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Polycystic ovary syndrome (PCOS), a complex endocrine and metabolic disorder, involves significant dysregulation of the immune system. Natural killer (NK) cells, as key components of innate immunity, demonstrate notable phenotypic and functional alterations in women with PCOS. These changes include not only an elevated proportion in peripheral blood but also dynamic shifts within the local microenvironments of the ovary and endometrium. The increased level of peripheral NK cells correlates with a chronic low-grade inflammatory state, potentially serving as a predictive marker in infertile PCOS patients. Within the endometrium, uterine NK (uNK) cells exhibit reduced numbers and impaired function, accompanied by dysregulation of cytokine networks such as IL-15 and IL-18, which disrupts the immune equilibrium essential for embryo implantation. Abnormal NK cell function further involves alterations in killer immunoglobulin-like receptor (KIR) repertoires and dysregulated secretion of angiogenic factors, thereby compromising endometrial receptivity and vascular remodeling. Hyperandrogenemia modulates the distribution and activity of NK cells in reproductive tissues by influencing their surface activation markers, while insulin resistance promotes the generation of myeloid-feature NK (myNK) cell subsets via the IL-6/Stat3 signaling pathway, collectively exacerbating metabolic inflammation and reproductive dysfunction. Deciphering the role of NK cells in the immunometabolic interplay of PCOS reveals their position as a critical link between. May represent a potential cutoff requiring validation in larger cohorts reproductive impairment and metabolic disturbances, opening new avenues for targeted immunomodulatory interventions. Collectively, NK cells appear to present an important immunometabolic link between reproductive dysfunction and metabolic disturbance in PCOS, highlight their potential relevance as therapeutic targets.

Pregnancy rates among adolescents and young people in South Africa remain high despite the widespread availability of sexual and reproductive health information and contraception being free of charge. Knowledge gaps, misconceptions, and insufficient attention to youth voices are critical barriers to informed decision-making. Support for adolescents and young people is often negatively framed, focusing on sexual abstinence before marriage. This paper explores youth perspectives on sexual and reproductive health information and support. It also examines gaps in contraceptive knowledge, providing insights for public health programmes and interventions. Findings highlight significant gaps in contraceptive knowledge, which contribute to low uptake. The quality and nature of relationships between young people and adults also shapes the support and information provided. For adolescents and young people, trust and feeling understood impact whether adults are perceived as valuable sources of information. Suitable interventions include the creation of safe support spaces for adolescents and young people to develop sexual and reproductive health knowledge and communication skills, access accurate information, and address socioeconomic constraints.

The accuracy of the non-invasive prenatal testing (NIPT) for common trisomies remains unclear in pregnancies following assisted reproductive technology (ART), and the adoption of NIPT as a prenatal screening test in ART pregnancies has been cautious due to the absence of clear recommendations. To estimate the accuracy of NIPT for screening for common chromosomal abnormalities compared with conventional karyotype or microarray testing in ART pregnancies. A comprehensive search of the following: PubMed, Scopus, and Embase. A systematic review and meta-analysis was conducted, and cross-sectional and cohort studies with antenatal women who conceived following ART and opted for prenatal testing with NIPT were included. Pooled sensitivity and specificity of NIPT for common chromosomal abnormalities (trisomy 21, 18, and 13). We identified a total of 548 records through electronic searches and finally included 13 studies for quantitative synthesis. The pooled sensitivity and specificity for combined abnormalities in singleton ART pregnancies were 88.2% (95% confidence interval, CI 61.0-97.3%) and 99.6% (95% CI 98.4-99.9%), respectively. Similarly, for twin ART pregnancies, the pooled sensitivity and specificity for combined abnormalities were 88.2% (95% CI 66.4-96.6%) and 99.8% (95% CI 99.6-99.9%), respectively. The pooled sensitivity and specificity for trisomy 21 in singleton ART pregnancies were 87.2% (95% CI 59.0-97.0%) and 99.7% (95% CI 98.8-99.9%), respectively, while in ART twin pregnancies, the pooled sensitivity was 86.9% (95% CI 63.4-96.2%) and the specificity was 99.8% (95% CI 99.6-99.9%). While the specificity of NIPT is high in ART-conceived pregnancies, its sensitivity in the detection of common fetal chromosomal aneuploidy, in particular trisomy 21, is substantially lower than in naturally-conceived pregnancies.

