Contraception and reproductive medicine最新文献

{"title":"Endometrial preparation protocols did not impact outcomes after frozen-thaw embryo transfer for chronic endometritis treatment.","authors":"Xiao Shi, Shuyi Zhang","doi":"10.1186/s40834-025-00363-6","DOIUrl":"https://doi.org/10.1186/s40834-025-00363-6","url":null,"abstract":"<p><strong>Background: </strong>Intended to investigate the potential effects of endometrial preparation procedures on the results of subsequent frozen embryo transfer (FET) cycles in infertile women with chronic endometritis (CE) following a single course of antibiotic therapy.</p><p><strong>Methods: </strong>From July 2020 to December 2023, 773 infertile patients participated in a retrospective research. CD138 was immunostained in endometrial tissues taken during the proliferative phase. CE was suggested by the presence of CD138-positive cells in the stromal cells. Oral antibiotics were administered to every patient with a CE diagnosis. After one course of drug treatment, patients had endometrial preparation and frozen embryo transfers. This study compared the impact of different endometrial preparation strategies on pregnancy outcomes.</p><p><strong>Results: </strong>Four regimens, hormone replacement treatment (HRT), ovulation induction, natural cycle, and gonadotrophin-releasing hormone agonist-HRT (GnRH agonist-HRT), did not significantly alter the outcome of pregnancy in patients with CE. Compared to other groups, the ovulation induction cycle group had a higher clinical pregnancy rate and embryo implantation rate. In addition, the miscarriage rate is lower compared to other populations. Patients with treated CE who received HRT, GnRH agonist-HRT, ovulation induction cycle, and natural cycle did not differ substantially (P > 0.05).</p><p><strong>Conclusion: </strong>Patients with treated CE did not see any change in pregnancy outcomes as a result of endometrial preparation procedures.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"10 1","pages":"28"},"PeriodicalIF":2.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804866","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":"Prevalence of successful vaginal birth after caesarean section and its associated factors among women delivered in the university of Gondar comprehensive specialized referral hospital, Northwest Ethiopia.","authors":"Yeshiwas Ayale Ferede, Yohannes Ayanaw Habitu, Worku Chekol Tassew, Desalegn Anmut Bitew","doi":"10.1186/s40834-025-00360-9","DOIUrl":"https://doi.org/10.1186/s40834-025-00360-9","url":null,"abstract":"<p><strong>Introduction: </strong>Caesarean section (CS) is an essential, life-saving surgical intervention used to address obstetric complications. Nonetheless, its excessive use has raised global concerns. In low- and middle-income countries (LMICs) like Ethiopia, the challenges of repeat CS and the limited success of VBAC are particularly problematic. Despite this, there is a significant gap in knowledge regarding vaginal births following a cesarean delivery in Ethiopia, especially in the specific study area.</p><p><strong>Objectives: </strong>To determine the prevalence and associated factors of successful vaginal birth after one caesarean section in the University of Gondar Comprehensive Specialized Hospital.</p><p><strong>Methods: </strong>Institutional based cross-sectional study was conducted among 409 women who were randomly selected and had one previous caesarean section delivery and underwent a trial of labor. Data were analyzed and computed using Stata version 14 Software. Multivariable logistic regression analysis was performed to identify the factors associated with successful vaginal birth after caesarean section. A crude and adjusted odds ratio with a 95% confidence interval was used to interpret the results. A P value of < 0.05 indicated statistically significant results.</p><p><strong>Results: </strong>Of 385 completed charts reviewed, the success rate of vaginal birth after caesarean section was 38.2%,( 95%CI;33.3-43.1%).The factors associated with successful vaginal birth after cesarean section were: prior history of spontaneous vaginal delivery at any point time (AOR = 1.84,95% CI;1.02-3.33), prior history of successful vaginal birth after previous cesarean section (AOR = 2.12, 95%CI;0.97-4.64), no history of stillbirth (AOR = 1.78, 95% CI;1.03-3.07), cervical dilation on admission ≥ 3 cm (AOR = 2.22, 95% CI; 1.14-4.35), station on admission ≥ 0(AOR = 1.94, 95% CI; 1.12-3.37), and Antenatal care follow-up (AOR = 2.48,95%CI;1.26-4.88).