Conception

概念
  • 文章类型: Journal Article
    OBJECTIVE: The aim of this study was to collect and analyze information from pregnancies of organ transplanted women and partners of organ transplanted men. The goal was to enhance counseling regarding pregnancy planning and management and to enable more targeted monitoring to improve maternal and child health.
    METHODS: In this retrospective, multicenter cohort study, women and men aged 18 to 45 who had undergone organ transplantation in Germany, Austria, and Switzerland were surveyed about their pregnancies before and after transplantation by using a self-developed questionnaire.
    RESULTS: Even through transplanted women planned their pregnancies more carefully than before transplantation, they still experienced more pregnancy complications afterward. The live birth rate for pregnancies of partners of transplanted men, especially men who received a thoracic organ, was lower compared to before transplantation. Furthermore, this study showed that pregnancies of the partners of male transplant recipients occurred significantly less by spontaneous conception in comparison to pregnancies of transplanted women.
    CONCLUSIONS: Pregnancies after organ transplantation are possible but associated with an increased risk of pregnancy complications. Therefore, early counseling for transplanted women and men who wish to have children, along with extensive monitoring during pregnancy, is necessary.
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  • 文章类型: Journal Article
    这项工作的目的是研究,到目前为止,动物行为特征的非遗传遗传可能取决于受孕时父母的状态,这是尚未探索的可能性。在这项研究中,我们测量了2个月和5个月大的大鼠的运动和探索活动水平。雄性和雌性大鼠在5月龄时交配。采用以下各组:2月龄和5月龄运动活动度高的雄性和雌性大鼠(ACT+);2月龄运动活动度高的雄性和雌性大鼠,但在5个月龄时活动低(ACT-);在2个月和5个月龄时活动低的雄性和雌性大鼠(PAS-);在2个月龄时活动低的雄性和雌性大鼠,但在5个月大(PAS+)时活性高。发现男性和女性ACT+的运动活动明显较高,在最初的10分钟内观察到,在接下来的20-60分钟内,与PAS大鼠相比,在笼子的中心和更多的背部。在ACT和ACT-大鼠的雄性后代之间发现探索活动的严重程度存在显着差异。在雄性和雌性大鼠中观察到PAS和PAS-大鼠的后代之间的差异。从注册开始后20分钟的时间内动物的运动活动在组间没有差异。因此,可以认为一般运动活动的个体特征是由于遗传因素,虽然探索活动水平不同,显然,是由于交配过程中父母的非遗传影响而形成的。
    The aim of this work was to study the, so far, unexplored possibility that non-genetic inheritance of animal behavioral characteristics could depend on the state of the parents at the time of conception. In this study, we measured the levels of motor and exploratory activity in rats at the ages of 2 and 5 months. Male and female rats were mated at the age of 5 months. The following groups were used: male and female rats with high motor activity at ages of 2 and 5 months (ACT+); male and female rats with high activity at the age of 2 months, but low activity at the age of 5 months (ACT-); male and female rats with low activity at the ages of 2 and 5 months (PAS-); male and female rats with low activity at the age of 2 months, but high activity at the age of 5 months (PAS+). It was found that both males and females ACT+ had significantly higher motor activity, which was observed in the first 10minutes, in the next 20-60minutes, in the center of the cage and more rearings as compared with PAS-rats. Significant differences in the severity of exploratory activity were found between the male offspring of ACT+ and ACT- rats. Differences between the offspring of PAS+ and PAS- rats were observed in both the male and female rats. The motor activity of animals in the period from 20minutes after the start of registration did not differ between groups. Thus, it can be considered that individual characteristics of general motor activity are due to genetically inherited factors, while differences in the level of exploratory activity, apparently, are formed due to non-genetic influences from parents during mating.
