<i>Background</i>. Modern contraceptives are highly effective and reliable methods of preventing unintended pregnancies and reducing maternal deaths. Only 22 percent of currently married women use modern methods of contraceptives in Afghanistan. This study assessed the factors associated with modern contraceptive use among married women attending comprehensive health centers (CHCs) in Kandahar Province. <i>Methods</i>. This was an institution-based cross-sectional study that included 325 married women who attended randomly selected comprehensive health clinics in Kandahar between September and October 2019. The total sample size was allocated proportionally to selected health clinics based on the recent 3-month average patients load. We used a consecutive sampling method to select study participants. Data were collected in a structured questionnaire, which included information on respondents’ demographic, socioeconomic, reproductive, and contraceptive experiences. Data was analyzed using SPSS 21.00 statistical software. We used descriptive statistics such as tables and proportions to present data. Binary and multiple logistic regression analyses were carried out to determine factors associated with modern contraceptive use. <i>Results</i>. Out of 325 married women, 127 used modern contraceptives with a prevalence of 39.1% (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="46.699pt" style="vertical-align:-0.4673605pt" id="M1" height="9.2207pt" version="1.1" viewBox="-0.0498162 -8.75334 46.699 9.2207"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-58" d="M244 635C114 635 38 519 38 422C38 317 111 240 217 240C236 240 255 244 277 256L345 292C311 140 203 39 59 15L64 -15C89 -15 150 -5 204 17C339 72 440 202 440 386C440 521 368 635 244 635ZM228 602C326 602 352 479 352 390C352 370 351 347 348 324C327 308 293 296 258 296C174 296 124 369 124 458C124 517 152 602 228 602Z"/></g><g transform="matrix(.013,0,0,-0.013,6.241,0)"><path id="g113-54" d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z"/></g><g transform="matrix(.013,0,0,-0.013,12.482,0)"><path id="g121-35" d="M594 629L561 652L159 -9L190 -32L594 629ZM194 635C92 635 49 534 49 453C49 374 92 272 193 272C295 272 338 374 338 454S295 635 194 635ZM193 605C257 605 265 504 265 453C265 405 257 302 194 302C133 302 122 403 122 454S133 605 193 605ZM567 351C465 351 421 250 421 169C421 90 465 -12 566 -12S710 90 710 170S667 351 567 351ZM566 322C628 322 637 221 637 169C637 121 628 18 567 18S494 119 494 170C494 223 506 322 566 322Z"/></g><g transform="matrix(.013,0,0,-0.013,22.31,0)"><path id="g190-68" d="M614 175C564 76 510 21 408 21C256 21 146 149 146 336C146 488 235 629 402 629C510 629 570 586 597 480L626 488C620 541 614 582 606 638C578 643 510 665 429 665C206 665 44 527 44 316C44 157 153 -15 402 -15C474 -15 558 5 586 11C604 45 629 119 643 165L614 175Z"/></g><g transform="matrix(.013,0,0,-0.013,30.954,0)"><path id="g190-74" d="M303 0V28C221 34 213 39 213 125V525C213 610 221 616 303 622V650H38V622C120 616 128 610 128 525V125C128 40 120 34 38 28V0H303Z"/></g><g transform="matrix(.013,0,0,-0.013,39.068,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z"/></g></svg><span class="irelop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="31.841pt" style="vertical-align:-0.4673605pt" height="9.2207pt" version="1.1" viewBox="50.2811838 -8.75334 31.841 9.2207"><g transform="matrix(.013,0,0,-0.013,50.331,0)"><path id="g113-52" d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z"/></g><g transform="matrix(.013,0,0,-0.013,56.572,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.013,0,0,-0.013,62.812,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,65.776,0)"><path id="g113-56" d="M447 623H65C61 580 56 530 47 475H76C100 541 106 550 172 550H388C308 376 196 170 91 -1L98 -12L172 -2C268 204 360 408 455 611L447 623Z"/></g><g transform="matrix(.013,0,0,-0.013,72.018,0)"><use xlink:href="#g121-35"/></g></svg></span>–44.6%). The results indicated that the area of residence (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M2" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-66" d="M673 0V28C608 34 594 43 563 129C499 303 432 494 370 665L339 656L132 132C98 43 84 37 20 28V0H238V28C162 35 154 45 175 108C188 150 203 192 219 237H432C454 176 474 122 487 83S491 36 428 28V0H673ZM418 280H234C265 362 296 450 328 535H330L418 280Z"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><path id="g190-80" d="M381 665C170 665 44 498 44 318C44 125 188 -15 369 -15C552 -15 703 117 703 333C703 534 550 665 381 665ZM359 629C491 629 601 517 601 306C601 114 502 21 390 21C249 21 146 158 146 346S248 629 359 629Z"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><path id="g190-83" d="M631 18C609 24 585 35 559 65C534 91 514 117 478 169C448 214 406 281 389 313C462 346 516 399 516 485C516 545 490 590 449 616C412 641 363 650 290 650H42V622C120 615 128 612 128 527V125C128 40 120 34 38 28V0H300V28C221 34 212 40 212 125V284H244C295 284 312 272 329 244C359 195 395 133 430 84C475 19 516 -3 592 -7C603 -8 615 -8 627 -8L631 18ZM212 316V563C212 591 215 602 223 607C231 613 248 617 277 617C352 617 423 577 423 469C423 415 407 375 368 345C343 324 310 316 260 316H212Z"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><path id="g113-51" d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 635 234 635C177 635 130 609 99 576L42 495L64 475C90 514 133 568 201 568C274 568 318 519 318 435C318 349 255 267 193 193C144 135 87 78 32 23V0H405C417 45 427 89 440 131L412 140Z"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><path id="g113-55" d="M137 343C167 482 260 545 321 574C357 591 397 603 429 609L423 641C382 634 335 622 295 608C189 570 37 457 37 238C37 84 125 -12 242 -12C362 -12 447 89 447 209C447 311 374 393 267 393C247 393 226 386 204 376L137 343ZM227 337C318 337 361 256 361 173C361 105 336 22 258 22C176 22 126 120 126 240C126 266 127 291 132 310C155 323 189 337 227 337Z"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g></svg>,</span></span> 95% CI 1.43-4.78) and ever use of contraceptives (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M3" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="28.157pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 28.157 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><path id="g113-53" d="M456 178V225H360V632H320C217 496 115 347 20 206V178H280V106C280 40 276 34 189 27V0H445V27C364 34 360 39 360 106V178H456ZM280 225H82C149 335 214 431 278 520H280V225Z"/></g><g transform="matrix(.013,0,0,-0.013,53.76,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><use xlink:href="#g113-58"/></g><g transform="matrix(.013,0,0,-0.013,62.965,0)"><use xlink:href="#g113-51"/></g></svg>,</span></span> 95% CI 6.88-32.34) are associated with modern contraceptive use among married women attending comprehensive health centers in Kandahar. <i>Conclusion</i>. This study found that modern contraceptive use was higher than reported on the national level. The most persistent factors associated with modern contraceptive use in this study were urban residence and ever use of contraceptives. As a policy measure, family planning programs should be prompted to the rural residency in Kandahar Province.