Bee venom (BV) is a product of bees and is produced by female worker bees. It contains several bioactive molecules, including peptides such as apamin, melittin, and adolapin, as well as enzymes such as phospholipase A2. These molecules have potential advantages for the treatment of central nervous system diseases and inflammation. Adding BV-derived material to animal diets has been shown to enhance productivity, provide health benefits, and act as a therapeutic agent. The present study tested the hypothesis that BV supplementation can ameliorate the stress induced by ambient temperature and advanced age in Sinai chicken breeders during the second production cycle (108-116 weeks of age). A total of 200 aged Sinai layer hens and 20 cocks were randomly allocated to four trial groups. Each trial group comprised 50 females and 5 males, further divided into 5 replicates, each with 10 females and 1 male. The first group received a control diet, while the other three groups (2, 3, and 4) received the control diet supplemented with 0.3, 0.4, and 0.5 g BV kg-1, respectively (BV 0.3, BV 0.4, and BV 0.5). The present findings indicated that BV addition significantly (P < 0.05) improved the layers' final body weight (FBW), body weight gain (BWG), egg production (EP), egg weight (EW), egg mass (EM), and feed conversion ratio (FCR) at the 0.3, 0.4, and 0.5 g BV kg-1 levels compared to the control treatment. Moreover, serum total protein, total lipids, and total cholesterol, as well as immunoglobulin IgY and IgM, thyroid hormones (triiodothyronine and thyroxine), and redox status (total antioxidant capacity and malondialdehyde) were significantly (P < 0.05) improved in response to adding BV to layers' diets during the summer season compared to the control treatment. Despite these improvements, BV supplementation did not significantly (P > 0.05) affect red blood cell count, mean corpuscular volume, or lymphocyte, eosinophils, or monocyte counts at the 0.3, 0.4, and 0.5 g BV kg-1 levels compared to the control treatment. Moreover, significant improvements (P < 0.05) were detected in hatchability traits for the aged Sinai layer hens with only (BV 0.4 and BV 0.5) supplementation during the summer season. The number of unfertilized eggs decreased by 29.41% and 17.65% in the groups administered 0.4 and 0.5 g BV kg-1 of diet, respectively, compared to the control group. Simultaneously, the number of fertilized eggs increased by 7.54% and 4.52% in these respective groups, and the total number of chicks hatched rose by 27.14% and 17.14% in the 0.4 and 0.5 g BV kg-1 treatments, respectively, compared with the control. These outcomes validate the hypothesis that dietary BV could enhance productive, reproductive, and certain physiological parameters in aged Sinai layer hens.

