencia de obesidad, resistencia a la insulina e hiperinsulinismo, no se incluyen como parte de los criterios diagnósticos actualmente. El tratamiento incluye cambios en los estilos de vida, unidos a inhibidores de la producción de andrógenos por los ovarios, inhibidores de la acción de los andrógenos y los sensibilizadores a la insulina; se establecerá según los intereses reproductivos de la paciente.

Polycystic ovary syndrome is an endocrine-genetic-gynecological disorder that mainly affects women of childbearing age, with manifestations of hyperandrogenism and infertility in early stages of life. This work aims to describe the diagnosis and treatment of polycystic ovary syndrome whose pathophysiology has not been fully understood, hence its diagnosis continues to be by exclusion. The Rotterdam consensus criteria have managed to improve diagnostic uniformity; however, an individualized diagnosis is necessary, which must include the study of the morphology of the ovaries. Although the literature suggests the association of this entity with the presence of obesity, insulin resistance and hyperinsulinism, they are not currently included as part of the diagnostic criteria. Treatment includes changes in lifestyle, together with inhibitors of androgen production by the ovaries, inhibitors of androgen action and insulin sensitizers; It will be established according to the patient´s reproductive interests.

Entering the “Field”: Challenges of conducting fieldwork in an infertility clinic

Carrying out fieldwork in private infertility clinics poses its own specific set of challenges. Gaining access to these field sites not only obliges researchers to negotiate with gatekeepers but also to deal with structures of hierarchy and power. Based on my preliminary fieldwork in Lucknow city of Uttar Pradesh, I discuss the challenges of conducting fieldwork in infertility clinics and how methodological challenges push the researcher to question the academically established notions of the “field”, “fieldwork” and “research ethics”. The paper stresses the importance of discussing the challenges of doing fieldwork in private health setups and is an attempt to answer vital questions about the nature of fieldwork, how the fieldwork was conducted, and the need to include questions and dilemmas that anthropologists might face in the process of making decisions in the field.

Association between microRNA expression and risk of male idiopathic infertility in Iraq

SUMMARY OBJECTIVE: The World Health Organization defines infertility as the inability to get pregnant after 12 months of unprotected sexual activity. This study was conducted to estimate the levels of gene expression for two mature miRNAs (i.e., miR-122 and miR-34c-5p) to evaluate susceptibility to male infertility. METHODS: This study included 50 male patients with idiopathic infertility who were admitted to hospital from the period November 2021 to May 2022 and another group consisting of 50 apparently healthy individuals used as controls. RESULTS: miR-122 level was significantly highest in azoospermia and followed by oligospermia, 39.22 (31.88) versus 37.34 (20.45), respectively. In addition, there was a very significant difference in miR-34c-5p levels between the study groups (p<0.05). CONCLUSION: Two miRNAs, namely, miR-34c-5p and miR-122, can be used as predictive and diagnostic biomarkers for infertility.

Intervención psicológica, desde el enfoque de la psicología positiva, en parejas infértiles que están en proceso de inseminación artificial

Fundamento: desde la mirada de la psicología positiva, el trabajo con la pareja infértil, que se insemina, permite potenciar las emociones positivas que favorecen el tratamiento y fortalecer en ellos la capacidad resiliente que les conduce a un mayor bienestar psicológico para enfrentar este proceso. Objetivo: aplicar una estrategia de intervención psicológica en parejas infértiles en proceso de inseminación artificial. Métodos estudio prospectivo, de enfoque mixto, que incluyó once parejas bajo tratamiento de inseminación artificial, atendidas en el Centro de Reproducción del Hospital Abel Santamaría, en Pinar de Río, desde diciembre de 2021 hasta abril de 2022. La vía esencial para la localización y accesibilidad de la muestra objeto de estudio fue la consulta propia de psicología dentro de la comisión multidisciplinaria que estudia estas parejas. Se realizaron entrevistas clínicas, observación participante y test psicométricos. Se aplicó una estrategia de intervención psicológica basada en la psicología tradicional y la psicología positiva. Se midió la resiliencia de las parejas antes y después de la intervención. Resultados: la intervención elevó a valores medios-altos la resiliencia de las parejas infértiles que se inseminan. Promovió el desarrollo de pensamientos y estados emocionales positivos, así como la identificación de fortalezas personales y de las parejas. Conclusiones: una estrategia de intervención psicológica basada en la psicología tradicional y la positiva contribuye a elevar la resiliencia de parejas infértiles en proceso de inseminación artificial.