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  • 文章类型: Journal Article
    目的:研究AMH与妊娠时间的关系。虽然有人假设血清抗苗勒管激素(AMH)水平可能表明受孕的机会,调查结果好坏参半。鉴于任何协会预计都是适度的,以前的研究可能动力不足,我们在迄今为止最大的前瞻性队列中调查了这种关系.
    方法:前瞻性妊娠时间队列研究。
    方法:3,150名试图怀孕不到3个月并购买了现代生育激素测试的美国女性。
    方法:我们在广义加性建模框架内利用二项式互补对数-对数误差结构开发了离散时间-事件模型,调整混杂因素,如年龄,BMI,奇偶校验,吸烟状况,PCOS,和其他人。敏感性分析在月经周期正常(21-35天)的女性中进行,没有报告使用生育治疗的人,使用替代AMH类别(<0.7,0.7-8.5,>8.5ng/mL),和AMH作为一个连续的措施。
    方法:主要结局包括12个周期内的累积受孕概率和每个月经周期的相对受胎率。概念是由自我报告的阳性妊娠试验定义的。
    结果:参与者贡献了7.21±5.32个周期,1,325(42.1%)实现怀孕。低AMH(<1ng/mL,n=427)与AMH正常(1-5.5ng/mL)的女性相比,自然受孕的机会较低(调整后的危险比(adjHR0.77,95CI0.64,0.94,p=0.009)。高(5.5ng/ml)和正常AMH类别之间没有差异(adjHR1.11,95%CI0.94,1.31,p=0.2)。AMH的纳入改善了模型(净重新分类指数0.10[0.06-0.14);P<0.001)。在所有AMH类别中,第4周期的瞬时受孕概率最高:低AMH的自然受孕概率为11.2%(95%CI9.0,14.0),正常AMH的14.3%(95%CI12.3,16.5),高AMH为15.7%(95CI12.9,19.0)。在常规周期敏感性分析(n=1,791)中,与正常AMH相比,低AMH组的受孕机会较低(adjHR0.7795%CI0.61,0.97,p=0.028),在连续模型中也是如此(adjHR0.90;95%CI0.85-0.95,p<0.0001)。
    结论:低AMH水平(<1ng/ml)与受孕机会的适度但显着降低独立相关。
    OBJECTIVE: To study the association between antimüllerian hormone (AMH) levels and time of pregnancy. Although it has been hypothesized that serum AMH levels may indicate the chance of conception, findings have been mixed. Given that any association is expected to be modest, and it is possible that previous studies have been underpowered, we investigated this relationship in the largest prospective cohort to date.
    METHODS: Prospective time-to-pregnancy cohort study.
    METHODS: Community.
    METHODS: A total of 3,150 US women who had been trying to conceive for <3 months and had purchased a Modern Fertility hormone test.
    METHODS: We developed a discrete time-to-event model using a binomial complementary log-log error structure within a generalized additive modeling framework, adjusting for confounding factors such as age, body mass index, parity, smoking status, polycystic ovary syndrome, and others. Sensitivity analyses were performed in women with regular menstrual cycles (21-35 days), who did not report using fertility treatments, using alternate AMH level categories (<0.7, 0.7-8.5, >8.5 ng/mL), and AMH levels as a continuous measure.
    METHODS: Primary outcomes included cumulative conception probability within 12 cycles and relative fecundability per menstrual cycle. Conception was defined by a self-reported positive pregnancy test.
    RESULTS: Participants contributed 7.21 ± 5.32 cycles, with 1,325 (42.1%) achieving a pregnancy. Women with low AMH levels (<1 ng/mL, n = 427) had a lower chance of natural conception (adjusted hazard ratio [adjHR], 0.77; 95% confidence interval [CI], 0.64-0.94) compared with women with normal AMH levels (1-5.5 ng/mL). There was no difference between high (5.5+ ng/mL) and normal AMH level categories (adjHR, 1.11; 95% CI, 0.94-1.31). The inclusion of AMH improved the model (net reclassification index 0.10 [0.06-0.14]). The instantaneous probability of conception was highest in cycle four across all AMH categories: the probability of natural conception was 11.2% (95% CI, 9.0-14.0) for low AMH levels, 14.3% (95% CI, 12.3-16.5) for normal AMH levels, and 15.7% (95% CI, 12.9-19.0) for high AMH levels. In the regular cycles sensitivity analysis (n = 1,791), the low AMH group had a lower chance of conception (adjHR, 0.77; 95% CI, 0.61-0.97) in the low AMH group compared with normal AMH, and similarly in the continuous model (adjHR, 0.90; 95% CI, 0.85-0.95).
