Contraception and reproductive medicine最新文献

{"title":"Examining fertility preferences and spousal communication on contraceptive uptake among postpartum mothers in selected facilities in Abuja, Nigeria.","authors":"Adaobi C Iluno, Adeyemi O Adekunle, Imose Itua","doi":"10.1186/s40834-026-00428-0","DOIUrl":"10.1186/s40834-026-00428-0","url":null,"abstract":"<p><p>BACKGROUND: The postpartum period is linked to a high risk of unintended pregnancies, contributing to the high fertility rate in Nigeria. The study investigated the fertility preferences and spousal communication on contraceptives among postpartum mothers attending maternal and child health clinics in the Abuja district hospitals. METHODS: A descriptive cross-sectional study was conducted, and 248 postpartum mothers were purposely selected from a cluster of women attending a postnatal clinic across four district hospitals in Abuja, Nigeria. The data were summarised using mean, standard deviation, frequency, and percentages. Bivariate analysis was conducted using the Pearson χ2 test at a 95% level of statistical significance. RESULTS: Regarding the respondents’ fertility preferences, about 80% desire to have another child; however, only a few desire to have a child soon, while over 70% want a child later. This desire to have another child increases as the parity level decreases. The study revealed a strong desire to use a contraceptive method (56.5%), however, only 15.3% of the respondents were current users. The data showed a significant association (P = 0.0001) between frequent spousal communication and contraceptive uptake. CONCLUSION: The study revealed a high unmet need for spacing, a strong desire for contraceptives and a low uptake among postpartum mothers. Improving access to family planning (FP) methods and including spousal communication in FP interventions can help postpartum mothers fulfil fertility preferences, reducing unintended pregnancies and negative reproductive health issues. </p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":" ","pages":"13"},"PeriodicalIF":2.5,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069508","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 autonomy and contraceptive use among married or cohabiting female youth: insights from recent Ghana demographic and health survey.","authors":"Anita Anima Daniels, Emmanuel Anongeba Anaba, Anita Asiwome Adzo Baku, James Akazili","doi":"10.1186/s40834-026-00427-1","DOIUrl":"10.1186/s40834-026-00427-1","url":null,"abstract":"<p><p>INTRODUCTION: The use of contraception has been effective in reducing unwanted pregnancy and sexually transmitted infections. However, it is not widely embraced by sexually active young people. The study aimed to investigate sexual autonomy and contraceptive use among married or cohabiting young women. METHODS: This study analysed the 2022 Demographic and Health Survey data. A total sample of 1003 (weighted) women aged 15–24 years were included. Frequency and percentages were computed at the univariate level and chi-square test at the bivariate level. At the multivariable level, binary logistic regression was conducted to determine the influence of sexual autonomy on contraceptive use. RESULTS: Majority of the participants had secondary or higher education, 85.1% were aged 20–24 years and 53.6% resided in rural areas. The results showed that 91% of the participants had sexual autonomy and 44.5% were using contraceptives. Exactly 94% of the participants with sexual autonomy were using contraceptives. At the bivariate level, women with sexual autonomy were two times more likely to use contraceptives (COR = 2.06; 95% CI: 1.12–3.77) compared to their counterparts. The relationship between sexual autonomy and contraceptive use was not statistically significant at the multivariable level. CONCLUSION: These findings suggest that the apparent influence of sexual autonomy on contraceptive use is largely shaped by broader socioeconomic and relational determinants, underscoring the need for multifaceted interventions that address regional and partner dynamics, alongside individual empowerment. This study has demonstrated that cohabiting and married young women in Ghana reported high sexual autonomy and relatively low contraceptive use. This implies that married and cohabiting young women might be overlooked by youth-friendly services that often target the unmarried. </p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":" ","pages":"12"},"PeriodicalIF":2.5,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12892743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992338","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":"Vasectomy knowledge, attitudes, and intentions among men in Ethiopia: a systematic review and meta-analysis.","authors":"Yonas