Ser o no ser fértil,esa es la cuestión: encuesta sobre la fertilidad masculina

IntroductionFertility and virility are often socially related to the concept of masculinity, and this generates a certain degree of uncertainty because it could lead to a series of emotional processes by relating these concepts with the word infertility.ObjectiveThe objective of the present work was to relate the responses on the perceptions of seminal quality with some concepts related to masculinity.Materials and methodsAn anonymous virtual survey of 500 men was carried out, in which questions were asked regarding the perception of some variables on seminal quality.ResultsAs regards the question, ‘what does it mean for you to have a high sperm count?’; in men with and without partners, the most frequent response was, good ability to fecundate, being higher in men with a partner (P = .013). In contrast, the second most frequent response (good health) was higher in the group that had no partner (P = .028). While the majority of participants answered that they would not feel anything (58.8% without a partner, and 64.5% with a partner) in response to the questions, ‘How would you feel if you have a low sperm count?’, and ‘How would you feel if you did not have any sperm?’, respectively. On the other hand, as regards the response ‘embarrassed’, the participants without a partner said they felt more embarrassed in both questions (P = .011 and P = .0057).ConclusionThe term infertility should be used carefully, since it has a significant impact an individual's life. It affects the well-being of the couple, as well as psychosocial well-being and sexual satisfaction itself.     

Attitudes of California Registered Nurses About Abortion

ObjectiveTo describe attitudes about abortion among registered nurses (RNs) licensed in California and to determine if demographic characteristics were associated with these attitudes.DesignCross-sectional, one-time survey.SettingOnline between 2015 and 2017.ParticipantsNurses with active RN licenses in California (N = 2,500).MethodsAn anonymous survey was sent to a random sample of 2,500 RNs with active California licenses between 2015 and 2017 to assess their personal and professional demographic characteristics and their attitudes toward abortion. Using scores on the Abortion Attitudes Scale, we dichotomized participants into proabortion and antiabortion categories. We used chi-square tests to determine differences based on demographic characteristics.ResultsData from 504 RNs licensed in California are included in this analysis. Most respondents identified as female (n = 462, 92%), older than 50 years of age (n = 379, 75%), married (n = 364, 72%), White (n = 354, 70%), and Christian (n = 322, 64%). They were more likely to have negative attitudes toward abortion care if they identified as Christian (p < .001) and more positive attitudes if they identified as White (p < .001) independent of identifying as Christian.ConclusionsRespondents had a complex range of attitudes about abortion. In some cases, these attitudes aligned and/or conflicted with stated religious orientation. This study highlights the demographic characteristics that are associated with the attitudes and beliefs about abortion among RNs licensed in California.     

‘Dr. Google,is caesarean section good for me?’ – the global Internet searches associated with mode of birth methods: Retrospective analysis of Google trends data

ObjectiveWe investigated Google queries in the years 2004–2019 as related to mode of birth methods in scope of global and local popularity, secular trends, and associations with real-world data.DesignWe retrieved data from Google Trends (GT) over time and regional interest in (n = 9) topics related to birth. We calculated the interest of all the topics in proportion to the Relative Search Volume (RSV) of ‘Caesarean section’”(CS). We retrieved WHO data on the CS rate and the World Bank data on the fertility rate. We analysed secular trends.FindingsGlobally, the highest popularity was observed for these topics: ‘Childbirth’ (6.93 [times higher than CS]), ‘Caesarean section’ (1.00), and ‘Preterm birth’ (0.59). The regional RSV of ‘Caesarean section’ was associated with the real CS rate (r = 0.29; p = 0.016) and the interest in ‘Childbirth’ was associated with the regional fertility rate (r = 0.48; p < 0.001). Globally, the most dynamic rate of increase of interest was observed for ‘Vaginal delivery’ (+4.96 RSV/year) and ‘Caesarean section’ (+4.88 RSV/year), while a decrease was noted only for ‘Home birth’ (−3.04 RSV/year) and ‘Water birth’ (−1.84 RSV/year).ConclusionsThe interest of Google users in most of the birth-related topics increased over time and is associated with real-world data. Using GT may provide insight into the interest of Google users regarding different birth-related matters.Implication for practiceHealth professionals should be active in e-discourse to provide reliable information and recommend trustworthy websites to women and those who support them.     