Foundation: from the positive psychology point of view, working with the infertile couple, who is inseminated, allows to enhance the positive emotions that favor the treatment and strengthen their resilient capacity that leads to greater psychological well-being to face this process. Objective: to apply a psychological intervention strategy in infertile couples during the artificial insemination process. Methods: prospective study, with a mixed approach, which included eleven couples undergoing artificial insemination treatment, treated at the Abel Santamaría Hospital Reproduction Center, in Pinar de Río, from December 2021 to April 2022. The essential route for localization and accessibility of the sample under study was the psychology consultation within the multidisciplinary commission that studies these couples. Clinical interviews, participant observation and psychometric tests were carried out. A psychological intervention strategy based on traditional psychology and positive psychology was applied. The resilience of the couples was measured before and after the intervention. Results: the intervention raised the resilience of infertile couples that are inseminated to medium-high values. It promoted the development of positive thoughts and emotional states, as well as the identification of personal and couple strengths. Conclusions: a psychological intervention strategy based on traditional and positive psychology contributes to increasing the infertile couples's resilience in the artificial insemination process.

Revelar e ter com quem contar: infertilidade e apoio social / Revelar y tener con quien contar: infertilidade y apoyo social / To disclose and have someone to count on: infertility and social support

Infertile couples seeking treatment experience a social stigma that can lead to the need for privacy and, in turn, compromise their access to social support. This multiple case study, that involved the collection of sociodemographic and health data and interviews with four heterosexual couples accessed by convenience, aimed to examine the perception of the couples about the social support received after the disclosure of the condition of infertility and/or of the assisted reproductive technology treatment. The cases were analysed individually and comparatively. From the couples' statements, it is highlighted that all of them revealed something about infertility and/or treatment at some point in the process, although some considered not revealing it. Both support and lack of support were perceived from the revelations. The non-disclosure was motivated by self-preservation and by avoidance of social pressure. The findings indicate the importance of psychological intervention to expand the couples' social support.

Parejas infértiles que buscan tratamiento experimentan un estigma social que puede acarrear la necesidad de privacidad y, a su vez, comprometer el acceso al apoyo social. Ese estudio de múltiples casos, que involucró la recogida de datos sociodemográficos, de salud y entrevistas con cuatro parejas heterosexuales accedidas por conveniencia, buscó examinar la percepción de las parejas sobre el apoyo social después de la revelación de la condición de infertilidad y/o del tratamiento con técnicas de reproducción asistida. Los casos fueron analizados individual y comparativamente. De las declaraciones de las parejas, se destaca que todas revelaron algo sobre la infertilidad y/o el tratamiento en algún momento del proceso, aunque algunos consideraron no revelarlo. Se percibió tanto el apoyo como la falta de apoyo a partir de las revelaciones. La no revelación fue motivada por la autopreservación y por la evitación de presión social. Los hallazgos indican la importancia de la intervención psicológica para ampliar el apoyo social de las parejas.