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Providing high-quality family planning services is one of the cornerstones&#xa0;for improving maternal and child health outcomes, and the intrauterine contraceptive device (IUD) is among the most cost-effective contraceptive methods available. Despite this, IUD use among&#xa0;women in Meghalaya remains very low.&#xa0;There is a strong need to understand the gaps in our system and monitor the delivery of services in order to optimize the existing services and ensure that the right impact is achieved in the community.&#xa0;To address this gap, a multiphase implementation research project, which included a Formative phase, Co-Implementation phase, and Iteration and Dissemination phases, was undertaken to increase IUD uptake.&#xa0;The formative phase of the study aimed to assess knowledge, attitudes, and practices (KAP) related to IUD use and to identify key barriers to its uptake. This research study has been planned to facilitate the coming together of all stakeholders across the broad spectrum of health systems to ensure maximizing the beneficial impact of using the IUCD as a spacing device.&#xa0;The&#xa0;Formative phase utilized a mixed-methods design combining&#xa0;a quantitative method via a cross-sectional KAP survey (n = 1,064), along&#xa0;with the qualitative methods (49 in-depth interviews and&#xa0;three focus group discussions).&#xa0;A KAP survey assessed KAP; qualitative interviews and focus group discussions (FGDs; guided by the WHO Health Systems Framework) explored barriers and facilitators to IUD uptake.&#xa0;East Khasi Hills and Ri Bhoi districts were chosen, covering urban, semiurban, and rural settings across Subcenters, Primary Health Centers, Community Health Centers, and a tertiary hospital. A KAP survey assessed KAP; qualitative interviews and FGDs explored barriers and facilitators to IUD uptake. Awareness of contraception was high (1,015 (95.4%) and 959 (90.1%) specifically for IUDs), but only 141 (13.3%) had ever used an IUD. Common barriers included fear of side effects, myths/misconceptions, spousal/family disapproval, and inadequate counseling. IUD use was more frequent among women with more than two children and an older youngest child. Despite widespread awareness, IUD uptake remains low due to persistent sociocultural barriers and health system gaps. Targeted counseling, strengthened provider training, and male engagement are essential to overcome these barriers and improve IUD uptake. Bridging this divide requires context-specific strategies that strengthen provider competence, foster community trust, and engage both men and families in open dialogue.

