reproductive medicine

生殖医学
  • 文章类型: Journal Article
    背景:体外受精导致的妊娠与发生妊娠期高血压疾病的风险增加有关,如先兆子痫,与自然怀孕相比。
    目的:在被确定为先兆子痫高风险的自然妊娠中,阿司匹林预防降低先兆子痫发生率的功效已得到证实。然而,阿司匹林对所有体外受精妊娠的先兆子痫发生率的降低效果仍不确定,尽管体外受精是子痫前期的一个众所周知的危险因素。因此,本研究的目的是全面概述目前有关使用小剂量阿司匹林预防体外受精后妊娠高血压疾病的文献.
    方法:本综述将确定所有同行评审发表的文章,包括在体外受精后接受胚胎移植的孕妇,并服用低剂量阿司匹林以降低妊娠期高血压疾病的风险。
    方法:我们设计了一种全面的搜索策略,以系统地识别2000年1月至2024年5月在Medline(PubMed界面)内发表的相关研究,Embase和Scopus数据库。搜索策略是基于关键词\'阿司匹林,\'\'妊娠高血压,\'和(\'体外受精\'或\'卵母细胞捐赠\'或\'胚胎移植\'或\'供体受孕\')。两名审阅者将独立筛选标题,摘要和全文文章选择相关文章,使用Covidence软件。
    背景:本研究没有患者参与。这项研究旨在发表在同行评审的期刊上,并可以在会议上发表。
    BACKGROUND: Pregnancies resulting from in vitro fertilisation are associated with an increased risk of developing hypertensive disorders of pregnancy, such as preeclampsia, when compared with naturally conceived pregnancies.
    OBJECTIVE: The efficacy of aspirin prophylaxis to reduce the incidence of preeclampsia is well established in naturally conceived pregnancies identified as high risk for developing preeclampsia. However, the efficacy of aspirin to reduce the rate of preeclampsia for all pregnancies resulting from in vitro fertilisation remains uncertain, although in vitro fertilisation conception is a well-known risk factor for preeclampsia. Therefore, the purpose of this scoping review is to provide a comprehensive overview of the current literature regarding the use of low-dose aspirin to prevent hypertensive disorders of pregnancy after in vitro fertilisation.
    METHODS: This review will identify all peer-reviewed published articles including pregnant women who underwent embryo transfer after in vitro fertilisation and were prescribed low-dose aspirin to reduce the risk of hypertensive disorders of pregnancy.
    METHODS: We have devised a comprehensive search strategy to systematically identify pertinent studies published from January 2000 until May 2024, within the Medline (PubMed interface), Embase and Scopus databases. The search strategy is based on the keywords \'aspirin,\' \'pregnancy-induced hypertension,\' and (\'in vitro fertilization\' OR \'oocyte donation\' OR \'embryo transfer\' OR \'donor conception\'). Two reviewers will independently screen the titles, abstracts and full-text articles to select the relevant articles, using the Covidence software.
    BACKGROUND: No patients are involved in this study. This study aims to be published in a peer-reviewed journal and could be presented at a conference.
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  • 文章类型: Journal Article
    目的:我们旨在探索和了解东南亚生育率下降的证据的程度和类型及其与计划生育(FP)的关系。
    方法:范围审查,遵循Arksey和O\'Malley制定的方法学原则,以及系统评价和Meta分析扩展报告指南的首选报告项目。
    方法:我们搜索了PubMed/MEDLINE,ProQuest,EBSCO,Scopus,WebofScience,2012年1月1日至2022年12月31日期间的Google学者和相关文章的参考列表。只考虑了英文的开放获取文章。
    方法:要包含在内,根据调查东南亚(SEA)国家15~49岁女性对FP的摄取及其与生育率下降的关系的原始文章,选择了符合资格的观察性研究.
