Frontiers in reproductive health最新文献

{"title":"Empowering youth and ensuring health: utilization of youth friendly service among preparatory school students in Gambella, Southwest Ethiopia.","authors":"Nardos Hailu, Benti Negero, Keno Melkamu, Yawkal Tsega","doi":"10.3389/frph.2024.1452315","DOIUrl":"10.3389/frph.2024.1452315","url":null,"abstract":"<p><strong>Background: </strong>Youth is a period with exposure to high risk of reproductive health (RH) problems. Despite, several strategies designed to solve these problems, youths are experiencing unsafe abortion, unintended pregnancy, and sexually transmitted infections (STIs) so far. The utilization of Youth Friendly Services (YFS) and its determinants has not been well studied in Gambella so far. This study aimed to assess YFS utilization and associated factors among preparatory school students in Gambella town, Southwest Ethiopia.</p><p><strong>Methods: </strong>Institution based cross-sectional study was conducted on 394 randomly selected preparatory school students in Gambella town from June 1-30/2023. Data were collected through self-administered questionnaire, entered to EpiData version 4.6, and exported to Stata version 17.0 statistical software for analysis. Bivariable and multivariable logistic regression analyses were employed. The <i>p</i>-value of <0.05 with 95% CI was used to declare statistical significance of association between YFS utilization and explanatory variables.</p><p><strong>Result: </strong>Less than one third (31.2%) of preparatory school students utilized YFS in Gambella town. Being married (AOR: 4.94, CI: 2.14, 11.38), having pocket money (AOR: 2.02, CI: 1.15, 3.56), no payment for YFS (AOR: 2.13, CI: 1.01, 4.50), having knowledge about YFS (AOR: 2.27, CI: 1.29, 4.00), convenient working time (AOR: 2.50, CI: 1.08, 5.83), and sexual experience (AOR: 3.38, CI: 1.90, 6.01) were the factors significantly associated with utilization of YFS in Gambella town.</p><p><strong>Conclusion: </strong>The study found that utilization of YFS in Gambella town was low. Being married, having pocket money, not asked payment for YFS, knowledge about YFS, convenient working time, and sexual experience were the factors positively affecting utilization of YFS in Gambella town. Therefore, the health decision makers better to design policies aimed to increase youths knowledge about YFS.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1452315"},"PeriodicalIF":2.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901046","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":"Prevalence and associated factors of non-consensual sexual acts among adolescents in the Democratic Republic of Congo.","authors":"Miangotar Yode, Felly Ekofo, Blaise Mudekereza Mihigo","doi":"10.3389/frph.2024.1437225","DOIUrl":"10.3389/frph.2024.1437225","url":null,"abstract":"<p><strong>Introduction: </strong>During adolescence, due to lack of experience, individuals may engage in or tolerate certain non-consensual acts under coercion. There are significant associations between forced sexual intercourse and a range of negative effects on reproductive health, as well as psychological and emotional health. Studies on non-consensual sexual acts among adolescents are rare in the Democratic Republic of Congo (DRC). This study is one of the first to focus on urban adolescents, aiming to assess the prevalence of non-consensual sexual acts and to identify associated factors.</p><p><strong>Methods: </strong>Data for this study were obtained from the baseline survey of the project \"Reducing the Vulnerability of Adolescents and Young Girls to Violence and HIV/AIDS Infection,\" conducted in 2018 in the provinces of Kinshasa and Kasaï Oriental among adolescents aged 10-24 years. A total of 2,123 adolescents were surveyed (46.8% in Kinshasa and 53.2% in Kasaï Oriental). A structured survey questionnaire was developed in French to collect data. This questionnaire was pre-tested and corrected before use. Non-consensual sexual acts were assessed using three variables: (i) Have you ever experienced non-consensual touching, (ii) Have you ever experienced an attempted forced sexual intercourse, and (iii) Have you ever been physically forced, injured, or threatened to have sexual intercourse. Bivariate and multivariate analyses were conducted on these three variables separately.