An unwanted pregnancy and language proficiency level are associated with first antenatal visit after the first trimester: Results from a prospective cohort study

ObjectiveTo study the association between the reasons for a ‘late’ first antenatal visit and the influence of several maternal determinants and practical limitations on the timing of the first antenatal visit.DesignA prospective cohort study.SettingSouthwest region of The Netherlands, mainly characterised by large urban and suburban areas.ParticipantsWomen receiving information and counselling about prenatal screening between April 2010 and December 2010 were included (n = 9,268).Measurements and findingsTiming of first antenatal visit, categorised as: ‘in time’ (<12+0 weeks of gestation), ‘late’ (≥12–23+6 weeks of gestation) and ‘very late’ (≥24 weeks of gestation).An unplanned or unwanted pregnancy was the most frequently reported reason for delay of the first antenatal visit (30.7%) especially in Surinamese women (79%), and women younger than 20 years (63%) or older than 40 years (50.0%). Compared to women who timed their first antenatal visit ‘in time’, women with a delay in their first visit were more often younger than 20 or older than 40 years of age, high order multiparous (P ≥3), with a previous miscarriage, and had an absent Dutch language proficiency level. The latter showed the strongest association with a ‘very late’ first antenatal visit (OR 4.96, 95%CI 2.45–10.05).Key conclusionsLanguage proficiency level was highly associated with a delay in the timing of the first antenatal visit. When women timed their first antenatal visit late, having an unplanned or unwanted pregnancy was the most frequently reported reason for this delay.Implications for practiceFindings from this study can be used to inform and develop interventions to improve timely antenatal care use.     

Early Postpartum Maternal and Newborn Responses to Auditory,Tactile, Visual,Vestibular, and Olfactory Stimuli

ObjectiveTo compare maternal psychological well-being, newborn behavior, and maternal and newborn salivary oxytocin (OT) and cortisol before and after two maternally administered multisensory behavioral interventions or an attention control group.DesignRandomized prospective clinical trial.SettingU.S. Midwest community hospital.ParticipantsNewborns and their mothers (n = 102 dyads) participated. Mothers gave birth vaginally at term gestation and had no physical or mental health diagnoses. Newborns with low Apgar scores, receipt of oxygen, suspected infection, or congenital anomalies were excluded.MethodsDyads were randomly assigned to the auditory, tactile, visual, and vestibular (ATVV) intervention, the ATVV with odor from a baby lotion (ATVVO), or the attention control (AC) Group. Maternal psychological well-being, newborn behavior, and endocrine responses (salivary cortisol and OT) were measured before and after the intervention.ResultsNewborns in the ATVV and ATVVO groups exhibited increases in potent engagement behaviors (p < .0001 and p = .001, respectively). Newborns in the AC group exhibited a decrease in potent engagement (p = .013) and an increase in potent disengagement (p = .029). Mothers in the ATVVO group exhibited an increase in OT (p = .01) and the largest change in OT (p = .02) compared to mothers in the ATVV and AC groups. We noted no change in maternal psychological well-being or newborn endocrine responses.ConclusionInclusion of an odor via lotion with a behavioral intervention (ATVV) influenced maternal OT more than the behavioral intervention alone. Newborns were behaviorally responsive to the interventions; however, endocrine measures were not associated with intervention changes.     

Immigration and Adherence to Cervical Cancer Screening: A Provincewide Longitudinal Matched Cohort Study Using Multistate Transitional Models

ObjectivePrevious studies highlighting inequities in cancer screening between immigrants and non-immigrants have been methodologically limited. This longitudinal matched cohort study used a multistate modelling framework to examine associations between immigration status and cervical cancer screening adherence.MethodsA 1:1 matched cohort of women aged 25 and older from 1992-2014 who were residing in Ontario was examined. For each woman, the proportion of time spent being non-adherent was determined. Disparities in cervical screening adherence, and specifically the association between immigration status and the rate of becoming adherent, were investigated with a three-state transitional model. The model was adjusted for individual- and physician-level characteristics, which were updated annually and incorporated as time-varying covariates.ResultsThe matched cohort consisted of 1 156 720 immigrant and non-immigrant women. The median proportion of time spent non-adherent was 38.9% for immigrants and 24.7% for non-immigrants. The rate of becoming adherent among immigrants was lower than that among non-immigrants, after accounting for individual- and physician-level characteristics (relative rate 0.933; 95% CI 0.928–0.937). Other characteristics such as socioeconomic status, immigrant region of origin, presence of primary physician, and physician's sex were found to be significantly associated with cervical screening adherence.ConclusionThis study assessed the association between immigration status and adherence to cervical cancer screening. The insights from this work can be used to target groups of women vulnerable to underscreening and to minimize their time spent non-adherent to cancer screening. The methodology serves as a useful framework for examining adherence to other types of cancer screening.     