    方法:两名评审员独立筛选记录的合格性并提取所有数据。研究的具体细节,包括作者的数据,出版年份,设置,研究设计,研究的目的/目标,具体干预,结果和主要发现,被报道。
    结果:我们检索了615篇文章,并保留了12篇纳入分析的文章。其中,11项为定量研究,1项为定性研究。经常报道的FP策略是使用避孕。FP不仅允许妇女通过间隔和限制怀孕来控制生育,而且还通过使用避孕方法来推迟第一次分娩。
    结论:我们的审查表明,旨在降低生育率的计划生育计划应特别侧重于改善计划生育服务的吸收和延续。
    OBJECTIVE: We aimed to explore and understand the extent and type of evidence on fertility reduction and its association with family planning (FP) in Southeast Asia.
    METHODS: Scoping review, following the methodological principles developed by Arksey and O\'Malley and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines for reporting.
    METHODS: We searched PubMed/MEDLINE, ProQuest, EBSCO, Scopus, Web of Science, Google Scholar and reference lists of relevant articles between 1 January 2012 and 31 December 2022. Only open-access articles in English were considered.
    METHODS: For inclusion, observational studies were selected for eligibility based on the original articles investigating the uptake of FP on women aged 15-49 years and its association with fertility decline in Southeast Asian (SEA) countries.
    METHODS: Two reviewers screened the records independently for eligibility and extracted all data. The specific details of the studies, including data on the authors, year of publication, setting, study design, aims/objectives of the study, specific intervention, outcomes and main findings, were reported.
    RESULTS: We retrieved 615 articles and retained 12 articles included in the analysis. Of these, 11 were quantitative studies and 1 was qualitative study. The frequently reported strategy of FP was the use of contraception. FP not only allows women to control their birth by spacing and limiting their pregnancies but also delay their first childbirth by using contraceptive methods.
    CONCLUSIONS: Our review suggests that the FP programmes aiming at reducing fertility should have a specific focus on improving the uptake and continuation of FP services.
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  • 文章类型: Journal Article
    目的:本研究旨在调查发病率,解决非洲人青少年怀孕参与(TPI)的相关因素和干预措施,加勒比和黑人(ACB)青少年在北美。
    方法:我们对文献进行了范围审查,以社会生态模式为指导。
    方法:从OvidMedline,OvidEmbase,CINAHL,CABDirect和谷歌学者,并导入COVIDENCE进行筛选。
    方法:JoannaBriggsInstitute范围审查方案指导了资格标准的建立。包括侧重于费率的研究,北美10-19岁的ACB男孩和女孩与TPI相关的相关因素和干预措施。出版时间限制在2010-2023年,包括不同背景的同行评审和非同行评审研究。
    方法:使用主要作者开发的表格从32篇文章中提取数据,关注与研究问题一致的变量。
    结果:范围审查显示,加拿大和其他北美文献中关于ACB青少年TPI的知识匮乏。尽管青少年怀孕率总体下降,差距仍然存在,干预措施,如产后处方长效节育和青少年指导计划被证明是有效的。
    结论:研究结果强调了提高意识的必要性,男性参与青少年怀孕的研究和认识。解决住房方面的差距,employment,healthcare,针对边缘化人群的性健康教育和卫生系统政策对于减轻ACB青少年的TPI至关重要。
    结论:评论强调了迫切需要其他北美国家提供更多知识,特别是那些不断增长的ACB移民人口。
    OBJECTIVE: This study aims to investigate the incidence, associated factors and interventions to address teen pregnancy involvement (TPI) among African, Caribbean and Black (ACB) adolescents in North America.
    METHODS: We conducted a scoping review of the literature, guided by the social-ecological model.
    METHODS: Studies were retrieved from databases such as Ovid Medline, Ovid Embase, CINAHL, CAB Direct and Google Scholar and imported into COVIDENCE for screening.
    METHODS: The Joanna Briggs Institute scoping reviews protocol guided the establishment of eligibility criteria. Included studies focused on rates, associated factors and interventions related to TPI among ACB boys and girls aged 10-19 in North America. The publication time frame was restricted to 2010-2023, encompassing both peer-reviewed and non-peer-reviewed studies with diverse settings.
    METHODS: Data were extracted from 32 articles using a form developed by the principal author, focusing on variables aligned with the research question.
    RESULTS: The scoping review revealed a dearth of knowledge in Canadian and other North American literature on TPI in ACB adolescents. Despite an overall decline in teen pregnancy rates, disparities persist, with interventions such as postpartum prescription of long-acting birth control and teen mentorship programmes proving effective.