Abebe, Diriba Bekele, Nagari Biratu Adugna, Nagasa Biratu Adugna","doi":"10.1186/s40834-026-00426-2","DOIUrl":"10.1186/s40834-026-00426-2","url":null,"abstract":"<p><p>BACKGROUND: Vasectomy is a highly effective (99.9%) and safe permanent family planning method for men. Despite these advantages, it remains one of the least utilized and most misunderstood contraceptive options. This systematic review and meta-analysis aimed to explore men’s knowledge, attitudes, and intentions toward vasectomy in Ethiopia by synthesizing scattered evidence to present a comprehensive national picture. METHODS: This systematic review and meta-analysis were conducted according to the Joanna Briggs Institute methodological guide and were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched for relevant literature in major databases, including PubMed, Google Scholar, ScienceDirect, Web of Science, and Scopus. Citation tracking and reference lists were also reviewed to ensure a complete search. The search was conducted from inception to 31 December 2024; the final search was run on 5 January 2025. Pooled prevalence estimates were calculated using the DerSimonian–Laird random-effects model. Heterogeneity was assessed with the Cochrane Q-test and the I² statistic, and publication bias was evaluated using funnel plots and Egger’s test. All analyses were performed using Stata version 17. RESULTS: Of the 393 articles initially identified, nine met the inclusion criteria, with a combined study population of 3,705 men. Only 39.8% (95% CI: 25.3–54.4) of men had good knowledge of vasectomy, 29.3% (95% CI: 16.8–41.7) had a positive attitude, and 20.8% (95% CI: 16.7–25.0) intention to use vasectomy. Higher education was linked to better knowledge, and having ≤ 4 children was associated with lower likelihood of having knowledge about vasectomy. Positive attitude toward vasectomy use was the strongest predictor of intention to use vasectomy. CONCLUSION: Among Ethiopian men, knowledge, attitudes, and intentions regarding vasectomy remain low. Educational attainment and family size play important roles in knowledge, and attitude is a key driver of intention. To boost vasectomy uptake, efforts must focus on dispelling myths, fostering positive perceptions, and encouraging male engagement in family planning decisions. REGISTRATION: This review was registered with PROSPERO (CRD420250634669). </p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":" ","pages":"11"},"PeriodicalIF":2.5,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12882196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947114","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":"Effect of the timing of surgical treatment of hydrosalpinx on in vitro fertilization/intracytoplasmic single-sperm injection pregnancy outcomes in patients with tubal factor infertility.","authors":"Yuanyuan Wang, Fang Wang, Qianyu Zhang, Wenjuan Liu, Yanqun Luo, Lin Fan, Yingqi Nong, Jianxing Ruan, Zhao Gong, Xiangyuan Li, Ruiqiong Zhou, Li Huang, Zhenghong Zhu, Mei Dong, Xiqian Zhang, Huinan Weng, Fenghua Liu","doi":"10.1186/s40834-025-00423-x","DOIUrl":"10.1186/s40834-025-00423-x","url":null,"abstract":"<p><strong>Background: </strong>In this study, we aimed to explore the effect of the timing of surgical management of hydrosalpinx on in vitro fertilization/intracytoplasmic single-sperm injection (IVF/ICSI) pregnancy outcomes in patients with tubal factor infertility.</p><p><strong>Methods: </strong>This retrospective study included 377 patients who underwent laparoscopic (LAP) unilateral or bilateral salpingectomy due to hydrosalpinx, IVF/ICSI-embryo transfer (ET), or frozen ET (FET) at the Department of Reproductive Medical Center, Guangdong Women and Children Hospital, between June 2013 and April 2023. Patients were divided into two groups: those who underwent oocyte retrieval first, followed by LAP, and FET (Group A, n = 190) and those who underwent LAP first, followed by oocyte retrieval, and ET/FET (Group B, n = 187). According to age, patients were divided into groups A1 ( < 35 years, n = 136), A2 (≥35 years, n = 54), B1 ( < 35 years, n = 153), and B2 (≥35 years, n = 34). According to the different ET times after LAP, patients were further divided into two groups: those who underwent ET ≤ 3 months after LAP (n = 193), and > 3 months after LAP (n = 184). According to the different oocyte retrieval times after LAP, the patients in group B (n = 187) were further divided into two groups: those who underwent oocyte retrieval ≤ 3 months after LAP (n = 83) and > 3 months after LAP (n = 104). We compared the pregnancy outcomes, complications after oocyte retrieval, oocyte contamination, and time and economic costs between the groups.