Sexual Function in Women 3 Days and 6 Weeks After Childbirth: A Prospective Longitudinal Study Using the Taiwan Version of the Female Sexual Function Index

IntroductionChildbirth impacts sexual function in women, but few reports have addressed sexual function shortly after childbirth.AimUsing the Taiwan version of the Female Sexual Function Index (FSFIT), this study aimed to describe women's sexual function and to examine differences between groups in sexual function shortly after delivery.MethodsA prospective longitudinal investigation was performed in women who completed the FSFIT, a numeric analog scale, the Taiwan version of the Center for Epidemiologic Studies Depression Scale (CES-D), and a demographic questionnaire in a Taiwanese medical center at 3 days and 6 weeks postpartum.Main Outcome MeasuresUsing a general linear model, differences were tested between groups, including those defined by delivery mode, type of feeding, depression score, pain score, and birth history.ResultsAfter adjusting for covariates, (i) significant differences in sexual function and desire were found between the vaginal delivery and Cesarean section groups at day 3 and week 6 postpartum (P = 0.0419 and <0.0001, respectively); (ii) differences in desire and satisfaction between the tubal ligation and not groups were significant at both time points (P = 0.0346 and 0.0338); (iii) differences in sexual function and sexual activity or intercourse between low and high CES-D scores were significant at 6 weeks postpartum (P = 0.0040 and 0.0043, respectively); and (iv) differences between pain level groups in sexual activity or intercourse and desire were significant at 6 weeks (P = 0.0493 and 0.0004). At 3 days postpartum, significant differences between educational level and ethnic groups were observed (P = 0.0002 and 0.0414).ConclusionsThe results showed significant differences in sexual function shortly after delivery between groups based on delivery method, tubal ligation, depression, pain, ethnicity, and educational level. This information may help health professionals to be more aware of women's perception of sexuality and may foster sensitivity in assessing their sexual function after childbirth. Chang S-R, Chang T-C, Chen K-H, and Lin H-H. Sexual function in women 3 days and 6 weeks after childbirth: A prospective longitudinal study using the Taiwan version of the Female Sexual Function Index.     

A better quality of life could be achieved by applying the endometriosis diet: a cross-sectional study in Dutch endometriosis patients

Research questionDoes the endometriosis diet positively affect quality of life (QoL) in women diagnosed with endometriosis?DesignA cross-sectional study was performed, recruiting women using the website and online peer platforms from the Dutch Endometriosis Society. In total, 211 women with a self-reported diagnosis of endometriosis were included in the study. They completed a questionnaire on the six QoL domains based on the conversation tool ‘My Positive Health’. Women who adhered to the endometriosis diet were compared with women who did not. A distinction was made between strict (score ≥8 on a scale of 0–10) and less strict adherence to the diet.ResultsA significantly higher score was seen in all six QoL domains in women who adhered to the endometriosis diet (n = 90) compared with women who did not (n = 121) (range P < 0.001 to P = 0.043). Furthermore, women with strict adherence (n = 48) compared to less strict adherence (n = 42) reported significantly higher scores in all six QoL domains (range P = 0.005 to 0.05). Women diagnosed with endometriosis more than 10 years ago (n = 13) adhered to the endometriosis diet significantly less often than women that were diagnosed more recently (n = 163; range P = 0.005 to 0.046).ConclusionThe endometriosis diet was associated with a better QoL in Dutch women with endometriosis. Strict adherence showed higher QoL scores compared with less strict adherence. Therefore, more research is needed to clarify the mechanism of this beneficial effect and to identify facilitators and barriers to dietary adjustments in patients with endometriosis.     