</p><p><strong>Conclusions: </strong>Our study demonstrated a low prevalence of successful VBAC, highlighting that factors such as a prior history of VBAC, spontaneous vaginal delivery at any time, cervical dilatation at admission, history of stillbirth, ANC follow-up, and fetal station at admission are significantly associated with positive outcomes. This evidence clearly indicates that targeted, evidence-based interventions are urgently needed to improve VBAC success rates. Therefore; the Federal Ministry of Health (FMOH), policymakers, and relevant stakeholders should collaborate to develop, implement, and continuously review comprehensive policies and guidelines that support these targeted interventions.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"10 1","pages":"29"},"PeriodicalIF":2.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804949","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":"Understanding and treating menstruation associated sickle cell pain.","authors":"Halimat Olaniyan, Bria Carrithers, Layla Van Doren","doi":"10.1186/s40834-025-00361-8","DOIUrl":"10.1186/s40834-025-00361-8","url":null,"abstract":"<p><p>Sickle cell disease (SCD) is a chronic inflammatory condition characterized by hemoglobin polymerization that precipitates recurrent vaso-occlusion, endothelial dysfunction, and multi-organ damage. Menstruation in persons with SCD presents a unique challenge due to blood loss and its ability to exacerbate SCD pain. This interaction between SCD-related vascular stress and menstruation-induced inflammation amplifies the risk of acute pain episodes during menstruation. In this manuscript, we explore the intersection of SCD and menstruation, emphasizing the role of hormonal therapy in managing menstruation-associated acute SCD pain. Progestin-only therapies, such as depot medroxyprogesterone acetate (DMPA) and levonorgestrel intrauterine devices (LNG-IUDs), are particularly effective in reducing menstrual blood loss. Data suggests DMPA mitigates acute SCD pain episodes around menstruation with minimal thrombotic risk in persons with SCD. Despite their effectiveness in menstrual regulation, combined hormonal contraceptives (CHCs) pose a significant concern due to their potential to exacerbate the hypercoagulable state in individuals with SCD. We highlight the importance of comprehensive care and collaboration between gynecologists and hematologists to optimize the management of menstruation-associated SCD pain.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"10 1","pages":"27"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782291","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":"Knowledge and perceptions of men towards vasectomy among men of reproductive age in Otuke District- Uganda.","authors":"Anna Grace Auma, Emmanuel Madira, Beth Namukwana, Ronald Izaruku, Amir Kabunga, Tamrat Endale WMichael","doi":"10.1186/s40834-025-00341-y","DOIUrl":"10.1186/s40834-025-00341-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess knowledge of and perceptions towards vasectomy as a family planning method among men of reproductive age in rural northern Uganda\".</p><p><strong>Methods: </strong>A cross-sectional study involving 624 participants was conducted. Sociodemographic characteristics, use of vasectomy, number of children, and knowledge of vasectomy were assessed. Perceptions of vasectomy were measured, focusing on cultural, religious, and gender-related aspects.</p><p><strong>Results: </strong>The study revealed a predominantly adult, married, and Catholic population with low educational attainment. 2% of participants had used vasectomy as a family planning method, this indicates the right to preference in choosing vasectomy as a family planning method. Approximately half of the participants demonstrated awareness of vasectomy, and negative perceptions were recorded, with 63.5% expressing their opinions. Cultural and religious beliefs, along with concerns about promiscuity, play a significant role in shaping the perceptions. The majority believed in male dominance in family planning decisions, and a considerable portion endorsed sterilization exclusively for women.</p><p><strong>Conclusion: </strong>This study highlights the low utilization and negative perceptions of vasectomy among men in rural northern Uganda, emphasizing the need for targeted interventions to address cultural and religious misconceptions and enhance education on family planning options. Public health campaigns should focus on dispelling misconceptions about vasectomy, particularly addressing cultural and spiritual concerns. Educational programs should target men and their communities, emphasizing the benefits of shared family planning decisions. Further research incorporating qualitative methods could provide a deeper understanding of the cultural aspects influencing vasectomy perceptions in this population.