Intracytoplasmic sperm injection (ICSI) has become an integral practice in assisted reproduction technology (ART), but the optimal time interval between oocyte denudation (DN) and ICSI is still not well defined. Libya remains underrepresented in global fertility estimates, and prospective paired data on DN-to-ICSI timing from Libyan IVF practice are limited. We aimed to investigate whether performing ICSI immediately after DN, compared with an intended four-hour delay, affects pregnancy outcomes and early embryology yield. This prospective cohort study was conducted at the Fertility and Reproductive Medicine Center, Beirut Hospital, Benghazi and included 88 Libyan ICSI cycles. After enzymatic-mechanical DN using hyaluronidase, mature metaphase II (MII) oocytes were injected with selected sperm. Within each cycle, sibling MII oocytes were allocated in a 1:1 ratio to immediate ICSI or delayed ICSI after an intended interval of about four hours, using a computer-generated within-cycle allocation sequence. For clinical comparison, cycles were allocated by pre-generated permuted-block randomization to transfer blastocysts under one timing condition (44 cycles/arm). The primary outcome was normal fertilization (two pronuclei); secondary outcomes included cleavage (Day 3), blastulation and blastocyst quality (Day 5/6; Gardner-Schoolcraft), biochemical pregnancy and clinical pregnancy. Immediate DN-ICSI was significantly associated with higher fertilization rates than delayed injection (80.07% &#xb1; 17.09% vs 70.80% &#xb1; 17.37%; mean difference: 9.26, 95% CI 4.40-14.12; p = 0.0003) and a higher cleavage rate (76.89% &#xb1; 17.03% vs 67.97% &#xb1; 18.47%; mean difference 8.93 points, 95% CI 3.59-14.26; p = 0.0013). Biochemical pregnancy (40.9% vs 54.5%; p = 0.200) and clinical pregnancy (29.5% vs 27.3%; p = 0.813) did not differ significantly. These results suggest that a shorter DN-to-ICSI interval may improve fertilization and early embryo development, with no observed differences in blastulation or early pregnancy outcomes. Larger multicenter studies with cumulative live births are required to determine clinical relevance.Intracytoplasmic sperm injection (ICSI) has become an integral practice in assisted reproduction technology (ART), but the optimal time interval between oocyte denudation (DN) and ICSI is still not well defined. Libya remains underrepresented in global fertility estimates, and prospective paired data on DN-to-ICSI timing from Libyan IVF practice are limited. We aimed to investigate whether performing ICSI immediately after DN, compared with an intended four-hour delay, affects pregnancy outcomes and early embryology yield. This prospective cohort study was conducted at the Fertility and Reproductive Medicine Center, Beirut Hospital, Benghazi and included 88 Libyan ICSI cycles. After enzymatic-mechanical DN using hyaluronidase, mature metaphase II (MII) oocytes were injected with selected sperm. Within each cycle, sibling MII oocytes were allocated in a 1:1 ratio to immediate ICSI or delayed ICSI after an intended interval of about four hours, using a computer-generated within-cycle allocation sequence. For clinical comparison, cycles were allocated by pre-generated permuted-block randomization to transfer blastocysts under one timing condition (44 cycles/arm). The primary outcome was normal fertilization (two pronuclei); secondary outcomes included cleavage (Day 3), blastulation and blastocyst quality (Day 5/6; Gardner-Schoolcraft), biochemical pregnancy and clinical pregnancy. Immediate DN-ICSI was significantly associated with higher fertilization rates than delayed injection (80.07% &#xb1; 17.09% vs 70.80% &#xb1; 17.37%; mean difference: 9.26, 95% CI 4.40-14.12; p = 0.0003) and a higher cleavage rate (76.89% &#xb1; 17.03% vs 67.97% &#xb1; 18.47%; mean difference 8.93 points, 95% CI 3.59-14.26; p = 0.0013). Biochemical pregnancy (40.9% vs 54.5%; p = 0.200) and clinical pregnancy (29.5% vs 27.3%; p = 0.813) did not differ significantly. These results suggest that a shorter DN-to-ICSI interval may improve fertilization and early embryo development, with no observed differences in blastulation or early pregnancy outcomes. Larger multicenter studies with cumulative live births are required to determine clinical relevance.Intracytoplasmic sperm injection (ICSI) has become an integral practice in assisted reproduction technology (ART), but the optimal time interval between oocyte denudation (DN) and ICSI is still not well defined. Libya remains underrepresented in global fertility estimates, and prospective paired data on DN-to-ICSI timing from Libyan IVF practice are limited. We aimed to investigate whether performing ICSI immediately after DN, compared with an intended four-hour delay, affects pregnancy outcomes and early embryology yield. This prospective cohort study was conducted at the Fertility and Reproductive Medicine Center, Beirut Hospital, Benghazi and included 88 Libyan ICSI cycles. After enzymatic-mechanical DN using hyaluronidase, mature metaphase II (MII) oocytes were injected with selected sperm. Within each cycle, sibling MII oocytes were allocated in a 1:1 ratio to immediate ICSI or delayed ICSI after an intended interval of about four hours, using a computer-generated within-cycle allocation sequence. For clinical comparison, cycles were allocated by pre-generated permuted-block randomization to transfer blastocysts under one timing condition (44 cycles/arm). The primary outcome was normal fertilization (two pronuclei); secondary outcomes included cleavage (Day 3), blastulation and blastocyst quality (Day 5/6; Gardner-Schoolcraft), biochemical pregnancy and clinical pregnancy. Immediate DN-ICSI was significantly associated with higher fertilization rates than delayed injection (80.07% &#xb1; 17.09% vs 70.80% &#xb1; 17.37%; mean difference: 9.26, 95% CI 4.40-14.12; p = 0.0003) and a higher cleavage rate (76.89% &#xb1; 17.03% vs 67.97% &#xb1; 18.47%; mean difference 8.93 points, 95% CI 3.59-14.26; p = 0.0013). Biochemical pregnancy (40.9% vs 54.5%; p = 0.200) and clinical pregnancy (29.5% vs 27.3%; p = 0.813) did not differ significantly. These results suggest that a shorter DN-to-ICSI interval may improve fertilization and early embryo development, with no observed differences in blastulation or early pregnancy outcomes. Larger multicenter studies with cumulative live births are required to determine clinical relevance.