</p><p><strong>Results: </strong>The differences in clinical pregnancy, live birth rates (57.9% vs 64.7%)[OR 0.750(0.495,1.137), p = 0.715; OR 0.841(0.445,1.591), p = 0.595], early abortion rates (4.5% vs 11.6%)[OR 0.364(0.127,1.046), p = 0.061; OR 0.320(0.074,1.379), p = 0.126], live birth rates(52.1% vs 52.9%)[OR 0.967(0.645,1.449), p = 0.871; OR 1.023(0.551,1.900), p = 0.941] between the two groups were not statistically significant (p > 0.05). A significantly higher time and economic costs were observed in Group A than in Group B (p < 0.05).</p><p><strong>Conclusions: </strong>The IVF/ICSI pregnancy outcomes were similar among patients with different timing of surgery. Group B spent less time and economic costs and had a lower risk of complications after oocyte retrieval than Group A. The optimal ET time after LAP was not reflected. the early abortion rates in the group that underwent ET ≤ 3 months after LAP showed a downward trend.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":" ","pages":"8"},"PeriodicalIF":1.9,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12825172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919345","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 mixed-methods cross-sectional study on early contraceptive implant removal and its associated factors among women implanted attending family planning settings in Bangladesh.","authors":"Abul Kalam Lutful Kabir, Shamsun Nahar, Emdad Hossain","doi":"10.1186/s40834-025-00422-y","DOIUrl":"10.1186/s40834-025-00422-y","url":null,"abstract":"<p><p>BACKGROUND: Early contraceptive implant removal before the projected duration of use leads to not only high costs and resource wastage but also disclosures women to the risk of unintended pregnancies and accompanying difficulties, resulting in the threat of maternal mortality and morbidity if an alternative contraceptive is not immediately employed. Therefore, we aimed to assess and determine the prevalence and explore the associated factors for early implant removal among the women who had discontinued attending the family planning settings in Bangladesh. METHODS: A cross-sectional mixed methods study was conducted between January and June 2025 at four government family planning settings. We collected both quantitative and qualitative data using a pretested structured questionnaire on sociodemographic, obstetric, contraceptives, and implant usage and its early removal through in-depth interviews. Additionally, we performed key informant interviews with the providers. We defined early removal as the discontinuation of the implant prior to the intended duration of three years. RESULTS: Out of 370 participants, 116 removed subdermal implants with a mean age of 28.33 ± 4.5 years (95% CI: 27.50-29.16). The proportion of implant discontinuation was 31.35% (n = 116, 95% CI: 26.84–36.25%) and the factors associated with implant discontinuation before the intended duration were irregular menstruation and dysmenorrhea (adjusted prevalence ratio [aPR] = 3.16, 95% CI: 2.39–4.19), desire to conceive (aPR = 2.10, 95% CI: 1.68–2.63), husband’s opposition (aPR = 2.69, 95% CI: 2.07–3.49), switch to alternative contraceptives (aPR = 2.10, 95% CI: 1.58–2.81) and self-reported side effects (aPR = 2.86, 95% CI: 2.09–3.93). From qualitative interviews, we found self-reported side effects and husband’s disapproval as the main reasons for early implant removal. CONCLUSION: Approximately one-third of the study women had contraceptive implants removed early. Healthcare providers should be more focused on pre- and post-insertion counseling in client-centered communication and common side-effects management. Moreover, male partners should be encouraged, and community women in awareness programs must be engaged to reduce socio-cultural resistance. </p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":" ","pages":"10"},"PeriodicalIF":2.5,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844383","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":"Exploring service providers' perspectives on facilitators and barriers to contraceptive uptake among women: implications for policy reform in Ghana.","authors":"Barnes Theresa, Sefogah E Promise","doi":"10.1186/s40834-025-00424-w","DOIUrl":"10.1186/s40834-025-00424-w","url":null,"abstract":"<p><p>OBJECTIVE: Healthcare providers play essential roles in delivering contraceptive and family planning services globally. In Ghana, previous research on contraceptive uptake among women has predominantly focused on clients in rural populations, leaving urban contexts and the perception of healthcare providers relatively underexplored. This study investigated the beliefs of service providers–physicians, midwives, and nurses regarding contraceptive uptake among women in Ghana. METHOD: We performed a qualitative exploratory study involving twenty-eight