BACKGROUND

Burn injuries remain a significant global public health problem, causing substantial morbidity, mortality, and economic burden, particularly in low- and middle-income countries where nearly 90% of cases occur. Despite the importance of timely and appropriate first aid in reducing complications, community responses to burn injuries in many settings continue to rely on traditional or non-evidence-based practices.

OBJECTIVES

This qualitative phenomenological study explored community-based knowledge and responses related to the causes and first aid of burn injuries.

METHODS

The study involved ten (10) purposively selected informants residing in South Mangga Dua Urban Village, Central Jakarta, Indonesia. Data collection methods included semi-structured interviews, direct observations, and focus group discussions (FGDs). Thematic analysis was used.

RESULTS

Three (3) core domains were identified: (1) community perceptions of burn causes and classifications, (2) indigenous first aid practices used in domestic settings, and (3) sources of knowledge and information pathways related to burn first aid. Participants commonly attributed burns to incidents involving fire, hot liquids, and electrical faults. Their understanding of burn severity was limited to superficial assessments, with little awareness of clinical classifications. First aid responses were largely based on traditional practices such as the application of toothpaste, honey, or aloe vera, while evidencebased practices like using running water were rarely mentioned. Notably, most participants relied on familial teachings and informal community experiences as their primary sources of knowledge, with limited exposure to health professionals or verified media content.

CONCLUSION

Community knowledge is culturally rooted but misaligned with medical standards, potentially leading to unsafe practices. Culturally sensitive health education integrating traditional beliefs and accurate information is essential to improve outcomes in burn injury management.

Wounds And Injuries ; Residence Characteristics ; Public Health ; Mortality ; Insemination, Artificial, Heterologous ; Income ; Financial Stress ; Burns ; Health Education ; Attitude ; First Aid ; Medicine ; Health Communication ; Urban Population

BACKGROUND

Managing low ovarian response remains challenging despite advancements in assisted reproductive technology (ART). Although several approaches have been proposed, there is no strong evidence that a particular stimulation protocol is superior over the other in terms of improving reproductive outcomes in this group of women. The double stimulation protocol (DuoStim) suggests ovarian stimulation during both the follicular phase and the luteal phase of the same ovarian cycle; hence, facilitating two oocyte retrievals in the shortest amount of time.

OBJECTIVE

This study assessed the effect of the double stimulation protocol (DuoStim) on poor ovarian responders in terms of cumulative live birth rates and clinical pregnancy rates, and compared these outcomes to conventional stimulation protocols.

METHODS

This is a systematic review and meta-analysis of randomized controlled trials (RCT), cohort and cross-sectional studies in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Data from eligible journals were tabulated and analyzed using Cochran’s Q and I² tests.

RESULTS

Eight studies involving poor ovarian responders were included in the meta-analysis. Pooled analysis demonstrated no significant difference between DuoStim and conventional ovarian stimulation protocols in clinical pregnancy rate (OR 0.99, 95% CI 0.75–1.30) and cumulative live birth rate (OR 0.87, 95% CI 0.59–1.28). Fertilization rates were likewise comparable between groups. Nevertheless, several included studies reported higher oocyte yield and greater numbers of mature oocytes and blastocysts with DuoStim

CONCLUSION

Current evidence does not demonstrate significant superiority of DuoStim over conventional ovarian stimulation protocols in terms of clinical pregnancy rates, cumulative live birth rates, or fertilization rates among poor ovarian responders. However, DuoStim appears to be an effective strategy for increasing oocyte yield within a shorter treatment timeframe. Its use may be particularly relevant in selected patients with diminished ovarian reserve, advanced maternal age, or urgent fertility preservation needs. Further high-quality prospective trials are warranted to clarify its impact on reproductive outcomes.

Human ; Ovulation Induction ; Ovarian Stimulation ; Ovarian Reserve ; Fertilization In Vitro

BACKGROUND

The benefits of preimplantation genetic testing for aneuploidy (PGT-A) in the advanced maternal age group are unclear.

