Browsing by Subject "fertility"

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  • Kuusipalo, Jussi (Suomen metsätieteellinen seura, 1985)
    The vegetation and some physical and chemical soil properties were studied in 410 sample plots in a random sample of stands by two-way indicator species analysis, discriminant analysis and analysis of variance. Understorey vegetation was dependent on site fertility and on the tree stand (especially species composition). Although the forest vegetation was distributed in a rather continuous way along a soil fertility gradient, relatively unambiguous site classification was possible based on the appearance of indicator species and species groups.
  • Stukenborg, Jan-Bernd; Jahnukainen, Kirsi; Hutka, Marsida; Mitchell, Rod T. (2018)
    Testicular function and future fertility may be affected by cancer treatment during childhood. Whilst survival of the germ (stem) cells is critical for ensuring the potential for fertility in these patients, the somatic cell populations also play a crucial role in providing a suitable environment to support germ cell maintenance and subsequent development. Regulation of the spermatogonial germ-stem cell niche involves many signalling pathways with hormonal influence from the hypothalamo-pituitary-gonadal axis. In this review, we describe the somatic cell populations that comprise the testicular germ-stem cell niche in humans and how they may be affected by cancer treatment during childhood. We also discuss the experimental models that may be utilized to manipulate the somatic environment and report the results of studies that investigate the potential role of somatic cells in the protection of the germ cells in the testis from cancer treatment.
  • Poczai, Peter; Santiago-Blay, Jorge A. (2022)
    Heredity is such a fundamental concept that it is hard to imagine a world where the connection between parents and offspring is not understood. Three hundred years ago thinking of the phenomenon of heredity bore on a cluster of distinct philosophical questions inherited from antiquity concerning the nature and origin of substances or beings that lacked biological meaning. We are reminded of this philosophical heritage by the fact that in the 18th century the study of reproduction, embryology and development was referred to as "the science of generation". It is now clear that reproduction, the biological process by which parents produce offspring, is a fundamental feature of all life on Earth. Heredity, the transmission of traits from parents to offspring via sexual or asexual reproduction, allows differences between individuals to accumulate and evolve through natural selection. Genetics is the study of heredity, and in particular, variation of fundamental units responsible for heredity. Ideas underlying this theory evolved in considerably different and unrelated ways across a number of knowledge domains, including philosophy, medicine, natural history, and breeding. The fusion of these different domains into a single comprehensive theory in 19th century biology was a historically and culturally interdependent process, thus examining genetic prehistory should unravel these entanglements. The major goal of our review is tracing the various threads of thought that gradually converged into our contemporary understanding of heredity.
  • Michel, Matthieu (Helsingin yliopisto, 2020)
    Hybrid wheat has been the focus of much research for its potential high yield, high protein content and better resistance to biotic and abiotic stresses. Nowadays, only CHA (Chemical Hybridizing Agent) method is used to induce male sterility at a commercial scale. However, this technique is hard to implement on a large production scale and other methods have been investigated for several years. CMS (Cytoplasmic Male Sterility) has been shown to be a promising way to develop hybrid wheat. However, one downside of the technique is the challenging breeding stage step and the associated conversion and restoration process. To fully express the potential gain in yield, the restoration of the cytoplasmic sterility must be complete for the F1 to be fully fertile. In this study, we investigated different methods to assess fertility restoration in nursery and compared the results with the trial notations. The collected data were also used to feed a genomic selection model to predict the behavior of untested hybrids. The results showed a high experimental error of the bagging method originated mostly from human manipulation. The visual scoring showed higher repeatability but was poorly correlated with trial score. A deeper study of the trial scoring revealed an interesting effect coming from the female and an expression of sterility for commercial lines and CHA hybrid checks. Good prediction accuracies were found for genomic selection on both methods, however deeper studies and cross prediction are needed. The multilocation trials remained the best option to score fertility restoration
  • EFSA Panel Dietetic Prod Nutr (2017)
    Following an application from Laboratoire Nurilia submitted for authorisation of a health claim pursuant to Article 14 of Regulation (EC) No 1924/2006 via the Competent Authority of France, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to Condensyl (R) and decreases sperm DNA damage. High sperm DNA damage is a risk factor for male subfertility/infertility'. Condensyl (R) is a fixed combination of opuntia fruit dry extract, N-acetyl cysteine, zinc, nicotinamide, vitamins B2, B6, B12 and E, and folic acid. The Panel considers that Condensyl (R) is sufficiently characterised. The Panel assumes that the disease that is the subject of the application is male infertility and that the target population for the claim includes males wishing to increase their fertility but excludes males with clinical infertility. The Panel considers that the reduction of DNA sperm damage is a beneficial physiological effect in the context of reducing the risk of male infertility. The applicant provided four human intervention studies conducted in males with clinical infertility, from which no conclusions could be drawn for the scientific substantiation of the claim. The Panel concludes that a cause and effect relationship has not been established between the consumption of Condensyl (R) and reduction of DNA sperm damage in the context of reducing the risk of male infertility. (C) 2017 European Food Safety Authority.