Exploring Factors Associated with Decisions about Feminizing Genitoplasty in Differences of Sex Development

Study ObjectiveInfants with genital development considered atypical for assigned female sex may undergo feminizing genitoplasty (clitoroplasty and/or vaginoplasty) in early life. We sought to identify factors associated with parent/caregiver decisions regarding genitoplasty for their children with genital virilization.DesignLongitudinal, observational studySettingTwelve pediatric centers in the United States with multidisciplinary differences/disorders of sex development clinics, 2015-2020ParticipantsChildren under 2 years old with genital appearance atypical for female sex of rearing and their parents/caregiversInterventions/Outcome MeasuresData on the child's diagnosis and anatomic characteristics before surgery were extracted from the medical record. Parents/caregivers completed questionnaires on psychosocial distress, experience of uncertainty, cosmetic appearance of their child's genitalia, and demographic characteristics. Urologists rated cosmetic appearance. For 58 patients from the study cohort with genital virilization being raised as girls or gender-neutral, we compared these data across 3 groups based on the child's subsequent surgical intervention: (i) no surgery (n = 5), (ii) vaginoplasty without clitoroplasty (V-only) (n = 15), and (iii) vaginoplasty and clitoroplasty (V+C) (n = 38).ResultsFathers’ and urologists’ ratings of genital appearance were more favorable in the no-surgery group than in the V-only and V+C groups. Clitorophallic length was greater in the V+C group compared with the V-only group, with substantial overlap between groups. Mothers’ depressive and anxious symptoms were lower in the no-surgery group compared with the V-only and V+C groups.ConclusionsSurgical decisions were associated with fathers’ and urologists’ ratings of genital appearance, the child's anatomic characteristics, and mothers’ depressive and anxious symptoms. Further research on surgical decision-making is needed to inform counseling practices.     

Quality assessment of ultrasonic foetal biometry during the IUGR Risk Selection (IRIS) trial: A cross sectional study

ObjectiveIntrauterine growth restriction is a major risk factor for perinatal morbidity and mortality. Ultrasonic foetal biometry is an important tool to monitor foetal growth. Therefore, the quality of these biometry scans is vital to achieve good diagnostic accuracy. We assessed the quality of foetal biometry during a nationwide trial and explored its association with sonographer's characteristics.MethodsFour scans from every sonographer (n = 154), performed at 29 and 35 weeks gestational age were collected. Two assessors scored these scans according to a national audit system. A quality score ≥ 65% was considered ‘adequate’.We compared the quality scores per scoring criterion (i.e. foetal head measurements, abdominal circumference and femur length with regard to magnification, correctness of the plane and calliper placement) and gestational age. We analysed the associations between characteristics of the sonographers and their scores. In a subsample of scans of 30 sonographers we determined the interrater agreement on the quality scores given by the two assessors independently.FindingsThe mean score was 81.3%. Thirteen sonographers (8.4%) failed to achieve ‘adequate quality’. Scores for femur length (83.8%) were significantly higher than those for head (77.9%) and abdominal circumference (78.6%) (both P < 0.05). Scores for correctness of the plane (73.4%) were lower than those for magnification (81.2%) and calliper placement (85.7%) (both P < 0.05). Gestational age did not affect the quality scores. Only the number of scans performed in the previous year was positively associated with the scores (β = 0.01; P < 0.05). The mean interrater difference in quality scoring was 11.1%, with 77.6% agreement on scans of ‘adequate quality’, but with no agreement on scans with ‘insufficient quality’.Key conclusions and implications for practiceMost sonographers achieved an ‘adequate quality’ score. Highest quality scores were attained for femur length, lowest quality scores for the correct plane. The number of scans one performs is associated with the quality scores, yet the minimum number of scans to perform for guaranteed quality still needs to be determined. Further research is needed to develop a standardized method to assess and maintain good ultrasonic foetal biometry quality.     

Fish Consumption and Premenstrual Syndrome and Dysphoric Disorder in Japanese Collegiate Athletes

Study ObjectiveTo determine the specific characteristics of premenstrual syndrome (PMS)/premenstrual dysphoric disorder (PMDD) in Japanese collegiate athletes, with a focus on their fish consumption.DesignCross-sectional study.SettingA university in Osaka, the largest city in western Japan.Participants and InterventionsThe participants were 312 female collegiate students. The study group was composed of 200 students who were members of sport clubs, and the control (nonathletes) group was composed of 112 members of cultural clubs.Main Outcome MeasuresPremenstrual symptoms and social activities.ResultsThe prevalence of moderate to severe PMS and PMDD in the study group was the same as in nonathletes. The prominent feature of premenstrual symptoms in athletes was that the severities of ‘physical symptoms’ and ‘performance in training or competition’ were much greater than those of nonathletes (P = .003 and P = .002, Mann–Whitney U test). There was a greater effect of PMS and PMDD on athletes, affecting their physical symptoms and performance compared with nonathletes. In terms of dietary habits, ‘fish or dried fish’ consumption was associated with a decreased risk of poor performance in athletes (odds ratio, 0.61; 95% confidence interval, 0.40-0.92).ConclusionThe results from this study indicate that fish consumption might be positively associated with the relief of PMS/PMDD-induced athletic disturbance.     