OBJECTIVE

This study aims to determine whether PGT-A improves pregnancy outcomes.

METHODS

This is a retrospective cohort study of PGT-A outcomes using next generation sequencing for advanced maternal age women undergoing IVF at CARMI from May 2017 to May 2021. Women were grouped by age: those 35-39 and those 40 and above. Pregnancy rate (PR), live birth rate (LBR), and miscarriage rate (MR) were computed per transfer and per cycle and compared with women who underwent single day-5 frozen transfer of a morphologically chosen embryo.

RESULTS

Overall euploid blastocyst rate was 38.5%: 16.9% for 40 and above and 47.6% for 35- 39 group. There were no transfers in 41.4% due to absence of a euploid embryo. PR and LBR per embryo transfer were higher in the PGT-A versus the non-PGT-A group (61.9% vs 24.1% p = < 0.001 and 42.9% vs 19% p = < 0.001). By age, the findings were similar: higher PR and LBR per-embryo transfer in PGT-A versus non-PGT-A in the 35-39 group (58.4% and 29%, p = 0.006 and 42.9% vs 22.6%, p < 0.001 respectively) and 40 and above (71.4% vs 18.5%, p < 0.001 and 53.6% vs 14.8%, p < 0.001 respectively). MR was increased in the PGT-A versus non-PGT-A group, but this may be due to the small number of events in the population.

CONCLUSION

The study suggests an increase in PR and LBR per embryo transfer in advanced maternal age women undergoing PGT-A. A larger sample size is needed to validate the results.

Human ; Female ; Fertilization In Vitro ; Aneuploidy ; High-throughput Nucleotide Sequencing ; Blastocyst ; Embryo Transfer ; Abortion, Spontaneous

Primary ciliary dyskinesia (PCD) is a clinically rare, genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections, male infertility, tympanitis, and laterality abnormalities. PCD is typically resulted from variants in genes encoding assembly or structural proteins that are indispensable for the movement of motile cilia. Here, we identified a novel nonsense mutation, c.466G>T, in cilia- and flagella-associated protein 300 ( CFAP300 ) resulting in a stop codon (p.Glu156*) through whole-exome sequencing (WES). The proband had a PCD phenotype with laterality defects and immotile sperm flagella displaying a combined loss of the inner dynein arm (IDA) and outer dynein arm (ODA). Bioinformatic programs predicted that the mutation is deleterious. Successful pregnancy was achieved through intracytoplasmic sperm injection (ICSI). Our results expand the spectrum of CFAP300 variants in PCD and provide reproductive guidance for infertile couples suffering from PCD caused by them.
Adult ; Female ; Humans ; Male ; Pregnancy ; China ; Ciliary Motility Disorders/genetics* ; Codon, Nonsense ; East Asian People/genetics* ; Exome Sequencing ; Homozygote ; Infertility, Male/genetics* ; Kartagener Syndrome/genetics* ; Pedigree ; Sperm Injections, Intracytoplasmic ; Cytoskeletal Proteins/genetics*

