Objective: To assess the utilization of reproductive health services in urban slum of Jodhpur city, India. Methods: A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021. Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care (ANC) services, delivery and post-partum services. Results: The majority of females were aged less than 25 years (n=195; 65.0%), married after 18 years (n=240; 80%), living in extended families (n=265; 88.3%) and with monthly family income less than 10000 rupees (n=182; 60.7%). Statistically significant associations were found between ≥4 ANC visits and educational level of secondary and above (OR 2.47, 95% CI 1.03-6.28; P=0.04), older age (OR 15.70, 95% CI 14.87–16.54 for women aged 26–35 years, OR 16.14, 95% CI 12.12–20.01 for women aged ≥36 years; P<0.01), and backward and general castes (OR 15.91, 95% CI 13.57–17.85 for backward caste and OR 8.11, 95% CI 8.07–8.26 for general category of caste; P<0.01). Seven percent of females had undergone parturition. Older age was associated with higher risks of postpartum complications (OR 1.06, 95% CI 1.01–1.57 for women aged 26-35 years, OR 3.56, 95% CI 1.29–4.69 for women aged ≥36 years; P<0.01). In addition, risks of postpartum complications were associated with backward and general castes (OR 1.69, 95% CI 1.34–2.13 for backward classes and OR 5.01, 95% CI 4.29–5.31 for general category castes; P<0.01), and more than 4 ANC visits (OR 0.20, 95% CI 0.09-0.34; P<0.01). Conclusions: More frequent ANC visits are associated with a lower risk of postpartum complications. Furthermore, a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.

Objective: To assess whether the coronavirus disease 2019 (COVID-19) mRNA vaccine affects sperm morphokinetics using a computer-assisted semen analyzer and other semen parameters using a sperm chromatin structure assay. Methods: Healthy male volunteers in two Japanese clinics between May 2021 and December 2021 were prospectively analyzed. Participants donated sperm twice, two days apart, in the following phases: before vaccination, 2 weeks after the first vaccine dose, and 2, 4, and 12 weeks after the second dose. Basic sperm parameters, sperm motility characteristics, and the percentage of DNA-damaged sperm were compared among the different phases. Results: Ninety-six semen samples from ten volunteers, who were vaccinated with the BNT162b2 mRNA vaccine, were evaluated. There were no significant differences between any phases in basic semen findings and parameters of the sperm chromatin structure assays. Regarding sperm motion characteristics, the average linear velocity, beat-cross frequency, and sperm motility index significantly decreased after the second vaccine dose (P=0.018, P=0.003, and P=0.027, respectively), with no significant differences between any two phases by post-hoc pairwise comparisons. Conclusions: After COVID-19 mRNA vaccination, while sperm motion characteristics might fluctuate, no apparent deterioration of basic sperm parameters or sperm DNA integrity was observed. Given the adverse effects of COVID-19 on sperm, our findings suggest that there might be no reason to refrain from vaccination for healthy individuals.

Objective: To elucidate the possible role of unfractionated heparin in patients with failed repeated in in vitro fertilization and embryo transfer (IVF-ET) and thrombophilia. Methods: This case control study evaluated the efficacy of the unfractionated heparin in increasing the pregnancy and implantation ratio in women with recurrent IVF-ET failures. Eighty-six women received in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) with a record of three or more previous IVF-ET failures. Participants were randomly distributed into two groups. Group A (n=43) received unfractionated heparin 5 000 IU twice daily, and group B (n=43) did not take any antithrombotic drugs. Coagulation abnormalities such as factor V Leiden (FVL) mutation, methylene tetra hydro folate reductase (MTHFR) mutation and prothrombin mutation (FII) were evaluated. Age, body mass index, basal follicular stimulating hormone, basal estradiol, duration of infertility, and number of IVF-ET failures were compared between two groups. Results: 45.0% and 17.4% of women were pregnant with and without MTHFR and prothrombin mutation, respectively, when they received unfractionated heparin treatment. The implantation rate was more in group A (12.5%) than group B (4.3%) and differences in the fertilization rate of the two groups were observed (27.7% vs. 35.9%). The clinical pregnancy rate per cycle was remarkably more in group A (30.2%) than group B (14.0%). Conclusions: Heparin is a safe and valuable treatment for patients with repeated IVF-ET failures. The clinical pregnancy and implantation rates are higher in the heparin-treated group in contrast with the control group. Trial registration: The trial registration was done with clinical registration number of “ IRCT138807202575N1”.