    CONCLUSIONS: Low AMH levels (<1 ng/mL) are independently associated with a modest but significant reduction in the chance of conception.
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  • 文章类型: Journal Article
    不育症影响发达国家15%的人口,其患病率正在增加。生育率可能受到不同因素的影响。尽管母亲年龄等关键因素无法改变,越来越多的证据表明,其他可改变的因素,比如饮食,会对生育率产生影响。近年来,饮食变得越来越重要,原因有很多:健康生活方式的新趋势,某些消化系统疾病的患病率较高,缺乏时间导致人们消费更多的准备和加工食品,和个人选择不吃肉,在其他人中。为了满足这些需求,几种饮食最近变得流行,比如地中海饮食,被称为健康的黄金标准;DASH饮食,以预防高血压而闻名;西方饮食,以加工食品为特征;生酮饮食,以碳水化合物摄入量低为特征;素食,这是不吃肉类或动物副产品的人的选择。饮食呈现出独特的组合物,其特征是存在或不存在特定的营养素,这也与男性和女性的生育能力有关。这篇综述评估了这些饮食以及大量和微量营养素对女性和男性生育能力的影响。
    Infertility affects 15% of the population in developed countries, and its prevalence is increasing. Fertility can be influenced by different factors. Although key factors like maternal age cannot be changed, there is growing evidence that other modifiable factors, such as diet, can have an impact on fertility. Diet has become increasingly important in recent years for a number of reasons: the new trend toward a healthy lifestyle, the higher prevalence of certain digestive disorders, a lack of time that leads people to consume more prepared and processed food, and personal choice to not eat meat, among others. To meet these needs, several diets have recently become popular, such as the Mediterranean diet, known as the gold standard of health; the DASH diet, known for preventing hypertension; the Western diet, characterized by processed food; the ketogenic diet, characterized by low carbohydrate intake; and the vegetarian diet, which is the choice for people who do not eat meat or animal by-products. Diets present a unique composition characterized by the presence or absence of specific nutrients, which have also been associated with male and female fertility individually. This review assesses the impact of these diets and of macro- and micronutrients on both female and male fertility.
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  • 文章类型: Journal Article
    这项研究调查了在19世纪城市空间中暴露于环境温度是否会影响出生时男孩与女孩的比例。此外,我们调查了温度对出生时性别比的影响时间的细节。该研究包括66,009例个体分娩,1847-1900年出生后几个月的总和,即33,922名男孩和32,087名女孩。女孩出生概率的统计建模基于具有惩罚样条和自动选择的复杂性的逻辑GAM。我们的研究强调了温度在受孕年份的显着影响:温度越高,观察到女孩出生的可能性较小。怀孕前和怀孕期间也有几个明显的温度滞后。我们的研究结果表明,在过去,环境温度,类似于心理压力,饥饿,营养不良,以及社会和经济因素,影响胎儿的生存能力。研究历史人口中气候对性别比的影响,可以更好地了解环境因素与生殖之间的关系,特别是关于历史人口,因为由于一些文化限制,他们比目前更容易受到更强的环境压力。
    This study examines whether exposure to ambient temperature in nineteenth-century urban space affected the ratio of boys to girls at birth. Furthermore, we investigate the details of temperature effects timing upon sex ratio at birth. The research included 66,009 individual births, aggregated in subsequent months of births for the years 1847-1900, i.e. 33,922 boys and 32,087 girls. The statistical modelling of the probability of a girl being born is based on logistic GAM with penalized splines and automatically selected complexity. Our research emphasizes the significant effect of temperature in the year of conception: the higher the temperature was, the smaller probability of a girl being born was observed. There were also several significant temperature lags before conception and during pregnancy. Our findings indicate that in the past, ambient temperature, similar to psychological stress, hunger, malnutrition, and social and economic factors, influenced the viability of a foetus. Research on the effects of climate on the sex ratio in historical populations may allow for a better understanding of the relationship between environmental factors and reproduction, especially concerning historical populations since due to some cultural limitations, they were more prone to stronger environmental stressors than currently.
