Lay understanding and experience of sexual intercourse among couples with infertility undergoing an assisted reproduction technology program: A qualitative study

Aim

To explore the perception and lay understanding of sexual intercourse and sexual life experiences among infertile couples before, during, and after undergoing an assisted reproduction technology (ART) program.

Method

The participants of this descriptive qualitative study were Indonesian couples with infertility who underwent an ART program. Semi-structured interviews were conducted between September and December 2022, and the participants' responses were recorded. Data were analyzed using a step-by-step analysis based on Braun's qualitative analysis. The study was reported based on the Consolidated Criteria for Reporting a Qualitative Research (COREQ) Checklist.

Results

Fifty participants were included, and five themes were developed before and two themes during or after the ART program. The couples' knowledge varied as they experienced sexual intercourse at different periods, such as before, during, and after the ART program. Many participants reported that ART affected their emotions and mood, leading to decreased desire to engage in sexual intercourse. However, some used sexual intercourse as a basis for creating optimism and confidence in having offspring. Furthermore, couples perceived that the purpose of sexual intercourse is not only to have offspring but also to improve communication, promote intimacy, and express affection. In contrast, some perceived the ART program as time consuming, preventing them from engaging in sexual activities. However, not all couples considered sexual activity solely as a means of procreation. They concluded that sexual behavior is not only determined by genetics.

Conclusion

Couples who underwent the ART program regardless of its effectiveness were aware that sexual interaction is not only for having children but also for preserving harmony and familial connection.

The effect of toxic air pollutants on fertility men and women, fetus and birth rate

Human health is affected by various factors such as air pollutants. Exposure to toxic air pollutants is impaired fertility in men and women. The purpose of this review study was investigation of the effect of toxic air pollutants on fertility and birth rate. Databases used to for searched were the PubMed, Web of Science, Springer and Science Direct (Scopus) and Google Scholar. Identify all relevant studies published 1999-2022. In this study, according to databases five hundred articles were retrieved. 33 studies were screened after review and 19 full-text articles entered into the analysis process. Finally, 11 articles were selected in this study. The literature signs a notable health effects from toxic air pollutants and increase risk of infertility in men and women and having a variety of reproductive system cancers such as prostate, bladder, ovary, kidney and uterus. According to the finding toxic air pollutants can increase the risk infertility in men and women, incidence of cancers of reproductive system and decrease the birth rate. Activities that play an important role in reducing the health effects of toxic air pollutants such as infertility in men and women and reducing the population rate of communities are improving the quality of fuel used in the home, car, industries, changing production processes in large industries, installing catalysts to reduce emissions in cars, use more public transportation, plant trees and increase green space per capita, increase public awareness about various effects of toxic air pollutants and protective measures.

The interplay between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, erectile dysfunction, and Peyronie's disease: A meta-analysis of observational studies

INTRODUCTION

This study aims to investigate the relationship between Neutrophil- Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR) with Erectile Dysfunction (ED) and Peyronie's disease (PD).

METHODS

We conducted a meta-analysis of the observational study by searching for the appropriate keywords in eight databases. The risk of publication bias of the included studies was assessed by Egger's test and Kendall's t. The data extraction was carried out for each study and analysed using Revman 5.0.

RESULTS

There were eleven eligible studies out of the 411 studies retrieved. Eight studies were conducted on cases of erectile dysfunction, and three studies on Peyronie's disease. There was a significant relationship between NLR, PLR and ED (SMD: 0.59, 95% CI: 0.33-0.85 and SMD: 0.64, 95% CI: 0.13-1.16, respectively). The same was also found for PD. The active phase of PD tended to have higher NLR (SMD: 0.68, 95% CI: 0.43-0.92) and PLR (SMD: 0.27, 95% CI: 0.06-0.49) compared to the chronic phase. No publication bias was found in both ED and PD studies.

