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PubMed1976

[The decrease in the number of marriages (author's transl)].

Demographers adhere to the thesis that the increasing or decreasing incidence of marriage shows a statistical link to the existing number of males and females in the age group for marriage. For several years now it can be observed that this thesis requires revision. The number of marriages especially the number of marriages in those age groups in which the highest number of men and women absolutely and relatively get married decreases continually. At the same time the number of males and females in these groups increases. This development is a sign of an incipient disconnection of marriage from demographic data such as the number of persons in the age group for marriage and a disconnection for social and economic factors. Causes of this development are primarily the improvement of general education and the liberalization of sexual behavior. The traditional philosophy that all sexual intercourse should serve potential procreation is fading. The low rate of marriages and the low birth rate are signs of this development. Modern contraceptive methods facilitate this development of mature and autonomous persons but also opens a new complex area of new material and philosophical difficulties apart from the legal position of marriage for the protection of the partners and their offspring and for the social stability of their relationships.

Contraception↗
PubMed1998

Multicentre approaches to donor insemination in the French CECOS Federation: nationwide evaluation, donor matching, screening for genetic diseases and consanguinity. Centre d'Etudes et de Conservation des Oeufs et du Sperme humain.

The French CECOS Federation collates the results of its 22 sperm banks and provides annual reports on their activity. These records allow studies on many different aspects; annual nationwide evaluation, matching of donors and recipients, follow-up of pregnancies, research into artificial procreation, and natural fertility. Risk of transmitted hereditary disease is minimised by genetic screening which establishes the genealogy of donor candidates and includes karyotyping and other biological investigations when a particular risk is suspected. The real risk of consanguinity is very small. Limiting the number of children born from a given sperm donor can be defined at the local level.

Consanguinity↗
PubMedDate not supplied

Pregnancy after heart transplantation.

The desire to procreate is normal in women, including those who are heart transplant recipients. The female transplant recipient attempting successful conception, pregnancy, and delivery presents a rare challenge to those responsible for her care. This article presents a comprehensive review of pregnancy after heart transplantation in female recipients by reviewing relevant literature, describing the effects of immunosuppressive therapy on reproduction, and suggesting strategies for reproduction counseling.

Contraception↗
PubMed2004

[Fertility of the aging male].

Although the effect of ageing on female fertility has been well documented, the reproductive functions of ageing males have been less extensively investigated. Unlike females, males do not experience a sudden arrest of gonadal endocrine and exocrine functions characteristic of menopausal ovarian deficiency. It therefore appeared useful to review the course of male fertility with age and the genetic consequences for children related to paternal ageing. The most recent histological and endocrine examinations demonstrate progressive alterations of testicular endocrine and exocrine function with ageing. Deterioration of male fertility with ageing can also be demonstrated by studying semen parameters. A review of the literature presented in this article demonstrates a decline in semen volume and a reduction of sperm mobility and the percentage of normal forms. The age-related variations of sperm concentration is more controversial. The study of the fertilizing property of spermatozoa raises difficult methodological problems. Under conditions of natural reproduction, the other factors of the couple's fertility (the spouse's age, declining frequency of sexual intercourse, etc.) constitute confounding factors and may introduce a bias in the analysis. However, epidemiologically, there is a strong correlation between the age of spouses. The study of male fertility in medically assisted procreation is more clearly documented. The various published series clearly demonstrate a reduction of the results with increasing paternal age. Age-related deterioration of male fertility is also associated with an increased genetic risk for the offspring, especially an increased risk of chromosomal aberrations and autosomal dominant mutations responsible for various malformations or functional disturbances and an increased risk of sex-linked recessive mutations.

Adult↗
PubMedDate not supplied

[Use of maternal-infant preventative health services in a group of Mexican women].

OBJECTIVE: To identify factors that promote the use of health services in a group of women of reproductive age from a gender perspective. METHOD: A retrospective and analytical study based on a questionnaire on maternal infant mortality of fifty women (users and non-users of preventative health services) in health centers in Mexico City was carried out. A conglomerate analysis of averages was executed. An analysis of variance was done to evaluate the fitness of the model. The statistical analysis was done using the SPSS statistical package version 12.0. RESULTS: Planning of the last pregnancy, including having had sexual relations with the intention of procreation, was the behavior that showed a significant difference (p=0.001) between users and non-users of preventative health services. Social-demographic characteristics (age, education level, martial status, woman's occupation) did not reveal any differences between the two groups. CONCLUSION: Reproductive planning could be an indicator of preventative behavior in the use of preventative health services.