Metabolic Syndrome (MetS) is a cluster of metabolic abnormalities including abdominal obesity, impaired glucose metabolism, hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol, and hypertension. It is diagnosed when at least three of these five criteria are present. Individuals with MetS are at increased risk of developing type 2 diabetes mellitus and cardiovascular disease. Beyond these well-established complications, infertility has emerged as an underrecognized consequence of metabolic dysfunction. Infertility, defined as failure to achieve pregnancy after one year of regular unprotected intercourse, affects approximately 10-15% of couples worldwide, with nearly 20% of cases classified as idiopathic. This review aims to examine the impact of metabolic syndrome and its components on male and female infertility and to highlight the potential mechanisms linking metabolic disturbances with impaired reproductive function. A narrative review of current literature was conducted, focusing on the relationship between metabolic syndrome components - obesity, dyslipidemia, hyperinsulinemia, and hypertension - and reproductive health outcomes. Evidence from clinical, epidemiological, and experimental studies evaluating reproductive dysfunction in both males and females was analyzed. Metabolic syndrome exerts significant adverse effects on reproductive health in both women and men. In women, it is associated with reduced ovulation, impaired oocyte competence, diminished follicular reserve, anovulation, and increased risk of ovarian pathology. In men, MetS contributes to reduced sperm count, impaired sperm motility and viability, poor semen quality, erectile dysfunction, and prostate-related disorders. Early identification and proper management of metabolic syndrome may play a crucial role in reducing the burden. Addressing metabolic abnormalities through lifestyle modification and appropriate medical interventions could improve reproductive outcomes.

Recurrent implantation failure (RIF) and recurrent pregnancy loss (RPL) remain major challenges in reproductive medicine. Although immune mechanisms are integral to implantation, clinical translation has been limited by indiscriminate use of immune-directed therapies in unselected populations, mistimed immune assessment outside the implantation window, and insufficient distinction between immune-mediated failure and non-immune causes, contributing to inconsistent or null outcomes in randomised trials of empiric immunotherapy. To address these limitations, this review introduces the Elgheriany Reproductive Immunology Framework (ERIF) as a conceptual interpretive model integrating prerequisite exclusion, synchronised immune profiling within the implantation window, and cytokine-informed consideration of immunomodulation initiation and withdrawal. The framework emphasises interpretation of immune findings rather than presumption of immune causality and conditions intervention on demonstrable dysfunction. Within this context, a subset of patients may exhibit failure of the normal transition from early inflammatory activation to immune tolerance, reflected by persistent Th1-skewed cytokine activity and, in selected phenotypes, altered natural killer (NK) cell cytotoxicity. Peripheral and uterine immune compartments are interpreted jointly, recognising their functional divergence and temporal specificity during implantation. ERIF is intended to support immune interpretation and the design of phenotype-stratified clinical trials rather than to function as a prescriptive therapeutic algorithm, providing a basis for future validation in recurrent reproductive failure.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, typically characterized by irregular menstrual cycles. Our study found that postpartum menstrual cycles were largely restored in PCOS patients following assisted reproductive technology (ART) therapy. However, this recovery in menstrual cycles was not -associated with any specific ART procedures. Using a PCOS mouse model, we demonstrated that elevated progesterone levels during pregnancy were responsible for normalizing estrous cyclicity. Elevated levels of progesterone induced granulosa cell apoptosis and depleted large follicles, which potentially contributed to ovarian function suppression during pregnancy. Mechanistic studies indicated that progesterone decreased follicle-stimulating hormone receptor (FSHR) expression in a GATA binding protein 2 (GATA2)-dependent manner. Interestingly, the capacity of granulosa cells to convert androgens to estrogens significantly increased after progesterone withdrawal, as evidenced by elevated expression of cytochrome P450 family 19 subfamily A member 1 (Cyp19a1) in granulosa cells when stimulated with follicle-stimulating hormone. In addition, we found that progesterone administration reduced the thickness of the uterine endometrium in PCOS mice. Our findings suggest that sustained high levels of progesterone during pregnancy can enhance ovarian reproductive endocrine capacity and improve endometrial function, thereby facilitating the recovery of postpartum menstrual cycles.

