reproductive health

The coronavirus was the causative agent of a global epidemic from 2019 to 2022. The viral effect on sexualhealth and hormonal profile plus the rate of healthy births are important issues in general health. In this review,we studied the effect of coronavirus on reproductive health using more than 70 articles to understand the inter-action of the virus with the reproductive system.High temperatures due to fever elevated ACE2 expression in both testis germ and somatic cells. Furthermore,they exhibit significantly elevated luteinizing hormone (LH) levels, but decreased testosterone, LH, and follicle-stimulating hormone (FSH)/LH ratios, which may indicate the possibility of hypogonadism and/or infertility. Incontrast, women diagnosed with SARS-CoV infections during the first trimester of pregnancy are at a higher riskof spontaneous miscarriages, while infections occurring during pregnancy are more likely to result in pretermdelivery.The Coronavirus can theoretically and potentially affect men’s fertility and sexual development, and possiblycause miscarriage in the first trimester of pregnancy with an unknown mechanism. The findings cannot affirmwhether the hormonal alterations are due to a direct/indirect effect of the virus. Therefore, more studies areneeded to answer related questions.

Context:

 Menstrual health is a critical component of sexual and reproductive health, which is deeply intertwined with human rights, gender equality, and sustainable development. Despite its importance, menstrual health management remains a significant challenge, particularly in low- and middle-income countries (LMICs), due to systemic barriers, cultural stigmas, and resource limitations. This paper aims to highlight the barriers to effective menstrual health management in LMICs, and their impact on health, educational and social, and economic outcomes.

Evidence Acquisition:

 A narrative review of the literature was conducted with a search across major academic databases, including PubMed, Scopus, Web of Science, and Google Scholar for peer-reviewed articles and reports. Grey literature was also reviewed using repositories such as WHO, UNICEF, and other global health organizations. Key information, including barriers, and reported outcomes was extracted and synthesized using a thematic approach.

Key barriers to menstrual health include poor hygiene infrastructure, lack of access to menstrual products, economic constraints, cultural taboos, and inadequate policies. These barriers led to adverse outcomes such as reproductive tract infections, poor academic performance, gender-based violence, and stigma. Overall, inadequate menstrual health management exacerbates inequalities and undermines the well-being of girls and women in LMICs.

Addressing menstrual health through informed policies and laws is essential to ensuring the dignity, health, and rights of girls and women in LMICs. Comprehensive education and access to menstrual products must be prioritized to mitigate the adverse outcomes associated with poor menstrual health.

Context: 

Pre-marriage education courses are held in a wide variety of subjects including reproductive health in Iran. The results of educational needs assessments can greatly contribute to the enhancement of the courses. Critically, comparing the results of these studies is essential for identifying patterns, regional trends, and best practices in pre-marriage education.

Evidence Acquisition: 

This narrative review analyses the results of needs assessment studies on pre-marriage education published between 2007 and 2023 by searching the databases of Sid, PubMed, Google Scholar and Irandoc. At first, using keywords "reproductive health, premarital education, Iran and needs assessment", 63 primary articles were extracted. Following the application of predefined inclusion and exclusion criteria, 12 studies met the eligibility requirements and were included in this review.

The findings revealed that the educational requirements of most participants, regardless of gender, exceeded the average. In most of the studies, the educational needs of women were greater than those of men. The primary educational needs in reproductive health encompass marital and sexual health, prevention of common cancers in women, prevention of unwanted and high-risk pregnancies, congenital diseases, premarital tests, sexually transmitted diseases, and menstrual health. For other issues, key areas of focus were mental health, the qualifications of educators, the use of appropriate educational technology, and ensuring sufficient educational content.

The review highlights the key areas for improvement in premarital education programs across Iran. The study emphasizes the importance of tailoring premarital education to address the specific needs of different populations.