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"10 1","pages":"26"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765845","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":"A systematic review and meta-analysis of randomized controlled studies comparing follicular flushing versus aspiration during oocyte retrieval in IVF cycles.","authors":"Nour A El-Goly, Ahmed M Maged, Aimy Essam, Amira Shoab","doi":"10.1186/s40834-025-00351-w","DOIUrl":"10.1186/s40834-025-00351-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the value of follicular flushing during ovum pick up compared to follicular aspiration in IVF cycles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search strategy: &lt;/strong&gt;Screening of PubMed, Web Of Science, Cochrane, Scopus, and clinical trials registry from inception to October 2024. The search key words included follicular flushing, follicle aspiration, ovum pick up, oocyte retrieval, IVF, and their MeSH terms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;This review included all RCTs that evaluated the use of follicular flushing during ovum pick-up. Seventeen studies including 2218 participants (1124 were subjected to follicular flushing and 1094 subjected to follicular aspiration) were included.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;The extracted data included the settings of the study, the number and characteristics of participants, intervention details including the number of flushes, and the suction pressure used, outcome parameters including number of retrieved oocytes, the oocyte/ follicle ratio, the number of MII oocytes, the time of the procedure, the fertilization, implantation, clinical pregnancy, chemical pregnancy, ongoing pregnancy, live birth, miscarriage and cancellation rates, and risk of bias assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;The number of retrieved and MII oocytes were evaluated in 14 and 11 studies with 1920 and 1588 participants and revealed a mean difference (MD) of 0.03 and 0.16 with [-0.50, 0.57] and [-0.29, 0.61] 95% CI (P value =0.9 and 0.48, I&lt;sup&gt;2&lt;/sup&gt; = 87% and 90%), respectively. The fertilization and implantation rates were evaluated in 4 and 7 studies with 3331 and 1605 participants and revealed an Odd Ratio (OR) of 1.48 and 0.91 with [0.98, 2.24] and [0.55, 1.51] 95% CI (P value =0.06 and 0.72, I&lt;sup&gt;2&lt;/sup&gt; = 82% and 61%), respectively. The clinical pregnancy rate was evaluated in 11 studies with 1542 participants and revealed an Odd Ratio (OR) of 1.23 with [0.86, 1.74] 95% CI (P value =0.26, I&lt;sup&gt;2&lt;/sup&gt; = 42%). The ongoing pregnancy /livebirth rate was evaluated in 11 studies with 1266 participants and revealed an Odd Ratio (OR) of 1.07 with [0.80, 1.43] 95% CI (P value =0.65, I&lt;sup&gt;2&lt;/sup&gt; = 0%). The time of the procedure was evaluated in 8 studies with 985 participants and revealed a mean difference (MD) of 178.58 with [98.23, 258.93] 95% CI (P value &lt;0.001, I&lt;sup&gt;2&lt;/sup&gt; = 97%). The cycle cancellation rate was evaluated in 5 studies with 856 participants and revealed an Odd Ratio (OR) of 0.66 with [0.45, 0.98] 95% CI (P value =0.04, I&lt;sup&gt;2&lt;/sup&gt; = 0%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Follicular flushing during oocyte retrieval did not improve the number of retrieved oocytes, the oocyte retrieved over the aspirated follicles ration, the number of MII oocytes, the fertilization rate, implantation rate, clinical pregnancy, chemical pregnancy, ongoing pregnancy/livebirth, and miscarriage rates and associated with significant prolongation of the procedure. Cycle ","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"10 1","pages":"25"},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756481","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":"Emergency contraception knowledge, utilization and its determinants among selected young females in Addis Ababa, Ethiopia.","authors":"Feven Berhanu Erko, Bezawit Negash Demissie, Abdella Birhan Yabeyu, Kaleab Taye Haile, Arebu Issa Bilal","doi":"10.1186/s40834-025-00344-9","DOIUrl":"10.1186/s40834-025-00344-9","url":null,"abstract":"<p><strong>Background: </strong>Emergency Contraceptives (EC) can play an important role in public health by preventing unwanted pregnancy and unsafe abortion, thereby reducing associated health risks and social and economic problems. In Ethiopia, early initiation of sex coupled with inadequate awareness and lower utilization of EC highlights the need for studies to assess knowledge and utilization of EC and its determinant factors.