[The situation concerning marriage and births among childbearing women in Shaanxi province].
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Asia↗
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Results for “Fertility Pattern Method”
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Women's income profile as a key indicator of women's status for the understanding of changing fertility behaviour in rural Kenya.
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Africa↗
Fertility and family planning in Vietnam.
This report provides the first reliable statistical data on fertility patterns and the family planning program in the Socialist Republic of Vietnam. Findings are from the 1988 Demographic and Health Survey of Vietnam and the 1989 census survey. The data show that the total fertility rate has declined from over 6 children per woman in the early 1970s to under 4 in the later 1980s. Contraceptive prevalence for modern methods is estimated at 37 percent among married women of reproductive age in 1988. The average duration of breastfeeding is over 14 months; marriage is relatively late. The IUD is the most common contraceptive method and abortion is widespread. The major factors likely to influence fertility and family planning in the future are the government's population policy, improved access to modern methods of contraception, and the institution of new economic policies that are currently under way in Vietnam.
Adolescent↗
Togo 1988: results from the Demographic and Health Survey.
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Adolescent↗
Billings natural FP method: correlation of subjective signs with cervical mucus quality and ovulation.
Daily self-appraisal of the degree of vulvar humidity sensation by highly motivated and trained volunteers was correlated to actual cervical mucus quality patterns and time of ovulation. Sixty-two ovulatory cycles were studied. Humidity degrees reported by the women showed a highly significant correlation with simultaneous values of cervical mucus spinnbarkeit and crystallization. On the other hand, ovulatory days were also closely related to the days reported with maximal (+++) humidity degree. In summary, the correct appraisal of vulvar humidity may provide consistent information on both cervical sperm penetrability and ovulation predictions; these in turn could complement each other in ascertaining the potentially fertile period of the cycle.
Cervix Mucus↗
Identification of follicles with fertilizable oocytes by sequential ultrasound measurements during follicular development.
Patients undergoing ovulation induction for in vitro fertilization and embryo transfer (IVF-ET) were monitored daily with serum estradiol-17 beta (E2) and ultrasound. The location of each individual follicle was established by taking ultrasound images through serial sections of the ovary. The diameter of each follicle and the volume of its follicular wall (FW) were determined from ultrasound images using a computer-controlled image analyzer. A total of 44 follicles from nine patients was studied, with an overall fertilization rate of 46% In all patients, serum E2 levels increased prior to human chorionic gonadotropin (hCG). Whereas changes in either the average diameter or the volume of the entire follicle did not identify follicles with fertilizable oocytes, FW volume measurements were predictive. Prior to hCG, FW volume increased 24 +/- 8%/day in follicles with fertilizable oocytes but decreased 3 +/- 6%/day in follicles with nonfertilizable oocytes (P less than 0.05). Three major patterns of follicular development were observed for follicles with nonfertilizable oocytes: slow growing (less than 20% increase in FW volume), nongrowing (no change in the FW volume), and "degenerating" (a decrease in the FW volume), suggesting that these follicles are "postmature." These data demonstrate that FW volume measurements made from sequential ultrasound images provide an accurate method to identify those follicles that contain fertilizable oocytes.
Chorionic Gonadotropin↗
The diffusion of modern contraception in Norway and its consequences for the fertility pattern.
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Condoms↗
Effects of melatonin in perimenopausal and menopausal women: a randomized and placebo controlled study.
In aging humans, night levels of melatonin (MEL) decline progressively. Also thyroid and gonadal functions decline during aging while gonadotropins (luteotropic hormone (LH) and follicle stimulating hormone (FSH)) steadily increase. A desynchronization of pineal circadian cyclicity as expressed by the progressive decrease of the MEL night peak may be permissively linked to the onset and progression of menopause. We studied the effects of exogenous, evening administration of MEL on the level of hormones which are known to be involved in the genesis and progression of menopause. Perimenopausal and menopausal women from 42 to 62years of age with no pathology or medication were selected. MEL was measured in saliva to divide them into low, medium and high-MEL patients. Half of them took 3mg MEL and half of them Placebo at bedtime (10-12p.m.) in a fully randomized and double-blind fashion. Three and six months later blood was taken for determination of pituitary (LH, FSH), ovarian, and thyroid hormones I(T3 and T4). All women taking MEL with low basal level of MEL and/or Placebo for three and six months showed a significant increase in levels of thyroid hormones. Before initiation of the study, a negative correlation was found in all women between LH, FSH and basal MEL levels. Within six months of treatment, MEL produced a significant diminution of LH in the younger women (43 to 49year-old), while no effect was seen in the older women (50-62years old). A decrement of FSH was observed in MEL-treated women with low basal MEL levels. In addition, most MEL-treated women reported a general improvement of mood and a significant mitigation of depression. MEL decline during aging may thus signal the derangement of pineal and pituitary-controlled ovarian cyclicity and the progressive quenching of fertility in women. These findings seem to show a recovery of pituitary and thyroid functions in MEL-treated women, towards a more juvenile pattern of regulation.