    CONCLUSIONS: The findings highlight the need for increased awareness, research and recognition of male involvement in adolescent pregnancies. Addressing gaps in housing, employment, healthcare, sexual health education and health systems policies for marginalised populations is crucial to mitigating TPI among ACB adolescents.
    CONCLUSIONS: The review underscores the urgent need for more knowledge from other North American countries, particularly those with growing ACB migrant populations.
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  • 文章类型: Journal Article
    背景:孕前护理是提供行为,受孕前对妇女和夫妇的社会或生物医学干预。迄今为止,孕前研究主要集中在孕产妇健康上,尽管男性伴侣在出生前对短期和长期子女结局都有贡献。审查的目标是:(1)确定,巩固和分析有关父亲孕前健康对妊娠和产时结局的文献,(2)识别,巩固和分析有关父亲孕前健康对产后和幼儿结局的文献。
    方法:将按照JoannaBriggs研究所的方法进行范围审查。MEDLINE,PsycINFO,Embase,Scopus和CINAHL数据库将搜索以英文发表的文章。两名独立的审稿人将使用Covidence筛选标题和摘要,然后筛选全文,冲突由第三位审阅者解决。将使用Covidence进行数据提取。
    背景:本范围审查不需要伦理批准。结果将在同行评审的期刊上发表,并在相关的国家和国际会议上发表。
    BACKGROUND: Preconception care is the provision of behavioural, social or biomedical interventions to women and couples prior to conception. To date, preconception research has primarily focused on maternal health, despite the male partner\'s contribution before birth to both short-term and long-term child outcomes. The objectives of the reviews are: (1) to identify, consolidate and analyse the literature on paternal preconception health on pregnancy and intrapartum outcomes, and (2) to identify, consolidate and analyse the literature on paternal preconception health on postpartum and early childhood outcomes.
    METHODS: A scoping review will be conducted following the Joanna Briggs Institute methodology. MEDLINE, PsycINFO, Embase, Scopus and CINAHL databases will be searched for articles published in English. Two independent reviewers will screen titles and abstracts and then full text using Covidence, with conflicts resolved by a third reviewer. Data extraction will be performed using Covidence.
    BACKGROUND: Ethics approval is not required for this scoping review. Results will be published in peer-reviewed journals as well as presented at relevant national and international conferences and meetings.
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  • 文章类型: Journal Article
    目的:关于孕前保健与利用计划生育和以往不良分娩结局的相关性的不一致的发现,在埃塞俄比亚尚未得到系统评价。因此,本综述旨在评估埃塞俄比亚孕前保健与计划生育利用和既往不良分娩结局的综合关联.
    方法:观察性研究的系统评价和荟萃分析。
    方法:MEDLINEComplete,CINAHL完成,Scopus和全球健康从成立到2023年7月28日进行了搜索。
    方法:纳入观察性研究,将孕前保健作为结果变量,并将怀孕前使用计划生育或先前的不良分娩结果作为暴露变量。
    方法:两名评审员独立进行研究筛选,数据提取和质量评估。使用固定效应模型来确定孕前护理与计划生育的利用和先前不良分娩结果的综合关联。
    结果:共有3829名参与者的8项研究被纳入综述。汇总荟萃分析发现,有计划生育史的女性使用孕前保健的可能性比那些在当前怀孕前未使用计划生育的女性更高(OR2.09,95%CI1.74至2.52)。同样,汇总荟萃分析发现,既往有不良分娩结局的女性使用孕前护理的几率高于既往无不良分娩结局史的女性(OR3.38,95%CI1.06~10.74).
    结论:本综述表明,孕前保健的使用与先前使用计划生育和先前不良分娩结局有正相关。因此,政策制定者和其他相关利益攸关方应加强孕前护理与计划生育和其他孕产妇保健服务的整合。
    CRD42023443855。
    OBJECTIVE: Inconsistent findings on the associations of preconception care with the utilisation of family planning and previous adverse birth outcomes have not been systematically reviewed in Ethiopia. Thus, this review aims to estimate the pooled association of preconception care with the utilisation of family planning and previous adverse birth outcomes in Ethiopia.