in-depth interviews with family planning service providers in the Greater Accra Region of Ghana. Participants were purposively selected from two large district hospitals in Ghana’s most populous region. The interviews were audio-recorded and transcribed following data saturation. The transcribed data were analyzed thematically and systematically categorized to identify themes and subthemes based on Anderson’s Model of Health Service Utilization. RESULTS: Our study found four themes and eleven subthemes. The first theme, predisposing factors, included three subthemes: knowledge and education, peer influence, and availability and accessibility. The second theme, need factors, comprised two subthemes: desired child spacing and psychological considerations. The third theme, enabling factors, comprised two subthemes: the capacity of service providers and systemic support. The fourth theme, barriers to contraceptive uptake, included four subthemes: partner dispute, misconceptions, economic restraints, and side effects. CONCLUSION: From the perspective of service providers, the uptake of contraceptives is shaped by a mix of predisposing, need, enabling, and contextual barriers. Factors like knowledge, education, peer influence, and accessibility influence awareness and the willingness to use contraceptives. Additionally, factors related to need, such as desired child spacing and psychological considerations, indicate women’s reproductive goals and readiness. Factors like provider capacity and systemic support boost confidence and improve service delivery. Barriers such as partner disagreement, misconceptions, economic challenges, and side effects hinder uptake. Enhancing provider training, broadening health coverage, and fostering community education can lead to more equitable contraceptive use among women. </p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":" ","pages":"9"},"PeriodicalIF":2.5,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829094","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":"Attitudes and practices of women's health specialists regarding fertility treatment for social reasons - a reproductive rights' survey from Pakistan.","authors":"Samia Husain, Sonia Husain, Rubina Izhar, Rahila Imtiaz, Zubaida Masood","doi":"10.1186/s40834-025-00421-z","DOIUrl":"10.1186/s40834-025-00421-z","url":null,"abstract":"<p><p>BACKGROUND: Treating subfertility continues to remain a low priority area in developing countries; a period of twelve months must elapse before a couple is labeled subfertile. This study aims to assess the attitude and practice of Women’s healthcare specialists for starting fertility investigations and treatment within 12 months of marriage for social reasons. METHODS: In this online survey, a self-administered questionnaire was administered to 464 women’s health care specialists in Pakistan. There were only three inclusion criteria: 1)Being a Pakistani resident 2) practicing obstetrics and gynaecology with a formal qualification in their specialty and 3) having a special interest in subfertility. All other healthcare professionals were excluded. RESULTS: Our study population comprised of 230(49.6%) gynecologists, 218(47.0%) obstetricians and 16 (3.4%) reproductive endocrinologists. Only one tenth (10.3%) had a positive attitude towards screening and offering treatment. Less than half (40.1%) had good practices. Those who had a local higher qualification (FCPS), (p = 0.001), worked as consultants(p = 0.001), and self-estimated themselves proficient in providing ovulation induction (p ˂ 0.001) were more likely to have positive attitude scores. Those whose area of expertise was gynaecology (p = 0.001), who had training in fertility (p = 0.005), and worked in a teaching hospital (p ˂ 0.001), were more likely to have good practice scores. CONCLUSION: Our study shows that healthcare providers have negative attitude and suboptimal practices regarding considering social reasons for starting fertility treatment within 12 months of marriage. Social grounds for starting fertility treatment in developing countries need to be established and local guidelines should be revised to include care for such couples. </p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":" ","pages":"7"},"PeriodicalIF":2.