  • Perälampi, Heidi (Helsingin yliopisto, 2020)
    Goals Economics and fertility are widely studied areas, and the link between economics and fertility is well proven. However, less research exists concerning economics as a life course factor to fertility. The first aim of this study is to research whether the 90's depression impacted Finnish children's future fertility. The hypothesis is that if the family's economic situation decreased during the 90's depression, the children would be less willing to have children of their own later in life. The other aim is to clarify whether this effect is different depending on children's age during the depression. Methods Participants in this study were selected among the FinnFamily-register data, consisting of a longitudinal following of 60000 Finish families for four generations. Among the FinnFamily data, 43 432 participants who were born between 1975-1989 were included in this study. Participants and their parents were followed to the end of 2012. Analyses were made using Cox regression. The robust covariance matrix -method was used to allow correlation among members of the same family. Results and conclusions A change in the parents' economic situation during the 90's depression was not connected to a decrease in the child's future fertility. Neither evidence of interaction between parents' income change and child's age was found. However, it was found that the decrease and a major increase in parents' income during the 90's depression was connected to the increase in the probability of having a first child in later life. The connection between income decrease and later fertility remained statistically significant after controlling the education level, sex, age cohort, and number of siblings. The connection between a major income increase and later fertility disappeared when the number of siblings was controlled. The finding was somewhat unexpected, and more research is needed to clarify the reasons behind this effect. Particularly longitudinal research, including measurements of participants' subjective experiences and narratives associating with parents' economic difficulties, is needed in the future.
  • Endometriosis Guideline Core Grp; ESHRE Endometriosis Guideline Grp; Becker, Christian M.; Bokor, Attila; Heikinheimo, Oskari; Vermeulen, Nathalie (2022)
    STUDY QUESTION: How should endometriosis be diagnosed and managed based on the best available evidence from published literature? SUMMARY ANSWER: The current guideline provides 109 recommendations on diagnosis, treatments for pain and infertility, management of disease recurrence, asymptomatic or extrapelvic disease, endometriosis in adolescents and postmenopausal women, prevention and the association with cancer. WHAT IS KNOWN ALREADY: Endometriosis is a chronic condition with a plethora of presentations in terms of not only the occurrence of lesions, but also the presence of signs and symptoms. The most important symptoms include pain and infertility. STUDY DESIGN, SIZE, DURATION: The guideline was developed according to the structured methodology for development of ESHRE guidelines. After formulation of key questions by a group of experts, literature searches and assessments were performed. Papers published up to 1 December 2020 and written in English were included in the literature review. PARTICIPANTS/MATERIALS, SETTING, METHODS: Based on the collected evidence, recommendations were formulated and discussed within specialist subgroups and then presented to the core guideline development group (GDG) until consensus was reached. A stakeholder review was organized after finalization of the draft. The final version was approved by the GDG and the ESHRE Executive Committee. MAIN RESULTS AND THE ROLE OF CHANCE: This guideline aims to help clinicians to apply best care for women with endometriosis. Although studies mostly focus on women of reproductive age, the guideline also addresses endometriosis in adolescents and postmenopausal women. The guideline outlines the diagnostic process for endometriosis, which challenges laparoscopy and histology as gold standard diagnostic tests. The options for treatment of endometriosis-associated pain symptoms include analgesics, medical treatments and surgery. Non-pharmacological treatments are also discussed. For management of endometriosis-associated infertility, surgical treatment and/or medically assisted reproduction are feasible. While most of the more recent studies confirm previous ESHRE recommendations, there are five topics in which significant changes to recommendations were required and changes in clinical practice are to be expected. LIMITATIONS, REASONS FOR CAUTION: The guideline describes different management options but, based on existing evidence, no firm recommendations could be formulated on the most appropriate treatments. Also, for specific clinical issues, such as asymptomatic endometriosis or extrapelvic endometriosis, the evidence is too scarce to make evidence-based recommendations. WIDER IMPLICATIONS OF THE FINDINGS: The guideline provides clinicians with clear advice on best practice in endometriosis care, based on the best evidence currently available. In addition, a list of research recommendations is provided to stimulate further studies in endometriosis.