Mirwais Saheem

Muhammad Haroon Stanikzai

Najeeb Rahimy

Najibullah Fazli

Ghulam Mohydin Mudasir

Hadia Sayam

Factors Associated with Modern Contraceptive Use among Married Women Attending Comprehensive Health Centers (CHCs) in Kandahar, Afghanistan

<i>Background</i>. It is estimated that more than 142 million married women in developing countries have an unmet need for family planning. This study is aimed at identifying factors associated with the unmet need of family planning among married women of reproductive age in Toke Kutaye district, Ethiopia in 2019. <i>Methods</i>. A community-based cross-sectional study was conducted in Toke Kutaye district from March 1–30, 2019. A systematic random sampling technique was used to select 494 reproductive-age women who were married during data collection. Data were collected using a pretested structured questionnaire. Bivariate and multivariate logistic regression analyses were used to assess factors associated with the unmet need of family planning at 95% CI with a <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-3.42943pt" id="M1" height="10.2124pt" version="1.1" viewBox="-0.0498162 -6.78297 7.83752 10.2124" width="7.83752pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z"/></g></svg> value of ≤ 0.05. <i>Result</i>. The prevalence of unmet need for family planning in the Toke Kutaye district was 23.1% [95% CI (19.2-26.7)], with 15.2% for spacing and 7.9% for limiting. Women’s education [AOR, 3.64, 95% CI: 1.43-9.25], number of living children [AOR, 2.63, 95% CI: 1.37-5.05], husband disapproval of family planning [AOR, 3.68, 95% CI: 2.20-6.16], and discussion with healthcare providers on family planning [AOR, 0.20, 95% CI: 0.13-0.37] were significantly associated with unmet need for family planning. <i>Conclusion</i>. The prevalence of unmet need for family planning was high. Therefore, program managers, partners, and health workers should work to address the gaps in maternal education, the number of living children, partner disapproval of family planning, and discussion on family planning issues through enhancing female education, awareness on family planning, and male involvement in family planning services.