Adult↗
PubMed1994

[Risk of hepatitis virus B and C transmission during medically assisted reproduction].

The transmissibility of viral hepatitis by medical technics is a topical question in public health care. So, it becomes important to assess transmission risk in medically assisted procreation (MAP), to define the management of couples according to their viral status. Mainly, B and C virus are concerned by transmission risk, because of their epidemiology. In that work, B and C virus epidemiology and transmissibility will be rapported, with the recent notions about detection and knowledge of C virus. According to that transmission risk a logical attitude in MAP will be defined.

Cross Infection↗
PubMed2002

[Cryopreservation of ovarian tissue].

Ovarian tissue cryopreservation (OTCP) is a new procedure of medically assisted procreation, still at the experimental stage, whose primary aim is to store female gametes as sperm cryopreservation permits to do for male gametes. Ovarian tissue is removed very simply by laparoscopy. It survives well to freezing if the medium contains a cryoprotective agent and the rate of freezing is slow. In contrast, thawing must be rapid. There are three processes for the utilization of ovarian tissue after thawing. In vitro maturation and xenografting remain impossible for technical and ethical reasons. Autologous transplantation (orthotopic or heterotopic) of the tissue is therefore the only foreseeable method over the short term. Indications for OTCP must remain rare as long as no pregnancy has been obtained in human. At the present time, only female patients who would inevitably suffer the loss of their fertility should be able to take advantage of OTCP. Basically, this would mean women subjected to castrating anticancer therapy. It would seem reasonable to set the age limit at 35-years for carrying out OTCP. Lastly, female patients should be clearly informed that the method is still at the research stage, and in France samples must be taken in accordance with the laws governing clinical research.

Adult↗
PubMedDate not supplied

A comparison of the families of mothers with borderline and nonborderline personality disorders.

The purpose of this study was to evaluate the families of procreation of mothers with borderline personality disorder (BPD) on measures of family stability, family satisfaction, and family environment. Families of nine BPD mothers were compared with families of 14 mothers with other personality disorders using a semi-structured interview to evaluate family history, the Family Environment Scale (FES), and the Family Satisfaction Scale (FSS). Families of procreation of BPD mothers were more unstable than comparison group families. FES scores of BPD mothers were significantly lower than controls in cohesion and organization, but not in conflict. Instability and low family cohesion are common in families of BPD mothers, and may place their children at increased risk for development of psychopathology.

Adolescent↗
PubMed2003

Conundrums with penumbras: the right to privacy encompasses non-gamete providers who create preembryos with the intent to become parents.

To date, five state high courts have resolved disputes over frozen preembryos. These disputes arose during divorce proceedings between couples who had previously used assisted reproduction and cryopreserved excess preembryos. In each case, one spouse wished to have the preembryos destroyed, while the other wanted to be able to use or donate them in the future. The parties in these cases invoked the constitutional right to privacy to argue for dispositional control over the preembryos; two of the five cases were resolved by relying on this right. The constitutional right to privacy protects intimate decisions involving procreation, marriage, and family life. However, when couples use donated sperm or ova to create preembryos, a unique circumstance arises: one spouse--the gamete provider--is genetically related to the preembryos and the other is not. If courts resolve frozen preembryo disputes that involve non-gamete providers based on the constitutional right to privacy, they should find that the constitutional right to privacy encompasses the interests of both gamete and non-gamete providers. Individuals who create preembryos with the intent to become a parent have made an intimate decision involving procreation, marriage, and family life that falls squarely within the the right to privacy. In such cases, the couple together made the decision to create a family through the use of assisted reproduction, and the preembryos would not exist but for that joint decision. Therefore, gamete and non-gamete providers should be afforded equal constitutional protection in disputes over frozen preembryos.