</p><p><strong>Results: </strong>Among all adolescents surveyed, 11.5% reported having experienced non-consensual touching, 15.3% reported having experienced an attempted forced sexual intercourse, and 5.8% reported having been physically forced, injured, or threatened to have sexual intercourse. Among the 575 sexually active adolescents, these proportions were 43.4%, 57.4% and 22.0%, respectively. Prevalences were higher among girls and in the province of Kinshasa. Factors associated with non-consensual sexual acts included gender, cohabitation with biological parents (father and mother), age at first sexual intercourse, communication about sexuality or intimate subjects with a family member, and adolescents' perceptions of the role and place of partners in intimate relationships. A quarter (25.5%) of adolescents who were victims of forced sexual intercourse and were aware of an appropriate institution or person sought help from a professional for the violence they experienced.</p><p><strong>Discussion: </strong>The results revealed a high prevalence of non-consensual sexual acts, the significance attributed by adolescents to traditional beliefs regarding the dominant role of men in intimate relationships, and the existence of barriers preventing victims of sexual violence from seeking appropriate care. These findings advocate for providing healthcare services tailored to the needs of adolescents and adapted to sociocultural contexts.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1437225"},"PeriodicalIF":2.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899872","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":"Corrigendum: Unveiling barriers to reproductive health awareness among rural adolescents: a systematic review.","authors":"Sri Wahyuningsih, Sri Widati, Sarva Mangala Praveena, Mohammad Wavy Azkiya","doi":"10.3389/frph.2024.1537155","DOIUrl":"https://doi.org/10.3389/frph.2024.1537155","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frph.2024.1444111.].</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1537155"},"PeriodicalIF":2.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901045","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":"Global, regional, and national burden of HIV and tuberculosis and predictions by Bayesian age-period-cohort analysis: a systematic analysis for the global burden of disease study 2021.","authors":"Xuebin Tian, Chong Wang, Zhihao Hao, Jingjing Chen, Nanping Wu","doi":"10.3389/frph.2024.1475498","DOIUrl":"10.3389/frph.2024.1475498","url":null,"abstract":"<p><strong>Objective: </strong>To assess sex, age, regional differences, and the changing trend in human immunodeficiency virus and tuberculosis (HIV-TB) in different regions from 1990 to 2021, and project future trends.</p><p><strong>Methods: </strong>Global Burden of Disease Study 2021 data were analyzed to assess HIV-TB incidence, death, prevalence, and DALY rates from 1990 to 2021, including different types of TB co-infections (drug-susceptible, multidrug-resistant, and extensively drug-resistant). Bayesian age-period-cohort models were used to forecast age-standardized DALY rates through 2035.</p><p><strong>Results: </strong>In 2021, there were approximately 1.76 million HIV-TB infections and 200,895 deaths globally. The highest burden of HIV-DS-TB and HIV-MDR-TB was found in Southern Sub-Saharan Africa, while HIV-XDR-TB was most prevalent in Eastern Europe. The co-infection burden was highest among individuals aged 30-49. Key risk factors were unsafe sex, drug use, and intimate partner violence, with regional variations. The global burden of HIV-TB remains high, and age-standardized DALY rates are expected to increase in the coming years, especially in regions with low socio-demographic indices (SDI).</p><p><strong>Conclusion: </strong>The burden of HIV-TB co-infection correlates with the socio-demographic index (SDI): countries with a low SDI have a higher burden. Therefore, clinical diagnosis and treatment in such areas are more challenging and may warrant more attention. High death rates underscore the importance of early management.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1475498"},"PeriodicalIF":2.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886470","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":"Oral pre-exposure prophylaxis implementation in South Africa: a case study of USAID-supported programs.","authors":"Jerome Wendoh Milimu, Lauren Parmley, Mahlodi Matjeng, Mathata Madibane, Mandisi Mabika, Jacques Livington, Joseph Lawrence, Orapeleng Motlhaoleng, Hasina Subedar, Rethabile Tsekoa, Zandile Mthembu","doi":"10.3389/frph.2024.1473354","DOIUrl":"10.3389/frph.2024.1473354","url":null,"abstract":"<p><p>Since the introduction of oral pre-exposure prophylaxis (PrEP) in 2016, countries have successfully scaled-up PrEP to populations at risk of HIV acquisition, including key populations, serodiscordant couples and pregnant women. Between 2016 and 2023, there were over 5.6 million oral PrEP initiations globally. Of these, over 1.2 million occurred in South Africa, with nearly 700,000 implemented through USAID/South Africa's PEPFAR program. This case study uses WHO's Building Blocks for Health Systems Strengthening to describe USAID's oral PrEP program in South Africa, reporting experiences and lessons