Abebe Tadesse G/Meskel

Habtamu Oljira Desta

Elias Teferi Bala

Factors Associated with Unmet Need for Family Planning among Married Reproductive Age Women in Toke Kutaye District, Oromia, Ethiopia

<i>Background</i>. Healthcare providers play a major role in the implementation of family planning policies. In Ghana, there has been a conscious effort to improve the knowledge of preservice and practicing health professionals on family planning. However, there have been concerns about the appropriateness of the attitudes and practices of these health cadres and, hence, their propensity to become barriers to the uptake of contraception in the general population. This study is aimed at assessing the attitudes and practices of healthcare workers and clinical-year medical students in contraceptives use, advocacy, and service provision. <i>Methods</i>. A cross-sectional survey was conducted among health workers and clinical-year medical students from January 1 to June 30, 2018. Variables assessed included sexual activity status, previous and current contraceptive use, and satisfaction with contraceptive use among others. Data from 400 self-administered, structured questionnaires comprising close- and open-ended questions was entered in SPSS version 22 and analysed using same. The variables assessed were presented as means, frequencies, and percentages. <i>Results</i>. About 58&#x0025; of the respondents were sexually active. Half of the participants (50.2&#x0025;) had used a form of contraception before, with condoms and other barrier methods being the most preferred (67.7&#x0025;). However, only 18&#x0025; of respondents were on a form of contraceptive at the time of the survey. Four out of five (82.6&#x0025;) of the users of these contraceptives were satisfied with their past use. A little over half of the participants had discussed contraception with their partners. Over four-fifths of participants thought family planning was beneficial and were willing to encourage others to use a method of family planning. Majority (63.7&#x0025;) of the participants had had formal training in family planning, but only 72 (18&#x0025;) were actively involved in the provision of family planning services. <i>Conclusions</i>. Although the attitudes of the health workers and trainees toward family planning were excellent generally, only a few were using a method of contraception at the time of the survey despite the fact that most of them were sexually active. There is a need to intensify communication on behaviour change towards contraception among health professionals and clinical-year medical students in order to strengthen their role as change agents in an effort to improve community uptake.

Evans Kofi Agbeno

Joseph Osarfo

Betty Anane-Fenin

Emmanuel Kusi Achampong

Naa Adei Neequaye

Douglas Aninng Opoku

Mohammed Aliyu

Sebastian Ken-Amoah

Anthony Amanfo Ofori

Joycelyn A. Ashong

Attitudes and Practices of Healthcare Professionals and Clinical Medical Students on Contraception: A Cross-Sectional Study in Cape Coast, Ghana

