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Reproductive Biology and Endocrinology... Jan 2022The utilization of oocyte cryopreservation (OC) has become popularized with increasing numbers of reproductive-aged patients desiring to maintain fertility for future... (Review)
Review
BACKGROUND
The utilization of oocyte cryopreservation (OC) has become popularized with increasing numbers of reproductive-aged patients desiring to maintain fertility for future family building. OC was initially used for fertility preservation in postmenarchal patients prior to gonadotoxic therapies; however, it is now available to patients to circumvent age-related infertility and other diagnoses associated with early loss of ovarian reserve. The primary aim of this paper is to provide a narrative review of the most recent and robust data on the utilization and outcomes of OC in both patient populations. OC results in similar oocyte yield in patients facing gonadotoxic therapies and patients undergoing planned OC. Available data are insufficient to predict the live birth rates or the number of oocytes needed to result in live birth. However, oocyte yield and live birth rates are best among patients < 37.5 years old or with anti-mullerian hormone levels > 1.995 ng/dL, at the time of oocyte retrieval. There is a high 'no use' rate (58.9%) in patients using planned OC with 62.5% returning to use frozen oocytes with a spouse. The utilization rate in medical OC patients is < 10%. There is currently no data on the effects of BMI, smoking, or ethnicity on planned OC outcomes.
CONCLUSION
It is too early to draw any final conclusions on outcomes of OC in medical OC and planned OC; however, preliminary data supports that utilization of OC in both groups result in preservation of fertility and subsequent live births in patients who return to use their cryopreserved eggs. Higher oocyte yield, with fewer ovarian stimulation cycles, and higher live birth rates are seen in patients who seek OC at younger ages, reinforcing the importance of age on fertility preservation. More studies are needed in medical OC and planned OC to help guide counseling and decision-making in patients seeking these services.
Topics: Adolescent; Adult; Cryopreservation; Family Planning Services; Female; Fertility Preservation; Humans; Oocyte Retrieval; Oocytes; Ovarian Reserve; Pregnancy; Treatment Outcome; Young Adult
PubMed: 34996479
DOI: 10.1186/s12958-021-00884-0 -
Reproductive Health Feb 2016
Topics: Congresses as Topic; Contraception Behavior; Family Planning Policy; Family Planning Services; Female; Global Health; Health Services Accessibility; Humans; Male; Patient Education as Topic; Quality of Health Care; Reproductive Health
PubMed: 26851946
DOI: 10.1186/s12978-016-0116-1 -
The Indian Journal of Medical Research Dec 2018Given the magnitude of the family planning programme in India, there is a need to strengthen the coordination of all its aspects, focusing on planning, programmes,... (Review)
Review
Given the magnitude of the family planning programme in India, there is a need to strengthen the coordination of all its aspects, focusing on planning, programmes, monitoring, training and procurement. The quality of care in family planning must be a major focus area to ensure the success of family planning programmes. Despite serious efforts and progress, India has yet to achieve its family planning goals. Furthermore, there is a need for greater male participation both as enablers and beneficiaries and also address the sexual and reproductive needs of the youth. It is imperative for the government to ensure the prioritization of family planning in the national development agenda. Family planning is crucial for the achievement of the sustainable development goals, and subsequent efforts need to be made to improve access and strengthen quality of family planning services.
Topics: Contraception; Developing Countries; Family Planning Services; Female; Health Services Accessibility; Health Services Needs and Demand; Humans; India; Male
PubMed: 30964076
DOI: 10.4103/ijmr.IJMR_2067_17 -
Women's Health Issues : Official... 2017To determine whether Bedsider text message and e-mail reminders increase family planning contraceptive continuation and appointment rates.
OBJECTIVE
To determine whether Bedsider text message and e-mail reminders increase family planning contraceptive continuation and appointment rates.
MATERIAL AND METHODS
We trained staff at three high-volume Family Planning, Access, Care, and Treatment (Family PACT) clinics to enroll women through a special portal to receive text message or e-mail reminders for contraceptive refills and clinic appointments. Women were matched by contraceptive method, time frame of index visit, age group, and language preference to Family PACT clients at comparison sites that did not use the Bedsider program. Family PACT claims data was used to assess the contraceptive coverage of Bedsider and comparison women over 12 months. We assessed differences in contraceptive coverage between the two groups using McNemar's test of matched comparisons. Clinic records from one clinic were available to assess impact on kept appointment rates.
RESULTS
Of the 488 women enrolled, 370 had a claim for a hormonal method (oral contraceptive, patch, ring, contraceptive injection) in the Family PACT database. Matching resulted in 365 matched pairs. The median length of enrollment in the reminder system was 115 days (16 weeks). A greater percentage of Bedsider women returned on time for contraceptive injections than women in the comparison group. However, McNemar's test showed no differences in contraceptive coverage between the intervention and comparison groups. Kept appointment rates showed a statistically significant increase after the intervention at the clinic providing data.