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  • 文章类型: Journal Article
    目的:孕前抑郁与妊娠时间(TTP)和不孕症相关吗?
    结论:孕前抑郁夫妇需要更长的时间才能怀孕,并且不孕风险增加。
    背景:女性孕前抑郁会导致临床人群的生育能力受损。然而,来自普通人群的证据——尤其是基于夫妇的证据——相对较少。
    在2019年4月至2021年6月期间,在16个婚检中心进行了一项基于夫妇的前瞻性孕前队列研究。最终分析包括16.521对夫妇,他们在入学时试图怀孕≤6个月。不孕症患者被定义为TTP≥12个月的患者和通过ART受孕的患者。
    方法:在基线时使用患者健康问卷-9评估夫妻抑郁。在入组后6个月和12个月通过电话获得生殖结果。使用Cox比例风险模型和logistic回归分析不同孕前抑郁组的生育优势比(FORs)和不孕风险比(RRs)。分别。
    结果:在分析的16521对夫妇中,10.834(65.6%)和746(4.5%)夫妇在前6个月以及第6个月和第12个月之间实现了怀孕,分别。中位(P25,P75)TTP为3.0(2.0,6.0)个月。不孕率为13.01%。在调整了潜在的混杂因素后,在个体特异性分析中,我们发现,女性的孕前抑郁与生育能力降低的几率显着相关(FOR=0.947,95%CI:0.908-0.988),男性或女性的孕前抑郁与不孕风险增加相关(女性:RR=1.212,95%CI:1.076-1.366;男性:RR=1.214,95%CI:1.068-1.381);在基于夫妇的分析中,我们发现,与双方都没有抑郁的夫妇相比,双方都有抑郁的夫妇的生育能力下降(调整后的FOR=0.904,95%CI:0.838-0.975).在只有女性患有抑郁症且双方都患有抑郁症的组中,不孕风险增加了17.8%(RR=1.178,95%CI:1.026-1.353)和46.9%(RR=1.469,95%CI:1.203-1.793),分别。
    结论:在这项大型流行病学研究中,报告和回忆偏差是不可避免的。一些残留的混杂因素-例如抗抑郁药和其他药物的使用,性习惯,之前的抑郁和焦虑症状仍然没有得到解决。我们用5分来定义抑郁症,低于之前的研究。最后,我们仅在基线时评估抑郁症,因此,我们无法检测到抑郁症的时间变化对生育能力的影响。
    结论:这项基于夫妇的研究表明,个体和夫妇的孕前抑郁对夫妇的生育能力产生负面影响。早期发现和干预抑郁症以提高生育能力应侧重于两性。
    背景:这项工作得到了国家自然科学基金委员会的资助(编号:82273638)和国家重点研究发展计划(No.2018YFC1004201)。所有作者都声明没有利益冲突。
    背景:不适用。
    OBJECTIVE: Is preconception depression associated with time to pregnancy (TTP) and infertility?
    CONCLUSIONS: Couples with preconception depression needed a longer time to become pregnant and exhibited an increased risk of infertility.
    BACKGROUND: Preconception depression in women contributes to impaired fertility in clinical populations. However, evidence from the general population-especially based on couples-is relatively scant.