</p><p><strong>Objectives: </strong>This study aims to assess the knowledge and utilization of emergency contraception and identify the factors that influence its use among young females in Addis Ababa, Ethiopia.</p><p><strong>Design and methods: </strong>A community-based cross-sectional study was conducted among selected young women in Addis Ababa, Ethiopia from July to September 2021. Participants were selected using convenience sampling. A single proportion formula was used to calculate the sample size. A self-administered structured questionnaire was used, and quantitative data was collected using Google Forms. Collected data was cleaned, entered, and analyzed using SPSS 26.</p><p><strong>Results: </strong>The response rate of the study was 87.7%. Almost all the participants were aware of EC (98.8%), but only 57.7% of them had good knowledge. Of the 261 participants who had sex, 240(91.2%) used EC. Factors associated with good knowledge about EC included attending university or college (AOR: 1.070, CI: 0.392-2.924, P-value = 0.002) and using EC every time they had sexual intercourse (AOR: 0.171, CI: 0.062-0.474, P-value = 0.001). Additionally, females with good knowledge about EC were 68.1% more likely to use EC compared to those with poor knowledge (AOR: 0.319, CI: 0.114-0.888, P-value: 0.029). Factors positively associated with EC utilization included having good knowledge of EC (AOR: 0.319, CI: 0.114-0.888, P-value: 0.029) and preferring to obtain EC services from pharmacy professionals (AOR: 0.246, CI: 0.072-0.847, P-value = 0.026).</p><p><strong>Conclusion: </strong>This study highlights the need for more information, education, and communication efforts to improve awareness and use of EC.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"10 1","pages":"24"},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756494","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":"Geographic patterns and determinants of family planning satisfaction among women of reproductive age in Ethiopia.","authors":"Natnael Kebede, Rahel Mulatie Anteneh, Natnael Moges, Sintayehu Simie Tsega, Melkamu Aderajew Zemene, Asaye Alamneh Gebeyehu, Melaku Ashagrie Belete, Denekew Tenaw Anley, Ermiyas Alemayehu, Ermias Sisay Chanie, Anteneh Mengist Dessie","doi":"10.1186/s40834-025-00356-5","DOIUrl":"10.1186/s40834-025-00356-5","url":null,"abstract":"<p><strong>Introduction: </strong>While studies in Ethiopia have explored family planning use and contraceptive determinants, limited research examines the spatial variation and predictors of satisfaction with family planning methods. This study addresses this gap using geographically weighted regression (GWR) analysis to assess spatial patterns and determinants of satisfaction with family planning methods among reproductive-age women. Utilizing nationally representative 2021 Performance Monitoring for Action Ethiopia (PMA-ET) data, the study aims to provide targeted insights for improving family planning services.</p><p><strong>Methods: </strong>A weighted sample of 1,456 reproductive-age women was analyzed. Spatial analysis was conducted using ArcGIS 10.7 and SaTScan 9.6. Hotspot detection, ordinary least squares (OLS) regression, and geographically weighted regression (GWR) were applied. The Bernoulli model was used to identify spatial clusters of satisfaction. Associations between satisfaction and explanatory variables were assessed using OLS and GWR, with statistical significance set at P < 0.05.</p><p><strong>Results: </strong>The overall satisfaction rate with current family planning methods was 84.1% (95% CI: 82.12, 85.97). Satisfaction levels exhibited a clustered spatial distribution. High-satisfaction hotspots were detected in Addis Ababa, most parts of Amhara, and some areas of Benishangul-Gumuz. SaTScan identified a primary spatial cluster (RR = 1.19, P < 0.001) in Addis Ababa, northern southwestern Ethiopia, and eastern Gambela, and a secondary cluster (RR = 1.18, P < 0.001) in northern Addis Ababa and southern Amhara. GWR analysis revealed that younger women (15-24 years), those with poor wealth status, and urban residents were significant spatial predictors of satisfaction.