  • Martikainen, K.; Tyrisevä, A. M.; Matilainen, K.; Pösö, J.; Uimari, P. (2017)
    Single nucleotide polymorphism (SNP) data enable the estimation of inbreeding at the genome level. In this study, we estimated inbreeding levels for 19,075 Finnish Ayrshire cows genotyped with a low-density SNP panel (8K). The genotypes were imputed to 50K density, and after quality control, 39,144 SNPs remained for the analysis. Inbreeding coefficients were estimated for each animal based on the percentage of homozygous SNPs (F-PH), runs of homozygosity (F-ROH) and pedigree (F-PED). Phenotypic records were available for 13,712 animals including non-return rate (NRR), number of inseminations (AIS) and interval from first to last insemination (IFL) for heifers and up to three parities for cows, as well as interval from calving to first insemination (ICF) for cows. Average F-PED was 0.02, F-ROH 0.06 and F-PH 0.63. A correlation of 0.71 was found between F-PED and F-ROH, 0.66 between F-PED and F-PH and 0.94 between F-ROH and F-PH. Pedigree-based inbreeding coefficients did not show inbreeding depression in any of the traits. However, when F-ROH or F-PH was used as a covariate, significant inbreeding depression was observed; a 10% increase in F-ROH was associated with 5days longer IFL0 and IFL1, 2weeks longer IFL3 and 3days longer ICF2 compared to non-inbred cows.
  • Martikainen, K.; Sironen, A.; Uimari, P. (2018)
    Inbreeding increases homozygosity, which in turn increases the frequency of harmful recessive alleles, resulting in inbreeding depression. Inbreeding depression on fertility reduces the profitability of dairy farming by decreasing the lifetime milk production of cows and by increasing insemination and veterinary costs. Continuous homozygous segments, called runs of homozygosity (ROH), are currently considered to provide an effective measure of genomic inbreeding. The aim of this study was to estimate the effect of increased intrachromosomal homozygosity for female fertility in the Finnish Ayrshire population using ROH and haplotype analysis. Genotypes were obtained from 13,712 females with the Illumina BovineLD v.2 BeadChip low-density panel (Illumina Inc., San Diego, CA) and imputed to 50K density. After quality control, 40,554 single nucleotide polymorphisms remained for the analysis. Phenotypic data consisted of records for nonreturn rate, intervals from first to last insemination (IFL), and intervals from calving to first insemination. The raw phenotypic values were preadjusted for systematic effects before statistical analyses. The ROH-based inbreeding coefficients (F-ROH) were used as covariats in the mixed model equation to estimate the association between inbreeding and inbreeding depression on female fertility. First, we estimated the effect of increased chromosomal F-ROH. We detected significant inbreeding depression on IFL. Based on our results, a 10% increase in F-ROH on chromosomes 2, 18, and 22 were associated with IFL of heifers lengthening by 1.6, 0.9, and 0.7 d, respectively. Similarly, a 10% increase in F-ROH on chromosome 15 was associated with IFL of second-parity cows increasing by 2.3 d. Next, we located the regions within the chromosomes showing inbreeding depression. Our analysis revealed regions near the beginning of chromosome 2 and toward the ends of chromosomes 15, 18, and 22 that were associated with inbreeding depression on IFL. Last, we performed a haplotype analysis for the detected regions. The most promising haplotypes of each region were associated with IFL of heifers increasing by 4.4, 3.2, and 4.1 d on chromosomes 2, 18, and 22, respectively. The haplotype on chromosome 15 associated with IFL of second-parity cows increasing by 7.6 d. Overall, the breeding program requires inbreeding control, as increased genomic inbreeding in our study was associated with reduced reproductive ability in Finnish Ayrshire cattle.