    UNASSIGNED: A couple-based prospective preconception cohort study was performed in 16 premarital examination centers between April 2019 and June 2021. The final analysis included 16 521 couples who tried to conceive for ≤6 months at enrollment. Patients with infertility were defined as those with a TTP ≥12 months and those who conceived through ART.
    METHODS: Couples\' depression was assessed using the Patient Health Questionnaire-9 at baseline. Reproductive outcomes were obtained via telephone at 6 and 12 months after enrollment. Fertility odds ratios (FORs) and infertility risk ratios (RRs) in different preconception depression groups were analyzed using the Cox proportional-hazard models and logistic regression, respectively.
    RESULTS: Of the 16 521 couples analyzed, 10 834 (65.6%) and 746 (4.5%) couples achieved pregnancy within the first 6 months and between the 6th and 12th months, respectively. The median (P25, P75) TTP was 3.0 (2.0, 6.0) months. The infertility rate was 13.01%. After adjusting for potential confounders, in the individual-specific analyses, we found that preconception depression in women was significantly related to reduced odds of fertility (FOR = 0.947, 95% CI: 0.908-0.988), and preconception depression in either men or women was associated with an increased risk of infertility (women: RR = 1.212, 95% CI: 1.076-1.366; men: RR = 1.214, 95% CI: 1.068-1.381); in the couple-based analyses, we found that-compared to couples where neither partner had depression-the couples where both partners had depression exhibited reduced fertility (adjusted FOR = 0.904, 95% CI: 0.838-0.975). The risk of infertility in the group where only the woman had depression and both partners had depression increased by 17.8% (RR = 1.178, 95% CI: 1.026-1.353) and 46.9% (RR = 1.469, 95% CI: 1.203-1.793), respectively.
    CONCLUSIONS: Reporting and recall bias were unavoidable in this large epidemiological study. Some residual confounding factors-such as the use of anti-depressants and other medications, sexual habits, and prior depressive and anxiety symptoms-remain unaddressed. We used a cut-off score of 5 to define depression, which is lower than prior studies. Finally, we assessed depression only at baseline, therefore we could not detect effects of temporal changes in depression on fertility.
    CONCLUSIONS: This couple-based study indicated that preconception depression in individuals and couples negatively impacts couples\' fertility. Early detection and intervention of depression to improve fertility should focus on both sexes.
    BACKGROUND: This work was supported by grants from the National Natural Science Foundation of China (No. 82273638) and the National Key Research and Development Program of China (No. 2018YFC1004201). All authors declare no conflicts of interest.
    BACKGROUND: N/A.
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  • 文章类型: Journal Article
    发情期水牛尽管周期性延长了服务期和产卵间隔,但并未表现出发情期迹象,从而造成了重大的经济损失。本研究描述了合成前列腺素(PGF2α)对发情行为的影响,卵泡和黄体形态测量,在非繁殖季节,亚发水牛的血清雌二醇(E2)和孕酮(P4)谱。在非繁殖季节,发情期的发生率为38.4%。亚发情水牛(n=33)分为两组,viz.,对照(n=16)和PGF2α处理(Inj.氯前列醇500μg,i.m.,n=17)。治疗中的发情诱导反应明显更大(100vs.18.75%,p<.001),治疗组中受孕的动物比例相对较高(29.41vs.6.25%,p=.08)。治疗组治疗后诱导发情和授精的时间明显低于对照组。卵泡直径的显着增加(9.72±0.45与13.00±0.45mm,P<.0001)和血清雌二醇(E2)浓度(66.01±11.92vs.104.9±13.21pg/mL,p=.003)在PGF2α治疗组中在治疗后阶段观察到。同时,与对照组相比,PGF2α处理的水牛的CL直径以更高的消退率显着降低。在回应的水牛中,只有30%的人表现出高强度发情期,归因于宫颈阴道粘液(CVM)的排出,子宫张力,排尿,和不断增加的预告片公牛的反应。从这项研究中,可以得出结论,在非繁殖季节,PGF2α的施用可以诱导亚发水牛发情。行为改变,随着POF的超声观察,回归CL,血清E2和P4浓度将有助于确定非繁殖季节亚发水牛授精的正确时间。