</p><p><strong>Conclusion: </strong>The study revealed that satisfaction with the current use of family planning methods among reproductive-age women in Ethiopia exhibits regional variations. Statistically significant clusters of higher satisfaction were identified in Addis Ababa, most parts of Amhara, and some parts of Benishangul-Gumuz. Geographically Weighted Regression (GWR) analysis indicated that women aged 15-24, those with poor wealth status, and urban residents were significant spatial predictors of satisfaction at the local level. These findings suggest the need for targeted regional strategies to improve satisfaction with family planning services. Interventions should prioritize high-satisfaction areas to sustain progress while addressing disparities in underserved regions. Policymakers should focus on enhancing equitable access, strengthening awareness campaigns, and mitigating socioeconomic barriers to improve satisfaction with family planning.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"10 1","pages":"22"},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756498","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":"Voices unveiled: a mixed-methods exploration of family planning education, access, and Sociocultural determinants for enhancing contraceptive decision-making in western Gujarat, India.","authors":"Vaibhav Shrivastav, Yogesh M, Dipesh Parmar, Rohankumar Gandhi, Sakshi Atulbhai Sojitra, Kundal Tanmay Subhash, Shah Pranjal Prasannakumar, Lathiya Moxa Ashokbhai","doi":"10.1186/s40834-025-00362-7","DOIUrl":"10.1186/s40834-025-00362-7","url":null,"abstract":"<p><strong>Background: </strong>Contraceptive use plays a crucial role in achieving desired fertility levels and improving maternal and child health outcomes. This study aimed to estimate the prevalence and determinants of contraceptive use among married women in Western Gujarat, India, using a mixed methods approach.</p><p><strong>Methods: </strong>A community-based mixed-method study was conducted. A multistage stratified cluster sampling technique was used to recruit 840 married women aged 18-49 years for the quantitative component. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with contraceptive use. Additionally, 20 in-depth interviews and 4 focus group discussions were conducted to explore qualitative aspects of contraceptive use, using a purposive sampling technique.</p><p><strong>Results: </strong>The contraceptive prevalence rate was 60.4%, with 46.7% using modern methods and 13.7% using traditional methods. Multivariate analysis revealed that higher education levels of women (graduation: aOR = 4.1, 95% CI: 1.4-12.0) and their husbands (graduation: aOR = 2.6, 95% CI: 1.0-6.9), women's employment status (not working: aOR = 0.6, 95% CI: 0.3-1.0), having 1-2 children (aOR = 3.6, 95% CI: 2.2-6.0), and joint decision-making was positively associated with contraceptive use. Age above 40 years (aOR = 0.2, 95% CI: 0.1-0.7) and contraceptive decisions made by other family members (aOR = 0.3, 95% CI: 0.1-0.8) were negatively associated with contraceptive use. Qualitative findings highlighted sociocultural barriers, such as community norms, religious beliefs, and gender power dynamics, as significant influences on contraceptive use.</p><p><strong>Conclusions: </strong>This study provides a comprehensive understanding of the factors influencing contraceptive use in Western Gujarat. The findings underscore the need for multifaceted interventions that address individual, interpersonal, and sociocultural factors to improve contraceptive uptake and reproductive health outcomes. Interventions should focus on enhancing family planning education, improving access to services, promoting women's empowerment, and addressing sociocultural barriers.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"10 1","pages":"23"},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756437","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":"\"I felt my rights were violated\": Challenges with the discontinuation of provider-dependent contraceptive methods in Eastern Uganda.","authors":"Agnes Nabulondera, Madeline Powers, Rose Chalo Nabirye, Sarah Racheal Akello, Munanura Turyasiima, Joshua Epuitai","doi":"10.1186/s40834-025-00354-7","DOIUrl":"10.1186/s40834-025-00354-7","url":null,"abstract":"<p><strong>Background: </strong>The right to autonomy in family planning is a cornerstone of reproductive health. Yet, many women face challenges when seeking to discontinue provider-dependent contraceptive methods, such as implants and intrauterine devices (IUDs). This study explored the experiences of women in Eastern Uganda regarding the discontinuation of implants/IUDs.</p><p><strong>Methods: </strong>Using a qualitative descriptive design, we conducted 15 in-depth interviews with women and six key informant interviews with healthcare providers. The study obtained ethical clearance and used a thematic analysis.