Tamoxifen induces testicular atrophy and azoospermia. Conversely, platelet-rich plasma (PRP) is a distinctive analog yield enriched with cytokines and growth factors for improving tissue regeneration. Thus, this present study explored the roles model of PRP on production of sperm via apoptosis of tamoxifen-induced toxicity. Animals at 48 days' post- normal saline treatment and intra-testicular injection of normal saline (0.2 ml, left testis) as a single dose per week for two weeks. Infertility was induced by the oral administration of tamoxifen [0.6 mg/kg b.wt/day], and was then allocated into three groups: tamoxifen: oral administration of tamoxifen for 14 consecutive days, and intra-testicular injection normal saline; PRP: intra-testicular of 10 μl PRP, single dose; and tamoxifen + PRP. Tamoxifen-injured rats showed significantly lower body weight, food intake, testicular weight and volume, LH and testosterone concentrations, production of sperm indices, and sperm motility considering the vehicle group. Tamoxifen-induced seminiferous tubular atrophy and testicular damages. Meanwhile, tamoxifen upregulated markers of apoptotic marker genes. In sum, the PRP supplement is potentially an impressive method for modifying production of sperm dysfunction via tamoxifen damages.

WHO estimated that approximately 15% of the world’s population lives with some form of disability. There are important gaps in knowledge about the Sexual and reproductive rights of this population. This study aimed to review the sexual and reproductive rights of disabled women.

Electronic searching of Medline, PubMed, Scopus, Cochrane, Embase, Web of Science, SID, and Google Scholar was performed up to Nov 2024, using Sexual rights, reproductive rights, reproductive health, Sexual health, disability, Handicap, and disabled persons as keywords. Inclusion criteria consist of both English and Persian-published reports in the field of disabled women’s reproductive and Sexual rights. In the long run, 38 documents met the inclusion criteria.

The CRPD Committee mandates state parties to protect persons with disabilities from violence, exploitation, and abuse and, ensure the right of people with disabilities to the highest attainable standard of health without discrimination, including in the area of sexual and reproductive health.

Findings from the study speak to the need to protect and realize the SRH rights of persons with disabilities.

Environmental epidemiologic studies have identified many associations between human exposure to chemicals during pregnancy and maternal and child health outcomes. This study is a systematic review in which the impact of environmental hazards including kinetics and mechanisms of toxicity and ways of exposure to heavy metals on fetal health and fertility has been reviewed. Search in scientific sites and search engines including SID, Magiran, ScienceDirect, Google Scholar, PubMed, Springer and, Scopus have been done using the desired keywords along with the review of sources that have provided the impact of environmental factors on fetal health and fertility. Finding of this review study point to several evidences that prenatal maternal exposure to heavy metals is related to fetal epigenomic changes, direct effects on reproductive potential, retards of fetal growth and, other risks during pregnancy. Accordingly, to achieve preventative processes including assessment, diagnosis and, planning for health promotion during pregnancy, developing national preventive guidelines to reduce exposure to heavy metals during pregnancy is inevitable.

Context: 

COVID-19 epidemic is a significant global concern. One of the most important aspects of health is sexual and reproductive health. COVID-19 would threaten sexual and reproductive health by risking the ability of service systems for providing relative health needs. A wide range of services and aspects of sexual and reproductive health has been affected by the global epidemic of COVID-19. The present study was conducted to determine the relation between COVID-19 epidemic and sexual and reproductive health of men and women to evaluate all the aspects of sexual and reproductive health and provide the best approach.

Evidence Acquisition: 

To conduct the present narrative review study, databases including PubMed, Scopus, SID, MagIran, Embase, Web of Science, Medline, and Science Direct and also the scientific search engine of Google Scholar were searched using the keywords of COVID-19, reproductive health, sexual health, and fertility from November 2022 to January 2023. The articles were published from 2019 to 2022. The search for articles was conducted by two researchers, and the articles were extracted. No limitation was considered for the entry of the articles in the study based on their design. The inclusion criterion was the evaluation of the effect of COVID-19 on different sexual and reproductive aspects of men and women, and the exclusion criterion was the lack of access to the article’s full text.