    METHODS: Systematic review and meta-analysis of observational studies.
    METHODS: MEDLINE Complete, CINAHL Complete, Scopus and Global Health were searched from inception to 28 July 2023.
    METHODS: Observational studies that reported preconception care as an outcome variable and the use of family planning before pregnancy or previous adverse birth outcomes as exposure variables were included.
    METHODS: Two reviewers independently conducted study screening, data extraction and quality assessment. A fixed-effects model was used to determine the pooled association of preconception care with the utilisation of family planning and previous adverse birth outcomes.
    RESULTS: Eight studies involving a total of 3829 participants were included in the review. The pooled meta-analysis found that women with a history of family planning use had a higher likelihood of using preconception care (OR 2.09, 95% CI 1.74 to 2.52) than those women who did not use family planning before their current pregnancy. Likewise, the pooled meta-analysis found that women with prior adverse birth outcomes had a higher chance of using preconception care (OR 3.38, 95% CI 1.06 to 10.74) than women with no history of prior adverse birth outcomes.
    CONCLUSIONS: This review indicated that utilisation of preconception care had a positive association with previous use of family planning and prior adverse birth outcomes. Thus, policymakers and other relevant stakeholders should strengthen the integration of preconception care with family planning and other maternal healthcare services.
    UNASSIGNED: CRD42023443855.
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  • 文章类型: Journal Article
    生殖医学的最新进展指导了解决男性不育的新策略。特别是在非梗阻性无精子症(NOA)的情况下。两个突出的侵入性干预措施,即睾丸精子提取(TESE)和显微切割TESE(micro-TESE),已成为检索辅助生殖技术(ART)配子的关键技术。NOA的异质性和复杂性对临床医生构成了多方面的挑战,因为这些程序的侵入性及其不可预测的成功强调了需要更精确的指导。精浆可以恰当地视为男性生殖道的液体活检,包括睾丸分泌物,附睾,精囊,尿道球腺,还有前列腺.这种液体含有多种无细胞核酸,微泡,蛋白质,和代谢产物与性腺活动密切相关。然而,尽管有大量的研究从精液中探索潜在的生物标志物,将其广泛纳入临床实践仍然有限。这可能部分是由于NOA固有的各种临床和遗传因素的复杂相互作用,这可能导致缺乏残留精子发生的确定性生物标志物。可以想象,临床数据与生物标志物的整合可以增加预测手术结果及其在NOA病例中的选择的潜力。这篇全面的综述解决了通过非侵入性生物标志物在NOA中回收精子的挑战。此外,我们深入研究有希望的观点,阐明以多组学方法为基础的创新方法,包括基因组学,转录组学和蛋白质组学。这些尖端技术,结合患者的临床和遗传学特征,可以改善生物标志物在个性化医疗方法中的使用,病人咨询,和决策连续体。最后,人工智能(AI)在结合生物标志物和临床数据的领域具有巨大潜力,也在确定非侵入性生物标志物的背景下用于精子提取。
    Recent advancements in reproductive medicine have guided novel strategies for addressing male infertility, particularly in cases of non-obstructive azoospermia (NOA). Two prominent invasive interventions, namely testicular sperm extraction (TESE) and microdissection TESE (micro-TESE), have emerged as key techniques to retrieve gametes for assisted reproduction technologies (ART). Both heterogeneity and complexity of NOA pose a multifaceted challenge to clinicians, as the invasiveness of these procedures and their unpredictable success underscore the need for more precise guidance. Seminal plasma can be aptly regarded as a liquid biopsy of the male reproductive tract, encompassing secretions from the testes, epididymides, seminal vesicles, bulbourethral glands, and prostate. This fluid harbors a variety of cell-free nucleic acids, microvesicles, proteins, and metabolites intricately linked to gonadal activity. However, despite numerous investigations exploring potential biomarkers from seminal fluid, their widespread inclusion into the clinical practice remains limited. This could be partially due to the complex interplay of diverse clinical and genetic factors inherent to NOA that likely contributes to the absence of definitive biomarkers for residual spermatogenesis. It is conceivable that the integration of clinical data with biomarkers could increase the potential in predicting surgical procedure outcomes and their choice in NOA cases. This comprehensive review addresses the challenge of sperm retrieval in NOA through non-invasive biomarkers. Moreover, we delve into promising perspectives, elucidating innovative approaches grounded in multi-omics methodologies, including genomics, transcriptomics and proteomics. These cutting-edge techniques, combined with the clinical and genetics features of patients, could improve the use of biomarkers in personalized medical approaches, patient counseling, and the decision-making continuum. Finally, Artificial intelligence (AI) holds significant potential in the realm of combining biomarkers and clinical data, also in the context of identifying non-invasive biomarkers for sperm retrieval.