Assessing depression,anxiety and couple psychological well-being in pregnancy: a preliminary study

Objective: The aim of the study was to evaluate symptoms of depression and anxiety and psychological well-being in men and women in their third trimester of pregnancy, and to compare them with two control groups of men and non-pregnant women, both with children and without children. Background: Perinatal research has largely focused on maternal depression, anxiety and the state of the marital relationship, but few studies exist including partners and comparisons with control groups of men and women both with and without children. Methods: The study was a cross-sectional survey. The total sample was 156 participants. Approximately equal numbers of participants in each group were recruited through a local community health centre in Zaragoza (Spain) and completed questionnaires in the presence of a psychologist. Anxiety, depression and the couple’s self-ratings of their well-being were assessed with the Beck Depression Inventory, the State-Trait Anxiety Inventory, and Psychological Well-being in the couple Scale, respectively. Results: The results show higher levels of depression symptoms in the ‘pregnancy group’; specifically, pregnant women reported higher levels of depression than their male partners. Also, the ‘pregnancy group’ (men and women) show lower scores on psychological well-being in the couple compared with the control groups. No significant differences in anxiety-state between the groups and sex were obtained. Conclusion: These findings are important for both researchers and clinicians in practice, in order to improve the identification of women with antenatal depressive symptoms and offer more psychological support for women and their partners during and after pregnancy.     

Gender Affirming Medical Treatment Desire and Treatment Motives in Binary and Non-Binary Transgender Individuals

BackgroundIt is currently unknown whether there are differences in desire for gender affirming medical treatment (GAMT) between binary and non-binary transgender individuals, although the latter seek treatment less prevalently.AimTo investigate differences between binary and non-binary individuals on received GAMT, desire for GAMT, and motives for (not) wanting GAMT, and to explore the association between having an unfulfilled treatment desire and general and sexual well-being.MethodsWe conducted an online questionnaire in a community sample of 125 transgender men, 72 transgender women, and 62 non-binary transgender individuals (age: M = 30.4, SD = 11.31, range 18-69).Outcome measuresUndergone GAMT, GAMT desire, motives for (not) wanting (further) GAMT, Utrecht Gender Dysphoria Scale, Satisfaction With Life Scale, Hospital Anxiety and Depression Scale, Global Measure of Sexual Satisfaction, transgender-specific body image worries, and sexual self-concept discrepancies.ResultsBinary transgender participants reported having undergone more GAMT procedures than non-binary transgender participants (P < .001 for both gender affirming hormone treatment (GAHT) and gender affirming surgery (GAS)). While binary participants reported a stronger desire for GAHT compared to non-binary participants (X²(1, N = 93) = 32.63, P < .001), the groups did not differ in their desire for GAS (X²(1, N = 247) = 0.68, P = .411). Binary and non-binary participants reported similar reasons for wanting treatment, mostly related to body and/or gender incongruence and gender affirmation. In terms of not wanting treatment, the non-binary group reported their gender identity as the most important reason, while the binary group mostly mentioned possible medical complications. The majority of both groups had an unfulfilled treatment desire (69% of binary participants and 64.5% of non-binary participants), which was related to lower levels of general life satisfaction (P < .001) and sexual satisfaction (P = .005), more anxiety (P = .006) and transgender-specific body image worries (P < .001), and larger sexual self-concept discrepancies (P < .001 for actual and/or ideal, P < .001 for actual and/or ought).Clinical implicationsSystemic barriers to GAMT (especially GAS) should be removed not only for binary but also for non-binary identifying transgender individuals to decrease the discrepancy between treatment desire and actually seeking treatment.Strengths & limitationsThis study was the first to systematically investigate differences in treatment desire motives between binary and non-binary transgender individuals, while also showing the possible negative consequences of an unfulfilled treatment desire. Given the online character of the study, results may not generalize to the broader transgender community.ConclusionSimilarly to binary transgender individuals, many non-binary transgender individuals have a desire for GAMT, and not being able to receive GAMT has a negative effect on their mental and sexual health. Further efforts should be made to make GAMT accessible for all transgender individuals, regardless of gender identity.Kennis M, Duecker F, T'Sjoen G, et al. Gender Affirming Medical Treatment Desire and Treatment Motives in Binary and Non-Binary Transgender Individuals. J Sex Med 2022;19:1173–1184.     

