Frontiers in reproductive health最新文献

{"title":"From anticipatory fear to relational trust: women's experiences of gynecological examination in Turkey: a qualitative study.","authors":"Çiğdem Can Bayrak, Ayse Sezer Balci","doi":"10.3389/frph.2026.1955456","DOIUrl":"10.3389/frph.2026.1955456","url":null,"abstract":"<p><strong>Background: </strong>While fear, embarrassment, and sociocultural barriers associated with gynecological examinations are well documented, existing literature has predominantly focused on their prevalence and consequences, with limited attention to the dynamic processes through which these meanings are constructed and transformed within the clinical encounter.</p><p><strong>Aim: </strong>This study aimed to explore how women construct, experience, and reinterpret gynecological examinations and to examine how communication and interpersonal interactions shape the negotiation of fear and trust during the clinical encounter.</p><p><strong>Methods: </strong>This qualitative study adopted a qualitative descriptive design informed by a social constructionist perspective. Twenty women who had undergone vaginal speculum examination in the outpatient gynecology clinic of a public hospital in Burdur, Turkey, were recruited using purposive sampling. Data were collected through semi-structured, in-depth interviews conducted immediately after the examination and analyzed using reflexive thematic analysis following Braun and Clarke's approach.</p><p><strong>Results: </strong>Four overarching themes and six interrelated subthemes were identified: (1) Constructing Fear Before the Examination, (2) Negotiating Embarrassment and Bodily Exposure, (3) Communication and the Development of Relational Trust, and (4) Reinterpreting the Examination Experience. Across these themes, anticipatory fear was often shaped by socially transmitted narratives and uncertainty, whereas communication and relational trust facilitated the reinterpretation of the examination as less distressing than anticipated.</p><p><strong>Conclusion: </strong>Gynecological examination should be understood not only as an invasive clinical procedure but also as a socially and relationally mediated experience. Strengthening patient-centered communication and privacy-sensitive care may improve women's engagement with gynecological services.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1955456"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residence-based inequalities among women and girls aged 15-49 years using reusable and single-use menstrual materials in Ghana: a cross-sectional study.","authors":"Patience Fakornam Doe, Yula Salifu, Joseph Lasong, Abraham Norman Nortey, Frank Offei Odonkor, Edward Odoom, Amidu Alhassan, Mustapha Amoadu","doi":"10.3389/frph.2026.1874349","DOIUrl":"10.3389/frph.2026.1874349","url":null,"abstract":"<p><strong>Background: </strong>Menstrual health is a critical component of sexual and reproductive well-being, yet inequalities in access to appropriate menstrual materials persist, particularly in low- and middle-income countries (LMICs). In Ghana, national progress in menstrual material use has been reported, but residence-based disparities remain insufficiently examined. This study assessed trends and rural-urban inequalities in the use of reusable and single-use menstrual materials among women and girls aged 15-49 years in Ghana.</p><p><strong>Methods: </strong>A repeated cross-sectional design was employed using nationally representative data from the 2016 Performance Monitoring for Action (PMA) survey and the 2017/18 Multiple Indicator Cluster Survey (MICS). Analysis was conducted using the WHO Health Equity Assessment Toolkit (HEAT). Survey data were accessed from the WHO HEAT platform and managed in Microsoft Excel prior to upload.</p><p><strong>Results: </strong>Reusable menstrual material use remained unchanged at 12.6% between 2016 and 2018. Single-use materials predominated (85.8% in 2016; 85.3% in 2018). Rural reusable use (21.3%; 18.0%) substantially exceeded urban use (5.5%; 7.4%). The absolute rural-urban difference narrowed from -15.8% to -10.6% for reusable, and 16.7% to 11.0% for single-use materials.</p><p><strong>Conclusion: </strong>Substantial and persistent residence-based inequalities in menstrual material use exist in Ghana. The study does not advocate for reusable over single-use materials, but calls for expanding safe, informed material choice across residential settings. Equity-responsive policies addressing affordability, access, and WASH infrastructure are urgently needed.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1874349"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of conventional follitropin delta 15 µg/day versus follitropin alfa 225 IU/day for ovarian stimulation: results from an exploratory <i>post hoc</i> analysis of Spanish participants from the ADAPT-1 randomized controlled trial.","authors":"Marta García Sánchez, Andrea Bernabeu, Ana Hernández Cesteros, Laura Blasco Gastón, Sofia Ortega Ricondo, Gemma Castillón, Marcos Ferrando Serrano, Signe Møgelmose, Enrica Gravotta, Rita Lobo","doi":"10.3389/frph.2026.1927550","DOIUrl":"https://doi.org/10.3389/frph.2026.1927550","url":null,"abstract":"<p><strong>Research question: </strong>Can follitropin delta be used in a conventional regimen (15 µg/day starting dose) without compromising efficacy and safety in patients seeking fertility treatment in Spain?