Insémination artificielle avec spermatozoïdes de donneur (IAD) : quels enjeux pour le couple conjugal et co-parental ?

BackgroundIn France, children conceived by sperm donation concerns about 1000 births a year. Researches show that Artificial Insemination with sperm donor (AID) have no impact on the child's development, but interrogations remain regarding the disclosure to the child of its conception with a donor. The majority of couples reported wanting to talk to their child later, yet only 10% of couples do so, regardless of the current legislation in terms of anonymity. In this research, we focus on the couple's dynamics and co-parenting to observe family alliance and communication. Co-parenting refers to the support that adults provide for one another in the raising of children for whom they share responsibility. A harmonious co-parental alliance would be predictive of a good development of the child, even more than the conjugal alliance.Patients and methodThis research was conducted as a three step procedure with semi-structured interviews and questionnaires. In depth, interviews were conducted with eight couples (16 participants) who conceived with sperm donation. Couples where eligible if it was their first child for both parents. Couples were first met at eight months of pregnancy, a second meeting with their child at three months and another when the child was 18 months. At three months and 18 months, couples participated at an interactive play with their baby, an LTP (Lausanne Triadic Play). The interactive dynamic of the couple with the child and co-parenting were observed.ResultsOur observations show that the co-parental and conjugal dynamics provide information on parents’ difficulties to evoke the donor's subject with the child. We observe an identification to one another between the two members of the couple and a “denial pact” concerning the existence of the donor needed to maintain the cohesion of the conjugal and parental couple. Furthermore, co-parenting showed a “child-at-center” dynamic which reveals the parents’ sensitivity to negative signals expressed by their child.DiscussionThe couples had a tendency to avoid what would weaken their relationship. The child, at-the-center of the couple and the family, tells us about a difficulty for couples to deal with negative emotions such as distress, sadness or anger, observable both between them and with the child. This could also explain parents’ fears and difficulties regarding disclosure. A psychological support could be offered to families who use sperm donation to conceive their child.     

中国2014年新报告男男性行为者中HIV感染者婚姻及配偶感染现状

目的 分析我国2014年新报告MSM中HIV感染者（MSM感染者）婚姻及配偶感染现况及相关因素。方法 收集国家艾滋病综合防治信息系统2014年新报告、经男男性行为途径感染HIV、≥22周岁的MSM感染者基线和随访信息。根据确诊后180 d内配偶首次HIV检测结果，分为“检测发现前发生配偶传播”和“检测发现前未发生配偶传播”两种感染类型。应用logistic回归分析检测发现前发生配偶间传播的相关因素。结果 共有22 337例MSM感染者纳入分析，22.7%（5 081/22 337）为已婚有配偶者，3 715例感染者确证后180 d内其配偶进行首次检测，7.6%（282/3 715）配偶为HIV阳性。多因素logistic回归分析显示，检测发现前发生配偶传播的相关因素包括MSM感染者年龄≥60岁（OR=2.64， 95% CI：1.50～4.65）、少数民族（OR=1.93， 95% CI：1.13～3.29）、CD₄⁺T淋巴细胞（CD₄）≤500个/μl［CD₄<200个/μl： OR=2.91（95% CI： 1.82～4.65）；CD₄为200～349个/μl： OR=1.98（95% CI： 1.22～3.23）；CD₄为350～500个/μl： OR=1.69（95% CI：1.00～2.86）］、自我报告不安全性行为（OR=1.92， 95% CI： 1.44～2.58）。结论 应加强MSM感染者中的已婚有配偶者的行为干预和HIV检测，尽早发现感染者，减少其传播给配偶的机会。     

1600例早孕夫妇红细胞G6PD检测分析

本文采用Ｇ６ＰＤ荧光斑点试验作定性初筛，Ｇ６ＰＤ／６ＰＧＤ比值法作定量确诊。从１９９６ 年９ 月至１９９８ 年６ 月对珠海地区１６００ 例早孕夫妇进行了红细胞Ｇ６ＰＤ检测。查出不同程度缺乏者７６ 人，检出率为４－７５ ％ 。其中夫妇双方均缺乏者１２ 对，占３１－５８％ ，而且珠海籍的人群发生率最高（８－０９％ ），其它广东籍人群次之（７－７６％ ），非广东籍人群最低（２－１８％ ）。结果表明在该市婚前体格和早孕建卡期开展Ｇ６ＰＤ缺乏症的筛查工作是非常重要的。同时加强孕期保健宣教和指导，提高携带者的防患意识，避免受到氧化性物质的损害，对优生优育同样具有重要意义。     

Are partners available for post-abortion contraceptive counseling? A pilot study in a Baltimore City clinic

About half of the 1.2 million abortions each year in the United States are repeat abortions. While most abortion providers counsel women about contraception, one reason for the high repeat rate could be failure to take into account the social context of the women--in particular, the male partner. To assess whether there might be a window of opportunity for a contraceptive intervention that includes the male partner at the time of the abortion, we undertook a pilot study at an urban abortion clinic to examine the role of the male partner among women receiving abortions. Between May 2001 and August 2002, two questionnaires were administered to 109 women receiving abortions in a Baltimore City clinic. On the procedure day, women were more likely to be accompanied by a male partner upon arrival (30%) or when leaving (34%) than by any other individual. The majority of women receiving abortions reported that their partners played positive decision-making and support roles throughout the abortion process. A significant proportion of couples could be available for contraceptive counseling following an abortion, providing rationale for couples' post-abortion contraceptive counseling for women whose partners are already actively and positively involved in the abortion process. Such an intervention may help to reduce repeat abortions.     

Contraceptive practice before and after termination of pregnancy: a prospective study

This study is part of a larger prospective research program focusing on termination of pregnancy (TOP). One hundred and three women requesting TOP were interviewed before the intervention and 6 months later using open and closed questions and psychological tests. This paper focuses on contraceptive practices before and after abortion. The analysis took into account specific aspects of contraceptive practices and patients' behaviors. The aims were to assess: the level of women's knowledge and practice of contraception at the time of request for a TOP; the behavioral modifications following professional counseling 6 months after TOP; the influence of psychological and sexual factors, and those linked to the women's use of contraception. Most women (n = 101) had already used recommended contraception. During the cycle that had resulted in pregnancy, more than half (n = 58) had used recommended contraception and one third had not used any contraception. Six months later, 86 women used recommended contraception, and 17 did not. The majority of women reported changes in their contraceptive methods (n = 82). Most changes were within recommended methods. The women (n = 10) who continued to practice unprotected intercourse post-TOP were slightly older, satisfied with their sexual relations with their partner, often involved in a long-term and good relationship. During post-TOP period, it is essential to take into account the psychological dynamics involved in the choice of contraceptive methods. Counseling should emphasize not only protection against an unwanted pregnancy but also protection against sexually transmitted diseases, which is often perceived as a less important issue following TOP.     

基于网络药理学研究黄连-黄柏药对治疗溃疡性结肠炎的作用机制

目的:运用网络药理学技术研究黄连-黄柏药对治疗溃疡性结肠炎的主要活性成分,预测活性成分的作用靶点、建立"药对-活性成分-疾病-作用靶点"网络,探讨黄连-黄柏药对治疗溃疡性结肠炎的潜在作用机制.方法:运用中药系统药理学数据库与分析平台(TCMSP)筛选黄连-黄柏药对的化学成分,借助人类基因数据库获取溃疡性结肠炎的相关靶点...