<i>Background</i>. Sexual and reproductive health (SRH) communication is most likely to promote healthy sexual practices and to reduce risky sexual behavior among adolescents. Communication is the principal means for parents to transmit sexual values and knowledge to their children. Although there are few studies conducted on parent-adolescent communication, there is no study conducted in the town of Ambo. This study was aimed at assessing the level of parent-adolescent communication on SRH issues and its associated factors among school students in Ambo town, Oromia, Ethiopia. <i>Method</i>. An institution-based concurrent mixed-method cross-sectional study was conducted among 591 secondary and preparatory school students in Ambo town from February 24<sup>th</sup> to March 9<sup>th</sup>, 2019. A systematic sampling technique was used to select the study subject. Data were collected through self-administered questionnaires, and FGD was conducted with parents of students. Data was entered using EpiData version 3.1 and exported to SPSS version 23.0 for statistical analysis. Binary and multivariable logistic regression analyses were used to ascertain the association using a 95% confidence interval (CI) and <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-3.42943pt" id="M1" height="10.2124pt" version="1.1" viewBox="-0.0498162 -6.78297 7.83752 10.2124" width="7.83752pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z"/></g></svg> value (&lt;0.05). <i>Results</i>. The proportion of students who had communication on sexual and reproductive health issues with their parents was 222 (37.6%). Being female (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M2" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-66" d="M673 0V28C608 34 594 43 563 129C499 303 432 494 370 665L339 656L132 132C98 43 84 37 20 28V0H238V28C162 35 154 45 175 108C188 150 203 192 219 237H432C454 176 474 122 487 83S491 36 428 28V0H673ZM418 280H234C265 362 296 450 328 535H330L418 280Z"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><path id="g190-80" d="M381 665C170 665 44 498 44 318C44 125 188 -15 369 -15C552 -15 703 117 703 333C703 534 550 665 381 665ZM359 629C491 629 601 517 601 306C601 114 502 21 390 21C249 21 146 158 146 346S248 629 359 629Z"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><path id="g190-83" d="M631 18C609 24 585 35 559 65C534 91 514 117 478 169C448 214 406 281 389 313C462 346 516 399 516 485C516 545 490 590 449 616C412 641 363 650 290 650H42V622C120 615 128 612 128 527V125C128 40 120 34 38 28V0H300V28C221 34 212 40 212 125V284H244C295 284 312 272 329 244C359 195 395 133 430 84C475 19 516 -3 592 -7C603 -8 615 -8 627 -8L631 18ZM212 316V563C212 591 215 602 223 607C231 613 248 617 277 617C352 617 423 577 423 469C423 415 407 375 368 345C343 324 310 316 260 316H212Z"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><path id="g113-51" d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 635 234 635C177 635 130 609 99 576L42 495L64 475C90 514 133 568 201 568C274 568 318 519 318 435C318 349 255 267 193 193C144 135 87 78 32 23V0H405C417 45 427 89 440 131L412 140Z"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g><g transform="matrix(.013,0,0,-0.013,56.723,0)"><path id="g113-56" d="M447 623H65C61 580 56 530 47 475H76C100 541 106 550 172 550H388C308 376 196 170 91 -1L98 -12L172 -2C268 204 360 408 455 611L447 623Z"/></g></svg>,</span></span> 95% CI: 1.40-3.07), private school (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M3" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><use xlink:href="#g113-56"/></g><g transform="matrix(.013,0,0,-0.013,56.726,0)"><use xlink:href="#g113-56"/></g></svg>,</span></span> 95% CI: 1.17-3.69), a father with secondary education (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M4" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><path id="g113-58" d="M244 635C114 635 38 519 38 422C38 317 111 240 217 240C236 240 255 244 277 256L345 292C311 140 203 39 59 15L64 -15C89 -15 150 -5 204 17C339 72 440 202 440 386C440 521 368 635 244 635ZM228 602C326 602 352 479 352 390C352 370 351 347 348 324C327 308 293 296 258 296C174 296 124 369 124 458C124 517 152 602 228 602Z"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><path id="g113-52" d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z"/></g></svg>,</span></span> 95% CI: 1.05-8.12) and diploma and above (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M5" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.013,0,0,-0.013,47.52,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.484,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><use xlink:href="#g113-56"/></g></svg>,</span></span> 95% CI: 1.23-8.71), considering sex education necessary (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M6" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><path id="g113-57" d="M249 635C141 635 70 555 70 471C70 401 114 353 179 316C143 294 106 267 90 252C68 231 45 202 45 157C45 50 130 -12 237 -12C322 -12 435 52 435 169C435 256 372 304 303 343C349 374 375 398 383 407C401 429 411 458 411 487C411 569 344 635 249 635ZM238 603C285 603 337 567 337 482C337 422 310 385 276 358C205 393 145 426 145 500C145 552 179 603 238 603ZM248 20C183 20 125 70 125 163C125 218 158 268 206 300C284 261 355 217 355 143C355 66 308 20 248 20Z"/></g><g transform="matrix(.013,0,0,-0.013,56.723,0)"><use xlink:href="#g113-52"/></g></svg>,</span></span> 95% CI: 1.22-6.57), got information about SRH issues from school (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M7" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,56.723,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g></svg>,</span></span> 95% CI: 1.06-2.36) and media (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M8" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><use xlink:href="#g113-58"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><use xlink:href="#g113-51"/></g></svg>,</span></span> 95% CI: 1.49-3.71), and mother’s openness to communicate about SRH issues (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M9" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.013,0,0,-0.013,47.52,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.484,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><use xlink:href="#g113-49"/></g></svg>,</span></span> 95% CI: 1.31-4.05) were found to be significantly associated with parent-adolescent communication on SRH issues. <i>Conclusions</i>. The study showed that parent-adolescent communication on SRH issues is low. Being female, those from a private school, father’s education, perceived importance of sex education, source of information about SRH issues (school and media), and mother’s openness to communicate about SRH issues were identified to be factors associated with the communication. Therefore, the concerned body should consider the identified factors to improve the current level of parent-adolescent communication and adolescent reproductive health.