    Sub-estrus buffaloes do not exhibit estrus signs despite being cyclic contributing to extended service periods and inter-calving intervals causing significant economic loss. The present study described the effect of synthetic prostaglandin (PGF2α) on estrus behaviour, follicular and luteal morphometry, and serum estradiol (E2) and progesterone (P4) profile in sub-estrus buffaloes during the non-breeding season. The incidence of sub-estrus was 38.4% during the non-breeding season. The sub-estrus buffaloes (n = 33) were divided into two groups, viz., Control (n = 16) and PGF2α treatment (Inj. Cloprostenol 500 μg, i.m., n = 17). Estrus induction response was significantly greater in the treatment (100 vs. 18.75%, p < .001), and a relatively greater proportion of animals conceived in the treatment group (29.41 vs. 6.25%, p = .08). The time elapsed to induction of estrus and insemination following treatment was significantly lower in the treatment group than control. A significant increment in the follicle diameter (9.72 ± 0.45 vs. 13.00 ± 0.45 mm, P < .0001) and serum estradiol (E2) concentration (66.01 ± 11.92 vs. 104.9 ± 13.21 pg/mL, p = .003) observed at the post-treatment period in the PGF2α treatment group. At the same time, CL diameter was reduced significantly at a higher regression rate in the PGF2α treated buffaloes than those of control. Of the responded buffaloes, only 30% showed high-intensity estrus attributed to the expulsion of cervico-vaginal mucus (CVM), uterine tonicity, micturition, and mounting response by a teaser bull. From this study, it can be concluded that the administration of PGF2α could induce estrus in the sub-estrus buffaloes during the non-breeding season. Behavioural changes, along with sonographic observation of POF, regressing CL, and serum E2 and P4 concentration would be useful to determine the right time of insemination in sub-estrus buffaloes during non-breeding season.
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  • 文章类型: Journal Article
    亚发情期是水牛不显示行为发情期迹象的一种情况,尽管处于发情期,但会导致受孕延迟,并增加服务期。本研究描述了单独的合成前列腺素(PGF2α)以及与微量矿物质结合对卵泡和黄体(CL)动力学的影响。在繁殖季节,亚发水牛的血清雌二醇(E2)和孕酮(P4)浓度与发情反应和妊娠结局相关。总共有50只亚发情水牛,通过超声检查(USG)确定,被随机分为三组,viz.T1(合成PGF2α,Inj.氯前列醇500μg,i.m,n=17),T2(合成PGF2α+微量矿物质补充剂,Inj.Stimvet1mL/100kg体重,i.m.,n=17)和对照(未处理;n=16)。治疗后,T1和T2组100%的亚发情水牛被诱导发情,而对照组仅诱导了18.75%。治疗后CL直径和血清P4浓度明显降低,而T1和T2组的排卵前卵泡(POF)大小和血清E2浓度明显高于对照组(p<0.05)。T2组的水牛的中等强度发情比例高于T1组。此外,T1和T2受孕的水牛比例分别为41.2%和52.95%,分别。较大的POF直径和较高的血清E2浓度与发情期水牛的强烈强度和较高的受胎率(66.7%)有关。同样,CL回归率,与未设想的水牛相比,设想的水牛的POF大小和血清E2浓度相对较高。结论是,合成的PGF2α与微量矿物质结合会在更大比例的亚发水牛中诱导中度至强烈的发情强度,并在繁殖季节提高受胎率。此外,与卵泡和黄体形态相关的行为发情属性,血清E2和P4浓度可用于优化繁殖时间,以提高亚发水牛的受胎率。
    Sub-estrus is a condition when buffaloes do not display behavioural estrus signs, despite being in estrus and causes a delay in conception and increases the service period. The present study describes the effect of synthetic prostaglandin (PGF2α) alone and in combination with trace minerals on the follicular and corpus luteum (CL) dynamics, serum estradiol (E2) and progesterone (P4) concentration correlating estrus response and pregnancy outcome in sub-estrus buffaloes during the breeding season. A total of 50 sub-estrus buffaloes, identified through ultrasonography (USG) examination, were randomly allocated into three groups, viz. T1 (Synthetic PGF2α, Inj. Cloprostenol 500 μg, i.m, n = 17), T2 (Synthetic PGF2α + Trace mineral supplementation, Inj. Stimvet 1 mL/100 kg body