Adult↗
Clinical evaluation of quinacrine pellets for chemical female sterilization.
Under the auspices of the Coordinating Board of Indonesian Fertility Research (BKS PENFIN), a clinical trial was undertaken to examine the safety and effectiveness of the quinacrine pellet method for nonsurgical female sterilization. One hundred women were selected to receive 3 monthly insertions of 250 mg of quinacrine and were followed up at 1, 3, 6 and 12 months after the third insertion. Socioeconomic data and complaints and menstrual patterns at each insertion and every follow-up visit were recorded, as were all failures. The life-table failure rate was determined to be 3.1. The continuation rate in this study was 96% at 1 year. Just over one-fifth of the women had amenorrhea by the third insertion, but most returned to normal by 1 year, and it appears that this amenorrhea was transient in nature. The method proved to be safe and effective, suggesting that larger clinical trials are in order.
Administration, Intravaginal↗
Study of bias in antenatal clinic HIV-1 surveillance data in a high contraceptive prevalence population in sub-Saharan Africa.
OBJECTIVE: To describe patterns, sources and consequences of bias in antenatal clinic (ANC) HIV prevalence estimates in a high contraceptive prevalence population. BACKGROUND: HIV surveillance in Africa relies on data from pregnant women attending ANCs. HIV estimates from pregnant women understate female infection levels in low income, high fertility populations. Bias in high contraceptive use, delayed sexual debut populations remains undescribed. DESIGN AND METHOD: Comparison of parallel cross-sectional population and antenatal survey data from rural Zimbabwe, where 60% of women are recent contraceptive users. RESULTS: HIV prevalence in recently pregnant women (25.7%; n = 576) and all women (25.5%; n = 5138) is similar over the age-range 15-44 years. As in high fertility populations, HIV prevalence is higher in pregnant women at young ages and lower at older ages but the crossover point occurs later due to delayed sexual activity. HIV understatement at older ages due to HIV-associated infertility is mitigated by less HIV infection and less frequent ANC attendance in contraceptive users. The local ANC HIV prevalence estimate is lower [21.2%; n = 1215; risk ratio versus pregnant women in the general population, 0.8; 95% confidence interval (CI), 0.7-1.0], possibly because women from more remote areas are included. ANC estimates overstate the relative risk of HIV in more educated women (age-adjusted odds ratio, 1.1; 95% CI, 0.8-1.4 versus 0.7; 95% CI, 0.6-0.9). CONCLUSIONS: ANC estimates understate female HIV prevalence in this low fertility population but, here, the primary cause is not selection of pregnant women. ANC estimate adjustment procedures that control for contraceptive use and age at first sex are needed.
Adolescent↗
Testicular sperm extraction with intracytoplasmic sperm injection for nonobstructive azoospermia: testicular histology can predict success of sperm retrieval.
PURPOSE: We present treatment results of testicular sperm extraction with intracytoplasmic sperm injection for men with nonobstructive azoospermia and reevaluate the role of testicular histology on open diagnostic testicular biopsy as a predictor of sperm retrieval success. MATERIALS AND METHODS: We evaluated 75 men diagnosed with nonobstructive azoospermia. Cases were categorized into 3 groups of hypospermatogenesis, maturation arrest or Sertoli-cell-only based on the most advanced pattern of spermatogenesis seen on histology. A total of 81 testicular sperm extractions with intracytoplasmic sperm injection were performed for these 75 men. The main outcome measures reviewed included sperm retrieval, fertilization and pregnancy rates with intracytoplasmic sperm injection. Sperm retrieval success rates for men in the 3 histological categories were compared. RESULTS: Spermatozoa were successfully retrieved during 47 of 81 (58%) testicular sperm extraction attempts, with subsequent fertilization of 268 of 439 (61%) injected metaphase II oocytes using intracytoplasmic sperm injection. Clinical pregnancies were obtained in 26 of 47 (55%) cycles when sperm were retrieved, with ongoing pregnancies or live deliveries for 20 of 47 (43%). Of 39 men with hypospermatogenesis on diagnostic biopsy 31 (79%) had successful sperm retrieval, compared to 9 of 19 (47%) with maturation arrest and 5 of 21 (24%) with a pure Sertolicell-only pattern. CONCLUSIONS: Critical examination of the most advanced pattern of spermatogenesis from open diagnostic testis biopsy allows prediction of sperm retrieval success with testicular sperm extraction. In this study population spermatozoa were retrieved in 58% of attempts. When this testicular sperm was used with intracytoplasmic sperm injection, clinical pregnancy rate was 55% for men with nonobstructive azoospermia.