  • Pettay, Jenni E.; Lummaa, Virpi; Lynch, Robert; Loehr, John (2021)
    Because sex ratios are a key factor regulating mating success and subsequent fitness both across and within species, there is widespread interest in how population-wide sex ratio imbalances affect marriage markets and the formation of families in human societies. Although most modern cities have more women than men and suffer from low fertility rates, the effects of female-biased sex ratios have garnered less attention than male-biased ratios. Here, we analyze how sex ratios are linked to marriages, reproductive histories, dispersal, and urbanization by taking advantage of a natural experiment in which an entire population was forcibly displaced during World War II to other local Finnish populations of varying sizes and sex ratios. Using a discrete time-event generalized linear mixed-effects model, and including factors that change across time, such as annual sex ratio, we show how sex ratios, reproduction, and migration are connected in a female-dominated environment. Young childless women migrated toward urban centers where work was available to women, and away from male-biased rural areas. In such areas where there were more females, women were less likely to start reproduction. Despite this constraint, women showed little flexibility in mate choice, with no evidence for an increase in partner age difference in female-biased areas. We propose that together these behaviors and conditions combine to generate an "urban fertility trap" which may have important consequences for our understanding of the fertility dynamics of today including the current fertility decline across the developed world.
  • Westman, Carl Johan (Suomen metsätieteellinen seura, 1981)
  • Global Burden of Disease Self-Harm Collaboration; Orpana, H.M.; Doku, D.T.; Meretoja, T.J.; Shiri, R.; Vasankari, T. (2019)
    Objectives To use the estimates from the Global Burden of Disease Study 2016 to describe patterns of suicide mortality globally, regionally, and for 195 countries and territories by age, sex, and Socio-demographic index, and to describe temporal trends between 1990 and 2016. Design Systematic analysis. Main outcome measures Crude and age standardised rates from suicide mortality and years of life lost were compared across regions and countries, and by age, sex, and Socio-demographic index (a composite measure of fertility, income, and education). Results The total number of deaths from suicide increased by 6.7% (95% uncertainty interval 0.4% to 15.6%) globally over the 27 year study period to 817 000 (762 000 to 884 000) deaths in 2016. However, the age standardised mortality rate for suicide decreased by 32.7% (27.2% to 36.6%) worldwide between 1990 and 2016, similar to the decline in the global age standardised mortality rate of 30.6%. Suicide was the leading cause of age standardised years of life lost in the Global Burden of Disease region of high income Asia Pacific and was among the top 10 leading causes in eastern Europe, central Europe, western Europe, central Asia, Australasia, southern Latin America, and high income North America. Rates for men were higher than for women across regions, countries, and age groups, except for the 15 to 19 age group. There was variation in the female to male ratio, with higher ratios at lower levels of Socio-demographic index. Women experienced greater decreases in mortality rates (49.0%, 95% uncertainty interval 42.6% to 54.6%) than men (23.8%, 15.6% to 32.7%). Conclusions Age standardised mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide. Suicide mortality was variable across locations, between sexes, and between age groups. Suicide prevention strategies can be targeted towards vulnerable populations if they are informed by variations in mortality rates. © Published by the BMJ Publishing Group Limited.
  • Global Burden of Disease Cancer Collaboration; Fitzmaurice, C.; Doku, D.T.; Hadkhale, K.; Meretoja, T.J.; Neupane, S. (2019)
    Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.