Tesfaye Shibiru Bikila

Nagasa Dida

Gizachew Abdissa Bulto

Bikila Tefera Debelo

Kababa Temesgen

Adolescents&#x2019; Communication on Sexual and Reproductive Health Matters with Their Parents and Associated Factors among Secondary and Preparatory School Students in Ambo Town, Oromia, Ethiopia

<i>Introduction</i>. Substance use by homeless reproductive age people may result to anxiety, involvement of risky sexual behaviors, and increasing the likelihood of unwanted pregnancy and sexually transmitted diseases (STDs). Therefore, this study assessed the magnitude of alcohol use, sexual intercourse after alcohol use, and its associated factors among homeless reproductive age people in southern Ethiopia. <i>Methods</i>. Community-based cross-sectional study design was conducted among homeless reproductive age people. The snowball sampling technique was used to recruit 842 participants. Pretested and structured interviewer-administered questionnaire was used to collect the data. Data were entered into Epidata version 3.1 and exported to SPSS version 23 for analysis. Binary logistic regression was used to determine the association of independent variables with the outcome variables. Odds ratio with their 95% confidence interval and <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.0498209pt" id="M1" height="8.68572pt" version="1.1" viewBox="-0.0498162 -8.6359 8.15071 8.68572" width="8.15071pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-81" d="M600 480C600 590 528 650 384 650H143L137 622C222 614 225 607 210 531L130 127C113 41 106 36 23 28L17 0H294L300 28C204 36 195 42 212 127L243 284L314 263C327 263 339 263 352 264C465 271 600 337 600 480ZM508 481C508 351 402 304 329 304C289 304 265 311 250 317L295 559C302 594 310 606 323 611C335 616 350 619 367 619C455 619 508 573 508 481Z"/></g></svg> value was used to identify the significant variables. <i>Results</i>. More than half 423 (53.2%) of the respondents had taken a drink that contains alcohol in the last one year of the study period. Out of 324 khat chewers, 190 (58.64%) had sex after chewing khat. More than one-thirds, 323(38.4%) homeless people were smoking cigarette during the study period. Factors associated with alcohol use were age 19-25 years (AOR: 0.49; CI: 0.34, 0.72), ≥26 years (AOR: 0.40; CI: 0.25, 0.65), level of education (AOR: 0.61; CI: 0.39, 0.94), place of residence: major urban (AOR: 0.31; CI: 0.18, 0.51), small town (AOR: 0.38; CI: 0.23, 0.63), ever heard about STDs (AOR: 0.14; CI: 0.07, 027), and being a cigarette smoker (AOR: 2.67; CI: 1.94, 3.71). <i>Conclusions</i>. In this study, significant percentage of respondents had taken a drink that contains alcohol. Age, level of education, place of residence, ever heard about STDs, and smoking cigarette were variables significantly associated with alcohol use. Awareness creation on the effect and outcome of substance use is recommended.