Evaluation of 42 articles showed that COVID-19 had a significant effect on reproductive (family planning services, prenatal and post-partum care, safe abortion, unwanted pregnancy, sexually transmitted infections, domestic violence, intention for pregnancy and having children, and maternal and fetal complications) and sexual (sexual and reproductive glands, sexual function, and sexual quality of life) health.

COVID-19 could affect different aspects of reproductive and sexual health in men and women. Therefore, it is recommended that, considering the occurred changes, effective policies and Plans would be implemented to provide quality services.

The impact of artificial light exposure on human health has garnered significant attention in recent years. In particular, its effects on reproductive health have raised concerns. Given that the onset of menarche serves as a crucial indicator of reproductive maturity, understanding the implications of artificial light exposure becomes paramount. Age of menarche onset occurs relatively earlier in urban females than females raised in rural areas. Besides the decline in age of menarche onset, exposure to artificial light may contribute to impairment in reproductive hormones, particularly gonadotropins, by disrupting rhythms of reproductive hormones, modulating stress hormones and kisspeptin productions, and causing body weight changes. This drastic environmentally induced change may increase the proportion of teenage pregnancies, unfulfilled childhood dreams, depression, and ill-prepared marriages, thus creating a potential need for public health intervention. Due to limited studies and often lack of longitudinal data, a significant knowledge gap exists in unraveling the potential mechanism involved in alteration of these physiologic processes. The purpose of the current review was to elucidate the intricate interplay between environmental factors, cultural practices, and biological processes within indigenous communities. By meticulously examining the multifaceted influences of artificial light, including its prevalence and varying intensity based on geographical locations and light pollution levels, this study aimed to provide scholarly insights in-to the pathophysiologic mechanisms underlying the observed changes. The findings of this inquiry will also inform evidence-based strategies and interventions aimed at safeguarding the reproductive well-being of indigenous populations amidst the escalating challenges posed by artificial light exposure.

 In Ghana, several qualitative studies have explored users’ perspectives on conventional sources of sexual and reproductive health (SRH) information and factors which influence provision of and access in rural settings. However, there is a dearth of qualitative studies on healthcare provider (HCP) perspectives on factors that deter access to conventional sources of SRH information among young people in rural Ghana and innovative ways for addressing barriers. This study explored perspectives on barriers to traditional sources of SRH information and services and innovative ways of using mHealth technologies for addressing provision and access challenges among young people in rural Ghana.

 This study used a qualitative approach using in-depth interviews. Semi-structured in-depth interviews were conducted with HCPs in rural areas in three regions of Ghana between May and August 2021. Participants were selected from rural communities using the convenience snowball sampling and were interviewed via Zoom. The interviews explored the experiences and perceptions of HCPs on conventional SRH information and services and young people’s access to this information and services. The interviews were audio recorded and transcribed verbatim. Data were analysed thematically using NVivo software version 12, following the approach outlined by Braun and Clarke.

 Twenty HCPs were interviewed for this study. The participants identified different sources of SRH information and services used by rural young people. Peers or friends, health facilities, health providers, and community settings were reported as the main services and sources of SRH information. Participants reported several barriers and challenges to the provision of and access to SRH information to young people, including socio-cultural norms, religious beliefs, unfriendly health facility environments, negative health providers’ attitudes, lack of privacy and confidentiality resulting in unfriendly youth SRH services, distance, and financial challenges due to costs of transportation which limits rural young people’s access to, and use of, SRH services. All the participants indicated that in addressing provision and access barriers, the use of mobile phones could be beneficial.

 This study highlights several barriers and challenges that deter provision of, and access to, SRH information and services for young people in rural Ghana. The findings indicate the use of innovative mobile health (mHealth) technologies may be one solution to some of the barriers and challenges.