Contracts↗
PubMed2002

Disclosure to therapists: what is and is not discussed in psychotherapy.

This study used the 80-item Disclosure to Therapist Inventory-R to investigate the nature of patient disclosure within therapy. Participants (45 men, 102 women) were all currently in therapy. A Principal Components Analyses with varimax rotation yielded nine meaningful factors; mean disclosure scores were lowest for the factors of Sexuality and Procreation and highest for the factors of Negative Affect and Intimacy. Specific items most extensively discussed included characteristics of parents that are disliked, and aspects of one's personality that are disliked or worrisome. No significant differences were found in overall degree of disclosure as a function of patient gender or shame-proneness; disclosure was, however, found to be positively correlated with strength of the therapeutic alliance.

Adolescent↗
PubMed1982

Psychoeducational intervention for sexuality with the aged, family members of the aged, and people who work with the aged.

Sexual attitudes, knowledge, and behavior have been shown to be a life-long pattern of evolving behavior without a clear beginning and ending. Older persons were educated and socialized in an environment that viewed sexuality as a procreative activity appropriate only for married persons in the child bearing years, thus neglecting the interpersonal and individual aspects of sexuality. A sexual psychoeducational intervention was conducted and evaluated with older persons, adult family members of older persons, and staff members of nursing homes. Results indicated significant changes in attitudes toward and knowledge about sexuality and aging and sexual behavior.

Aged↗
PubMed1994

Pure ovarian immature teratoma, a unique and curable disease: 10 years' experience of 32 prospectively treated patients.

OBJECTIVE: To report and evaluate a conservative and individualized treatment policy in a homogeneously selected series of patients affected by pure ovarian immature teratoma. METHODS: This prospective trial, with specific treatment policies according to stage and grade, was planned and started in 1982. The study population consisted of 32 patients affected by pure immature teratoma, with the exclusion of mixed germ cell tumors. Fertility-sparing surgery was performed whenever possible. Surgery alone, with careful follow-up, was adopted for stage I or II according to the International Federation of Gynecology and Obstetrics (FIGO) and grade 1 or 2 tumors. The other patients, with stage III or with grade 3 stage I or II tumors, or those referred at relapse, were treated with platinum-based chemotherapy regimens. RESULTS: Thirty of 32 patients underwent fertility-sparing surgery. Ten of 32 patients received chemotherapy after surgery, either as adjuvant treatment or in the presence of visible tumor. All 32 patients are alive and disease-free, with a median follow-up from surgery of 47 months (range 11-138). In six patients, regardless of the administration of chemotherapy, the tumor either spontaneously differentiated toward mature glia or increased in volume, mimicking progression but still remaining completely mature. Five of six patients wishing to procreate had a total of seven normal pregnancies. CONCLUSIONS: Pure ovarian immature teratoma is a potentially curable disease with a unique natural history. Our data substantiate the hypothesis that low-grade and low-stage tumors do not require chemotherapy, and that a fertility-sparing surgical approach is warranted in all cases.

Adolescent↗
PubMed1994

The sociocultural relevance of sex research. Challenges for the 1990s and beyond.

This article discusses six factors influencing research on sex and reproductive health: (a) the selection of grouping variables on the basis of race; (b) conceptual frameworks to examine sexual risk taking; (c) use of recreational rather than procreation-based models of sex; (d) research designed to control rather than to understand sexual behaviors; (e) use of a dominant, male perspective; and (f) the focus on women to minimize sexual risk taking. The effect of these factors on what is understood about sociocultural, ethnic, gender, and other issues that have yet to be examined is presented, with the ultimate goal of maximizing sexual health for diverse populations.

Contraception Behavior↗
PubMed1999

[Motherhood and fatherhood after liver transplantation].