Negash Wakgari

Terefe Woyo

Emnet Kebede

Hirut Gemeda

Wakgari Binu

Gonfa Moti

Substance Use among Homeless Reproductive Age People in Southern Ethiopia

<i>Background</i>. Several studies have investigated on the polymorphism Ser680Asn of FSHR and its use as a predictive indicator of response to an IVF/ICSI protocol. Furthermore, measurement of AMH in serum and follicular fluid is a useful prognostic indicator for the outcome of an assisted reproduction attempt. The purpose of this study is to examine the FSH receptor Ser680Asn polymorphism in combination with AMH levels in both serum and follicular fluid, on the day of oocyte collection. <i>Materials and Methods</i>. A total of 32 women who underwent IVF/ICSI were included. Women were grouped into 2 groups: those who received rFSH (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="17.789pt" style="vertical-align:-0.2063904pt" id="M1" height="8.55521pt" version="1.1" viewBox="-0.0498162 -8.34882 17.789 8.55521"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-111" d="M495 86L479 114C446 82 419 66 409 66C401 66 401 72 406 97C420 166 436 231 453 297C489 435 454 448 428 448C406 448 384 439 354 422C305 394 222 327 161 247H159L183 345C200 415 194 448 173 448C143 448 82 410 23 351L38 325C64 349 95 371 105 371C111 371 116 365 109 336L25 -4L31 -12C50 -4 77 3 107 9C119 69 132 122 145 168C197 254 321 381 370 381C387 381 393 374 378 305L329 95C309 17 320 -12 345 -12C372 -12 430 19 495 86Z"/></g><g transform="matrix(.013,0,0,-0.013,10.158,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="12.679pt" style="vertical-align:-0.2063904pt" height="8.55521pt" version="1.1" viewBox="21.3711838 -8.34882 12.679 8.55521"><g transform="matrix(.013,0,0,-0.013,21.421,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g><g transform="matrix(.013,0,0,-0.013,27.661,0)"><use xlink:href="#g113-50"/></g></svg>)</span></span> and those who received hMG (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="17.789pt" style="vertical-align:-0.2063904pt" id="M2" height="8.55521pt" version="1.1" viewBox="-0.0498162 -8.34882 17.789 8.55521"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-111"/></g><g transform="matrix(.013,0,0,-0.013,10.158,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="12.679pt" style="vertical-align:-0.2063904pt" height="8.55521pt" version="1.1" viewBox="21.3711838 -8.34882 12.679 8.55521"><g transform="matrix(.013,0,0,-0.013,21.421,0)"><path id="g113-51" d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 635 234 635C177 635 130 609 99 576L42 495L64 475C90 514 133 568 201 568C274 568 318 519 318 435C318 349 255 267 193 193C144 135 87 78 32 23V0H405C417 45 427 89 440 131L412 140Z"/></g><g transform="matrix(.013,0,0,-0.013,27.661,0)"><use xlink:href="#g113-50"/></g></svg>).</span></span> Serum AMH was measured on day 3 of the cycle, and AMH in the follicular fluid on the day of oocyte retrieval; the same day peripheral blood was collected for the genotyping of Ser680Asn. <i>Results</i>. No statistical significant difference was found between serum AMH and follicular fluid AMH regarding the FSH receptor genotype for the Ser680Asn polymorphism. Regarding the sAMH/ffAMH ratio in the 3 genotypes, the value was lower in Asn/Asn women than Ser/Ser and Ser/Asn, but no statistical difference was obtained. Women who carry the Ser allele have a higher number of follicles, retrieved oocytes, and mature oocytes than women who do not contain the Ser allele. Women with <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="41.901pt" style="vertical-align:-3.403299pt" id="M3" height="12.7112pt" version="1.1" viewBox="-0.0498162 -9.3079 41.901 12.7112"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-66" d="M673 0V28C608 34 594 43 563 129C499 303 432 494 370 665L339 656L132 132C98 43 84 37 20 28V0H238V28C162 35 154 45 175 108C188 150 203 192 219 237H432C454 176 474 122 487 83S491 36 428 28V0H673ZM418 280H234C265 362 296 450 328 535H330L418 280Z"/></g><g transform="matrix(.013,0,0,-0.013,8.983,0)"><path