Contraception最新文献

{"title":"Dilation and evacuation in the setting of trachelectomy and abdominal cerclage: A case report and review of the literature.","authors":"Megan Masten, Cosette Kathawa, Tsion Shiferaw, Cara Clure, Nancy Fang","doi":"10.1016/j.contraception.2025.110840","DOIUrl":"10.1016/j.contraception.2025.110840","url":null,"abstract":"<p><p>This is a patient with a history of radical trachelectomy and abdominal cerclage who underwent an uncomplicated dilation and evacuation at 15 weeks gestation with mifepristone preparation. Dilation and evacuation may be attempted and safely completed for patients in the early second trimester with this history.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110840"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-acting reversible contraceptive preference and initiation among clinic-based and telemedicine medication abortion patients at one academic health system in California.","authors":"Rebecca Woofter, Rajita Patil, May Sudhinaraset, Jessica Gipson","doi":"10.1016/j.contraception.2025.110838","DOIUrl":"10.1016/j.contraception.2025.110838","url":null,"abstract":"<p><strong>Objectives: </strong>To examine possible differences in postabortion long-acting reversible contraception (LARC) preference and initiation among clinic-based medication abortion and telemedicine medication abortion patients.</p><p><strong>Study design: </strong>We examined electronic medical records among 576 medication abortion patients at one health system in California between 2020 and 2022.</p><p><strong>Results: </strong>Overall, 25% of patients preferred LARC and 21% initiated LARC. Among those who preferred LARC, 77% initiated LARC. No statistically significant differences were found in LARC preference or initiation across medication abortion modalities.</p><p><strong>Conclusions: </strong>In this health system, clinic-based medication abortion and telemedicine medication abortion patients did not differ in postabortion LARC preference or initiation.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110838"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical development of a novel injectable hydrogel for vas-occlusion.","authors":"Nicholas M Matsumoto, Tyler G Chiartas, Benjamin R Paysour, Timothy J Barry, Lindsey E Ott, Yelena Tropsha, Kevin S Eisenfrats","doi":"10.1016/j.contraception.2025.110839","DOIUrl":"10.1016/j.contraception.2025.110839","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this work is to outline the preclinical development of ADAM, an injectable, two-component polyethylene glycol hydrogel designed for long-lasting and nonpermanent vas-occlusive contraception.</p><p><strong>Study design: </strong>A newly developed hydrogel was comprehensively characterized to evaluate its potential as a male contraceptive device. The material was optimized for porosity to ensure sperm occlusion, rheological properties, injectability, and mechanical durability within the dynamic vessel. Biocompatibility of the hydrogel was assessed using a suite of ISO 10993 tests, which are critical for clinical translation and supporting a future regulatory submission. The canine model was utilized to assess the chronic tissue response of the vas deferens post implantation, providing insights into long-term safety and functionality.</p><p><strong>Results: </strong>The vas-occlusive hydrogel demonstrates selective permeability with a pore size of 10 to 20 nm, effectively preventing sperm passage while allowing diffusion of small molecules. Its mechanical properties facilitated injection into the vas deferens with minimal force (3.1 N), forming a viscoelastic material within 30 seconds, with the ability to resist ejaculatory pressures. The implant and its degradation products were found to be noncytotoxic, nonirritating, nonsensitizing, and nongenotoxic. Moreover, a 2-year in vivo study in a canine model showed minimal tissue reaction following implantation, with no adverse effects reported.</p><p><strong>Conclusions: </strong>These findings indicate that the hydrogel's chemical and mechanical properties align with the requirements for a safe, effective, and nonpermanent vas-occlusive contraceptive.</p><p><strong>Implications: </strong>Currently, men lack options for effective, long-lasting, and reversible contraception. The development and evaluation of the study hydrogel described here suggest it would make a safe and effective vas-occlusive contraceptive and should be researched further in a clinical setting.