</p><p><strong>Design: </strong>This was an exploratory <i>post hoc</i> analysis of the ADAPT-1 randomized controlled trial. Participants, 18-40 years, enrolled at specialist reproductive centers in Spain in this accessor-blinded, multicenter trial assessing efficacy and safety of conventional follitropin delta 15 μg/day and follitropin alfa 225 IU/day for ovarian stimulation. The primary endpoint was the number of oocytes retrieved. During the follow-up period, clinical pregnancies from the first fresh or frozen transfer within 3 months of the start of stimulation, and ovarian hyperstimulation syndrome (OHSS) rates were assessed. All cycles used a gonadotropin-releasing hormone (GnRH) antagonist protocol.</p><p><strong>Results: </strong>A total of 132 patients were randomized (10-AUG-2022 to 11-MAR-2024): follitropin delta group, <i>n</i> = 85; follitropin alfa group, <i>n</i> = 47. The adjusted mean number of oocytes retrieved was 10.6 and 11.0 for each group, respectively [difference: -0.3 (95% CI: -2.4; 1.7)]. Adjusted clinical pregnancy rates per started cycle were 34.8% and 32.0%, respectively [difference: 2.8% (95% CI: -14.3; 20.0)]. Adverse events were reported for 28.2% and 42.6% of participants, respectively, with the most common adverse events being headache [10.6% (<i>n</i> = 9) and 8.5% (<i>n</i> = 4)], pelvic discomfort [4.7% (<i>n</i> = 4) and 4.3% (<i>n</i> = 2)], dysmenorrhea [0% and 6.4% (<i>n</i> = 3)], and early OHSS [1.2% (<i>n</i> = 1) and 4.3% (<i>n</i> = 2)].</p><p><strong>Conclusions: </strong>Our exploratory analysis shows that a higher starting dose of follitropin delta 15 µg/day in a conventional regimen can be successfully used in appropriately selected infertile patients, resulting in a good average oocyte yield without compromising first-transfer clinical pregnancy rates and while maintaining a low incidence of early OHSS.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1927550"},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic inequality in the completion of the continuum of care for maternal, newborn, and child health in Malawi.","authors":"Redson Mwandama, Spy Munthali","doi":"10.3389/frph.2026.1919232","DOIUrl":"https://doi.org/10.3389/frph.2026.1919232","url":null,"abstract":"<p><strong>Background: </strong>Despite improvements in maternal, newborn, and child health (MNCH) service coverage in Malawi, completion of the continuum of care (CoC) remains low and unequally distributed across socioeconomic groups. This study quantified socioeconomic inequality in MNCH CoC completion and its determinants.</p><p><strong>Methods: </strong>We analyzed pooled data from the 2010, 2015-16, and 2024 Malawi Demographic and Health Surveys, including 18,741 women with a live birth; analytic samples were 15,552 women for maternal CoC and 7,625 children aged 12-23 months for full CoC. Wealth-related inequality was assessed using Erreygers concentration indices. Multivariable and multilevel logistic regression identified determinants of CoC completion, while Wagstaff, Oaxaca-Blinder, Fairlie, and inequality-of-opportunity decompositions identified inequality contributors.</p><p><strong>Results: </strong>Full CoC completion rose from 1.4% (2010) to 6.8% (2024); maternal CoC rose from 4.9% to 17.4%. Women completed an average of 8.3 of 11 interventions. Pro-rich inequality persisted for maternal CoC (Erreygers index = 0.036, <i>p</i> < 0.001); inequality in full CoC was smaller and not statistically significant (0.004, <i>p</i> = 0.497). Women's education, particularly higher education, was the strongest and most consistent predictor of completion (adjusted OR: 3.42 maternal, 3.45 full CoC, pooled). Contributors varied by method: education, wealth, and rural residence dominated the Wagstaff decomposition, while education, age, and parity contributed more consistently in the Oaxaca-Blinder and Fairlie decompositions. Circumstance variables reproduced the entirety of observed maternal CoC inequality, falling to 78.7% when wealth was excluded.</p><p><strong>Conclusions: </strong>Although MNCH CoC coverage improved substantially in Malawi, socioeconomic inequalities persisted, particularly for maternal CoC, and were closely linked to structural circumstances. Policies improving geographic access, expanding girls' and women's education, and addressing structural barriers may support more equitable progress toward Sustainable Development Goal 3.