Casais inférteis que buscam tratamento experimentam um estigma social que pode acarretar a necessidade de privacidade e, por sua vez, comprometer o acesso ao apoio social. Este estudo de casos múltiplos, que envolveu a coleta de dados sociodemográficos, de saúde e entrevistas com quatro casais heterossexuais acessados por conveniência, objetivou examinar a sua percepção sobre o apoio social recebido após a revelação da condição de infertilidade e/ou de tratamento com técnicas de reprodução assistida. Os casos foram analisados individualmente e comparativamente. A partir das falas, destaca-se que todos revelaram algo sobre a infertilidade e/ou o tratamento em algum momento do processo, ainda que alguns tenham considerado não revelar. Percebeu-se tanto apoio como falta de apoio diante das revelações. A não revelação foi motivada pela autopreservação e pela evitação de pressão social. Os achados indicam a importância da intervenção psicológica para ampliar o apoio social dos casais.

An Appraisal of Behavioural and Non-Behavioural Factors Influencing the Male Infertility: Narrative Approach

Male infertility implies a man can't begin a pregnancy with his female accomplice. Male infertility can have many causes. You may not make sufficient sperm or sound sperm. You might have a hereditary issue like cystic fibrosis. You might have a blockage in your genital plot. According to the latest WHO statistics, approximately 50– 80 million people worldwide suffer from infertility, and male factors are responsible for approximately 20– 30% of all infertility cases. The diagnosis of infertility in men is mainly based on semen analysis. the incidence of male infertility has increased worldwide. Infertility is characterized as the failure of couples to have a child following one year of customary unprotected intercourse, influencing 10 to 15% of couples. It is necessary to study the factors that influence male infertility in each area/region for better management. This paper represents various factors based on behavioral and non-behavioral conditions prompting for male infertility augmentation rapidly.

AYURVEDIC MANAGEMENT OF OLIGOSPERMIA: A CASE STUDY

The condition known as oligoasthenozoospermia occurs when the two parameters, sperm count and sperm motility, are changed. It is assessed by semen analysis and shows a decrease in the concentration and proportion of motile spermatozoa in a sperm sample. Research indicates that conditions or causes affecting male reproduction account for roughly 50% of infertility cases in India. According to a research by the WHO from 1982 to 1985 in many locations, 20% of cases of infertility are caused by male factors. About 23% of Indian couples receiving infertility treatment blamed male factors for their infertility. It is possible to correlate oligoasthenozoospermia to the Sukra kshaya Lakshanas stated in Ashta sukra dushtis. A 31-year-old man with 1.5 years of marriage was diagnosed with oligospermia, which is characterised by a low sperm count and a lack of motile spermatozoa. Shodhan (Virechan) and Shamanchikitsa demonstrated an improvement in seminal parameters following Deepan/Pachan. This demonstrates the effectiveness of Ayurvedic medicine in the treatment of male infertility

SUCCESSFUL HYSTEROSCOPY GUIDED SUCTION & EVACUATION OF PRODUCT OF CONCEPTION ALONG WITH REMOVAL OF UTERINE SEPTUM IN SAME SITTING

Objective To report a case of early pregnancy loss with septate uterus, successfully managed by hysteroscopy guided suction & evacuation of product of conception along with removal of uterine septum in same sitting. Case report. Tertiary care hospital. One woman with early pregnancy loss with septate Design Setting Patient uterus. Hysteroscopy guided suction & evacuation of product of conception along with removal of uterine septum Intervention in same sitting. Hysteroscopy guided suction & evacuation of product of conception followed by septum removal with Result hysteroscopic scissor was performed, with minimal blood loss, in same sitting. Products of conception were sent for pathologic examination. There were no intra-operative or postoperative complications. Even though the role of septum as a Conclusion contributing factor to miscarriage in not certain, early pregnancy loss may be seen in patients with septate uterus. Blind removal of POCs with dilatation & curettage, may be complicated with retained products of conception (RPOC) or intrauterine adhesion formation, which can lead to adverse fertility outcomes in the future. Also removal of septum, which may or may not be the cause, is often performed before further pregnancy. This requires another admission & exposure to anaesthesia, along with added cost. Hysteroscopy guided resection of POC with septum removal in same sitting has been associated with complete tissue removal under vision, less damage to surrounding endometrium, cost effective combination of two surgical procedures & earlier time to conception compared with 2 sitting procedure (dilation and curettage than septum removal). Thus, hysteroscopy guided suction & evacuation of POC & septum removal in same sitting can be considered as an alternative surgical technique for management of early pregnancy loss in patients diagnosed with septate uterus. This case report demonstrates the successful application of hysteroscopic procedure in a case of early pregnancy loss with septate uterus.