id="g190-78" d="M861 0V28C774 35 771 41 768 147L759 509C756 612 762 614 851 622V650H681L449 149L221 650H57V622C148 613 153 609 144 479L130 271C123 166 117 123 111 88C104 46 85 34 26 28V0H259V28C192 35 169 42 167 90C166 130 166 173 170 256L185 541H187L411 7H431L675 555H679L683 147C683 41 680 35 598 28V0H861Z"/></g><g transform="matrix(.013,0,0,-0.013,20.566,0)"><path id="g190-73" d="M729 650H468V622C546 615 554 610 554 527V365H213V527C213 610 221 616 297 622V650H38V622C120 616 128 611 128 527V123C128 39 120 34 40 28V0H303V28C221 34 213 40 213 123V322H554V123C554 39 546 34 460 28V0H728V28C647 34 639 39 639 123V527C639 610 647 615 729 622V650Z"/></g><g transform="matrix(.013,0,0,-0.013,34.27,0)"><path id="g117-91" d="M512 -3V55L134 254V256L512 456V514L75 281V230L512 -3Z"/></g></svg><span class="irelop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="42.356pt" style="vertical-align:-3.403299pt" height="12.7112pt" version="1.1" viewBox="45.4831838 -9.3079 42.356 12.7112"><g transform="matrix(.013,0,0,-0.013,45.533,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,51.773,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,54.737,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,60.977,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,69.392,0)"><path id="g190-111" d="M524 0V26C466 32 460 36 460 104V297C460 393 411 449 331 449C302 449 276 437 248 419C223 402 201 387 181 372V451C137 432 90 420 42 411V388C96 378 102 374 102 310V104C102 38 97 33 29 26V0H246V26C187 32 181 36 181 104V339C211 365 250 390 290 390C357 390 381 345 381 276V109C381 40 374 32 315 26V0H524Z"/></g><g transform="matrix(.013,0,0,-0.013,76.399,0)"><path id="g190-104" d="M463 437C426 431 375 425 327 422C297 440 264 449 231 449H230C153 449 51 396 51 283C51 215 94 168 139 149C123 129 91 103 51 88C50 78 53 60 62 46C75 25 100 2 136 -9C112 -28 73 -59 53 -79C38 -94 29 -113 29 -135C30 -192 91 -257 203 -257C336 -257 452 -160 452 -59C452 39 371 59 309 59C275 59 240 58 203 58C158 58 140 77 140 96C140 110 157 129 170 138C186 135 205 133 221 133C306 133 396 185 396 293C396 328 384 360 366 381L423 378C439 387 459 413 468 429L463 437ZM219 418C277 418 314 362 314 284C314 205 275 166 231 165C176 165 137 221 137 299C137 376 177 418 219 418ZM241 -11C285 -11 314 -14 339 -24C367 -36 384 -61 384 -95C384 -157 335 -206 240 -206C166 -206 108 -165 108 -110C108 -82 128 -54 154 -32C172 -17 195 -11 241 -11Z"/></g><g transform="matrix(.013,0,0,-0.013,82.533,0)"><path id="g113-48" d="M368 703H309L44 -163H104L368 703Z"/></g></svg><span class="isep"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="14.278pt" style="vertical-align:-3.403299pt" height="12.7112pt" version="1.1" viewBox="87.84418380000001 -9.3079 14.278 12.7112"><g transform="matrix(.013,0,0,-0.013,87.894,0)"><path id="g190-110" d="M797 0V26C739 32 732 36 732 103V296C732 394 682 449 605 449C576 449 550 437 529 423C504 407 475 389 446 366C425 418 382 449 334 449C303 449 279 437 253 421C222 403 201 385 180 371V452C135 432 85 419 41 411V388C99 379 102 374 102 310V103C102 38 93 32 27 26V0H238V26C189 32 180 38 180 103V338C210 363 250 390 289 390C351 390 377 348 377 275V103C377 37 368 32 306 26V0H520V26C465 32 456 38 456 101V296C456 314 455 326 453 338C491 369 529 390 565 390C628 390 653 345 653 274V107C653 36 642 32 583 26V0H797Z"/></g><g transform="matrix(.013,0,0,-0.013,98.606,0)"><path id="g190-109" d="M238 0V26C174 32 166 38 166 104V712C132 700 70 683 18 677V653C81 647 87 645 87 577V104C87 38 78 32 15 26V0H238Z"/></g></svg></span> presented lower AMH follicular fluid levels and lower serum AMH/follicular fluid AMH ratio in a statistically significant manner. Concerning the genotype for the polymorphism Ser680Asn of FSHR in relation to AMH levels, no statistically significant differences were found. <i>Conclusions</i>. The identification of polymorphisms, such as Ser680Asn of FSHR, along with the determination of endocrine markers in the follicular fluid, such as AMH, could lead at some point, to the personalized therapy setting per woman.