  • Utriainen, Pauliina; Suominen, Anu; Mäkitie, Outi; Jahnukainen, Kirsi (2019)
    Background: Neuroblastoma is the most common extra-cranial solid tumor in children. Intensive therapy including autologous stem-cell transplantation (HSCT) has improved the poor prognosis of high-risk neuroblastoma (HR-NBL) but may impair gonadal function. Objectives: To investigate the gonadal function and fertility in long-term survivors of childhood HR-NBL. Design: A cohort including all Finnish (n = 20; 11 females) long-term (> 10 years) survivors of HR-NBL and an age-and sex-matched control group (n = 20) was examined at a median age of 22 (16-30) years. Oncologic treatments, pubertal timing, hormonal therapies and the number of off-spring were recorded, and pituitary and gonadal hormones were measured. Results: Altogether 16/20 of the long-term survivors of HR-NBL entered puberty spontaneously; puberty was hormonally induced in four survivors (three females). Among the 8/11 female survivors with spontaneous puberty, seven had spontaneous menarche, but 5/8 developed ovarian failure soon after puberty. Nine females currently needed estrogen substitution. AMH, a marker of ovarian reserve, was lower in the female survivors than controls (median 0.02 vs. 1.7 mu g/l, p <0.001). As a group, male survivors had smaller testicular size (8.5 vs. 39ml, p <0.001) and lower inhibin B ( Conclusion: Gonadal failure is common in long-term survivors of HR-NBL treated with HSCT. Fertility may be preserved in some survivors treated without total-body irradiation.
  • Tikkanen, Minna (Helsingfors universitet, 2014)
    Genetic and phenotypic parameters and relationships for fertility traits, body type traits and production were estimated. The data analyzed included 21,450 Ayrshires. Animals were reared in 2,647 herds, born from 1994 to 2005 and were progeny of 1652 sires. Analyzed fertility traits were days from first service to last insemination and number of inseminations to conception for heifers, and days from calving to first insemination for first parity cows. Production traits were first lactation milk and lifetime milk and body type traits were stature, body depth, chest width, angularity, top line, rump width and rump angle. Variance components and the heritability estimates were calculated by restricted maximum likelihood (REML) method using the DMU software. The heritability estimates of first lactation milk yield and lifetime milk yield were 0.28 and 0.08, re-spectively. The heritabilities for fertility traits in virgin heifers and first lactation cows were low (0.02 – 0.03). Heritability estimates for the type traits varied from 0.10 to 0.43. The largest heritability was found for stature (0.43) and rump width (0.27). The highest positive genetic correlations were angularity with first lactation milk (0.41) and lifetime milk (0.45), and the highest negative genetic correlation was between top line and first lactation milk (-0.33). Chest width and rump angle had a positive genetic correlation to days from calving to first insemination. The significant genetic correlations were heifer fertility with body depth, rump width and rump angle. Estimated correlations between heifer fertility traits and lifetime milk yield were positive and moderate. First parity cow fertility was not related to production traits. Fertility traits and lifetime milk have a low heritability. Progress can be made relatively fast in body traits and first lactation milk by breeding, because of the moderate heritabilities. Selection for some body type traits may cause improvement in production but deterioration in fertility. Declined heifer fertility is associated with high lifetime production. However is not reasonable to put emphasis on poor heifer fertility in selection.
  • Hossain, Md. Anwar (2002)
    As in many other countries in South Asia, population development in Bangladesh has been favorable. There has been a decline in mortality, fertility and an increase in family planning through the increased use of contraceptives. Bangladesh is unique in showing a decline in mortality and fertility, and a relatively high contraceptive prevalence rate in an environment of low socioeconomic development. The main purpose of this study is to analyze the development of mortality and fertility and the family planning situation in Bangladesh. The study attempts to determine the relation between the secular decline of mortality and fertility and the increased use of modern contraception between 1970 and 1995. The relation and interaction between child mortality and fertility decline through the direct or indirect effect of contraceptive use has been described, based on the materials from several national surveys. In addition, information from other sources were utilized to assess a consistency and to arrive at reasonable conclusions to determine the interaction between mortality, ferility and family planning. A substantial decline in child mortality and fertility has occured between 1975 and 1995. The decline is greater in the urban than in the rural areas, and also a noticeable regional variation can be detected. The level of infant mortality has declined from 153 deaths to 82 deaths per 100 live births through the influence of family planning (FP) and maternal and child health (MCH) programs. The level of total fertility has fallen from more than 7 births to 3.3 births per women of reproductive age. The fertility decline has resulted primarily from the family planning programs with the key proximate determinant of contraceptive use. Family planning services and the use of contraceptives have increased sharply between 1975 and 1995. The contraceptive prevalence rate has increased from about 8 to 49 percent among married women of reproductive age. The prevalence rate of contraception is higher in the urban than in the rural areas, among women with secondary or more education than among women with no or low education, and also noticeable regional differences can be detected. The high level of contraceptive practice has had a direct effect on the decline in fertility and an indirect effect on the decline of infant mortility during previous decades. The contemporary secular decline in mortality, fertility and the increased use of modern contraception have provided clear evidence of the interaction between infant mortality, total fertility and family planning.