learned in 14 districts across 7 provinces. Key lessons include: (i) Substantial donor financial investment was critical for expanding oral PrEP in South Africa, but sustained leadership and investment from government stakeholders, such as the Department of Health and the National Treasury, have been essential for sustainability. Despite fluctuations in USAID funding, annual PrEP initiations have continued to increase in USAID-supported districts largely due to local leadership. (ii) Health information and supply chain systems required agility to monitor oral PrEP introduction and scale-up. When systems lacked agility, temporary solutions like the development of interim reporting tools were necessary. (iii) Integrating community-based and facility-based service delivery supported client-centered care. Nurses and lay health workers contributed to over 80% of the full-time equivalents supporting PrEP under USAID's human resources for health portfolio. (iv) Integrating sexual and reproductive health services with oral PrEP service delivery provided clients with comprehensive, client-centered care. (v) Other client-centered care included differentiated service delivery options, such as mobile and gazebo modalities, and expanded PrEP choice through implementation science activities for new PrEP products. (vi) USAID-supported PrEP initiations have been highest among females of reproductive age in the general population and men who have sex with men among key populations, priority populations in South Africa. As done in this case study, sharing best practices and lessons learned from USAID/South Africa's oral PrEP program can strengthen the implementation evidence base and inform more efficient PrEP service delivery, particularly as new PrEP products become available.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1473354"},"PeriodicalIF":2.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886483","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":"What emerging adults say about the appropriateness of sexual and reproductive health programmes: evidence from a suburb in Accra, Ghana.","authors":"Laud R Sowah, Adriana A E Biney, D Yaw Atiglo, Delali Badasu, Angela A Boateng, Kwadwo Ohene Sarfoh, Augustine Ankomah","doi":"10.3389/frph.2024.1459825","DOIUrl":"10.3389/frph.2024.1459825","url":null,"abstract":"<p><strong>Introduction: </strong>Young people's access to appropriate health information in Ghana has been marginal, hence their utilisation of existing services remains poor. Most sexual and reproductive health (SRH) policies and outreach programmes target adolescents, neglecting emerging adults who are equally vulnerable to SRH risks. This study seeks to elicit emerging adults' knowledge and experiences with SRH programmes, and their recommendations to improve the services for their needs.</p><p><strong>Methods: </strong>Using data from 30 in-depth interviews and 10 focus group discussions with youth aged 18-24 years in a suburb of Accra, we provide insights on emerging adults' experiences with SRH programmes and their recommendations for their improvement, as well as young men's perspectives on SRH programmes, in particular.</p><p><strong>Results: </strong>The participants were in three socio-economic groups: tertiary students, informal workers and apprentices. The main SRH education that the emerging adults had received was from their earlier formal education in Junior and Senior High Schools but not in their current places of school or work. However, they indicate that the SRH education programmes and information they received earlier in life were inadequate to tackle pragmatic issues that contemporary youth face. Furthermore, SRH programmes operate in unfriendly environments with negative messages that cause them to lack vital information.</p><p><strong>Discussion: </strong>For the success of SRH programmes, the youth should be targeted with diverse contemporary approaches specific for their SRH needs. Key recommendations comprised making available SRH education tailored for emerging adults' current demographic and socio-economic groups, and providing appropriate SRH content and youth-friendly community centres.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1459825"},"PeriodicalIF":2.