Elli Anagnostou

Despina Mavrogianni

Ilectra-Niki Prifti

Evangelia Dimitroulia

Athanasios Protopapas

Peter Drakakis

Dimitrios Loutradis

The Role of FSHR SNPs and AMH in Follicular Fluid and Serum in Ovarian Response during COS: A Pilot Study

<i>Objective</i>. The follicular fluid (FF) plays an essential role in the physiology of the follicle and the oocyte. Gonadotropin stimulation affects the FF steroid hormone and anti-Mullerian hormone (AMH) concentrations, which has been suggested to be the reason for lower oocyte competence in conventional gonadotropin stimulated <i>in vitro</i> fertilisation (cIVF) compared to natural cycle IVF (NC-IVF). To analyse the effect of gonadotropin stimulation on a broad spectrum of signalling proteins, we ran proteomic antibody arrays on FF of women undergoing both treatments NC-IVF and cIVF. <i>Method</i>. Twenty women underwent one NC-IVF and one cIVF treatment cycle. Follicular fluids of the first aspirated follicle were compared between the two groups using a protein microarray which included antibodies against 224 proteins related to cell signalling and reference proteins. Each of the 40 albumin-stripped, matched-pair samples was labelled in the reverse-dye (Cy3/Cy5) procedure before undergoing array hybridisation. Signal analysis was performed using normalisation algorithms in dedicated software. Five proteins yielding a value of <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="19.289pt" style="vertical-align:-0.6370001pt" id="M1" height="9.2729pt" version="1.1" viewBox="-0.0498162 -8.6359 19.289 9.2729"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-81" d="M600 480C600 590 528 650 384 650H143L137 622C222 614 225 607 210 531L130 127C113 41 106 36 23 28L17 0H294L300 28C204 36 195 42 212 127L243 284L314 263C327 263 339 263 352 264C465 271 600 337 600 480ZM508 481C508 351 402 304 329 304C289 304 265 311 250 317L295 559C302 594 310 606 323 611C335 616 350 619 367 619C455 619 508 573 508 481Z"/></g><g transform="matrix(.013,0,0,-0.013,11.658,0)"><path id="g117-91" d="M512 -3V55L134 254V256L512 456V514L75 281V230L512 -3Z"/></g></svg><span class="irelop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.918pt" style="vertical-align:-0.6370001pt" height="9.2729pt" version="1.1" viewBox="22.8711838 -8.6359 21.918 9.2729"><g transform="matrix(.013,0,0,-0.013,22.921,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g><g transform="matrix(.013,0,0,-0.013,29.161,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,32.125,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,38.365,0)"><path id="g113-54" d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z"/></g></svg></span> in the array experiment (Cystatin A, Caspase-3, GAD65/67, ERK-1, and ERK-2) were then submitted to quantitative determination by ELISA in the same follicular fluids. <i>Results</i>. Array analysis yielded only a small number of differentially expressed signalling markers by unadjusted <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.0498209pt" id="M2" height="8.68572pt" version="1.1" viewBox="-0.0498162 -8.6359 8.15071 8.68572" width="8.15071pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-81"/></g></svg> values. Adjustment as a consequence of multiple determinations resulted in the absence of any significant differential marker expression on the array. Five unadjusted differentially expressed proteins were quantified immunometrically with antibodies from different sources. Follicular fluid concentrations of Cystatin A and MAP kinase ERK-1 concentrations were significantly higher in the cIVF than in the NC-IVF follicles, while GAD-2 (GAD65/67) did not differ. The assays for Caspase-3 and MAP kinase ERK-2 did not have the required sensitivities. <i>Conclusion</i>. In contrast to FF steroid hormones and AMH, FF concentrations of signalling proteins are not or only marginally altered by gonadotropin stimulation.

Nick A. Bersinger

Markus Eisenhut

Petra Stute

Michael von Wolff

Gonadotropin Stimulation Has Only a Limited Effect on the Concentration of Follicular Fluid Signalling Proteins: An Antibody Array Analysis

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<p><em>International Journal of Reproductive Medicine</em> publishes clinical research and review articles on reproductive medicine.</p>


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International Journal of Reproductive Medicine