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110839"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping ethical concerns in algorithm-driven period and fertility tracking technologies.","authors":"Maria Carmen Punzi, Tamara Thuis","doi":"10.1016/j.contraception.2025.110837","DOIUrl":"10.1016/j.contraception.2025.110837","url":null,"abstract":"<p><strong>Objective: </strong>The proliferation of algorithms in period and fertility tracking technologies has increased reliance on data and analytics to interpret menstrual cycle symptoms and guide health and fertility-related action. We set out to map the ethical concerns of the (often invisible) algorithmic influence on users' experience of, and behavior related to their menstrual cycle and fertility.</p><p><strong>Study design: </strong>Reviewing literature and media, we map six ethical concerns of algorithms in period and fertility tracking technologies - inconclusive evidence, inscrutable evidence, misguided evidence, unfair outcomes, transformative effects, traceability - and highlight their potential implications, particularly for vulnerable groups.</p><p><strong>Results: </strong>Based on this mapping, we identify three overarching themes for further analysis: self-knowledge, power and control, representation and inclusion. We find that organizational activity, individual user activity and societal dynamics interact with each other and influence how we can prevent and address the mapped ethical concerns of algorithms.</p><p><strong>Conclusion: </strong>Algorithm-driven period and fertility tracking technologies carry more (and more nuanced) ethical concerns than those currently discussed in the literature and in media. We call for future research to integrate the ethics of (AI) algorithms into the field of sexual and reproductive health, recognizing the complex connections between individual, organizational, and societal levels.</p><p><strong>Implications: </strong>When taking the mapped ethical concerns seriously, we see a potential for algorithm-driven period and fertility tracking technologies to empower - and not discriminate - its users; for users to learn about their bodies and use the technologies responsibly; and for society to actively scrutinize its biases and achieve health equity.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110837"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do Australian contraceptive users say about their experience of having an intrauterine device inserted? Findings from an online, qualitative survey.","authors":"Claire Felix-Faure, Jacqueline Coombe, Henrietta Williams, Cassandra Caddy","doi":"10.1016/j.contraception.2025.110836","DOIUrl":"10.1016/j.contraception.2025.110836","url":null,"abstract":"<p><strong>Objectives: </strong>We sought to explore contraceptive users' experiences of the intrauterine device (IUD) insertion in Australia.</p><p><strong>Study design: </strong>We conducted an online qualitative survey with people in Australia, aged 18-45, who had undergone IUD insertion in the last 2 years. We recruited participants using online advertisements on social media and via researcher networks and inductively analysed the data.</p><p><strong>Results: </strong>Of a total 294 recorded responses to our online survey, we included 175 based on completion of selected questions for analysis. Participants' responses to questions regarding their overall feelings toward their experience of IUD insertion varied greatly. Here, we report on three key themes: preparedness for the procedure, the role of staff and providers, and the role of the non-clinical support person. Those who described being poorly prepared for the pain often reported feeling 'shocked' by the experience. Participants reported that support people fostered a sense of safety and served as advocates. Those reporting positive experiences with insertion typically described care that aligned with patient-centered principles.</p><p><strong>Conclusions: </strong>Healthcare providers who insert IUDs should follow clinical guidelines that include guidance on preventing pain and preparing patients for potential pain. Providers can use patient-centered practice to improve patients' experiences of IUD insertion.</p><p><strong>Implications: </strong>These results can be used to improve patient experience of IUD insertion. This work highlights important areas in clinical guidelines requiring review.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110836"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of social deprivation index and contraception care in a statewide contraceptive access initiative.","authors":"Caitlin Bernard, Brownsyne Tucker Edmonds, Kelly Kean, Rebecca Evans, Surya S Bhamidipalli, Yan Tong, Steven A Brown, Maria Fernandez, Kathleen Wendholt, Jeffrey F Peipert, Tracey A Wilkinson","doi":"10.1016/j.contraception.2025.110833","DOIUrl":"10.1016/j.contraception.2025.110833","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the association of social deprivation index (SDI) and contraception care in a statewide contraceptive access initiative (PATH4YOU) in Indiana.