Adult↗
Evaluation of acrosome reaction and viability of human sperm with two fluorescent dyes.
OBJECTIVE: To evaluate the usefulness of the Hoechst 33258/FITC-Pisum sativum agglutinin (FITC-PSA) staining for simultaneous assessment of viability and acrosome reaction rate (%AR) of human sperm. MATERIAL AND METHODS: Fresh sperm was collected 13 fertile donors provided fresh semen. We used motile sperm selected by the "swim-up" procedure using modified HTF. Hoechst 33258 was added and co-incubated with sperm for 10 min. Samples were washed free of unbound stain and the sperm were mounted as smears on glass slides. After drying, sperms were incubated with FITC-PSA for 30 min. Sperm were examined by fluorescence microscopy. Also, FITC-Concanavalin A (FITC-ConA) staining and vital staining with yellowish eosin were performed simultaneously. The correlation of viability and %AR were analyzed. RESULTS: Four different staining patterns were observed and clearly distinguished as follows: a) Viable acrosome-reacted sperm, b) Viable acrosome-intact sperm, c) dead acrosome-reacted sperm, d) dead acrosome-intact sperm. There was significant correlation between the results obtained by Hoechst 33258 and vital staining methods in viability of human sperm (r = 0.927, P < 0.001). There was significant correlation between the two methods (FITC-PSA and FITC-ConA) in %AR of human sperm (r = 0.92, P < 0.001). CONCLUSION: Viability and acrosome status of a human sperm can be easily assessed simultaneously by Hoechst 33258/FITC-PSA staining method. This combination method is considered useful to evaluate sperm function.
Acrosome Reaction↗
Age and sex related variations in biologically active and immunoreactive serum luteinizing hormone.
Relatively recent data from the literature show some discrepancies between bioactive LH (Bio-LH) and radioimmunoreactive LH (Ria-LH) in different endocrinological conditions. In 202 subjects of both sexes we have studied biologically active and immunoreactive LH and their ratio (B/l ratio) pattern through life. The results show that in male puberty the in vitro bioassay method gives a more discriminating measurement of serum LH than the radioimmunoassay. The ratio between bioactive and immunoreactive LH is well correlated with the increase of serum testosterone levels from male prepuberty to adulthood. On the contrary, there is no difference of B/l ratio between prepubertal girls and fertile women, in spite of the different gonadotropin levels. Finally LH bioactivity increases less markedly in elderly men than in postmenopausal women. These data suggest that, among several factors which may influence not only the quantity but also the quality of LH secreted, gonadotropin secretion rate and sex steroid milieu play an important role and may partly explain the B/l ratio changes in the situations investigated.
Adolescent↗
Women's health and the privatization of fertility control in Brazil.
In Brazil, privatization of the public sphere and neglect of public health is part of a conservative modernization strategy that is dominated by elite groups. The politics of human reproduction, consistent with this pattern, have left women dependent on the private sector for access to the means of fertility control, in spite of the existence of a conceptually-advanced public programme for comprehensive health care for women--a programme which expressed the demands of, and is widely supported by, the women's movement. While both the rate of contraceptive use and the types of methods used (oral contraceptives and surgical sterilization) are modern, the privatization of fertility control has resulted in a complete separation between fertility control and health care for poor women, who are the vast majority. Evidence indicates that many, perhaps most, women accumulate the health effects of totally uncontrolled and incorrect use of oral contraceptives, including unwanted pregnancies and illegal abortions, in the end resorting to clandestine surgical sterilization, which is usually performed through unnecessary caesarean section. Data on reproductive morbidity and mortality, however, are virtually non-existent. International women's reproductive rights networks and alternative services for women have advocated greater empowerment for women, in terms of improved standards of self-care and increased power in the use of health services. As a result, a gender approach to reproductive health care is now being proposed for government programmes. The Brazilian case services as an example of the limits faced by such programmes when adopted in a wider context of unfavorable political conditions.
Adult↗
[A research review on "fertile islands" of soils under shrub canopy in arid and semi-arid regions].
Due to the inclemency of climate and soil conditions and the intense disturbance of human beings, the soil resources heterogeneity in arid and semi-arid grassland ecosystems worldwide was gradually increased during the last century. The interaction between soil heterogeneity and shrubs induced the autogenic development of "fertile islands" and the increasing spread of shrubs in the grassland ecosystems. The development of "fertile islands" around individual shrubs could change the vegetation composition and structure, as well as the distribution patterns of soil resources, and thus, reinforced the changes of the ecosystem function and structure from a relative stable grassland ecosystem to a quasi-stable shrubland ecosystem. The study of "fertile islands" phenomenon would help us to understand the causes, consequences and processes of desertification in arid and semi-arid areas. In this paper, the causes of "fertile islands", its study methods and significance and its relationship with shrub spreading as well as the responses of vegetation to it were summarized. The problems which might occur in the study of this phenomenon were also pointed out. Our aim was to offer some references to the study of land desertification processes and vegetation restoration in the arid and semi-arid regions.