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1919232"},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Primary endometrioid adenocarcinoma of the cervix and secondary cervical involvement by endometrial carcinoma: diagnostic pitfalls and an integrated approach based on two cases.","authors":"Lina Geng, Tianci Fan, Guanwen Gao, Yunfei Wang, Changzhong Li","doi":"10.3389/frph.2026.1966107","DOIUrl":"10.3389/frph.2026.1966107","url":null,"abstract":"<p><strong>Background: </strong>Primary endometrioid adenocarcinoma of the cervix (PEAC) is a rare subtype of HPV-independent cervical adenocarcinoma. Due to overlapping clinical, histological, and immunophenotypic features, distinguishing PEAC from endometrioid adenocarcinoma of endometrial origin with cervical involvement remains challenging.</p><p><strong>Case presentation: </strong>We present two cases illustrating the diagnostic pitfalls in determining the primary site of endometrioid adenocarcinoma involving the cervix. The first case was ultimately diagnosed as PEAC based on comprehensive evaluation of the hysterectomy specimen, with no identifiable endometrial primary lesion. Molecular testing revealed microsatellite instability-high status and a pathogenic PMS2 germline variant associated with Lynch syndrome. The second case represented lower uterine segment endometrioid adenocarcinoma with secondary cervical involvement, which closely mimicked a cervical primary tumor. Careful assessment of tumor distribution and the relationship between uterine and cervical lesions supported an endometrial origin.</p><p><strong>Conclusion: </strong>The primary site of endometrioid adenocarcinoma involving the cervix cannot be reliably determined by morphology or immunohistochemistry alone. Accurate diagnosis requires integrated evaluation of clinical, radiological, pathological, and molecular findings, with comprehensive examination of the hysterectomy specimen-particularly assessment of the tumor epicenter, lesion distribution, and the presence of precursor lesions-remaining crucial for definitive site assignment in operable cases. The suggestive framework presented here is intended to provide a systematic, teaching-oriented approach to this challenging differential diagnosis.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1966107"},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation into biomarkers to predict preterm birth (INSIGHT): a longitudinal UK pregnancy cohort for spontaneous preterm birth research.","authors":"Raphaella Jackson, Carlotta Valensin, Evonne Chin-Smith, Natalie Suff, Andrew H Shennan, Natasha L Hezelgrave, Rachel M Tribe","doi":"10.3389/frph.2026.1926506","DOIUrl":"https://doi.org/10.3389/frph.2026.1926506","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous preterm birth (sPTB) remains a leading cause of perinatal morbidity and mortality worldwide. Progress in prediction and prevention has been limited by the biological heterogeneity of sPTB and a lack of longitudinal pregnancy cohorts integrating detailed clinical phenotyping with serial biological sampling. The INSIGHT study was established to enable mechanistic and biomarker-driven investigation of sPTB, with a focus on inflammatory pathways associated with cervical shortening.</p><p><strong>Methods: </strong>INSIGHT is a prospective, multicentre UK pregnancy cohort that was active between 2013 and 2024 (recruitment finished in 2023). Pregnant women were recruited between 10 ⁺ ⁰ and 28 ⁺ ⁰ weeks' gestation and classified as high- or low-risk of preterm birth using predefined clinical criteria, including obstetric history, cervical length, prior cervical procedures, multiple pregnancy, and uterine anomalies. Serial clinical data were collected alongside longitudinal biological sampling, including maternal blood and cervicovaginal specimens, to support multiomic analyses. Pregnancy, delivery, and neonatal outcomes were ascertained through prospective data collection and routine clinical records.</p><p><strong>Results: </strong>A total of 2,272 women were enrolled and completed the study, spanning a broad sociodemographic background and risk spectrum, with 1,317 (58%) classified as high-risk of preterm birth. The cohort captured a high incidence of sPTB in singleton pregnancies (<i>n</i> = 184/2,184, (8.4%)), alongside detailed treatment, delivery, and neonatal outcome data. Extensive biological material was collected longitudinally, enabling transcriptomic, microbiome, metabolomic, proteomic, and immune profiling across pregnancy. A total of 34,863 specimens were collected over 4,999 participant sampling visits. Descriptive characteristics of participants, risk factor distributions, pregnancy outcomes, and sample collection are presented.</p><p><strong>Conclusion: </strong>INSIGHT provides a large, deeply phenotyped pregnancy cohort enriched for sPTB, integrating longitudinal clinical data with serial multiomic biological sampling. The study infrastructure supports discovery-driven and translational research into the mechanisms underlying sPTB and the development and independent validation of clinically scalable biomarker-based prediction strategies.