</p><p><strong>Study design: </strong>A cross-sectional analysis was performed to examine associations of participant's chosen appointment type and contraceptive method with age and SDI.</p><p><strong>Results: </strong>Of the 1201 participants, 45.2% chose a short-acting contraception, 76.9% received in-person care. Those within the highest SDI quartile (greatest social deprivation) chose in-person care (93.1% vs. 63.4%) and long-acting contraception (62.8% vs. 35.6%) when compared to participants within the lowest quartile (p < 0.01). This was confirmed by multivariable analysis, which showed that as SDI quartiles increased, OR for in-person care and long-acting contraception increased.</p><p><strong>Conclusions: </strong>Participant chosen type of appointment and contraceptive method were associated with levels of social deprivation.</p><p><strong>Implications: </strong>Analysis of appointment type and contraceptive method within a statewide contraceptive initiative in Indiana (PATH4YOU) was done and showed differences based on social deprivation quartiles. Those living in geographic areas of greatest social deprivation chose in-person care (vs. telehealth) and long-acting contraception.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110833"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Where do female contraceptive users get their methods, and does this differ by insurance coverage? A state-level examination.","authors":"Hannah Olson, Megan L Kavanaugh","doi":"10.1016/j.contraception.2025.110834","DOIUrl":"10.1016/j.contraception.2025.110834","url":null,"abstract":"<p><strong>Objective: </strong>Describe where female contraceptive users obtained their method, by insurance and state.</p><p><strong>Study design: </strong>Using 2022 Behavioral Risk Factor Surveillance System data from female contraceptive users in 26 states, we describe source of contraception by state and type of insurance coverage.</p><p><strong>Results: </strong>Most female contraceptive users utilized private providers, but those with public or no insurance often used community health centers and family planning clinics, which commonly receive public funding.</p><p><strong>Conclusion: </strong>People who are publicly insured or uninsured often rely on publicly supported providers.</p><p><strong>Implications: </strong>Supporting a variety of providers may facilitate people accessing care, regardless of income.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110834"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Web traffic and Google Trends data show increased interest in novel male contraception following the Supreme Court's Dobbs v. Jackson ruling.","authors":"Claudia Brewer, Brian T Nguyen","doi":"10.1016/j.contraception.2025.110835","DOIUrl":"10.1016/j.contraception.2025.110835","url":null,"abstract":"<p><strong>Objectives: </strong>Explore online public interest in male contraception in the United States after the Supreme Court's Dobbs v. Jackson ruling.</p><p><strong>Study design: </strong>We used Google Trends to examine relative search volumes for \"male birth control\" and observed the number of daily visits to two male contraception research websites during the weeks before and after the ruling.</p><p><strong>Results: </strong>The mean relative search volume for \"male birth control\" more than doubled during the period after the ruling was publicized (p = 0.002). Daily visits to both male contraception websites peaked immediately following the ruling.</p><p><strong>Conclusions: </strong>The overturning of federal abortion protections preceded a spike in United States public interest in male contraception.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110835"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus recommendations for measuring the impact of contraception on the menstrual cycle in contraceptive clinical trials.","authors":"Amelia C L Mackenzie, Stephanie Chung, Emily Hoppes, Nora Miller, Anne E Burke, Sharon L Achilles, C Leigh Allen, Luis Bahamondes, Diana L Blithe, Vivian Brache, Rebecca L Callahan, Alice F Cartwright, Kathryn B H Clancy, Enrico Colli, Amanda Cordova-Gomez, Elizabeth C Costenbader, Mitchell D Creinin, Hilary O D Critchley, Gustavo F Doncel, Laneta J Dorflinger, Alison Edelman, Thomas Faustmann, Christoph Gerlinger, Lisa B Haddad, Julie Hennegan, Cássia Raquel Teatin Juliato, Simon P S Kibira, Diana Mansour, Andres Martinez, Kristen A Matteson, Jacqueline A Maybin, Alexandria K Mickler, Kavita Nanda, Chukwuemeka E Nwachukwu, Funmilola M OlaOlorun, Kevin J Peine, Chelsea B Polis, Carolina Sales Vieira, Regine Sitruk-Ware, Jennifer A Smit, Marsden Solomon, Lisa M Soule, Douglas Taylor, Elizabeth E Tolley, Olivia Vandeputte","doi":"10.1016/j.contraception.2025.110829","DOIUrl":"10.1016/j.contraception.2025.110829","url":null,"abstract":"<p><strong>Objective: </strong>We sought to develop consensus recommendations for measurement and analysis of data on contraceptive-induced menstrual changes (CIMCs) in contraceptive clinical trials. We built upon previous standardization efforts over the last 50 years and prioritized input from a variety of global experts and current regulatory authority guidance on patient-reported outcomes.