weight, i.m., n = 17) and control (untreated; n = 16). Following treatment, 100% of sub-estrus buffaloes were induced estrus in the T1 and T2 groups, while only 18.75% were induced in the control. The CL diameter and serum P4 concentration were significantly lower at post-treatment, whereas the pre-ovulatory follicle (POF) size and serum E2 concentration were significantly higher in the T1 and T2 groups as compared to the control (p < .05). The buffaloes of the T2 group had a greater proportion of moderate intensities estrus than those of T1. Moreover, the proportion of buffaloes conceived in the T1 and T2 were 41.2% and 52.95%, respectively. The larger POF diameter and higher serum E2 concentration were associated with intense intensity estrus and higher conception rate (66.7%) in sub-estrus buffaloes. Similarly, CL regression rate, POF size and serum E2 concentration were relatively higher in the buffaloes conceived as compared to those not conceived. It is concluded that synthetic PGF2α in combination with trace minerals induces moderate to intense intensities estrus in a greater proportion of sub-estrus buffaloes and increases the conception rate during the breeding season. Moreover, behavioural estrus attributes correlating follicle and luteal morphometry, serum E2 and P4 concentration could be used to optimise the breeding time for augmenting the conception rate in sub-estrus buffaloes.
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  • 文章类型: Journal Article
    子宫内膜异位症,影响到全球大约10%的育龄妇女,带来重大挑战,包括慢性盆腔疼痛,痛经,和不孕症。在印度这样的中低收入国家,获得负担得起的不孕症治疗仍然是一个问题。这项多中心前瞻性队列研究,从2017年到2022年,在印度的六家三级医院进行了研究,旨在探索子宫内膜异位症妇女的自然妊娠进展和妊娠结局。在257名参与者中,19.1%在研究期间受孕,揭示了显著的地理和基于收入的差异(p<0.001,p=0.01)。痛经(p<0.001)和性交困难(p=0.027)与受孕有关,而与慢性盆腔疼痛或月经因素没有发现这种关联。病变类型,number,严重程度与受孕没有决定性的联系。70%的病例发生自然受孕,术后受孕时间平均为282.1天。活产率为85.7%,而并发症包括前置胎盘(16.4%),先兆子痫(4.1%),和早产(4.1%)。这项研究,印度第一个关于子宫内膜异位症相关生育进展的研究之一,强调需要全面了解和管理受孕和妊娠结局。考虑到印度大量的子宫内膜异位症负担,该研究建议优先考虑更大的多中心调查,以更好地理解和有效的不孕症管理策略.
    Endometriosis, affecting approximately 10% of reproductive-aged women globally, poses significant challenges, including chronic pelvic pain, dysmenorrhea, and infertility. In low- and middle-income countries like India, accessibility to affordable infertility care remains a concern. This multicenter prospective cohort study, conducted across six tertiary care hospitals in India from 2017 to 2022, aims to explore the natural progression of conception and pregnancy outcomes in women with endometriosis. Of the 257 participants, 19.1% conceived during the study, revealing significant geographic and income-based variations (p < 0.001, p = 0.01). Dysmenorrhea (p < 0.001) and dyspareunia (p=0.027) were correlated with conception, while no such associations were found with chronic pelvic pain or menstrual factors. Lesion type, number, and severity showed no conclusive link with conception. Natural conception occurred in 70% of cases, with an average post-surgery conception time of 282.1 days. Live birth rate was 85.7%, while complications included placenta previa (16.4%), preeclampsia (4.1%), and preterm births (4.1%). This study, one of the first in India on endometriosis-related fertility progression, emphasizes the need for comprehensive understanding and management of conception and pregnancy outcomes. Considering India\'s substantial endometriosis burden, the study recommends prioritizing larger multicenter investigations for a better understanding and effective strategies for infertility management.