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1926506"},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol and male infertility: is there a safe dose? Evidence of accessory gland dysfunction, oxidative stress, and sperm DNA damage.","authors":"P Jagadesh, T B Sridharan","doi":"10.3389/frph.2026.1934203","DOIUrl":"https://doi.org/10.3389/frph.2026.1934203","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol consumption is a recognized modifiable lifestyle factor affecting male reproductive health. Yet, its dose-dependent effects on accessory gland function and sperm genomic integrity remains poorly elucidated. This cross-sectional study examined the relationship between alcohol consumption and the accessory gland-sperm function axis, focusing on the mediating role of oxidative stress in cellular and molecular damage.</p><p><strong>Methods: </strong>A total of 126 men undergoing fertility evaluation were stratified into a control cohort (non-drinkers with normozoospermia, <i>n</i> = 25) and three alcohol-consuming infertile cohorts: mild (<i>n</i> = 37), moderate (<i>n</i> = 31), and heavy (<i>n</i> = 33). A standard semen analysis was performed following world Health Organization (2021) guidelines, while seminal plasma was quantified for accessory gland markers (fructose and total protein concentration) and an oxidative stress marker (malondialdehyde levels). Nuclear maturity and DNA integrity were evaluated using aniline blue and acridine orange fluorescence staining.</p><p><strong>Results: </strong>The findings demonstrated that alcohol consumption was associated with a dose-dependent deterioration across all standard semen parameters, particularly correlating with teratozoospermia (<4% normal morphology). Seminal fructose and total protein concentrations were decreased significantly with alcohol intake levels (<i>p</i> < 0.0001), whereas MDA levels exhibited a drastic elevation (<i>p</i> < 0.0001). A correlation analysis revealed a strong positive association between seminal fructose and total motility (r = 0.867, <i>p</i> < 0.0001). Furthermore, MDA levels were strongly correlated with chromatin condensation defects (r = 0.841) and the sperm DNA fragmentation index (r = 0.880, <i>p</i> < 0.0001).</p><p><strong>Discussion: </strong>These findings suggest that chronic alcohol consumption is associated with impaired male fertility potential by supressing accessory gland secretory function and with elevated systemic oxidative stress. Even long-term mild alcohol consumption was associated with considerable levels of oxidative stress that affect chromatin packaging and DNA integrity. Men undergoing fertility evaluation, particularly prior to assisted reproductive techniques, may benefit from counseling on alcohol reduction or abstinence to safeguard embryo genomic integrity.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1934203"},"PeriodicalIF":3.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic and demographic determinants of children ever born among ever-married women in Somalia: a multilevel negative binomial regression analysis.","authors":"Abdirahman Osman Alin","doi":"10.3389/frph.2026.1907831","DOIUrl":"https://doi.org/10.3389/frph.2026.1907831","url":null,"abstract":"<p><p>Somalia has one of the highest fertility rates in the world, occurring alongside widespread socioeconomic disadvantage, low female educational attainment, and limited access to reproductive health services and information.</p><p><strong>Objective: </strong>This study examines the socioeconomic, demographic, and information-access determinants of fertility among ever-married Somali women and identifies the count-regression model that best represents total children ever born.</p><p><strong>Methods: </strong>Data were drawn from the 2020 Somali Health and Demographic Survey (SDHS), restricted to 10,772 ever-married women aged 15-49 years with complete information on all study variables. Children ever born were modeled using Poisson, Negative Binomial (NB) and Multilevel Negative Binomial (MENB) regression. Model selection was based on log-likelihood, AIC, and BIC, with comparisons restricted to models with comparable likelihood frameworks.</p><p><strong>Results: </strong>The distribution of children ever born was right-skewed, with a mean of 4.11 children and evidence of over-dispersion. The MENB model provided the best fit, with the lowest AIC (45,392.37) and BIC (45,691.04), indicating the importance of accounting for both over-dispersion and clustering. Age was the strongest predictor of fertility; women aged 45-49 years had approximately 7.5 times the expected number of children compared with those aged 15-19 years (IRR = 7.52, 95% CI: 6.94-8.14, <i>p</i> < .001). Higher education (IRR = 0.70) and higher wealth were associated with lower fertility. Significant regional differences were observed, while nomadic women had lower fertility than urban women (IRR = 0.84, <i>p</i> < .001). Divorced and widowed women also had lower fertility than currently married women. Employment, radio, and television exposure were not significant.