Understanding how women navigate induced abortion care pathways is critical to ensuring person-centred, quality reproductive health services. Evidence indicates that persistent abortion stigma, the lack of choices of abortion methods and respectful care during abortion remain a global challenge to reproductive healthcare. Yet there is minimal evidence regarding abortion care pathways. This study explored induced abortion care pathways in Addis Ababa healthcare facilities. We used a descriptive qualitative approach, adopting purposive sampling techniques to recruit women who sought induced abortion care from seven facilities. The data were collected from May to July 2024. In-depth semi-structured interviews with sixteen women were digitally recorded and transcribed into the local language before being translated into English. Data were coded, organised, and analysed using inductive thematic analysis. Five main themes and their corresponding subthemes were developed through data analysis. Themes were: (i) social and emotional support, (ii) moral and social meanings shaping abortion care, (iii) accessibility and service delivery, (iv) perceived competency of abortion providers, and (v) physical and emotional effects of abortion. Many women attended the clinic alone, without their families, and received no support. Women often sought care at clinics away from their community due to concerns related to fear of stigma and social pressure. This study found long waiting times to receive abortion care, a lack of medicine and ultrasound at some facilities and limited availability of second-trimester abortions. Women reported that many providers were welcoming and competent, while others reported poor communication, the use of medical jargon, and stigmatising behaviours. Participant reported pressure to accept methods they did not want during contraceptive counselling and fear of breaches in privacy and confidentiality. Participants also described physical symptoms such as bleeding and pain, and felt ashamed and upset after the abortion, which could be associated with negative experiences. Inadequate social support, abortion stigma, and barriers to accessing abortion services, such as long waiting times and insufficient resources, were identified as significant gaps. These findings emphasised the need to strengthen person-centred abortion care and address systemic and socio-cultural barriers that undermine the quality of care. Abortion care should be easy to access, fair for everyone, and respectful of women&#x2019;s needs. Kind communication and emotional support during abortion enhance the quality of care. This study explored abortion care experiences in healthcare facilities in Addis Ababa.We spoke with women who came for abortion care. We conducted face-to-face interviews employing open-ended questions. We analysed the data by thoroughly reading and checking the information to identify common patterns in women&#x2019;s experiences.Women had varied experiences of support. Some received strong support from family or friends, which made them feel less worried and more confident. Some went through the abortion procedure alone as they feared pressure or shame. Many women felt abortion was a &#x201c;sin&#x201d; or morally wrong, while others felt confident that they had made the best decision for their lives. Women reported waiting times and service availability as challenges to accessing quality care. In addition, negative experiences such as feeling judged and ignored, as well as poor communication from providers, are reported. Women explained physical symptoms such as bleeding, fatigue and emotional outcomes including anxiety, guilt and self-blame after abortion. At the same time, some felt relieved after the abortion and satisfied with the care received.This study found that women faced challenges such as stigma and judgment, long waiting times, and limited availability of abortion services in some places. Improving the quality of abortion care can help women feel supported, reduce emotional distress, and protect their health and dignity.

Praziquantel (PZQ) is the only drug for schistosomiasis, a disease that frequently coexists with protein malnutrition in endemic populations. While this comorbidity is highly prevalent, its specific influence on PZQ's efficacy and the resulting parasite damage is poorly defined. This study addresses this knowledge by conducting a structural investigation into how the therapeutic efficacy of PZQ against Schistosoma mansoni in a hypoprotein diet murine model impacts on parasites. After four weeks of a normoprotein diet (22% protein) or hypoprotein diet (8% protein) feeding, mice were infected with 100 cercariae and treated with PZQ eight weeks post-infection. Mice were divided into Normoprotein Infected (NI), Normoprotein Infected and Treated (NIT), Hypoprotein Infected (HI), and Hypoprotein Infected and Treated (HIT) groups. At nine weeks post-infection, animals were euthanized to access parasitological burden, egg viability, and detailed ultrastructural integrity of the adult helminth reproductive system and tegument. The qualitative oogram revealed an increase in dead eggs and a reduction in mature eggs observed in both treated groups. Groups HI, NIT, and HIT showed reproductive degeneration, characterized by vitelline glands with a cell scarcity and presence of immature cells, ovary structural disorganization in females, and low sperm density and immature germ cells in male parasites. The ultrastructural tegument male analysis showed that the HIT group exhibited erosive lesions and severe tegumental desquamation that exposed the subtegumental layer, alongside empty testicular lobes. Structural damage observed under combined nutritional and pharmacological stress highlights an important factor for schistosomiasis control programs in malnourished populations.

