Journal of Family and Reproductive Health
Volume:3 Issue: 1, Mar 2009

Early life events influence life-long patterns of emotionality and stress responsiveness and alter the rate of brain and body aging. Much research attention has focused on the programming effects of the hypothalamus pituitary axis (HPA) in early life and on understanding HPA function in response to stressors in adulthood. In comparison, there has been relatively little research on adolescence, a time of significant brain development particularly in the frontal lobe and a time which is of great importance for mental and physical health. The hippocampus, amygdala, and prefrontal cortex undergo stress-induced structural remodeling, which alters behavioral and physiological responses. During adolescence, HPA function is characterized by a prolonged activation in response to stressors compared to adulthood, which may render ongoing development of the brain vulnerable. Stress reactivity is markedly influenced by both the pubertal maturation and the experience of the individual. The frequency of the pulses is increased in chronic stress, since the neuroendocrine system is such a good candidate for mediators of many diseases linked to chronic stress. The activity of HPA axis in life time of female, sex maturity, pregnancy or lactation is a plasticity of the diurnal rhythm of pulse amplitude; chronic stress can change this program for formation disorder in behavioral and physiological responses.

The lack of adequate recognition of health importance of non-HIV reproductive health infections (RHIs) in Nigeria has led into this study, which was to determine clinical pathogens in non-HIV RHI in Nigeria using a tertiary health facility as case study. A nine-year investigation was carried out between 1997 and 2005 on 4047 (n = 1626 males; n = 2421 females) patients presenting at Special Treatment Clinic (STC) of University College Hospital (UCH) Ibadan, Nigeria. Routine laboratory procedures using appropriate culture media, culture conditions, and current phenotypic taxonomic tools for classification of isolated pathogens were employed. Age (p = 0.019) and gender (p<0.0001) were related to the recovery rates of pathogens Candida species (55.6 %), Neisseria gonorrhoae (11.1%), Gardenella vaginalis (10.3%), Escherichia coli (9.2 %), Klebsiella sp. (4.2%), streptococci (4.0%), Staphylococcus aureus (2.3%), Proteus sp., (1.8%), Haemophilus ducreyi (0.5%), Trichomonas vaginalis (0.44%) and Pseudomonas aeruginosa (0.18%). Candida and Gardenella vaginalis species were mostly recovered from female patients, while N.gonorrhoeae were mostly isolated from male patients. Age brackets for the recovery of pathogens were Neisseria gonorrhoeae (16-30 years); Gardenella vaginalis (21-25 and 31-35 years) and C.albicans (21-30 years). Candida, Neisseria gonorrhoea and Gadrenella vaginalis were the most recovered pathogens from patients presenting at Special Treatment Clinic of a tertiary health institution in Nigeria, and the relationship between age, gender and the aetiological agents was statistically significant.

This study aimed to evaluate the effect of seasonal variability on the assisted reproductive technique (ART) success rate. This study was a descriptive – analytical survey performed on 91 infertile women undergoing intracytoplasmic sperm injection – embryo transfer (ICSI-ET) in different seasons. The patients aged less than 35 years old and had normal LH/FSH ratio. All patients entered long protocol down regulation treatment cycle and the picked up oocytes were transferred to GIII medium in the infertility laboratory. The cumulus characteristics, oocyte parameters including number of the retrieved oocytes, morphological characteristics, fertilization and degeneration rate and number of cleaved embryos were recorded. Data were analyzed by SPSS software. The number of embryos was significantly higher in autumn. Abnormal morphological parameters (color, size, zona thickness) and the degeneration rate were significantly higher in spring. The number of retrieved oocytes, MI, MII oocytes and fertilization rate had no significant seasonal variations. The results of this study showed a significant seasonal variation in morphological parameters of the oocytes, degeneration rate and the number of formed embryos.

To evaluate the effect of emotional adjustment on IUD continuation to understand why persons with similar clinical problems have different interpretation and select different strategies to cope with their complaints. This historical cohort study was carried out on 12 randomly chosen health centers of Isfahan province in 2007. Two hundred forty eight literate and married women aged 15-49 years who had chosen IUD as a contraceptive method since 2002 entered the study. After explaining the aim of study and taking informed consent, women completed the demographic, individual characteristics and 32 questions in emotional domain of Bell’s Adjustment Inventory (adult form). May 2007 was considered the end time of IUD consumption as a defined outcome. Data analysis was performed with the SPSS version 15. T–test, chi–square, Mann–Whitney, General Linear Model, Regression were used for data analysis. During this period 60% (146) of women preserved their IUD and 40% (98) of them removed their IUD. The mean score of emotional adjustment was 16.16±6.28 in IUD preserved women in comparison to 18.23±5.63 in IUD removed women. Poor, moderate and good grades of emotional adjustment were 54%, 40% and 6% in IUD preserved woman vs 72.4%, 24.5% and 3.1% in IUD removed women. Psychological factors such as emotional adjustment can influence IUD survival; so improved counseling and good candidate selection before IUD insertion is recommended.

A twin pregnancy with a coexisting complete hydatidiform mole and a healthy fetus (CMCF) is rare. Here we report three cases of CMCF with different clinical courses but similar outcome without a surviving neonate. Two women required uterine evacuation before 20 weeks of gestational age because of vaginal bleeding and medical complications and the other patient underwent termination of her pregnancy at 24 weeks of gestation due to severe pre-eclampsia. The pathologic diagnosis of complete hydatidiform mole was confirmed in each case and the chromosome complement was 46XX in two molar gestations and 46XY in one gestation. One of the three women required chemotherapy for treatment of low-risk gestational trophoblastic disease. The hCG level was normalized after 4 cycles and the patient was free of disease at 1 year follow-up. Review of the literature discussing the diagnostic tools, clinical features, management and outcome of pregnancies with CMCF are presented.