</p><p><strong>Results: </strong>Two themes were identified: (1) reasons for refusal and (2) women's reactions to refusal to discontinue IUDs/implants. Women were denied to discontinue IUDs/implants because the due date had not been reached, insertion cards were missing, and there were healthcare constraints, especially inadequate equipment. Early removal or discontinuation before the due date was considered as a waste of resources, unjustifiable, and it was seen to increase risk of pregnancy among young girls. Healthcare workers preferred to first counsel for side effects instead of heeding women's requests to discontinue IUDs/implants. Women often felt betrayed and powerless when they were denied to discontinue using IUDs/implants. They felt that their reproductive rights were undermined which fostered mistrust towards future use of provider-dependent contraceptives. Women reported physical, social, and mental health struggles including strained marital relationships following denial to discontinue IUDs/implants. Most of the women incurred costs in discontinuing the use of IUDs/implants in private facilities.</p><p><strong>Conclusion: </strong>The findings underscore the need to uphold women's autonomy by improving access to removal services, and addressing systemic and provider-level barriers to discontinuation of IUDs/implants. Insertion cards should not be a mandatory requirement during discontinuation of contraceptives, while enhancing record-keeping systems can address the need for insertion cards. Respecting women's rights to discontinue contraceptives is essential for ensuring voluntary and sustained family planning use.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"10 1","pages":"21"},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660103","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":"Population characteristics of intrauterine device users in real-world clinical practice across Europe - insights from the EURAS-LCS12 study.","authors":"Lisa Eggebrecht, Anja Bauerfeind, Tanja Boehnke, Manuel Rizzo, Christine Hagemann, Jens Lange, Mareike Viet, Karl Pauls, Sophia von Stockum, Moritz Klinghardt, Klaas Heinemann","doi":"10.1186/s40834-025-00353-8","DOIUrl":"10.1186/s40834-025-00353-8","url":null,"abstract":"<p><strong>Background: </strong>The European Active Surveillance Study of LCS12 (EURAS-LCS12) investigates effectiveness and safety of intrauterine devices (IUDs) in routine clinical practice. Here, we aim to characterise the general population of IUD users across Europe recorded in a real-world setting.</p><p><strong>Methods: </strong>EURAS-LCS12 is a prospective, non-interventional cohort study in ten European countries, that started in 2014. All types of approved IUDs were enrolled: levonorgestrel (LNG)-IUS 8 (LNG release rate ~ 8 µg/day); LNG-IUS 12 (LNG release rate ~ 12 µg/day; LNG-IUS 20 (LNG release rate ~ 20 µg/day; ); copper IUDs and other hormonal IUDs (OHIUD). A great variety of baseline characteristics and endpoints are assessed in patient-reported questionnaires. The follow-up duration aligns with the intended maximum duration of use of 3 to 5 years, depending on the respective IUD.</p><p><strong>Results: </strong>Currently, 97,187 users are enrolled in the study, of whom the vast majority uses IUDs for contraceptive purposes (96.3%), and roughly two thirds are first-time IUD users (64.1%). Heavy menstrual bleeding (HMB) was reported as the second most common reason for IUD use but with apparent variations between devices and countries. Mean age of LNG-IUD 8 users was about 9 years lower compared with LNG-IUD 20 (26.2 vs. 34.6 years). Greatest differences in the proportion of gravid and parous women were observed between LNG-IUS 8 and OHIUD users (gravid: 38.6% vs. 89.8%; para: 30.6% vs. 88.0%).</p><p><strong>Conclusions: </strong>With more than 97,000 IUD users, EURAS-LCS12 is one of the largest contemporary studies focusing on IUD usage and provides a substantial source of real-world data. IUD prescription patterns appear in line with assumptions that high-dose LNG-IUDs with longer approved durations of use are predominantly prescribed among older, gravid women, who may have completed their family planning, as opposed to younger nulligravidae. Overall, the study is a great source to depict which IUD type fits women with certain characteristics and needs at a certain time of life.</p><p><strong>Trial registration: </strong>NCT02146950.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"10 1","pages":"20"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635038","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}