  • Mäkelä, Eija P.; Roine, Risto P.; Taskinen, Seppo (2020)
    Introduction Spermatic cord torsion (SCT) may lead to organ loss and can potentially influence fertility. Long-term effects of SCT are not fully investigated. Objective The purpose was to evaluate paternity rates in adults who have had SCT in childhood and to compare the results to those of a control population. The secondary purposes were to compare paternity rates after testis-preserving surgery with those after orchiectomy and to evaluate erectile function and health-related quality of life (HRQoL). Study design Questionnaires concerning paternity, erectile function (International Index of Erectile Function [IIEF]-5 questionnaire), and HRQoL (15D questionnaire) were mailed to 74 men who had been treated for SCT and to 92 controls treated for testicular appendage torsion in 1977-1995 and who were currently older than 30 years. Results Thirty-five of the 74 (47%) patients with SCT and 58 of the 92 (63%) controls responded. A same-aged control was selected for each patient with SCT. The median age at investigation was 41 (interquatile range [IQR]: 36 to 46) years in the SCT group and 41 (IQR: 38 to 46) years in the control group (p = 0.81). The paternity rate was 23 of 35 (66%) in the SCT group and 26 of 34 (76%) in the control group (p = 0.43). Nine percent of patients and controls suffered from infertility. Of the 30- to 50-year-old patients with SCT, 9 of 16 (56%) had children after orchiectomy, and 13 of 16 (81%), after detorsion (p = 0.25). Significant or moderate erectile dysfunction (IIEF-5 total score Discussion Paternity, erectile function, or HRQoL was not impaired in the general level in the patients with SCT in comparison with controls. Both the modes of treatment, orchiectomy or detorsion, had no significant impact on the results. However, the results cannot be generalized to the individual level. The limitations were a small sample size and inability to investigate maternal factors to the paternity. However, the results are encouraging for the patients and families. Conclusion Paternity rate and HRQoL were similar in patients with SCT and controls. The type of surgery (orchiectomy vs. detorsion) did not affect paternity rates statistically. Moderate or significant erectile dysfunction was rare in both groups.
  • Tuominen, Anni I; Saavalainen, Liisu V K; Tiitinen, Aila; Heikinheimo, Oskari; Härkki, Päivi (2021)
    Objective: To study reproductive outcomes, and pregnancy and delivery complications after conservative or operative treatment of rectovaginal endometriosis during long-term follow-up. Design: Retrospective cohort study. Setting: University hospital. Patient(s): Women with rectovaginal endometriosis referred to hospital due to any indication from 2004 to 2013 (N = 543) who were treated initially either conservatively (group CONS, n = 183), or operatively (OPER, n = 360) either with resection of rectovaginal nodule (RVR, n = 192) or with concomitant bowel resection (BR, n = 132). Intervention(s): Conservative or operative management. Main Outcome Measure(s): Clinical pregnancy rate, live-birth rate, and assessment of the complications during pregnancy and delivery. Results(s): Between women in the CONS group or OPER group, no differences were found in either clinical pregnancy rate (56%, n = 102 vs. 50%, n = 181) or live-birth rate (48%, n = 87 vs. 42%, n = 153). Of the pregnancies, 64% (n = 65) and 49% (n = 89), respectively, started after medically assisted reproduction. No differences emerge in the subanalysis of women Conclusion(s): Women with rectovaginal endometriosis have comparable and good reproductive prognosis regardless of the treatment method. ((C) 2020 by American Society for Reproductive Medicine.)