CONCLUSION
Contraceptive injection users showed a positive impact from receiving reminders, but overall there was no impact of the Bedsider reminders on return on time for contraceptive refills and injections. We were able to measure a significant increase in kept appointment rates at one clinic using the Bedsider text message and e-mail reminder system.
Topics: Adult; Ambulatory Care Facilities; Appointments and Schedules; Contraception; Contraceptive Agents; Electronic Mail; Family Planning Services; Female; Humans; Patient Compliance; Reminder Systems; Text Messaging
PubMed: 28284586
DOI: 10.1016/j.whi.2017.02.001 -
A review of family planning policies and services in WHO Eastern Mediterranean Region Member States.Eastern Mediterranean Health Journal =... Mar 2019Family planning (FP) is a cost-effective public health and development intervention. Eastern Mediterranean Region (EMR), has one of the lowest contraceptive prevalence... (Review)
Review
BACKGROUND
Family planning (FP) is a cost-effective public health and development intervention. Eastern Mediterranean Region (EMR), has one of the lowest contraceptive prevalence rate (CPR) and high unmet need for family planning.
AIMS
The aim of this review is to assist Member States in highlighting those areas that need strengthening to improve quality of FP services in information and commodity supplies.
METHODS
A structured questionnaire focusing on FP services was sent to 22 Member States of the WHO Eastern Mediterranean Region between August and December, 2015. Sixteen (73%) countries responded.
RESULTS
Family planning services are part of the basic health benefits package and are delivered at hospitals, primary healthcare centres and outreach clinics to all women regardless of their ability to pay in the majority of Member States. In 16 Member States the family planning/birth spacing (FP/BS) counselling and FP methods are provided by general practitioner/ family doctor, nurses and midwives. In many Member States the services are integrated with child health, STI and HIV services. In 16 Member States FP/BS is part of the pre- and in-service training programmes for all cadres of healthcare providers. FP/BS is actively promoted through effective social marketing of FP/BS methods in two thirds of Member States.
CONCLUSIONS
The findings of the survey indicate that national policies and programmes endorse FP to achieve national targets. Despite progress in many areas in FP services, many countries still struggle with weak implementation of FP programmes. There are also policy gaps for key vulnerable groups including the poor, the disabled and adolescents. This review highlighted policy and programmatic gaps required to strengthen those FP services that can help improve maternal and infant health outcomes. Special programmes for adolescents, refugees and persons with disabilities need to be streamlined and strengthened.
Topics: Family Planning Policy; Family Planning Services; Humans; Mediterranean Region; Middle East; World Health Organization
PubMed: 30942477
DOI: 10.26719/emhj.18.023 -
Philosophical Transactions of the Royal... Oct 2009This paper provides a personal perspective on the rich discussions at the Bixby Forum. The size, rate of growth and age structure of the human population interact with...
This paper provides a personal perspective on the rich discussions at the Bixby Forum. The size, rate of growth and age structure of the human population interact with many other key factors, from environmental change to governance. While the details of future interactions are sometimes difficult to predict, taken together they pose sombre threats to a socially and economically sustainable future for the rich and to any realistic possibility of lifting the world's bottom two billion people out of poverty. Adaptive changes will be needed to cope with an ageing population in countries with low fertility or below, but these are achievable. More worrying, continued rapid population growth in many of the least developed countries could lead to hunger, a failure of education to keep pace with growing numbers, and conflict. The assumption that the demographic transition from high to low birth rates occurs as a result of exogenous social and economic forces is being replaced by a clearer understanding of the many barriers that separate women from the knowledge and technologies they need to manage their childbearing within a human rights framework. The forum ended with a clear consensus that much more emphasis needs to be given to meeting the need for family planning and to investing in education.
Topics: Environment; Family Planning Services; Female; Fossil Fuels; Global Warming; Humans; Population Dynamics; Public Policy
PubMed: 19770160
DOI: 10.1098/rstb.2009.0181 -
Global Health, Science and Practice Mar 2020The Standard Days Method (SDM), a modern fertility awareness-based family planning method, has been introduced in 30 countries since its development in 2001. It is still... (Review)
Review
The Standard Days Method (SDM), a modern fertility awareness-based family planning method, has been introduced in 30 countries since its development in 2001. It is still unclear to what extent the SDM was mainstreamed within the family planning method mix, particularly in low- and middle-income country (LMIC) settings, where the SDM had been introduced by donors and implementing partners. This review of implementation science publications on the SDM in LMICs first looked at community pilot studies of the SDM to determine the acceptability of the method; correct use and efficacy rates; demographics of users; and changes to contraceptive prevalence rates and family planning behaviors, especially among men and couples. Then, we examined the status of the SDM in the 16 countries that had attempted to scale up the method within national family planning protocols, training, and service delivery. At the community level, evidence demonstrated a high level of acceptability of the method; efficacy rates comparable to the initial clinical trials; diversity in demographic characteristics of users, including first-time or recently discontinued users of family planning; increased male engagement in family planning; and improved couple's communication. Nationally, few countries had scaled up the SDM due to uneven stakeholder engagement, lackluster political will, and competing resource priorities. Results of this review could help policy makers determine the added value of the SDM in the contraceptive method mix and identify potential barriers to its implementation moving forward.