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12822287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764681","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":"Psychosocial determinants of contraceptive desire and use among sexually-active adolescent girls in Kenya and Nigeria: implications for girl-centered contraceptive programs.","authors":"Abednego Musau, Sophie Schlingemann, Roselyn Odeh, Lydiah Ndungu, Alhassan Bulama, Harmon Momanyi, Meghan Cutherell, Albert Tele, Regien Biesma, Jelle Stekelenburg","doi":"10.1186/s40834-025-00416-w","DOIUrl":"10.1186/s40834-025-00416-w","url":null,"abstract":"<p><p>INTRODUCTION: The high rates of unintended and early pregnancies among adolescent girls in sub-Saharan Africa are concerning and are substantially contributed to by low contraceptive uptake. Contraceptive use can avert these pregnancies, but demand remains low. We investigated the influence of psychosocial determinants on three outcomes: desire for contraception, current use and preference-aligned use among sexually-active adolescent girls from Kenya and Nigeria. METHODS: Our study involved data from household-based cross-sectional surveys in 282 primary sampling units in two Nigerian states and four Kenyan counties. Participants were adolescent girls aged 15–19 years. The data was collected after mapping and listing of the households where eligible participants resided. Six psychosocial determinants (contraceptive knowledge, perceived self-efficacy, contraceptive relevance and reproductive control, future aspirations and descriptive norms) were fitted into generalized linear mixed-effects models against the study outcomes. RESULTS: Data from 2,327 participants were analyzed. The majority (81.5%) were married or living as married, 16.2% were attending school and 60% were Muslim. Three-quarters had ever given birth, 71% had sex weekly while 93.5% had desire for future conception. Overall, 46.0% expressed current desire for contraception, 37.2% were using contraception while 86.5% practiced preference-aligned contraceptive use. Controlling for selected covariates, contraceptive knowledge, perceived contraceptive relevance, self-efficacy and descriptive norms were positively associated with desire for and current use. Future aspirations and perceived reproductive control were not associated with all three outcomes. In the main analysis, no psychosocial determinant was associated with preference-aligned contraceptive use. CONCLUSIONS: Our study demonstrated modest desire for contraception and low contraceptive prevalence amidst high desired fertility, highlighting a critical opportunity for contextualized girl-centered programs. Such programs should focus on enhancing contraceptive knowledge, building self-efficacy, increasing perceived relevance and shifting descriptive norms to drive contraceptive demand and use. Investigated determinants could serve as intermediate outcomes tracked to monitor progress towards contraceptive use outcomes and to inform program adaptations. Despite the high preference-aligned contraceptive use demonstrated, this metric is nascent, and more research is warranted to establish its utility for evaluating programs. </p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":" ","pages":"6"},"PeriodicalIF":2.5,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12797765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710497","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, attitudes, and practices toward contraceptive use among Syrian women attending the Syrian family planning association clinics in Damascus and Rif Dimashq: a cross-sectional study.","authors":"Aisha Alfakhry, Maria Jourieh, Hazar Taha, Joury Hasan, Omar Jassem Alsheikh, Dema Adwan","doi":"10.1186/s40834-025-00420-0","DOIUrl":"10.1186/s40834-025-00420-0","url":null,"abstract":"<p><p>BACKGROUND: High fertility rates remain a significant public health concern, particularly in developing countries, where they are often associated with adverse maternal and child health outcomes. OBJECTIVES: This study aimed to assess the prevalence and factors influencing contraceptive use among married women in Damascus and Rif Dimashq. METHODS: A cross-sectional survey was conducted among married women of reproductive age (15–49 years) attending family planning centers in Damascus and Rif Dimashq. The study was carried out across four clinics from September to the end of November 2024. A total of 295 married women were interviewed using a structured questionnaire. Data were collected using a structured questionnaire collected on socio-demographics, family planning knowledge, attitudes, utilization, reproductive history, and contraceptive decision-making factors. RESULTS: Of the 295 participants, 67.8% reported current use of contraceptive methods, with oral contraceptive pills and intrauterine devices being the most frequently used. Knowledge levels varied, with the average participant recognizing approximately five different contraceptive methods. While awareness of pills and IUDs was high, knowledge of less common methods such as implants, patches, and female condoms remained limited. Contraceptive use was significantly associated with factors such as age, parity, education level, and the hometowns of both partners. Among