CONCLUSIONS

NLR and PLR indicate an ongoing inflammatory process in both ED and PD. These findings can be used as markers of treatment and prognosis of both diseases in sexual health care.

Framing and understanding the whole aspect of oral sex from social and health perspectives: a narrative review

Historically, oral sex is part of human sexual behaviour even though some consider it taboo, and its expression is deemed inappropriate. Human rights also stand out as technology becomes more sophisticated, leading to its practice disclosure in the 21st century. The large-scale oral sex discussion in media encourages people to express it, and there is feedback on whether it is right or not. It all depends on each person’s values. We found this sexual behaviour occurs everywhere regardless of religion, culture and race. Pop culture influences this behaviour considerably. It can be seen in music, movies and television programmes that allude to oral sex. Numerous motivations underlying this behaviour include sexual pleasure for the sake of psychological well-being. It is undeniable that this behaviour is still controversial. There is a risk of it causing disease, but it reportedly provides many benefits. Oral sex is not a new behaviour crossing boundaries, according to our theory. It is an old behaviour that has been highlighted because of the factors that support it. This behaviour, still considered taboo, has its disadvantages, such as sexually transmitted disease and oral cancer, but also has benefits, such as preventing preeclampsia.

Comprehensive Intersystemic Assessment Approach to Relieve Psychogenic Erectile Dysfunction: A Review

Psychogenic erectile dysfunction (ED) is a very common condition in men. About 40% of ED cases are psychogenic. Many of the psychogenic ED patients are young men. The causes of psychogenic ED can be generalized as well as situational. Psychogenic management approaches are different from organic ED. In patients with psychogenic ED, an intersystemic approach is needed for both the patient and his partner. This intersystemic approach will inspect the real cause of the problem. Intersystemic approach: The intersystemic approach not only focuses on the patient side but also on his partner. This approach provides space for partners to explore and understand their sexual life. In this article, we focus to explore a research that conducts intersystemic principle in ED management. We conclude that in psychogenic ED, an intersystematic approach is important for determining the root cause of the problem. Finding the right core cause will determine the right treatment. This therapy can combine with pharmacologic treatments. These therapies can give a better outcome for psychogenic ED.

IMPACT OF PREPARATION USING CONVENTIONAL AND MODIFIED DENSITY GRADIENT CENTRIFUGATION METHODS ON SPERM CONCENTRATION, MOTILITY AND NUMBER OF NORMAL MOTILE SPERM RECOVERY (NMSR)

Some preparation techniques, either conventional or advanced, have been provided. Advanced technique may overcome the limitations of conventional techniques. Recently, not all fertility clinics in Indonesia are able to provide advanced preparation techniques. Some techniques require expensive equipments and can only be used for intracytoplasmic sperm injection (ICSI). Some fertility clinics use a modified procedure, namely the combination of density gradient centrifugation with a swim-up method for the preparation of the sperm to be used in ART. This study aimed to determine whether the modified density gradient centrifugation, which is density gradient centrifugation followed by a swim-up, is able to yield better results than conventional density gradient centrifugation. This study was a laboratory experimental pre and pos-test control group design. Population was all adult men aged 21-40 years old and the sampling unit was the man donor’s semen which fulfilled inclusion criterias, collected during the periode of the study. Sample size was eight. Sperm analysis were done before and after preparation in conventional and modified group. Descriptive comparation analysis have been used. This study obtained NMSR 7.9+5.5 million/ejaculate and recovery rate (RR) 27.66+11.8 %. RR was lower compared to RR obtained conventional DGC method. RR might be lower because in modified DGC samples undergo two steps selection while conventional DGC only one step selection. But conventional DGC samples should be centrifuged twice, therefore sperms might experience more trauma. Lower RR sperm does not exclude the possibility to be used for ART, because still within the required number for all TRBs. In conclusion, modified DGC preparation method obtained lower NMSR and RR, nevertheless harvested sperms can still be used in all kind of ART.