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  • 文章类型: Journal Article
    背景:子宫内膜异位症是全世界育龄妇女普遍的妇科疾病。虽然子宫内膜异位症主要涉及生殖系统,它还可以渗透到其他内脏,如胃肠道。结直肠子宫内膜异位症患者可能有严重的症状,需要手术干预。基于肠切除术与剃刮或椎间盘切除术治疗结直肠子宫内膜异位症的功能结果,指导切除技术的选择的数据有限。该方案旨在概述将在文献的系统回顾中使用的方法,比较手术治疗结直肠子宫内膜异位症时肠切除术与剃须和椎间盘切除术的功能结果。
    方法:论文将通过数据库搜索进行识别,扫描相关研究的参考列表和关键论文的引文搜索。两名独立审稿人将根据资格标准筛选研究,并使用标准化表格提取数据。包括MEDLINE在内的数据库,EMBASE和Cochrane将从每个数据库的开头进行搜索,直到2024年2月。主要结果是比较不同手术治疗方法之间的功能性肠结果。次要结果将是生活质量,基于低位前切除综合征评分和术后疼痛发生率。如果数据是同质的,将进行荟萃分析。
    背景:本研究不需要伦理批准。本协议中描述的系统审查的结果将通过相关会议上的介绍和同行评审期刊上的出版物进行传播。这些方法将用于为今后的审查提供信息。
    CRD42023461711。
    BACKGROUND: Endometriosis is a prevalent gynaecological condition for women of reproductive age worldwide. While endometriosis primarily involves the reproductive system, it can also infiltrate additional viscera such as the gastrointestinal tract. Patients with colorectal endometriosis can have severe symptoms that require surgical intervention. There are limited data available to guide the choice of resection technique based on the functional outcomes of bowel resection versus shaving or disc excision in treating colorectal endometriosis. This protocol aims to outline the methods that will be used in a systematic review of the literature comparing the functional outcomes of bowel resection to shaving and disc excision when surgically treating colorectal endometriosis.
    METHODS: Papers will be identified through database searches, scanning reference lists of relevant studies and citation searching of key papers. Two independent reviewers will screen studies against eligibility criteria and extract data using standardised forms. Databases including MEDLINE, EMBASE and Cochrane will be searched from the beginning of each database until February 2024. The primary outcome is comparing the functional bowel outcomes between the different methods of surgical treatment. Secondary outcome will be quality of life, based on the Low Anterior Resection Syndrome score and the incidence of postoperative pain. A meta-analysis will be performed if the data are homogenous.
    BACKGROUND: This study does not require ethics approval. The results of the systematic review described within this protocol will be disseminated through presentations at relevant conferences and publication in a peer-reviewed journal. The methods will be used to inform future reviews.
    UNASSIGNED: CRD42023461711.