Resultados de las consultas municipales de atención a la pareja infértil 2017-2020 / Results of the Municipal Consultations for Infertile Couple Care 2017-2020

Introducción: La infertilidad afecta hasta un 15 por ciento de las parejas en edad reproductiva en el mundo y es uno de los factores que inciden en la baja natalidad de Cuba. Antes del 2016 no existían consultas de infertilidad en todos los municipios y era bajo el número de embarazos logrados, lo que motivó la decisión de extenderlas a todos los municipios del país. Objetivo: Describir los resultados de las consultas municipales de infertilidad en los primeros cuatro años de su implementación (2017-2020). Métodos: Estudio observacional transversal de casos, atendidos en las 82 consultas municipales de infertilidad existentes antes del 2016 y después de su generalización a todos los municipios del país. Resultados: En las consultas municipales han sido atendidas 81,3 por ciento de las parejas infértiles que lo demandan, se incrementó el número de consultas ofrecidas de 24 215 en el año 2016 a 140 183 en el 2020. En ese período se elevó en 10 por ciento los embarazos obtenidos, 63,5 por ciento de los logrados en todos los niveles de atención. Conclusiones: Las consultas municipales incrementaron sus resultados entre el año 2017 al 2020 y los nacimientos obtenidos pueden ser considerados como una contribución del sector salud a reducir la baja natalidad que experimenta el país(AU)

Introduction: Infertility affects up to 15percent of couples of reproductive age in the world and is one of the factors affecting the low birth rate in Cuba. Before 2016, infertility consultations did not exist in all municipalities and the number of pregnancies achieved was low, which motivated the decision to extend them to all municipalities in the country. Aim: To describe the results of municipal infertility consultations in the first four years of their implementation (2017-2020). Methods: Cross-sectional observational study of cases, attended in the 82 municipal infertility consultations existing before 2016 and after their generalization to all municipalities in the country. Results: 81.3percent of the infertile couples requesting treatment were attended in the municipal consultations. The number of consultations offered increased from 24 215 in 2016 to 140 183 in 2020. In that period, pregnancies obtained increased by 10 percent, 63.5 percent of those achieved at all levels of care. Conclusions: Municipal consultations increased their results from 2017 to 2020 and the births obtained can be considered as a contribution of the health sector to reduce the low birth rate experienced by the country(AU)

Deep infiltrating endometriosis: cine magnetic resonance imaging in the evaluation of uterine contractility / Endometriose infiltrativa profunda: cine ressonância magnética na avaliação da contratilidade uterina

Abstract Objective: To evaluate uterine function by using cine magnetic resonance imaging to visualize the contractile movements of the uterus in patients with and without deep infiltrating endometriosis (with or without associated adenomyosis). Materials and Methods: This was a prospective case-control study. The study sample comprised 43 women: 18 in the case group and 25 in the control group. We performed cine magnetic resonance imaging in a 3.0 T scanner, focusing on the presence, direction, and frequency of uterine peristalsis. Results: The frequency of uterine peristalsis was higher in the case group than in the control group, in the periovulatory phase (3.83 vs. 2.44 peristaltic waves in two minutes) and luteal phase (1.20 vs. 0.91 peristaltic waves in two minutes). However, those differences were not statistically significant. There was a significant difference between the patients with adenomyosis and those without in terms of the frequency of peristalsis during the late follicular/periovulatory phase (0.8 vs. 3.18 peristaltic waves in two minutes; p < 0.05). Conclusion: The frequency of uterine peristalsis appears to be higher during the periovulatory and luteal phases in patients with deep infiltrating endometriosis, whereas it appears to be significantly lower during the late follicular/periovulatory phase in patients with adenomyosis. Both of those effects could have a negative impact on sperm transport and on the early stages of fertilization.