Comprehensive studies on the determinants of modern contraceptive use in humanitarian settings are relatively uncommon in Bangladesh. The aim of this study was to examine the prevalence and determinants of modern contraceptive use among Rohingya women living in the refugee camp of Cox's Bazar, Bangladesh.

A cross-sectional survey was conducted among 160 Rohingya refugee women aged 15-49 living in   unregistered camps (Camps 7 and 14) in Ukhiya Upazila, Cox's Bazar. In the study, participants were selected using a convenience sampling method, and the sample size was calculated using the single population proportion formula. However, only 160 participants were recruited due to travel restrictions and safety measures implemented throughout Bangladesh during the COVID-19 pandemic. The data were gathered via a structured questionnaire. Results were summarized using both descriptive and inferential statistics and SPSS v.23 software was used for data analysis at 5% level of significance.

The prevalence of contraceptive use was found to be 41.9%. The most commonly used contraceptives were Injection Depot-Provera (65.7%) and Oral Contraceptive Pill (OCP) (28.4%) followed by implant (4.5%) and intrauterine device (IUD) (1.5%). Multivariate logistic regression revealed lower odds of modern contraceptive use among women who had more than a 1.5 year interval between the last two pregnancies (OR = 0.19; 95% CI = 0.07– 0.51) and higher odds were found who expressed a lack of desire for future pregnancies (OR = 13.69; 95% CI = 3.43–54.68). Community Health Workers (CHWs) (80.4%) were the main sources of information on modern contraceptives, whereas hospitals (83.6%) were the most accessible places to obtain contraceptives.

Community health workers play a vital role in disseminating information, emphasizing the need for their training and involvement in relevant programs. These findings are crucial for shaping future research, policies, and reproductive health services in humanitarian settings.

Reproductive health, crucial for public health and sustainable development, encompasses family planning and contraceptive use. However, global disparities persist in the adoption of family planning, highlighting the need for a comprehensive understanding of the complex factors shaping these reproductive health choices.

Following Preferred Reporting Items for Systematic Review and Meta‑Analyses guidelines, we conducted a systematic search of the Scopus, ScienceDirect, PubMed, Web of Science, and ProQuest databases from July to August 2023. Inclusive criteria covered various study designs and populations, ranging from individuals to communities, and encompassed sociocultural factors. The review included open access articles published between 2018 and 2023, utilizing a combination of the keywords: Family planning determinants, Contraceptive use factors, Sociocultural factors in family planning, Individual‑level influences on family planning, and Factors affecting contraceptive choices.

Data from 25 selected studies underscore the critical influence of determinants at both individual and community levels in shaping family planning behaviors. Key drivers at the individual level included education, age, knowledge, and attitudes. At the community level, factors such as geographical disparities and healthcare accessibility played pivotal roles. Sociocultural determinants, including media exposure, gender norms, and spousal dynamics, highlighted the need for culturally sensitive strategies.

Advancing equitable family planning requires education, improved access, peer influence, and the active participation of husbands and male partners. Comprehensive programs should bridge the gap between knowledge and action, reduce disparities, and ensure equal access to contraception. Context‑specific research and evaluating interventions are crucial steps toward achieving global reproductive health objectives.

Sexual  and Reproductive  Health  Education  (SRHE) helps  adolescents  avoid  risky  sexual  behaviors  such  as  unintended  pregnancies and sexually  transmitted  infections.  However, it is frequently said that school-based SRHE is insufficient and uneven.  This study aimed to investigate the   perceptions of teachers, students, and healthcare workers regarding the current delivery of school-based sexual and reproductive health education and the challenge it faces in Ethiopia.