A Large-Scale Comparison of Canadian Sexual/Gender Minority and Heterosexual,Cisgender Adolescents’ Pornography Use Characteristics

BackgroundThe ease of access to pornography has made its use common among adolescents. Although sexual and gender minority (SGM) (eg, gay, transgender) adolescents may be more prone to use pornography owing to sexual orientation–related information seeking and/or scarcity of potential romantic or sexual partners, relatively little attention has been paid to their pornography use and to the quantitative examination of the similarities and differences between heterosexual, cisgender (HC) and SGM adolescents’ pornography use characteristics.AimThe aim of the present study was to compare SGM and HC adolescents’ pornography use considering potential sex differences.MethodsWe used a sample of 2,846 adolescents (52.5% girls; M_age = 14.5 years, SD = 0.6), which was collected as part of an ongoing longitudinal study on adolescents’ sexual health. Data were analyzed with 5 groups: HC boys; HC girls; SGM boys; SGM girls; and SGM non-binary individuals.OutcomesAdolescents completed a self-report questionnaire about sexual and gender minority status and pornography use (ie, lifetime use, age at first exposure, and frequency of use in the past 3 months.)ResultsResults indicated significant differences between all groups: 88.2% of HC boys, 78.2% of SGM boys, 54.2% of SGM girls, 39.4% of HC girls, and 29.4% of SGM non-binary individuals reported having ever viewed pornography by the age of 14 years. SGM girls indicated a significantly younger age at first pornography use than HC girls, but this difference was not significant among boys. SGM boys reported the highest (median: many times per week), whereas HC girls reported the lowest (median: less than once a month) frequency of pornography use.Clinical TranslationResults suggest that SGM and HC boys' pornography use characteristics are rather similar, whereas SGM and HC girls’ pornography use patterns may be considered different presumably because of the varying underlying motivations (eg, using pornography to confirm sexual orientation).Strengths & LimitationsSelf-report measures and cross-sectional designs have potential biases that should be considered. However, the present study involved a large sample of adolescents including SGM adolescents, a population group that is understudied.ConclusionApproximately two-thirds of teenagers had gained their first experience with pornography in the present sample, and 52.2% reported using it once a week or more often in the past 3 months, indicating that pornography use may play an important role in both HC and SGM adolescents’ sexual development. Gender-based differences concerning pornography use seem to be robust regardless of SGM status.Bőthe B, Vaillancourt-Morel, MP, Girouard A, et al. A Large-Scale Comparison of Canadian Sexual/Gender Minority and Heterosexual, Cisgender Adolescents’ Pornography Use Characteristics. J Sex Med 2020;17:1156–1167.     

Comparison of stimulated versus modified natural cycles for endometrial preparation prior to frozen embryo transfer: a randomized controlled trial

Research questionTo compare stimulated cycle (STC) versus modified natural cycle (MNC) for endometrial preparation prior to frozen embryo transfer (FET) in terms of convenience and efficacy.DesignProspective, open-label, randomized controlled study including 119 patients aged 20–38 years, undergoing intra-conjugal IVF/intracytoplasmic sperm injection, having regular cycles, at least two day 2 or day 3 frozen embryos, for whom it was the first or second FET performed, randomized to either MNC (n = 59) or STC (n = 60). Monitoring consisted of ultrasound and hormonal measurements. The number of monitoring visits required was compared between the two groups.ResultsSTC required a significantly lower number of monitoring visits compared with MNC (3.6 ± 0.9 versus 4.4 ± 1.1, respectively, P < 0.0001), a lower number of blood tests (2.7 ± 0.8 versus 3.5 ± 1.0, respectively, P < 0.0001) and of ultrasounds (1.2 ± 0.4 versus 1.5 ± 0.6, respectively, P = 0.0039). FET during ‘non-opening’ hours (22.6% versus 27.5%, respectively, P = 0.32) and cancellation rates (11.7% versus 11.9%, respectively, P = 0.97) were comparable between the STC and MNC groups. No difference concerning HCG-positive rates (34.0% versus 23.1%, respectively, P = 0.22) nor live birth rates (24.5% for STC versus 23.1% for MNC, respectively, P = 0.86) was observed. Quality of life as defined by the FertiQol score was not different (P > 0.05 for each item).ConclusionAltogether, these findings can be used for everyday clinical practice to better inform patients when deciding on the protocol to use for FET. These results suggest that MNC is a good option for patients reluctant to have injections, but requires increased monitoring. STC may offer more flexibility for patients and IVF centres.     