Access to high quality contraception care and related information can enable women to exercise their reproductive autonomy and is commonly delivered in primary care. However, populations such as migrant women may face additional barriers to accessing contraception care. This systematic review aimed to establish evidence on the barriers and facilitators to accessing contraception information and care for South Asian women living in high-income, English-speaking countries. The five databases, Ovid-Medline, Embase, Scopus, PsycINFO, CINAHL were systematically searched for relevant literature up to July 2024. Following PRISMA guidelines, two independent reviewers screened all titles and abstracts and full text data for relevant studies. The quality of each included study was appraised using the KMET Standard Quality Assessment Criteria for Evaluating Primary Research framework tool. Following data extraction, a narrative synthesis was used to report the findings about contraception use and the barriers and facilitators of contraception access. Of 3541 records, eleven studies were identified, six followed qualitative methodology and five followed quantitative methodology. The included studies were set in the United Kingdom and The United States of America and included South Asian women from India, Pakistan, Bangladesh or Sri Lanka. The barriers to accessing contraception identified by the studies centred around, culturally informed beliefs about the unacceptability of contraception, a lack of information and the obstacles in the delivery of care. The availability of formal information provision through schooling and from trusted primary healthcare providers were reported as the most beneficial factors in enabling women to make informed contraception choices. This review highlights the persistence of barriers to accessing contraception information and care for South Asian women in high-income, English-speaking countries. The facilitators uncovered by the included studies highlight how access to contraception could be improved for South Asian women through the provision of accurate information and the delivery of culturally informed contraception care in primary care settings. This could ultimately promote women's ability to make informed decisions on contraception use that align with their reproductive intentions.

Endocrine disorders in pediatric patients often involve a variety of imaging modalities as part of a&#xa0;diagnostic workup or disease surveillance. This pictorial essay and review of the literature highlights adrenal and reproductive system imaging findings related to endocrine-related diseases. This review includes descriptions of normal adrenal gland anatomy and imaging characteristics, as well as the clinical presentations and diagnostic imaging of congenital adrenal hyperplasia and of benign and malignant adrenal masses. Additionally, normal reproductive tract development and puberty will be covered, followed by an overview of M&#xfc;llerian anomalies, 46,XY gonadal dysgenesis, and polycystic ovarian syndrome. Differential diagnostic considerations, appropriate imaging protocols, and clinical management strategies will be discussed.

This study assesses the frequency and severity of ultrasound-detected testicular alterations across age groups (young and adult) in 219 bucks. Sperm quality and testicular echotexture were evaluated, and their associations with reproductive pathogens (Coxiella (C.) burnetii, caprine arthritis encephalitis virus (CAEV), Chlamydia (C.) abortus and Mycoplasma (M.) agalactiae) were analyzed. Additionally, qPCR was also performed on ejaculates from seropositive bucks. Seminal microbiota was characterized in three groups: 1 (seronegative without lithiasis), 2 (seropositive with lithiasis), and 3 (qPCR-CAEV-positive). A 68.5% of bucks showed testicular microlithiasis (50.2% bilateral and 18.2% unilateral). Moreover, frequency of bilateral lesions differed according to age, being higher in adults, who also showed larger microlithiasis area (P&#x202f;<&#x202f;0.05). Age was negatively correlated with sperm concentration (P&#x202f;<&#x202f;0.05). Seropositivity was 35.8% for C. burnetii and 58.8% for CAEV. Adults showed higher CAEV seropositivity (P&#x202f;<&#x202f;0.001), and 4.2% of ejaculates tested qPCR positive for this pathogen. Bacterial richness was greater (P&#x202f;<&#x202f;0.001) in group 2 than in group 1. Firmicutes dominated groups 1 and 2, whereas Fusobacteriota prevailed in group 3. The most frequent genus in all three experimental groups was Oceanivirga, with higher abundance in group 1 than in group 2 (P&#x202f;<&#x202f;0.05). These findings suggest that ejaculate microbiota may be influenced by ultrasound abnormalities and exposure to CAEV and C. burnetii, supporting the use of testicular ultrasound to detect bucks prone to reproductive problems and associated health risks, while also highlighting the need to include males in CAE and Q fever control programs.