Desert Climate↗
Involvement of mu-calpain in human sperm capacitation for fertilization.
PROBLEM: The distribution and physiological role of calpains in human sperm were investigated. METHOD OF STUDY: Semen collected manually from healthy donors was liquefied then centrifuged by percoll gradient centrifugation. After exposure to different concentrations of Ca2+ ionophore A23187, the samples were used for immunostaining sodium dodecyl sulfate polyacrylamide gel electrophoresis, and western blot analysis. It was speculated from the results of the study using calpain-specific inhibitors that calpain contributes to the sperm motility and acrosome reaction. RESULTS: With the anti-pro mu-calpain antibody, sperm were immunostained, whereas all were negative for anti-pro mu-calpain antibody binding. Stained sperm were classified into four types according to the staining pattern: acrosome type, equatorial segment type, whole head type, and neck and tail segments type. Western blot analysis of sperm homogenate revealed a single 80-kDa band using the anti-pro mu-calpain antibody, its dose-dependent reduction with Ca2+ ionophore A23187 suggesting activation by this treatment. In the presence of membrane permeable calpain inhibitors, sperm motility and acrosome reaction were significantly suppressed. CONCLUSION: These results indicate that mu-calpain may play pivotal roles in the process of fertilization of human sperm.
Amino Acid Sequence↗
A pilot study to assess the effect of three short-term treatments on frequent and/or prolonged bleeding compared to placebo in women using Implanon.
BACKGROUND: The major side-effect of progestogen-only contraception is disruption of menstrual bleeding patterns, which can lead to a high incidence of early discontinuation. The aim of this study was to compare three treatments with placebo on the duration and recurrence of frequent and/or prolonged bleeding in Implanon users. METHOD: Women between the ages of 18 and 45 years, who had used Implanon for > or =3 months and were experiencing prolonged or frequent bleeding patterns, were recruited at four Australian sites. Subjects were randomized to treatment using computer-generated random number table if they met the World Health Organization criteria for prolonged and/or frequent bleeding in the previous 90 days [Belsey, E.M., Pinol, A.P.Y. and Taskforce on Long-Acting Systemic Agents for Fertility Regulation, World Health Organization (1997) Contraception 55,57-65]. Treatments were: (1) mifepristone 25 mg given twice on day 1 followed by 4 days of twice daily placebo; (2) mifepristone 25 mg given twice on day 1 followed by 4 days of ethinyl estradiol (EE) 20 microg in the morning and placebo at night; (3) doxycycline 100 mg twice daily for 5 days; and (4) placebo twice daily for 5 days. Analysis was by intention to treat. The primary endpoint was the number of days of bleeding and spotting immediately following initiation of the 5 day course of each active therapy compared with placebo. RESULTS: A total of 179 women was assigned to treatment. Both mifepristone in combination with EE and doxycycline alone were significantly more effective in stopping an episode of bleeding {mean 4. 3 days [confidence interval (CI) 3.5-5.2], and 4.8 days (CI 3.9-5.8) respectively} than mifepristone alone or placebo [5.9 days (CI 4.8-7.2) and 7.5 days (CI 6.1-9.1) respectively]. No effect on subsequent bleeding patterns was observed in any treatment group. CONCLUSION: Both mifepristone plus EE and doxycycline alone were significantly more effective than placebo in terminating an episode of bleeding in women with prolonged and/or frequent bleeding using Implanon. We believe that the observed reduction in the number of bleeding days by almost 50% compared to placebo in both the mifepristone combination group and the doxycycline group demonstrates a clinically significant improvement in bleeding patterns and that further trials are needed to compare different combinations of therapy as well as multiple dosing regimens in order to establish which is the most effective treatment option. The effect of repeat administration or combinations of these preparations on long-term bleeding patterns requires further investigation.
Adolescent↗
Famine, disease, and mortality patterns in the parish of Borshevka, Russia, 1830-1912.
Scholars have projected a dismal image of nineteenth-century, rural Russia as a society repeatedly punctuated by crop failures, famine, starvation, and epidemics of famine-related diseases. But there has been no rigorous attempt, using appropriate methods, to assess the nature of demographic crises in Russia and their contribution to overall mortality and population growth. The pattern of mortality evident in the parish under examination is distinguished by an extremely high incidence of infant, diarrhoeal diseases and childhood, infectious diseases. This unfavourable disease environment and resulting high rates of infant and early childhood mortality were more closely related to fertility levels, household size, housing conditions, and weaning practices than to annual or seasonal food availablity and the nutritional status of the population. In a disease-driven society, the susceptibility to infection and the force of infection can, to a considerable extent, be determined by demographic factors, familial norms, and climatic constraints.
Cause of Death↗