The golden hour in Finnish birthing units - An ethnographic study

ObjectiveTo explore midwives’ and parents’ perceptions and actions as well as the culture surrounding the first hour after the birth of a baby – the golden hour.DesignShort-term ethnographic study, which included observations, informal interviews and focus group interviews. Thematic network analysis was used to analyse the data.SettingTwo birthing hospitals in Finland.ParticipantsThe first hour following 16 births was observed and informal interviews of attending midwives (n = 10) and parents (n = 3 couples and n = 6 mothers) were conducted to supplement the observations. The 16 cases included both primiparous (n = 8) and multiparous (n = 8) women, as well as vaginal (n = 12) and elective caesarean births (n = 4). Furthermore, two focus group interviews with midwives (n = 9) were conducted to deepen the understanding.FindingsThe over-arching theme Unchallenged hospital ‘rules’ comprised the two main themes of Safety-driven support by midwives and Silent voices of the parents. The hospital guidelines and practices guided the first hour, unchallenged by parents and midwives. Based on the guidelines, all the babies were given skin-to-skin contact early but not immediately. Midwives strictly followed the guidelines and performed many activities with the mothers during the first hour. Embedded power was present: midwives were in control but tended to listen to the parents. Although the mothers displayed a strong need to be close to their babies, their voices were silent in the units. The parents’ compliance with midwives and parents’ intense focus on the baby strengthened the midwives’ embedded power.Key conclusionCare culture in birthing units was ‘rule-based’ and the guidelines and practices sometimes inhibited uninterrupted skin-to-skin contact without questioning. The golden hour was mainly controlled by the maternity care staff.Implications for practiceRe-evaluation of hospital guidelines should enable more woman- and family-centred care. The golden hour is unique to families, and unnecessary separation and interventions should be avoided.     

What is the effect of regular group exercise on maternal psychological outcomes and common pregnancy complaints? An assessor blinded RCT

Objectiveto examine the effects of supervised group exercise on maternal psychological outcomes and commonly reported pregnancy complaints.Designan observer-blinded randomized controlled trial.SettingNorwegian School of Sport Sciences, Oslo, Norway.Participants105 sedentary, nulliparous pregnant women, mean age 30.7(±4.0) years, pre-pregnancy BMI 23.8 (±4.3), were assigned to either exercise (n=52) or control group (n= 53) at mean gestation week 17.7 (±4.2).Interventionthe exercise intervention followed ACOG guidelines and included a 60 minutes general fitness class, with 40 minutes of endurance training/aerobic and 20 minutes of strength training and stretching/relaxation, performed at least twice per week for a minimum of 12 weeks.Measurementsoutcome measures were assessed through standardized interviews pre- and post-intervention (gestation week 36.6, ±0.9), and included psychological variables related to quality of life, well-being, body image and pregnancy depression, as well as assessment of 13 commonly reported pregnancy complaints.Findingspost-intervention, using intention to treat (ITT) analysis, women randomized to exercise rated their health significantly better compared to women in the control group (p=0.02) and reported less fatigue related to everyday activities (p=0.04). Women with complete exercise adherence (≥24 sessions) had significantly better scores on measurements of feelings related to sadness, hopelessness and anxiety (p<0.01), compared to the control group. Contradictory, the control group reported higher life enjoyment (p<0.01). There were no significant group differences in body-image or pregnancy depression. With respect to analysing pregnancy complaints according to ITT, no differences between the groups were found. A comparison of the women who attended ≥19 (80%, n=21) or ≥24 (100%, n=14) exercise sessions with the control-participants, showed that fewer women in the exercise group reported nausea/vomiting and numbness/poor circulation in legs.Key conclusion and implication for practiseparticipation in regular group exercise during pregnancy contributed to improvements in some variables related to maternal well-being and quality of life. Women with high exercise adherence had significantly better results on several health variables reaping the highest benefits. A qualitative study exploring the barriers of women in achieving recommended amount of activity may be necessary to understand this population and developing better clinical practice educational tools.