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  • 文章类型: Journal Article
    背景:越来越多的妇女在世界各国的武装部队中服役。怀孕期间经历的压力与不良分娩结局相关,包括早产(PTD)和低出生体重(LBW)。军事就业和生活方式的一些特征会增加对现役军人(ADSW)的压力,因此可能会增加新生儿不良结局的风险。本文综述了PTD的患病率,早产(PTL),武装部队中ADSW出生的婴儿的LBW和死产。
    方法:本系统评价遵循系统评价和Meta分析方案的首选报告项目。Medline,EMBASE,WebofScience,从成立到2021年7月(2023年11月,EMBASE),使用主题标题和关键字搜索有关ADSW在任何军事部门和任何国家/地区出生的婴儿的英语期刊文章,对全球健康和CINAHLPlus数据库进行了搜索。JoannaBriggs研究所的患病率关键评估工具评估了论文中的偏倚风险。研究与比较的非现役人群配对,以产生患病率比率作为效果度量。进行了叙事综合。
    结果:21项观察性研究符合资格标准。它们都是在美国军方进行的,共有650628名参与者,并在1979年至2023年之间出版。他们的结果表明,与非服务女性相比,ADSW的LBW增加。没有足够的证据来得出结论或排除ADSW是否增加了PTD或PTL的发生率。
    结论:ADSW可能会增加LBW婴儿的风险。然而,如果试图将调查结果推广到美国以外,则需要谨慎行事。这篇评论强调了在其他武装部队中对针对女性的研究的日益增长的需求,具体来说,生殖健康。这种研究对于以保护母亲及其婴儿的方式为军事孕产途径和政策提供信息是必要的,同时加强军事准备。
    BACKGROUND: Increasing numbers of women serve in the armed forces in countries worldwide. Stress experienced during pregnancy is associated with adverse birth outcomes including preterm delivery (PTD) and low birth weight (LBW). Several characteristics of military employment and lifestyle can increase stress acting on active-duty servicewomen (ADSW) and hence may increase the risk of adverse neonatal outcomes. This paper reviews the prevalence of PTD, preterm labour (PTL), LBW and stillbirth in babies born to ADSW in the armed forces.
    METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Medline, EMBASE, Web of Science, Global Health and CINAHL Plus databases were searched from inception to July 2021 (November 2023, EMBASE) using subject heading and keyword searches for English language journal articles on babies born to ADSW in any military branch and any country. The Joanna Briggs Institute prevalence critical appraisal tool assessed risk of bias in included papers. Studies were paired with a comparator non-active-duty population to generate a prevalence ratio as the effect measure. A narrative synthesis was conducted.
    RESULTS: 21 observational studies fulfilled the eligibility criteria. They were all conducted in the US military, involved a total of 650 628 participants, and were published between 1979 and 2023. Their results indicate increased LBW in ADSW compared with non-service women. There was insufficient evidence to conclude or rule out whether ADSW have increased rates of PTD or PTL.
    CONCLUSIONS: ADSW may be at increased risk of having an LBW baby. However, caution is needed if seeking to generalise the findings beyond the US context. This review highlights a growing need for female-specific research in other armed forces and, specifically, into reproductive health. Such research is necessary to inform military maternity pathways and policies in ways that safeguard mothers and their babies while enhancing military readiness.
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  • 文章类型: Journal Article
    不育症是一种常见的临床疾病,大约一半的主要原因是男性相关的不育症。这种异常的发病机制通常不确定;因此建立适当的治疗方案相对不确定。近年来,大量证据表明,间充质干细胞(MSCs)可为男性不育的创新和有效治疗提供希望。本研究回顾了MSCs在人类和动物男性不育中精子发生恢复中的可能应用,为未来的临床实践提供了新的途径。从2000年1月1日至2023年8月1日在“PubMed”和“GoogleScholar”上发表的文章,通过搜索“间充质干细胞”项目进行了调查,“细胞疗法”,“细胞移植”,and,“再生医学”关键词,除了“泌尿外科”,\"男科\",“生殖医学”,“男性不育”,“无精子症”,和“精子发生”。MSCs移植治疗男性不育症的结果似乎令人鼓舞,它们揭示了这些细胞恢复精子发生的安全性和有效性;尽管在招募MSCs治疗男性不育症的临床应用之前,仍需要进一步的干细胞研究。进行更明确的定义,标准化,和可重复的方案,并在更长的随访期内纳入更大的样本量,可以有利于MSC移植在恢复精子发生和治疗男性不育中的相关性。似乎开发和利用干细胞移植,外泌体,脚手架输送系统,和三维(3D)培养方法可能为从细胞疗法治疗男性不孕症中获得更多益处打开一个新窗口。