Y chromosome microdeletions are an important cause of male infertility. At present, research on the Y chromosome is mainly focused on analyzing the loss of large segments of the azoospermia factor a/b/c (AZFa/b/c) gene, and few studies have reported the impact of unit point deletion in the AZF band on fertility. This study analyzed the effect of sperm quality after sY1192 loss in 116 patients. The sY1192-independent deletion accounted for 41.4% (48/116). Eight patterns were found in the deletions associated with sY1192. The rate of sperm detection was similar in the semen of patients with the independent sY1192 deletion and the combined sY1192 deletions (52.1% vs 50.0%). The patients with only sY1192 gene loss had a higher probability of sperm detection than the patients whose sY1192 gene locus existed, but other gene loci were lost (52.1% vs 32.0%). The hormone levels were similar in patients with sY1192 deletion alone and in those with sY1192 deletion and other types of microdeletions in the presence of the sY1192 locus. After multiple intracytoplasmic sperm injection (ICSI) attempts, the pregnancy rate of spouses of men with sY1192-independent deletions was similar to that of other types of microdeletions, but the fertilization and cleavage rates were higher. We observed that eight deletion patterns were observed for sY1192 microdeletions of AZFb/c, dominated by the independent deletion of sY1192. After ICSI, the fertilization rate and cleavage rate of the sY1192-independent microdeletion were higher than those of other Y chromosome microdeletion types, but there was no significant difference in pregnancy outcomes.
Humans ; Female ; Pregnancy ; Male ; Chromosomes, Human, Y/genetics* ; Adult ; Chromosome Deletion ; Pregnancy Outcome/genetics* ; Infertility, Male/genetics* ; Spermatozoa/physiology* ; Semen Analysis ; Sex Chromosome Disorders of Sex Development/genetics* ; Sperm Injections, Intracytoplasmic ; Azoospermia/genetics* ; Sex Chromosome Aberrations

Nonobstructive azoospermia (NOA) affects about 60% of men with azoospermia, representing a severe form of male infertility. The current approach to manage NOA primarily involves testicular sperm retrieval methods such as conventional testicular sperm extraction (c-TESE) and microdissection testicular sperm extraction (micro-TESE). While combining testicular sperm retrieval with intracytoplasmic sperm injection (ICSI) offers hope for patients, the overall sperm retrieval rate (SRR) stands at around 50%. In cases where micro-TESE fails to retrieve sperm, limited options, like donor sperm or adoption, can be problematic in certain cultural contexts. This paper delves into prospective treatments for NOA management. Gene editing technologies, particularly clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated (Cas) protein 9 (CRISPR/Cas9), hold potential for correcting genetic mutations underlying testicular dysfunction. However, these technologies face challenges due to their complexity, potential off-target effects, ethical concerns, and affordability. This calls for research to address key challenges associated with NOA management within the clinical settings. This also necessitate ongoing research essential for developing more sensitive diagnostic tests, validating novel treatments, and customizing current treatment strategies for individual patients. This review concluded that the future of NOA management may entail a combination of these treatment options, tailored to each patient's unique circumstances, providing a comprehensive approach to address NOA challenges.
Humans ; Male ; Gene Editing/methods* ; Azoospermia/genetics* ; Sperm Retrieval ; Sperm Injections, Intracytoplasmic ; CRISPR-Cas Systems ; Spermatozoa ; Stem Cells

Ureaplasma urealyticum (UU) is one of the most commonly occurring pathogens associated with genital tract infections in infertile males, but the impact of seminal UU infection in semen on intrauterine insemination (IUI) outcomes is poorly understood. We collected data from 245 infertile couples who underwent IUI at The First Affiliated Hospital of USTC (Hefei, China) between January 2021 and January 2023. The subjects were classified into two groups according to their UU infection status: the UU-positive group and the UU-negative group. We compared semen parameters, pregnancy outcomes, and neonatal birth outcomes to investigate the impact of UU infection on IUI outcomes. There were no significantly statistical differences in various semen parameters, including semen volume, sperm concentration, total and progressive motility, sperm morphology, leukocyte count, the presence of anti-sperm antibody, and sperm DNA fragmentation index (DFI), between the UU-positive and UU-negative groups of male infertile patients (all P > 0.05). However, the high DNA stainability (HDS) status of sperm differed between the UU-positive and UU-negative groups, suggesting that seminal UU infection may affect sperm nuclear maturation ( P = 0.04). Additionally, there were no significant differences in pregnancy or neonatal birth outcomes between the two groups (all P > 0.05). These results suggest that IUI remains a viable and cost-effective option for infertile couples with UU infection who are facing infertility issues.
Humans ; Male ; Ureaplasma Infections/complications* ; Female ; Infertility, Male/therapy* ; Ureaplasma urealyticum/isolation & purification* ; Pregnancy ; Adult ; Pregnancy Outcome ; Semen Analysis ; Insemination, Artificial ; Semen/microbiology* ; China