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  • 文章类型: Journal Article
    背景:以前对怀孕时间识别的调查分析了来自国家调查和诊所的数据,但这还没有在数字生育应用的背景下进行调查。及时的怀孕识别可以帮助个人进行健康和怀孕管理,降低孕产妇和胎儿的风险和成本,在增加治疗选择的同时,可用性,和成本。方法:该数据集包含23,728例怀孕(在2018年6月至2022年12月期间怀孕),来自20,429名参与者,他们使用美国食品药品监督管理局(FDA)清除了生育应用程序。大多数参与者(具有非缺失信息)被确定为非西班牙裔白人,三分之一的人报告获得了大学学位。我们用了双尾韦尔奇t检验,Mann-WhitneyU-test,和两尾Z测试,以比较使用应用程序怀孕或避孕的人之间的怀孕识别时间。结果:使用应用程序怀孕的参与者平均在末次月经期(LMP)后31.3天确认怀孕,而使用应用程序预防怀孕的参与者为35.9天。结论:概括性有限,因为所有参与者都在使用生育应用程序,并且具有相对同质的社会人口统计学特征。
    早期意识到怀孕的人可能会受益,因为早期认识可以降低成本和风险,并提供更多治疗选择。在过去,研究人员研究了个人在国家调查中或在诊所就诊时认识到自己怀孕所需的时间。然而,随着数字生育追踪应用程序的出现,我们调查了使用这样的应用程序识别怀孕所需的时间。我们分析了2018年6月至2022年12月期间来自20,429名自然周期应用程序用户的23,728例怀孕数据。我们发现,使用该应用程序尝试怀孕的参与者比使用该应用程序预防怀孕的参与者平均提前4.6天。
    Background: Previous investigations of time-to-pregnancy recognition have analysed data from national surveys and clinics, but this has not been investigated in the context of digital fertility applications. Timely pregnancy recognition can help individuals in health and pregnancy management, reducing maternal and foetal risk and costs, whilst increasing treatment options, availability, and cost. Methods: This dataset contained 23,728 pregnancies (conceived between June 2018 and December 2022) from 20,429 participants using a Food and Drug Administration (FDA) cleared fertility app in the United States. Most participants (with non-missing information) identified as Non-Hispanic White, and one-third reported obtaining a university degree. We used two-tailed Welch\'s t-test, Mann-Whitney U-test, and two-tailed Z-tests to compare time to pregnancy recognition between those using the app to conceive or contracept. Results: Participants using an app to conceive recognised pregnancy on average at 31.3 days from last menstrual period (LMP) compared to 35.9 days among those using the app to prevent pregnancy. Conclusion: Generalisability is limited, as all participants were using a fertility app and had relatively homogenous sociodemographic characteristics.
    People who recognise pregnancy early may benefit, as earlier recognition can reduce costs and risks, and make more treatment options available. In the past, researchers have studied the time it takes for an individual to recognise that they are pregnant by asking them in national surveys or when they attend a clinic. However, with the advent of digital fertility tracking apps, we investigated the time it takes to recognise pregnancy when using such an app. We analysed data from 23,728 pregnancies from 20,429 users of the Natural Cycles app between June 2018 and December 2022. We found that participants using the app to try to get pregnant recognised pregnancy an average of 4.6 days earlier than those using the app to prevent pregnancy.
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