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900309","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":"Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis.","authors":"Gaby Moawad, Youssef Youssef, Arrigo Fruscalzo, Slim Khedhri, Hani Faysal, Paul Pirtea, Benedetta Guani, Alexandre Vallée, Jean Marc Ayoubi, Anis Feki","doi":"10.3389/frph.2024.1484202","DOIUrl":"10.3389/frph.2024.1484202","url":null,"abstract":"<p><p>Adenomyosis is a commonly encountered pathology in women of reproductive age and frequently coexists with infertility. The effect of adenomyosis on fertility, particularly on <i>in vitro</i> fertilisation and intracytoplasmic sperm injection outcomes, is not well understood. Various pretreatment modalities have been used to improve pregnancy rates and live birth outcomes; however, because of a lack of high-quality evidence, there is no clear consensus on the best pretreatment option. This review was conducted through a PubMed search aiming to highlight the relationship between pretreatment and fertility in women with adenomyosis. Medical, ablative surgical, and non-surgical therapies were reviewed. According to the current literature, gonadotropin-releasing hormone agonist therapy and placement of a levonorgestrel intrauterine system are two suitable medical pretreatment strategies that can improve the clinical pregnancy rates of patients with adenomyosis. Surgical ablation of adenomyosis can also be beneficial, although surgical management can be challenging. Non-surgical thermal techniques, including high-intensity focused ultrasound ablation, percutaneous microwave ablation, and radiofrequency ablation, are much less invasive techniques that have shown effectiveness in improving fertility. Although evidence remains limited, all these procedures have demonstrated a favourable safety profile. Further studies are needed to better develop these techniques and demonstrate their effectiveness.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1484202"},"PeriodicalIF":2.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883826","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":"Sexual decision-making: an exploratory interview study of Cambodian adolescents.","authors":"Gloria Park, Youngran Yang","doi":"10.3389/frph.2024.1409351","DOIUrl":"10.3389/frph.2024.1409351","url":null,"abstract":"<p><strong>Introduction: </strong>The rate of sexual activity among adolescents is very high, with serious repercussions such as human immunodeficiency virus (HIV) and sexually transmitted diseases. Understanding the factors that influence adolescents' engagement in sexual activity is crucial for promoting healthy sexual attitudes and behaviors in schools, sex education programs, communities, and families. This study aimed to examine the factors influencing sexual decision-making among Cambodian adolescents.</p><p><strong>Methods: </strong>In accordance with the Standards for Reporting Qualitative Research (SRQR), this study used a descriptive qualitative methodology with individual interviews. The participants in the study were 30 Cambodian adolescents (15 males and 15 females) who were all unmarried and sexually active. They were recruited using various methods, including social networking services, and interviewed to explore their sexual decision-making processes.</p><p><strong>Results: </strong>The analysis revealed that the decision-making process was influenced by both internal and external factors. Internal factors included sexually explicit Internet material and arousal from sexy outfits, while external factors included foreign vs. Khmer culture, the surrounding environment including community, peers, and family, and educational advice received at school. Gender differences were noted in responses to stimuli like sexy outfits and perceptions of cultural norms.</p><p><strong>Conclusions: </strong>This study underscores the complexity of adolescent sexual decision-making in Cambodia. It highlights the need for sex education that is not only comprehensive but also culturally sensitive, addressing the diverse influences on these adolescents. Future research should include a broader demographic group, including rural adolescents, to gain more comprehensive insights.</p><p><strong>Implications for practice: </strong>This study uncovers how cultural norms, peers, and the media impact sexual behaviors, emphasizing the significant gender differences in these aspects. The findings shed light on the necessity of culturally sensitive and comprehensive sex education and the urgent need for tailored approaches to health promotion and education.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1409351"},"PeriodicalIF":2.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840452","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":"Spatial distribution and urban-rural disparity of unmet need for family planning among married/in-union women in Ethiopia: a spatial and decomposition analysis.","authors":"Shimels Derso Kebede, Daniel Niguse Mamo, Jibril Bashir Adem, Agmasie Damtew Walle, Yawkal Tsega, Elsabeth Addisu, Zinabu Bekele Tadese, Ermias Bekele Enyew","doi":"10.3389/frph.2024.1416280","DOIUrl":"10.3389/frph.2024.1416280","url":null,"abstract":"<p><strong>Background: </strong>High unmet need for family planning combined with other factors, such as high early marriage and teenage pregnancy, increases the risk of developing obstetric fistula and other complications. This study aimed to assess spatial distribution and urban-rural disparities of unmet need for family planning among married/in-union women in Ethiopia.