</p><p><strong>Study design: </strong>We completed a formal consensus-building process with an interdisciplinary group of 57 experts from 30 organizations and 14 countries in five global regions who work across academia, nonprofit research organizations, the pharmaceutical industry, and funding agencies. Smaller topical working groups drafted and revised recommendations.</p><p><strong>Results: </strong>We developed 44 consensus recommendations, including research approaches to establish the evidence for future improvement in the measurement and analysis of CIMC data and guidance for investigators to implement presently. Priority recommendations call for simplification of terminology to make measurement accessible and patient-centered, accounting for intrinsic and extrinsic factors that may impact outcomes during study design and recruitment, standardized data collection of primary CIMC and acceptability outcomes, and harmonized approaches for analysis of these data, including addressing missing data.</p><p><strong>Conclusion: </strong>By virtually convening a large group of global experts working across disciplines and sectors via a formal methodology, we developed consensus recommendations that will improve the current and future measurement and analysis of CIMC data in contraceptive clinical trials. Using these standardized approaches will permit valid and reliable contraceptive product labeling on CIMC outcomes that matter to users and greater comparability across trials that can inform clinical guidance and contraceptive counseling.</p><p><strong>Implications: </strong>Consensus recommendations on measuring bleeding changes and related outcomes in contraceptive clinical trials can improve reporting of standardized, patient-centered outcomes in future product labeling. These improvements can enable healthcare providers to offer more relevant guidance on contraceptives and users to make more informed decisions about their choice of method.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110829"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of institutional and state policies in management of pregnancies of unknown location: A 2024 online survey of Ryan Programs in the United States.","authors":"Madeline V Smith, Jema Turk, Rebecca Mercier, Jody Steinauer, Agatha Berger, Kavita Vinekar","doi":"10.1016/j.contraception.2025.110832","DOIUrl":"10.1016/j.contraception.2025.110832","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the perceived impact of state and institutional policies on managing pregnancies of unknown location (PULs) at US Ryan residency programs.</p><p><strong>Study design: </strong>We conducted a cross-sectional electronic survey of US Ryan residency programs (n = 113) from March to April 2024. We compared the perceived influence of institutional and state policies on PUL management among Ryan Programs in restrictive vs nonrestrictive abortion climates. Provision of diagnostic uterine aspiration in the workup of PUL was a secondary outcome. We compared proportion of responses between restrictive and nonrestrictive climates with Fisher exact tests.</p><p><strong>Results: </strong>We obtained responses from 75 Ryan Programs in 32 states (66.4% response rate). 29 (38.7%) were from states with restrictive abortion policies. Eight programs (10.7%) changed PUL management after the Dobbs decision. Compared to programs in nonrestrictive states, programs in restrictive states were more likely to report that state policy inhibits their ability to care for patients with PUL (34.5% vs 2.17%, p < 0.001), rarely or never offer diagnostic uterine aspiration (34.5% vs 8.7%, p = 0.01), and identify institutional leadership as a barrier to offering diagnostic uterine aspirations (20.7% vs 2.2 %, p = 0.01). The most common institutional barriers to providing diagnostic uterine aspiration were staffing and faculty comfort/willingness, which did not differ by state abortion climate.</p><p><strong>Conclusions: </strong>State abortion policy and institutional policy may impact the options available to patients with PULs.</p><p><strong>Implications: </strong>Programs in all legislative climates should address institutional barriers to providing diagnostic uterine aspiration. Legislative advocacy in restrictive states is needed to ensure access to expedient PUL management.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110832"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}