</p><p><strong>Conclusion: </strong>Fertility in Somalia remains high but is strongly shaped by age, education, wealth, marital status and region. Expanding female education, reducing poverty, and improving access to reproductive health services and information are essential to support improve maternal and child health outcomes across Somali populations.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1907831"},"PeriodicalIF":3.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiretroviral therapy, perceived health, and fertility decision-making among people living with HIV: a qualitative study at a district antiretroviral therapy clinic in the Ashanti Region, Ghana.","authors":"Priscilla Asantewaa Boadi, Victor Luckyboy Dzramado","doi":"10.3389/frph.2026.1914707","DOIUrl":"https://doi.org/10.3389/frph.2026.1914707","url":null,"abstract":"<p><p>Antiretroviral therapy has changed what parenthood can mean for people living with HIV, yet little is known about how patients at district-level clinics in West Africa themselves connect treatment, bodily health, and decisions about childbearing. This study explored how people living with HIV attending one district antiretroviral therapy clinic in Ghana's Ashanti Region described the place of treatment in their reproductive thinking. A qualitative interview study analysed using reflexive thematic analysis informed by an interpretive phenomenological orientation. Twelve adults receiving antiretroviral therapy at the St. Michael's Hospital clinic in Pramso took part in semi-structured interviews conducted in English or Twi between August and October 2024. Interviews were audio-recorded, transcribed, and coded inductively, with the Theory of Planned Behaviour applied interpretively after coding. Four participants described treatment access and clinic services as adequate. Within these accounts, one participant linked daily medication-taking to a felt state of bodily wellness, and one reported believing that medication would not harm a baby; no participant explicitly connected bodily wellness to a decision about childbearing. Transmission concern was more widely expressed, and several participants relayed provider messages that a baby could be protected, with one woman also reporting having been told how to conceive without infecting her partner. Fertility positions were heterogeneous: some deferred decisions, some limited further births after completing their families, one woman described pressure from her husband to have another child, and the one man whose account addressed this topic framed his position economically rather than around transmission. Emotional uncertainty persisted alongside accurate prevention information. No participant referred to viral load results, undetectable status, or viral load monitoring, and the interview guide did not ask about these. Reproductive positions at this clinic were shaped by parity, partnership, economic circumstance, and emotion, with HIV status carrying variable weight. The data show that treatment access was valued but do not establish that perceived health drove reproductive intentions, and because viral suppression was neither verified nor discussed, claims that suppression shapes fertility decisions are not supported. Findings are specific to this setting and indicate scope for counselling that pairs biomedical information with emotional and individualised support.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1914707"},"PeriodicalIF":3.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catamenial pneumothorax presenting as tension pneumothorax: a case report.","authors":"John Olukorode, Nwachukwu Nwachukwu, Akinboade Popoola, Heritage Kristilere, Yetunde Oladipupo, Rolake Akin-Adewale, Ayotemi Oluwagbemi, Oluwafemi Fafiola, Lucky Ogidan, Raymond Omiko","doi":"10.3389/frph.2026.1871134","DOIUrl":"https://doi.org/10.3389/frph.2026.1871134","url":null,"abstract":"<p><strong>Introduction: </strong>Catamenial pneumothorax is a rare condition. It may present with complications such as tension pneumothorax.</p><p><strong>Case presentation: </strong>A 35-year-old nulliparous woman without a pre-existing diagnosis of endometriosis presented with recurrent episodes of chest tightness, breathlessness, and dizziness, occurring in relation to her menstrual cycle. Initial evaluation revealed a right-sided pneumothorax, requiring chest tube insertion. Although she experienced temporary improvement, symptoms recurred at the onset of her next menstrual period, with imaging confirming tension pneumothorax. Video-assisted thoracoscopic surgery (VATS) identified diaphragmatic perforations and endometriotic lesions.</p><p><strong>Conclusion: </strong>Timely diagnosis and treatment should be adopted in order to limit complications associated with catamenial pneumothorax.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1871134"},"PeriodicalIF":3.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}