</p><p><strong>Methods: </strong>The study was conducted on secondary data from a cross-sectional survey that was conducted nationally between September and December 2019 using a two-stage cluster design on a total of 265 enumeration areas. A total weighted sample of 5,349 married/in-union women was included in the analysis. ArcGIS Pro and SaTScan software were used to handle spatial analysis. Finally, multivariable decomposition analysis via a logit model was used to decompose the observed difference in unmet need by the compositional difference and the difference in effects of explanatory variables between places of residence.</p><p><strong>Results: </strong>Spatial distribution of unmet need for family planning was clustered in Ethiopia with a global Moran's I index value of 0.25 (<i>p</i>-value = 0.004). Accordingly, enumeration areas in West Hararge, Arsi, Bale, Gujji, Borena, Jimma, and East Wellega zones of Oromia region, and Gurage, Hadiya, Silte, Gedio, Sidama, Wolaita, Alaba, and Dawro zones of South Nation and Nationality People region, and the southern part of Zone 3 in Afar region were detected as hotspot areas. The decomposition results revealed that there is a significant disparity in unmet need between urban and rural resident women (0.074, <i>p</i>-value < 0.001). Endowment and coefficient factors accounted for the urban-rural disparity, contributing 68.32% and 31.68%, respectively. Household size, husband's opinion of family planning, community acceptance of family planning, woman's age at first sexual intercourse, and the woman's age were key determinants of the urban-rural disparity.</p><p><strong>Conclusion: </strong>The results revealed a significant disparity in the unmet need for family planning based on place of residence, with a clustered spatial distribution across the study area and notable hotspot areas. Thus, targeted interventions should focus on mobilizing resources to high-risk areas and addressing the needs of high-risk groups to reduce the observed variation.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1416280"},"PeriodicalIF":2.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840453","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":"Endometrial scratching and intralipid treatment-no general recommendations.","authors":"Paolina Mrosk, Nathallie Sandi-Monroy, Friedrich Gagsteiger, Thomas Wolfram Paul Friedl, Katharina Hancke, Karin Bundschu","doi":"10.3389/frph.2024.1505842","DOIUrl":"10.3389/frph.2024.1505842","url":null,"abstract":"<p><strong>Objectives: </strong>Endometrial scratching (ES) and/or intravenous intralipid therapy (in cases of increased uterine natural killer cells, uNKs) are still conducted in several fertility centers as \"add-on\" treatments in patients undergoing ART, although convincing evidence for beneficial effects is lacking.</p><p><strong>Study design: </strong>In this retrospective study, associations between ES treatment or additional intralipid therapy and pregnancy and live birth rates of 1,546 patients undergoing 2,821 IVF-/ICSI-treatment cycles with fresh or frozen embryo transfers in a German fertility-center between 1st January 2014 and 31th May 2017 were analyzed.</p><p><strong>Results: </strong>Overall pregnancy and live birth rates for all 2,821 treatment cycles (468 cycles with ES) were 32.8% and 23.5%. There were no statistically significant differences in pregnancy or live birth rates between first treatment cycles with and without ES (<i>p</i> = 0.915 and <i>p</i> = 0.577) or between second cycles following an unsuccessful first cycle with and without ES (<i>p</i> = 0.752 and <i>p</i> = 0.623). These results were confirmed using multivariable generalized estimating equations (GEE) models accounting for non-independency of multiple treatment cycles per patients that included all cycles and showed no significant effect of ES on pregnancy (<i>p</i> = 0.449) or live birth rates (<i>p</i> = 0.976). Likewise, a GEE model revealed no significant effect of intralipid treatment on pregnancy (<i>p</i> = 0.926) and live birth rates (<i>p</i> = 0.727).</p><p><strong>Conclusions: </strong>Our results reveal no evidence that ES increases the pregnancy or live birth rates in women undergoing their first or further IVF cycle with fresh or frozen embryo transfer. Intralipid treatment was also not beneficial. Even if patients explicitly ask for it, these procedures are not recommended outside of clinical studies.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1505842"},"PeriodicalIF":2.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815127","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}