BACKGROUND AND OBJECTIVE: Liver transplantation for terminal liver failure enables patients to look forward to many years of good quality life. As a result, more and more of the often still relatively young transplant recipients inquire about the possible risks to a child procreated after transplantation. PATIENTS AND METHODS: During 9.5 years (between September 1988 and April 1998) 1000 liver transplantations were performed on 911 patients (374 females, 537 males) at our hospital. The potential for parenthood existed for 163 women (aged between 16 an 46 years) and 520 men. 14 children were born of 14 women, six pregnancies ended in spontaneous abortion or miscarriage and three other women are now pregnant. Seven men reported paternity of eight children after transplantation. All data were collected prospectively. RESULTS: Six of the 14 births (42.9%) proceeded normally, but up to three complications developed in the other eight (57.1%). Six women (35.7%) developed hypertension during the pregnancy. There was no case of transplant dysfunction or toxaemia of pregnancy. Half the births were by caesarean section. Premature births occurred in two women (14.3%); four children were underweight (< 2500 g) at birth (28.6%). The seven men, at a mean age of 44 (7-75) months after transplantation, fathered eight children, at present aged between 11 months and 6 years, all of whom have developed normally. The 13 children of the post-transplantation mothers are also without malformation or abnormal development. One child's development is retarded due to a fetal alcohol syndrome resulting from the mother's post-transplantation alcohol abuse during pregnancy. All the patients are well at present and live with their children. CONCLUSIONS: Both men and women can procreate at a relatively low risk to the off-spring. But for this to happen, an informed decision for parenthood must be made by the prospective parent together with her/his partner and the doctor in charge, she/he must be in good physical condition with stable transplant function, and there must be frequent interdisciplinary monitoring during any post-transplantation pregnancy.

Abortion, Spontaneous↗
PubMed1999

[Toxoplasmosis at the Pasteur Institute of Bangui, Central African Republic (1996-1998): serological data].

A serological study of toxoplasmosis was conducted between 1996 and 1998 on 1953 patients of the Medical Analysis Laboratory of the Institut Pasteur de Bangui. The mean age of patients was 28 years. Among sera tested by ELISA, seropositivity to IgG antibodies was observed in 50.6%, and 2.6% sera were found positive for IgM antitoxoplasma antibodies (immuno-capture). The seroprevalence did not vary significantly according to sex or age. The results showed 40.8% sera had IgG antibodies titered 400 Ul/ml and more. The proportion of high level (> 400 Ul) IgG was more important in males than in females. High level IgG antibodies were statistically significant more frequently in the sera of females aged 10-29 years. Of the procreative women, 49.1% were at risk of contacting toxoplasmosis. The diagnosis of recently acquired infection, based on the coexistence of IgM antibodies and high level IgG antibodies, was noted in 1.6% among sera of procreative women. In the Central African Republic, serologic survey during pregnancy is not systematic and HIV seroprevalence is high (15%). Risks of acute infections during pregnancy and of opportunistic infections in HIV-infection patients are high. A control of toxoplasmosis is justifiable (screening during pregnancy, sanitary education) in CAR.

Adolescent↗
PubMed1992

[Seroepidemiological study of toxoplasmosis in Libreville, Gabon].

A sero-epidemiological survey of toxoplasmosis has been carried out in 1178 subjects residing in urban and suburban areas of Libreville, Gabon. Two techniques were used: Pastorex toxo of the Institut Pasteur and ISAGA of bioMérieux. The acquisition of antibodies occurs at an early age, from the age of six months on. After the age of 15 years, the age of procreation, the prevalence is 68%. Between the ages of 15 and 19 years, 19% have IgM. The risk for toxoplasmosis acquired during pregnancy is not to be neglected. It decreases between the ages of 20 and 30 years. The most probable source of contamination is the reservoir from the soil. No difference between the sexes was observed.

Adult↗
PubMed1997

Men, women and the trouble with condoms: problems associated with condom use by migrant workers in rural Zambia.

Understanding cultural attitudes to condoms is of the utmost importance in promoting their use as a means of protection against HIV transmission. This article examines condom use in relation to what people see as the purpose of sex, what good sex entails and how this relates to ideas of being a proper woman or man. It seems that the underlying and pervasive ideal is that sex is essentially a procreative act, since an emphasis on male potency and male and female fertility often overrides anxieties about contracting HIV and other sexually transmitted diseases. Hence condom use is usually only negotiated within some short-term relationships and then not consistently. Whilst both men and women have negative attitudes to condoms, women because of their economic and ideological dependence on men are in a much weaker position to negotiate condom use.

Condoms↗