non-users, the primary reasons cited were the desire to conceive, fear of side effects, and lack of spousal approval. Approximately one in five participants had experienced an unintended pregnancy, with a notable proportion occurring despite IUD use, indicating potential issues related to device quality or provider technique. Additionally, most women were unaware of or unprepared for emergency contraception options following unprotected sex. CONCLUSION: Among married women attending SFPA clinics in Damascus and Rif Dimashq, contraceptive use was relatively high and dominated by OCPs and IUDs. This finding was expected, as these clinics provide multiple services, including family planning, yet knowledge gaps and persistent barriers remained. Poor contraceptive knowledge was strongly associated with non-use, and awareness of emergency contraception was notably limited. The proportion of unintended pregnancies among IUD users also suggests possible gaps in counseling or service quality. Enhanced education and improved service delivery are needed to support informed contraceptive choices in this population. </p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":" ","pages":"4"},"PeriodicalIF":2.5,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12781796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710471","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":"Microbial load and composition of intrauterine device string correlates with symptomatic removals in parous women.","authors":"Laura K Hamann, Rachel L Washburn, Michael Makii, Elisa Brown, Moss Hampton, Natalia Schlabritz-Lutsevich, Gary Ventolini, Kendra P Rumbaugh, Craig Tipton, Whitni K Redman","doi":"10.1186/s40834-025-00413-z","DOIUrl":"10.1186/s40834-025-00413-z","url":null,"abstract":"<p><p>BACKGROUND: A contraceptive intrauterine device (IUD) is a US Food and Drug Administration (FDA) approved method of contraception that is effective and generally well tolerated by patients. However, reports show that IUDs might be associated with inflammation, leading to symptoms like abnormal bleeding and pelvic pain. Pelvic inflammation potentially could be linked to IUD pathogenic biofilm colonization. However, the role of non-pathological microbial communities in this context is not well understood. The aim of the present observational study was to describe the microbiome of the IUD string located in the vagina and cervix in patients with and without IUD related complications. METHODS: Patients being seen for the removal of their IUD were identified for this study and were grouped according to removal for ‘asymptomatic’ or ‘symptomatic’ reasons. Asymptomatic removals included IUD expiration and desire to conceive while symptomatic removals stemmed from patient complaints, including abnormal bleeding, pelvic pain, and vaginitis. The IUD strings were sent for microbiome profiling by 16S ribosomal ribonucleic acid (rRNA) gene sequencing to characterize bacterial composition and universal 16S quantitative polymerase chain reaction (qPCR) to estimate bacterial bioburden. Microbial composition was compared to determine if symptomatic IUD removal was associated with altered bacterial load, diversity, or composition, with an emphasis on Lactobacillus and non-Lactobacillus abundance. RESULTS: Asymptomatic removals (group A, n = 8) had higher parity (p = 0.012) while relative abundance of Lactobacilli did not differ between groups (p = 0.57). Group A demonstrated a higher abundance of Lactobacillus reuteri compared to symptomatic removals (group S, n = 5), which showed increased overall bacterial load (p = 0.011) and a greater relative abundance of non-Lactobacillus species (p = 0.054), including potentially pathogenic genera such as Fusobacterium and Haemophilus. CONCLUSIONS: This study revealed differences in bacterial populations associated with symptomatic IUD removal with a higher overall bacterial burden and abundance of non-Lactobacillus genera. Though the current study is not powered to make conclusions on whether different types of IUDs have differential microbiota or how IUD type relates to complications, these results suggest that the microbiome may contribute. Future research should investigate bacterial composition through the duration of IUD use as well as the variation of the bacterial composition on the different components of the IUD device and explore the potential of targeted intervention with probiotics or antibiotics to prevent or reduce complications associated with IUD contraception. </p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":" ","pages":"5"},"PeriodicalIF":2.5,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12781424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696374","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}