Resumo Objetivo: Avaliar a função uterina mediante visualização dos movimentos contráteis do útero por meio de cine-ressonância magnética em pacientes com e sem endometriose infiltrativa profunda (com ou sem adenomiose associada). Materiais e Métodos: Estudo caso-controle prospectivo. A amostra foi composta por 43 mulheres, sendo 18 mulheres no grupo caso e 25 mulheres no grupo controle. A cine-ressonância magnética foi realizada com magneto 3.0 T, com foco na presença, direção e frequência do peristaltismo uterino. Resultados: O peristaltismo uterino foi mais frequente nas pacientes do grupo endometriose do que no grupo controle na fase periovulatória (3,83 × 2,44 peristalses em dois minutos) e lútea (1,20 × 0,91 peristalse em dois minutos). No entanto, esses resultados não foram estatisticamente significantes. Nas pacientes com adenomiose, observou-se redução significativa na frequência de peristaltismo durante a primeira fase do ciclo menstrual (3,18 × 0,8 peristalses; p < 0,05). Conclusão: A frequência de peristaltismo uterino parece estar aumentada durante a fase periovulatória e lútea em pacientes com endometriose infiltrativa profunda e significativamente reduzida em pacientes com adenomiose durante a primeira fase do ciclo menstrual. Ambos os efeitos têm potencial de interferir negativamente no transporte de espermatozoides e nos primeiros estágios de fecundação.

Variables socio-epidemiológicas de la infertilidad femenina en la provincia Camagüey

Fundamento: la infertilidad femenina es un término utilizado para referirse a una mujer que no ha podido quedar embarazada después de haberlo intentado por lo menos en un año al mantener relaciones sexuales desprotegidas. Objetivo: caracterizar algunas variables socio-epidemiológicas de la infertilidad femenina en la provincia Camagüey. Métodos: se realizó un estudio descriptivo, longitudinal y retrospectivo en el Hospital Docente Ginecobstétrico Provincial Ana Betancourt Mora de Camagüey durante el año 2021. El universo estuvo constituido por 304 pacientes con diagnóstico de infertilidad. Las variables estudiadas incluyeron: grupo etáreo, tipo de infertilidad, municipio de origen, tasa de incidencia, nivel educacional, hábitos tóxicos, factores de riesgo y antecedentes personales. Los datos se expresaron en números y porcientos. Resultados: el 30,9 % correspondió al grupo etáreo de 30 a 34 años, procedentes en su mayoría del municipio Camagüey (43,5 %), mientras Céspedes alcanzó la mayor tasa de incidencia (13,8 %) por cada 1000 mujeres con rango de edad que pudieran ser admitidas en el programa. Un porciento elevado tenía estudios universitarios (45,4 %) y preuniversitarios (24,3 %), predominó el consumo de café (24,0 %) y tabaco (14,5 %) como hábitos tóxicos; así como enfermedades de trasmisión sexual (24,7 %) y el uso de anticonceptivo (21,1 %). La obesidad (13,5 %) resultó ser el principal antecedente personal. Conclusiones: la infertilidad femenina está determinada por varios factores, incluidos los epidemiológicos, como los hábitos tóxicos, el estado nutricional, los antecedentes personales, entre otros, en su mayoría modificables, que pueden ser tratados desde la Atención Primaria de Salud.

