key: cord-1047180-bces7b8j
authors: Iko, Ijeoma N.; Adeleye, Amanda; Zamah, A. Musa
title: DESCRIPTIVE DIFFERENCES IN FERTILITY TREATMENT USAGE AFTER THE START OF THE COVID-19 PANDEMIC: A PILOT STUDY - FEELINGS ABOUT INFERTILITY IN RESPONSE TO THE COVID-19 EPIDEMIC (FIRE)
date: 2020-09-30
journal: Fertility and Sterility
DOI: 10.1016/j.fertnstert.2020.09.125
sha: 8ccee018e64e5081f560513640e8cde1c018a39d
doc_id: 1047180
cord_uid: bces7b8j

nan

OBJECTIVE: Oleanolic acid (OA) is a pentacyclic triterpenoid that has long been used as an effective drug in treating hepatitis, but its role in endometriosis remains unclear, our study aims to investigate the effect of OA in endometriosis progression in vitro.

DESIGN: Pharmacologic interventions in human endometriotic stromal cells.

MATERIALS AND METHODS: Patients with ovarian endometriosis undergoing laparoscopy were recruited at the Sixth affiliated Hospital of Sun Yat-sen University from January 2018 to May 2020. Primary human endometriotic stromal cells that isolated from ectopic endometrium (endometriotic tissue, n¼12) were exposed to 20mM, 40mM, 60mM and 80mM of OA for 24 h. MTT assay, BrdU incorporation assay and Caspase-Glo luminescent-based assay were performed to detect cell growth and apoptosis. Enzyme-linked immunosorbent assay was carried out to measure expression of vascular endothelial growth factor (VEGF).

RESULTS: OA reduced the viability of stromal cells in a dose-dependent manner, 60 and 80 mM of UA treatment led to a decrease in the endometriotic stromal cell viability to 64.2% and 53.3%, respectively (p＜ 0.05), as compared to the viability in the vehicle. BrdU assay confirmed that the growth inhibition effect of OA started at 40 mM and increased up to 80 mM (22.5% of that in the vehicle group). Caspase-3 activity was also promoted dose-dependently, and 2.3-, 5.8-, 18.7-, and 89.6fold of increase were found in the four concentration groups. Besides, OA inhibited the secretion of the proangiogenic factor VEGF in endometriotic stromal cells, 40mM, 60mM and 80mM of OA remarkably downregulated the levels of VEGF in supernatants by 29.5%, 44.7% and 73.6%, respectively.

CONCLUSIONS: OA plays a role in suppressing the survival of human endometriotic stromal cells by inhibiting proliferation and angiogenesis and promoting apoptosis. OBJECTIVE: Evaluate the effects of the ZIKVepidemic in the male reproductive function in a cohort of fertile men two years after a major outbreak in Brazil.

DESIGN: Cross-sectional study. MATERIALS AND METHODS: We enrolled 39 fertile men who attended the urology an outpatient clinic at Recife -Brazil for vasectomy. All subjects completed an epidemiological questionnaire, underwent standard semen analysis, sexual hormone levels measurement, and ZIKV serologic tests. Based on their serologic tests results, subjects were divided in two groups, a ZIKV negative (Z-) group and a ZIKV positive group (Z+). Epidemiological, clinical and laboratory variables were compared between both groups.

RESULTS: There were 25 (64%) ZIKV positive subject based on positive serum IgG anti-ZIKV antibodies; no subject showed IgM anti-ZIKV antibodies or viral RNA by PCR in semen samples. There were no significant differences between the groups regarding demographic and clinical data, but a few variables deserve mention. Overall, only 7 subjects reported ZIKV infection symptoms in the last two years, a small number compared to the overall prevalence of ZIKV of positive serologic test. The proportion of participants that reported symptoms was higher in the Z+ group when compared to the Z-group (24% and 7% respectively). Fever, myalgia, headache and cutaneous rash were the symptoms described. There were no known neurologic sequelae in patients or first-degree family members. The Z+ group had a clinically significant higher incidence of mosquito bites than the Z-group, although without statistically significance. In addition, semen analysis parameters and hormone levels showed no differences between the groups.

CONCLUSIONS: The prevalence of serum IgG anti-ZIKVantibodies was high in this cohort of fertile men, despite a low prevalence of ZIKV infection symptoms. There was no statistical difference in semen parameters or hormone between the groups. Screening of all male infertility patients should be considered in areas with high risk of exposure to Zika Virus. OBJECTIVE: Prior research has demonstrated that economic health has an influence on the utilization of assisted reproductive technology (ART). It is indisputable that the United States (US) economy has been negatively impacted by the novel coronavirus (COVID-19) pandemic. However, there is limited data on how the pandemic has affected patient interest in fertility treatment and limited data on how concern about infectious disease and physical health may affect family building decisions. We hypothesized that there would be a decrease in interest in fertility treatments due to the COVID-19 pandemic. The aim of this pilot study was to assess if the experience of COVID-19 in the US has influenced intentions to pursue fertility treatment.

DESIGN: Prospective internet-based survey. MATERIALS AND METHODS: An internet based survey, administered through Redcap was used to assess demographics, concern about COVID-19, fertility treatment prior to and after statewide lockdowns which became widespread on March 15 th 2020. The pilot survey was administered June 1 st to July 31 st 2020 to infertile participants between the ages of 18-43 years. The CloudResearch platform was used to recruit participants and administer the survey. COVID-19 related questions were derived from the validated COVID concern survey. Summary statistics are presented. Institutional Review Board approval was obtained.

RESULTS: The pilot survey was completed by 55 participants (female ¼46, 83.6%; male¼9, 16.4%) from 23 states. The mean age was 29.6 years (+/-7.6). The majority were White (78%), non-Hispanic (92.7%), with varying education levels, 45.5% (25/55) with some college education, 20% with a bachelor's degree (11/55) and 14.5% with graduated education (8/55). The majority of participants were ''somewhat concerned'' that they would lose their current job in the next 12 months (41.4%). While the majority believed that COVID-19 had spread widely in the US (32.7%) and had ''inflicted serious damage in the area that'' they lived (38.2%), most individuals felt that they could protect themselves from the virus (48.2%).

Prior to the pandemic, 29.1% (n¼16) participants sought ovulation induction medications, 16.4% (n¼9) sought intrauterine insemination and 9.1% sought (n¼5) in vitro fertilization (IVF). The remainder of patients were contemplating treatment. After the pandemic, 13 patients were no longer interested in fertility treatment. The majority of patients, 53% (n¼7) stated ''I am worried about the coronavirus/COVID-19'' as the primary reason they discontinued treatment, compared to several other reasons including spontaneous conception, financial concerns, and lack of partner support.

CONCLUSIONS: COVID-19 is an important consideration for people who discontinue treatment; however, it may not deter the majority of patients who seek care. Data is part of an ongoing larger prospective study.

The Great Recession, insurance mandates, and the use of in vitro fertilization services in the United States

Social Psychological Measurements of COVID-19: Coronavirus Perceived Threat

Perceptions of the Adult US Population regarding the Novel Coronavirus Outbreak Questionnaire. SUPPORT: None e560 ASRM Abstracts