Objective: To investigate the protective role of pumpkin seed ethanolic extract against escitalopram-induced reproductive toxicity in male mice. Methods: Swiss albino male mice were randomly divided into five groups with six mice in each group. Group I received normal water orally, Group II, III, IV and V received escitalopram oxalate (10 mg/kg), pumpkin seed extract (300 mg/kg) plus escitalopram oxalate (10 mg/kg), escitalopram oxalate (20 mg/kg), and pumpkin seed extract (300 mg/kg) plus escitalopram oxalate (20 mg/kg), respectively. All test doses were continuously administered orally once daily per animal body weight for 30 days and 60 days. Body weight and sexual organ weight were evaluated on day 31 and 61. Effects of pumpkin seed extract on sperm parameters, biochemical parameters and histology of testis were also investigated. Results: Escitalopram 10 or 20 mg/kg caused reproductive toxicity in male mice after 30 and 60 days of treatment. However, simultaneous administration of escitalopram oxalate (10 or 20 mg/kg) with pumpkin seed extract (300 mg/kg) attenuated escitalopram-induced testicular toxicity. Significant increase in the body weight and relative organ weight was observed. Sperm count, sperm motility and viability significantly increased (P<0.05). The histopathological alterations caused by escitalopram was also ameliorated. Conclusions: Ethanolic extract of pumpkin seeds (300 mg/kg body weight) protects again reproductive toxicity induced by escitalopram. Therefore, dietary intake of pumpkin seed extract might be useful for male patients who expose to antidepressant drug due to depression.

Objective: To investigate the protective effect of vitamin E in dehydroepiandrosterone (DHEA)-induced polycystic ovary in rats. Methods: Premature female Wistar rats were randomly allocated into four groups, with 7 rats in each group. Group I received corn oil (vehicle) and served as the control group; group II received 0.2 mL of 0.06 mg/g DHEA in corn oil; group III received 200 mg/kg vitamin E; group IV received DHEA plus vitamin E. All treatments lasted for 15 days, with DHEA administered subcutaneously, while vitamin E and corn oil were administered orally. After the experiment, serum samples and ovaries were harvested for biochemical, immunohistochemical, hormonal, and histological analysis. The ovarian mRNA expression of androgen receptor was analyzed by reverse transcriptase quantitative polymerase chain reaction (qPCR). Results: The antioxidant and metabolic enzyme activity significantly decreased in the DHEA-treated rats compared to the control rats (P<0.05). Administration of vitamin E to DHEA-treated rats significantly decreased cytokines and malondialdehyde compared to the DHEA-treated rats. The histological analysis showed reduced atretic and cystic ovaries, increased E-cadherin and Bcl-2 expression, and reduced expression of Bax in the DHEA-treated rats co-treated with vitamin E. The mRNA expression of androgen receptor was upregulated in the DHEA-treated rats compared to the control rats. Conclusions: Vitamin E ameliorates the hyperandrogenic effect of DHEA-induced polycystic ovaries via metabolic, antioxidant, and anti-apoptotic pathways.

Objective: To compare the effect of human chorionic gonadotropin (hCG)-producing peripheral blood mononuclear cells (PBMCs) and PBMCs activated by hCG in vitro and expressions of related immune genes in mouse implantation. Methods: hCG-producing PBMCs (transfected PBMC) and PBMCs activated by hCG in vitro were introduced into isolated mouse endometrial cells, while cell cultures were divided into four groups: the control, PBMC, transfected, and activated PBMC groups. The expression of studied genes (IL-lβ, IL-6, Lif, and Vegf) was evaluated and blastocyst attachment on the cocultured cells (isolated endometrial cells and PBMC cells) was monitored in all four groups. Results: Data showed that expression decreased in the PBMC group compared to the treated PBMC (transfected and activated PBMCs) and increased in transfected PBMC compared to the activated PBMC. Attachment and migration of blastocysts were dramatically enhanced in the transfected PBMC group compared to the activated PBMC group (P<0.05). Conclusions: Use of hCG-producing PBMCs (transfected PBMC) has more influence on endometrial receptivity.