Background: female infertility is a term used to refer to a woman who has not been able to get pregnant after trying for at least a year by having unprotected sexual intercourse. Objective: to characterize some socio-epidemiological variables of female infertility in Camagüey province. Methods: a descriptive, cross-sectional study was carried out at the Ana Betancourt Mora Camagüey Provincial Gynecobstetric Teaching Hospital during the year 2021. The universe consisted of 304 patients diagnosed with infertility. The variables studied included: age group, type of infertility, municipality of origin, incidence rate, educational level, toxic habits, risk factors, and personal history. Data were expressed in numbers and percentages. Results: 30.9 % corresponded to the age group of 30 to 34 years, coming mostly from the Camagüey municipality (43.5 %), while Cespedes reached the highest incidence rate (13.8 %) per 1000 women with age range that could be admitted to the program. A high percentage had university studies (45.4 %) and pre-university studies (24.3 %), the consumption of coffee (24.0 %) and tobacco (14.5 %) predominated as toxic habits; as well as sexually transmitted diseases (24.7 %) and the use of contraception (21.1 %). Obesity (13.5 %) turned out to be the main personal history. Conclusions: female infertility is determined by several factors, including epidemiological ones, such as toxic habits, nutritional status, personal history, among others, mostly modifiable, which can be treated from Primary Health

Seroprevalencia de enfermedad celiaca en pacientes con infertilidad. Un estudio de casos y controles / Celiac disease seroprevalence in patients with infertility. A case-control study

Resumen Antecedentes: Aunque los pacientes con enfermedad celiaca (EC) tienen en su mayoría manifestaciones digestivas, algunos pueden presentarlas de índole extraintestinal (atípicas), como anemia crónica, ataxia y trastornos de la fertilidad. Objetivo: Determinar la prevalencia de anticuerpos relacionados con EC en mujeres mexicanas con trastornos de la fertilidad. Material y métodos: Estudio de casos y controles de mujeres que acudieron a valoración por trastornos de la fertilidad en un centro especializado. Se cuantificó h-tTG IgA, gliadina IgA II y gliadina IgG II; los títulos > 30 UI fueron considerados como positivos. Resultados: Se incluyeron 171 casos y 171 controles; 137 pacientes (80.1 %) tuvieron infertilidad y 34 (19.9 %), esterilidad. Ocho pacientes (4.6 %, IC 95 % = 2.3-8.9) tuvieron al menos un marcador positivo para EC comparadas con una mujer del grupo control (0.5 %, IC 95 % = 0.01-3, p = 0.04, razón de momios = 8.3). Seis de las ocho pacientes presentaron infertilidad inexplicable. Conclusiones: Hasta 4.6 % de las mujeres con infertilidad presentó al menos un marcador positivo para EC. Al igual que en otras partes del mundo, podría recomendarse el escrutinio para EC en mujeres con infertilidad, en especial en quienes padecen infertilidad inexplicable.

Abstract Background: Although most patients with celiac disease (CD) have digestive manifestations, in some of them they may be of extraintestinal (atypical) nature, such as chronic anemia, ataxia, and fertility disorders. Objective: To determine the prevalence of CD-related antibodies in Mexican women with fertility disorders. Material and methods: Case-control study of women who attended evaluation for fertility disorders in a specialized center. h-tTG-IgA, gliadin IgA II and gliadin IgG II were quantified; titers > 30 IU were considered positive. Results: One-hundred and seventy-one cases and 171 controls were included; 137 patients (80.1%) had infertility, and 34 (19.9%), sterility. Eight patients (4.6%, 95% CI = 2.3-8.9) had at least one positive marker for CD in comparison with one woman in the control group (0.5%, 95% CI = 0.01-3, p = 0.04, odds ratio = 8.3). Six of the eight patients had unexplained infertility. Conclusions: Up to 4.6% of women with infertility had at least one positive marker for CD. As in other parts of the world, screening for CD could be recommended in women with infertility, especially in those with unexplained infertility.