  • Laakso, Saila; Holopainen, Elina; Betterle, Corrado; Saari, Viivi; Vogt, Elinor; Schmitt, Monica M.; Winer, Karen K.; Kareva, Maria; Sabbadin, Chiara; Husebye, Eystein S.; Orlova, Elizaveta; Lionakis, Michail S.; Mäkitie, Outi (2022)
    Context: Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED; also known as autoimmune polyendocrine syndrome type 1) has a severe, unpredictable course. Autoimmunity and disease components may affect fertility and predispose to maternal and fetal complications, but pregnancy outcomes remain unknown. Objective: To assess fetal and maternal outcomes and course of clinical APECED manifestations during pregnancy in women with APECED. Design and Setting: A multicenter registry-based study including 5 national patient cohorts. Patients: 321 females with APECED. Main Outcome Measure: Number of pregnancies, miscarriages, and deliveries. Results: Forty-three patients had altogether 83 pregnancies at median age of 27 years (range, 17-39). Sixty (72%) pregnancies led to a delivery, including 2 stillbirths (2.4%) and 5 (6.0%) preterm livebirths. Miscarriages, induced abortions, and ectopic pregnancies were observed in 14 (17%), 8 (10%), and 1 (1.2%) pregnancies, respectively. Ovum donation resulted in 5 (6.0%) pregnancies. High maternal age, premature ovarian insufficiency, primary adrenal insufficiency, or hypoparathyroidism did not associate with miscarriages. Women with livebirth had, on average, 4 APECED manifestations (range 0-10); 78% had hypoparathyroidism, and 36% had primary adrenal insufficiency. APECED manifestations remained mostly stable during pregnancy, but in 1 case, development of primary adrenal insufficiency led to adrenal crisis and stillbirth. Birth weights were normal in >80% and apart from 1 neonatal death of a preterm baby, no serious perinatal complications occurred. Conclusions. Outcome of pregnancy in women with APECED was generally favorable. However, APECED warrants careful maternal multidisciplinary follow-up from preconceptual care until puerperium.
  • Lindh, Ingela; Skjeldestad, Finn Egil; Heikinheimo, Oskari; Hognert, Helena; Lidegaard, Ojvind; Bergh, Christina; Gemzell-Danielsson, Kristina (2022)
    Introduction: The aim was to describe and compare changes in the reproductive pattern of women in their 40s observed over a decade in Scandinavia. Material and Methods: Cross-sectional study using the total population of women aged 40-49 years between 2008-2018 in Denmark, Norway and Sweden (on average n = 1.5 million). Aggregated data concerning birth and induced abortion rate were collected and analyzed from national health registers. National data on redeemed prescriptions of hormonal contraceptives in the three countries were collected from prescription registers. Births after spontaneous and assisted conceptions were identified by using cross-linked data on deliveries from the Medical Birth Registers and National Registers of Assisted Reproduction in the three countries. Results: Use of hormonal contraception increased among women aged 40-44 years in Denmark from 24% to 31%, in Sweden from 27% to 30%, and in Norway from 22% to 24%. The levonorgestrel-releasing intrauterine device was the most frequently used method in all countries. Birth rates among women 40-44 years increased continuously from 9.5 to 12/1000 women in Denmark and from 11.7 to 14.3/1000 in Sweden, but remained stable in Norway at similar to 11/1000 women. There was a doubling of assisted conceptions in Denmark from 0.71 to 1.71/1000 women, Sweden from 0.43 to 0.81/1000 and Norway from 0.25 to 0.53/1000 women 40-49 years of age. Sweden had the highest induced abortion rate (7.7 to 8.1/1000 women) in women aged 40-49 years during the study period. Conclusions: From 2008 to 2018, birth rates continuously increased among women aged 40-49 years in Denmark and Sweden and births resulting from assisted reproductive technology doubled in all three countries.