Topics: Developing Countries; Family Planning Policy; Family Planning Services; Humans; Implementation Science; Natural Family Planning Methods; Patient Acceptance of Health Care; Patient Satisfaction; Pilot Projects; Stakeholder Participation
PubMed: 32033980
DOI: 10.9745/GHSP-D-19-00287 -
Medical History Apr 2020This paper scrutinises the relations between different models of family planning advice and their evolution in Poland between the mid-1950s and the late 1980s, focusing...
This paper scrutinises the relations between different models of family planning advice and their evolution in Poland between the mid-1950s and the late 1980s, focusing on their similarities and dissimilarities, conflicts and concordances. From 1956 onwards, the delivery of family planning advice became a priority for both the Polish Catholic Church and the party-state, especially its health authorities, which supported the foundation of the Society of Conscious Motherhood and aspired to mainstream birth control advice through the network of public well-woman clinics. As a consequence, two systems of family planning counselling emerged: the professional, secular family planning movement and Catholic pre-marital and marital counselling. We argue that reciprocal influence and emulation existed between state-sponsored and Catholic family planning in state-socialist Poland, and that both models used transnational organisations and debates relating to contraception for their construction and legitimisation. By evaluating the extent to which the strategies and practices for the delivery of birth control advice utilised by transnational birth control movements were employed in a 'second world' context such as Poland, we reveal unexpected supranational links that complicate and problematise historiographical and popular understandings of the Iron Curtain and Cold War Europe.
Topics: Catholicism; Contraception; Family Planning Services; Female; History, 20th Century; Humans; Poland; Religion and Medicine; Socialism; Women's Health Services
PubMed: 32284636
DOI: 10.1017/mdh.2020.5 -
Global Health, Science and Practice Sep 2019Family planning programs are guided by the principle of informed choice as well as the goal of providing a broad choice of contraceptive methods to clients. Provider... (Review)
Review
Family planning programs are guided by the principle of informed choice as well as the goal of providing a broad choice of contraceptive methods to clients. Provider bias is an important barrier to realizing this goal, but it must be clearly defined and understood to be effectively addressed. This review presents an overview of the concept of provider bias in family planning, focusing on the following issues: (1) what it is, (2) how widespread it is, (3) its underlying causes, (4) its impacts, and (5) how it can be effectively addressed. The definitions of provider bias include common themes about providers creating barriers to choice, typically based on the characteristics of either a client or a contraceptive method. However, an agreed-upon definition is lacking. Measurement of provider bias has often relied on self-reports by providers but has also included observation and use of mystery clients for supplemental data. The general trend in the data is clear: large numbers of providers impose barriers and restrictions beyond those that are in guidelines or are necessary for any medical reasons. This trend indicates the presence of bias. Providers have shown bias based on age, parity, marital status, and other criteria, with a bias against provision of various contraceptive methods to youth being the most common. Provider bias often stems from broader social norms, particularly judgments about sexual activity among youth and concerns about the impact of hormonal methods on future fertility. Little documentation of the impact of provider bias exists, although method mix skew has been identified as a possible red flag for bias. Newer approaches to address bias that have moved beyond traditional training and guidelines development to more fundamental behavior change efforts show promise, and learning from their lessons will be important. A major question is how to scale up such approaches.
Topics: Attitude of Health Personnel; Family Planning Services; Health Services Accessibility; Humans
PubMed: 31515240
DOI: 10.9745/GHSP-D-19-00130 -
Reproductive Health Jan 2017Although the range of contraceptives includes methods for men, namely condoms, vasectomy and withdrawal that men use directly, and the Standard Days Method (SDM) that... (Review)
Review
Although the range of contraceptives includes methods for men, namely condoms, vasectomy and withdrawal that men use directly, and the Standard Days Method (SDM) that requires their participation, family planning programming has primarily focused on women. What is known about reaching men as contraceptive users? This paper draws from a review of 47 interventions that reached men and proposes 10 key considerations for strengthening programming for men as contraceptive users. A review of programming shows that men and boys are not particularly well served by programs. Most programs operate from the perspective that women are contraceptive users and that men should support their partners, with insufficient attention to reaching men as contraceptive users in their own right. The notion that family planning is women's business only is outdated. There is sufficient evidence demonstrating men's desire for information and services, as well as men's positive response to existing programming to warrant further programming for men as FP users. The key considerations focus on getting information and services where men and boys need it; addressing gender norms that affect men's attitudes and use while respecting women's autonomy; reaching adolescent boys; including men as users in policies and guidelines; scaling up successful programming; filling gaps with implementation research and monitoring & evaluation; and creating more contraceptive options for men.
Topics: Adolescent; Contraception Behavior; Family Planning Services; Female; Humans; Male
PubMed: 28115004
DOI: 10.1186/s12978-017-0278-5