The study was conducted using conventional content analysis of qualitative approach in Arsi Zone, Ethiopia.  Overall, 36 participants were involved in the study.  Among  these,  24  were  students  took part in  focus  group  discussions  and  12  key  informants  who participated in  in-depth-interview.  The data were collected using pretested and semi-structured interview guides.  All the interviews were recorded and transcribed exactly as spoken. Guba and Lincoln (1985) criteria were used to achieve trustworthiness.  The data were analyzed simultaneously with data collection using ATLAS.ti 8 software.

The main themes emerged included: 1) Current school-based Sexual and Relationships Health Education consisted  of   sub-themes of  curriculum  contents,  teaching  approach  and  students’  knowledge  of  SRHE., 2) Implementation obstacles of SRHE including  subthemes such as  teachers’  confidence,  lack  of  resources/reading  materials, cultural and religious barrier sand  discomfort  with  sexual  health  terminology and 3) Suggestion to improve  SRHE  comprising subthemes of health promotion policies, creation supportive environments and avoiding obstacles.

The  status  of  school  based  SRHE  is  insufficient  due  to  various  factors.  Policymakers and program  managers  are  advised  to  incorporate  comprehensive  SRHE  within  the  normal  school  curriculum  and  work  on  capacity  building  of  teachers  through  training.

Reproductive health services have remained a top priority in humanitarianemergencies. As more people are displaced, and their mobility areas become more diverse,emergency response efforts must ensure access to standard RH care services. This systematicreview aimed to evaluate and interpret the research on reproductive health in disastersconducted in 2022.

From January 2010 to December 2022, a systematic search was conducted in thePubMed, Cochran Library, Scopus, and EMBASE databases, as well as Science Direct, Web ofScience, and ProQuest databases. The author chose the articles based on keywords. Inclusionand exclusion criteria were also considered for the selection of articles, and the quality ofthe articles was checked with the relevant checklists. Finally, the articles were mined forinformation on Reproductive health (RH) in disasters.

213 articles were extracted after searching the databases. 7 articles were completelyin line with the study objective after their titles, abstracts, and texts were evaluated. A crosssectionalarticle, a combined article, two qualitative articles, an experimental article, and acase report were among the chosen articles. These 6 studies uncovered a diverse range of RHissues. Most women’s problems in disasters are caused by lack of awareness and knowledge,lack of support and protection equipment, lack of support from organizations in charge, andignorance of cultural factors.

The most vulnerable individuals in society are women and girls. Women’s livingconditions are worsened, and they experience mental, psychological, and physical stress dueto emergencies and disasters. Therefore, the issue of RH among women should be givenspecial consideration by health policymakers. Creating RH programs for women affected bydisasters is essential to disaster management. Therefore, to lessen their suffering and issuesduring disasters, countries should develop thorough guidelines and programs to improve theRH of women and girls of childbearing age.

The magnitude of postpartum depression in Jordan during the COVID‑19 pandemic is under‑documented, and little is known about its potential social, demographic, and clinical correlates. This study aimed to explore the prevalence and related factors of postpartum depression among Jordanian mothers with a history of COVID‑19 during pregnancy or after childbirth.

This cross‑sectional descriptive study was carried out in March‑June 2021 among a convenient sample of 109 women with a history of COVID‑19 during pregnancy or after childbirth, who were at a leading hospital equipped to care for COVID‑19 cases in North Jordan. An online survey using the Edinburgh Postnatal Depression Scale (EPDS) was used to collect information from mothers with a history of COVID‑19‑positive tests.

Among the total number of women who participated in the study (n = 109), 73 women had postpartum depression. The prevalence of postpartum depression in the present study was 67%. In addition, the study found a positive statistically significant correlation between EPDS scores and being a smoker, delivery method, experiencing severe COVID‑19 symptoms, and being hospitalized.

During the COVID‑19 pandemic, women had a high level of postpartum depression. It would be necessary to follow further the confirmed cases of COVID‑19, and mothers should be screened for depressive symptoms during pregnancy and followed up for antenatal and postnatal care.