    Infertility is a common clinical condition and about half of the major causes are due to male-related infertility. Pathogenesis of this abnormality is generally undefined; so establishing a proper treatment option is relatively uncertain. In recent years, several evidences demonstrated that mesenchymal stem cells (MSCs) can be a hope for innovative and efficient treatment of male infertility. This study reviews possible applications of MSCs in the restoration of spermatogenesis in male infertility of both humans and animals to suggest new avenues for future clinical practices. Articles published in \"PubMed\" and \"Google Scholar\" from January 1, 2000, to August 1, 2023, were investigated by searching items of \"mesenchymal stem cells\", \"cell therapy\", \"cell transplantation\", and, \"regenerative medicine\" keywords, in addition to the \"urology\", \"andrology\", \"reproductive medicine\", \"male infertility\", \"azoospermia\", and \"spermatogenesis\". The results obtained from the transplantation of MSCs in the treatment of male infertility seemed encouraging and they revealed the safety and efficacy of these cells to recover spermatogenesis; eventhough further stem cell research is still required before recruiting clinical application of MSCs in the treatment of human male infertility. Undertaking more well-defined, standardized, and reproducible protocols and enrolling larger sample sizes during a longer follow-up period can benefit the relevance of MSC transplantation in the restoration of spermatogenesis and treatment of male infertility. It seems that developing and utilizing stem cell transplantations, exosomes, scaffold delivery systems, and three dimensional (3D) culture methods may open a new window to getting more benefits from cell therapy in the treatment of men infertility.
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  • 文章类型: Systematic Review
    背景:增加助产劳动力已被确定为减少全球孕产妇死亡率和生殖健康差异的循证方法。同时,助产专业,和所有医疗保健行业一样,随着远程医疗使用以扩大访问的加速,在实践中发生了重大转变。我们进行了系统的文献综述,以确定和综合有关助产士经历的现有证据,感知并接受与远程医疗的距离提供性和生殖保健服务。
    方法:搜索了五个数据库,PubMed,CINHAL,PsychInfo,Embase和WebofScience,使用与“助产士”相关的搜索词,\'远程健康\'和\'经验\'。同行评议的研究与定量,检索并筛选以英文发表的定性或混合方法设计。符合纳入标准的研究将进行全文数据提取和质量评估。使用收敛方法,研究结果被综合为主要主题和次主题。
    结果:应用纳入/排除标准后,回顾了10篇关于助产士远程医疗经验的文章。出现的主要主题被总结为将远程医疗整合到临床实践中;平衡增加的连通性;通过远程医疗建立关系的挑战;集中一些患者,同时远离其他患者;以及按年龄和专业经验进行远程医疗的经验。
    结论:目前的大多数研究表明,助产士的远程医疗经验与助产士对COVID-19大流行的总体反应经验密切相关。需要更多的研究来了解助产士如何持续使用远程医疗或远程医疗和现场护理的新混合模式。
    BACKGROUND: Increasing the midwifery workforce has been identified as an evidence-based approach to decrease maternal mortality and reproductive health disparities worldwide. Concurrently, the profession of midwifery, as with all healthcare professions, has undergone a significant shift in practice with acceleration of telehealth use to expand access. We conducted a systematic literature review to identify and synthesize the existing evidence regarding how midwives experience, perceive and accept providing sexual and reproductive healthcare services at a distance with telehealth.
    METHODS: Five databases were searched, PubMed, CINHAL, PsychInfo, Embase and the Web of Science, using search terms related to \'midwives\', \'telehealth\' and \'experience\'. Peer-reviewed studies with quantitative, qualitative or mixed methods designs published in English were retrieved and screened. Studies meeting the inclusion criteria were subjected to full-text data extraction and appraisal of quality. Using a convergent approach, the findings were synthesized into major themes and subthemes.
    RESULTS: After applying the inclusion/exclusion criteria, 10 articles on midwives\' experience of telehealth were reviewed. The major themes that emerged were summarized as integrating telehealth into clinical practice; balancing increased connectivity; challenges with building relationships via telehealth; centring some patients while distancing others; and experiences of telehealth by age and professional experience.
    CONCLUSIONS: Most current studies suggest that midwives\' experience of telehealth is deeply intertwined with midwives\' experience of the response to COVID-19 pandemic in general. More research is needed to understand how sustained use of telehealth or newer hybrid models of telehealth and in-person care are perceived by midwives.
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