Infertility, defined as the inability to conceive after 1 year of regular unprotected intercourse, impacts 10%-20% of couples globally. Both male and female factors contribute equally to this condition. Azoospermia, particularly nonobstructive azoospermia (NOA), which affects 10%-15% of infertile men, represents a significant challenge in male infertility. The advent of assisted reproductive technology (ART), specifically microdissection testicular sperm extraction (micro-TESE) followed by intracytoplasmic sperm injection (ICSI), offers a possibility for men with NOA to father biological children. Recent studies have focused on the predictors of sperm retrieval in NOA patients, such as age, testicular volume, and follicle-stimulating hormone (FSH) level. This review aims to explore the limited data on the anatomical characteristics of NOA patients and provide surgical considerations for micro-TESE, thereby enhancing understanding and improving outcomes for this challenging condition.
Humans ; Azoospermia/surgery* ; Male ; Testis/pathology* ; Sperm Retrieval ; Scrotum/pathology* ; Sperm Injections, Intracytoplasmic ; Microdissection

Since the early days of assisted reproductive technology (ART), the importance of sperm processing, employed to separate the motile, morphologically normal sperm from the semen, has been shown to be beneficial. The aim of the semen processing technique has been to remove seminal plasma and facilitate capacitation. Additionally, the presence of leukocytes, bacteria, and dead spermatozoa has been shown to be detrimental as it may cause oxidative stress that has an adverse effect on oocyte fertilization and embryo development. Hence, removal of leukocytes, bacteria, and dead spermatozoa is an important step of sperm processing for assisted reproduction. Currently, several sperm processing techniques have been evolved and optimized in the field of assisted reproduction. The requirements for in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and testicular sperm extraction (TESE) are different than those of intrauterine insemination (IUI). The yield of as many motile, morphologically normal sperm as possible is a prerequisite for the success of IVF insemination procedure. In ICSI, where injection of a single spermatozoon into the oocyte is performed by the embryologist, sperm selection techniques play a crucial role in the ICSI procedure. Finally, sperm retrieval in TESE samples with very low number of sperm may be challenging and requires extra care during sample processing. Additionally, sperm cryopreservation is necessary in TESE cases in order to avoid multiple biopsies.
Humans ; Sperm Injections, Intracytoplasmic/methods* ; Male ; Fertilization in Vitro/methods* ; Sperm Retrieval ; Andrology/methods* ; Cryopreservation ; Female ; Spermatozoa

The use of fresh versus frozen spermatozoa in men with nonobstructive azoospermia (NOA) undergoing in vitro fertilization (IVF) has been a debated hot topic among reproductive specialists. Each approach presents distinct advantages and disadvantages, with fresh sperm typically showing superior sperm quality, while frozen sperm offers logistical flexibility and a reliable backup for repeated cycles. This review summarizes the latest advancements in sperm retrieval and cryopreservation techniques, providing practitioners with a comprehensive analysis of each option's strengths and limitations. Comparative studies indicate that, although fresh sperm often has better quality metrics, cryopreservation methods such as vitrification have significantly improved postthaw outcomes, making frozen sperm a viable choice in assisted reproductive technologies (ART). The findings show comparable rates for fertilization, implantation, clinical pregnancy, and live birth between fresh and frozen microdissection testicular sperm extraction (micro-TESE) sperm in many cases, although patient-specific factors such as timing, cost-effectiveness, and procedural convenience should guide the final decision. Ultimately, the choice of using fresh or frozen sperm should align with the individual needs and conditions of patients. This tailored approach, supported by the latest advancements, can optimize ART outcomes and provide personalized reproductive care.
Humans ; Cryopreservation/methods* ; Male ; Sperm Retrieval ; Semen Preservation/methods* ; Azoospermia/therapy* ; Pregnancy ; Female ; Fertilization in Vitro ; Spermatozoa ; Microdissection ; Pregnancy Rate