 The concept of menstrual rights is usually discussed as a marginalized topic; in addition, the realization of women’s menstrual rights faces ambiguous structures and challenges. This study, therefore, aimed to systematically review the concept and the most important structural dimensions of the menstrual rights of menstruators in order to evaluate the suggestions on different dimensions of menstrual rights and to raise the awareness of health service providers in this regard.

 In this study, all papers and documents addressing this subject and accessible in international databases (i.e., PubMed, Google Scholar, Scopus, and Web of Science) and Iranian ones (i.e., IranMedex and Magiran) were reviewed from September to November 2021. Then 28 papers and documents were selected for final review and analysis.

 The concept of menstrual rights concerned with the ability of women and girls to manage menstrual issues and enjoy a healthy and sanitary period of menstruation. The structure of menstrual rights consisted of menstrual rights in subcultures and religions, components of menstrual rights (e.g., social rights, health rights, educational rights) and menstrual rights in special cases (e.g., natural disasters, disabilities, transgender, etc).

 According to our findings, decisive evidence was found about different dimensions of menstruation rights, which may have provided useful background information for the authorities involved in national and reproductive health, private sectors, charities, and activist groups in this field. These authorities, in turn, may have used the obtained evidence to perform civil acts focused on women and girls’ menstruation and reproductive health.

Preparing to deal with natural disasters, is important for the health of the society, and a valid clinical guideline which fits the country's conditions can lead to a reduction in complications caused by the aforementioned disasters. Therefore, the present study was conducted to develop and validate the clinical guidelines for reproductive health in natural disasters.

This mixed methods study was carried out in three phases. The first phase was a structured review of literature which systematically reviewed the articles and clinical guidelines related to the reproductive health in disasters. In the second phase, a qualitative study was conducted with the content analysis approach in order to identify the needs related to women's reproductive health in disasters, and a draft clinical guide was prepared. In the third phase, the validation of the prepared draft was carried out by a group of experts using the (RAND) Research and Development technique.

The themes obtained included the consequences of facing a disaster and the need to provide comprehensive services. The clinical guideline  consists of 5 chapters including an introduction on the importance of reproductive health in natural disasters, general clinical guidelines, prevention of physical and mental injuries in a crisis, access to reliable sources of information and the availability of the health services provider team. 

Correct management of crisis, empowering information skills and access to service providers in crises are of particular importance. Therefore, support of health care providers and training of service providers to learn about evidence-based performance in crises and their use is a necessary step to implement the clinical guidelines prepared in the country.

 The potential impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on male fertility is a complex and evolving area of research. Although there is some evidence to suggest that the virus might have negative effects on semen from mild to moderate symptoms or recovery of coronavirus disease 2019 (COVID-19) and might induce epididymal-orchitis, further research is needed to definitively determine the risks.

 This study aimed to investigate the presence of SARS-CoV-2 ribonucleic acid (RNA) in semen and to determine any possible implications of SARS-CoV-2 infection on semen parameters and genital tract complications.

 Thirty-two subjects with a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) cycle threshold (Ct) value of less than 20 were recruited, and semen samples were collected. Additionally, testicular discomfort and urogenital abnormality were assessed.

 No SARS-CoV-2 RNA was detected in the seminal sample of men; however, semen quality impairment was detected, especially in patients with Ct values less than 15 in the upper respiratory tract. Total sperm count, the number of motile spermatozoa, progressive motility, and the percentage of normal morphology were significantly reduced. Acute epididymo-orchitis and testicular tenderness were observed in 4 patients in the acute stage of the disease.

 This study showed no evidence of SARS-CoV-2 RNA in semen, suggesting that sexual transmission of the virus is unlikely. However, semen quality impairment was observed in patients with SARS-CoV-2 infection, particularly those with higher viral loads. Further research is needed to elucidate the mechanisms by which SARS-CoV-2 affects male fertility and develop effective interventions to protect men's reproductive health during the pandemic.