Prevalencia de la chlamydia trachomatis en pacientes sometidas a técnicas de reproducción asistida. Cienfuegos, 2016-2018

Fundamento: la Chlamydia trachomatis es el agente causal de una de las infecciones de transmisión sexual más comunes en el mundo. Provoca cervicitis, endometritis y salpingitis; las secuelas incluyen enfermedad inflamatoria pélvica, embarazo ectópico e infertilidad por obstrucción tubárica. Objetivo: determinar la prevalencia de infección por Chlamydia trachomatis en pacientes sometidas a técnicas de reproducción asistida. Métodos: estudio de serie de casos desarrollado en el Hospital General Universitario Dr. Gustavo Aldereguía Lima, de Cienfuegos, durante el periodo comprendido del 2016- 2018. Incluyó pacientes sometidas a técnicas de reproducción asistida que estaban infestadas con Chlamydia trachomatis. Se analizaron las variables edad, antecedentes patológicos personales y ginecobstétricos, número de parejas sexuales, años de infertilidad, antecedentes de uso de dispositivo intrauterino, antecedentes de enfermedad inflamatoria pélvica, resultado del test de Chlamydia, así como criterio o no de fertilización in vitro, como indicador de que ocurrió daño a nivel de las trompas. Resultados: la edad estuvo comprendida entre los 19 y 40 años, con promedio de 35,7 años. El germen se detectó en el 42 % de las parejas, con predominio de las de Cienfuegos. El 47,6 % de las pacientes que tenían una chlamydiasis refirió haber tenido de una a tres parejas. El 54 %, por su afectación, requería de fertilización in vitro. Hubo una alta incidencia en el tiempo siendo infértiles, con el 72,6 % con más de cuatro años. Conclusiones: las infecciones por Chlamydia trachomatis pueden influir en la fertilidad de las mujeres.

Background: Chlamydia trachomatis is the causal agent of one of the most common sexually transmitted infections in the world. Causes cervicitis, endometritis and salpingitis; after effects include pelvic inflammatory disease, ectopic pregnancy, and infertility due to tubal obstruction. Objective: to determine the prevalence of Chlamydia trachomatis infection in patients undergoing assisted reproductive techniques. Methods: case series study developed at the Dr. Gustavo Aldereguía Lima Hospital General Universitario, Cienfuegos, during 2016-2018. It included patients subjected to assisted reproduction techniques who were infested with Chlamydia trachomatis. The variables age, personal and gynecological pathological history, number of sexual partners, years of infertility, history of intrauterine device use, history of pelvic inflammatory disease, Chlamydia test result, as well as criteria or not for in vitro fertilization were analyzed as an indicator that damage occurred at the level of the tubes. Results: the age was between 19 and 40 years old, with an average of 35.7 years. The germ was detected in 42% of the couples, with a predominance of those from Cienfuegos. 47.6% of the patients who had chlamydiasis reported having had from one to three partners. 54%, due to their involvement, required in vitro fertilization. There was a high incidence over time being infertile, with 72.6% over four years. Conclusions: Chlamydia trachomatis infections can influence fertility in women.

Ayurvedic Management of Primary Infertility Associated with PCOS - A Case Report

Poly cystic ovarian syndrome is a condition characterised by a wide range of signs and symptoms including menstrual irregularities, obesity, acne, hirsutism and is causing adverse effects on metabolic and endocrinal system. Exact etiology and pathophysiology is still unclear but it’s having a strong familial predisposition. This is a case report on an anovulatory infertility caused by PCOS. A 27-year-old female patient presented to the Streeroga OPD at ITRA On December 29, 2020, complaining of infertility, irregular and delayed menstruation, and weight gain over the past three years. She has been taking allopathic medicine for the same for the last two years. During her initial opd visit, she received a thorough medical history as well as all relevant clinical, physical, and laboratory tests. Bulky ovaries with polycystic morphology were discovered on sonography. Anovulatory factor infertility owing to PCOS was determined based on clinical symptoms and sonography. Pathadi choorna and Arogyavardhini rasa were chosen as medications and Samana oushadha was chosen as the line of management. The patient was counselled on lifestyle changes, the need of exercise, and correction of food habits. Patient was under medication for a period of 5 months. Patient got conceived after that and on 8th February 2022 she gave birth to a healthy male baby per vaginally with a baby weight of 3.2 kg.