Avian leukosis virus subgroup J (ALV-J) remains a major threat to poultry health and production, particularly in indigenous chicken populations in China. In this study, a highly pathogenic ALV-J field strain, YN2021, was first isolated from indigenous black-bone chickens in Yunnan Province, China, and its biological characteristics and pathogenicity were systematically evaluated in specific-pathogen-free (SPF) chickens. Infected chickens exhibited significant growth retardation, delayed sexual maturation, and increased mortality, accompanied by pathological lesions consistent with ALV-J. To further assess reproductive performance, egg production and egg weight were recorded. YN2021-infected hens showed a reduction in total egg production (70 vs. 92 eggs; ~23.9% decrease) and a significantly lower mean egg weight (35.2&#x2009;&#xb1;&#x2009;0.2&#xa0;g vs. 43.7&#x2009;&#xb1;&#x2009;0.3&#xa0;g; P&#x2009;<&#x2009;0.001) compared to controls. To facilitate mechanistic studies and future control strategies, a full-length infectious clone of YN2021 was constructed using a reverse genetics approach, and a synonymous molecular marker was introduced for viral identification. The rescued recombinant virus exhibited replication kinetics, p27 antigen expression, and biological characteristics in DF-1 cells comparable to those of the parental strain, and the molecular marker remained genetically stable during serial passages. Collectively, these results demonstrate that the ALV-J YN2021 strain exhibits high pathogenicity and negatively affects growth and reproductive performance in chickens. The infectious clone established in this study provides a reliable experimental platform for investigating ALV-J pathogenesis and supports the development of effective control strategies to mitigate production losses in poultry.

Energy stress-induced dysfunction of granulosa cells (GCs) is a major etiological factor in diminished female reproductive performance. Although vitamin E affords cytoprotection to GCs, its specific mechanisms of action under energy stress conditions in the yak model remain unclear. This study aimed to elucidate the pathways and cell fate decisions through which vitamin E alleviates energy stress-induced damage in yak GCs. Our results indicate that energy stress triggers a signaling cascade initiated by the AMPK-mTOR pathway, which functions as an upstream regulator for downstream events. Activation of this pathway promotes PINK1/Parkin-mediated mitophagy, leading to ferroptosis, characterized by the downregulation of SLC7A11 and GPX4 and the upregulation of ACSL4. This cascade ultimately drives the cells toward apoptosis, as evidenced by an increased Bax/Bcl-2 ratio and elevated levels of Cleaved-caspase-3, along with impaired intercellular communication due to downregulation of Cx43 and Cx37. Vitamin E intervention mitigated apoptosis and rescued the expression of gap junction proteins by intercepting this AMPK-mTOR-mitophagy-ferroptosis axis. Our study suggests a mechanism by which vitamin E modulates GC fate via this pathway. These findings provide insight into ovarian follicular pathophysiology in yaks and may inform strategies targeted at reproductive disorders associated with energy metabolic dysregulation.

Leydig cells (LCs) are primary for testosterone production and the preservation of male reproductive function; however, their activity is highly susceptible to oxidative stress (OS)-induced damage. Accumulating evidence indicates that excessive reactive oxygen species (ROS) disrupt redox homeostasis, impair mitochondrial function, and interfere with key steroidogenic processes, ultimately promoting cellular senescence in LCs. This review provides an updated synthesis of the molecular mechanisms underlying OS-induced LC dysfunction, with particular emphasis on mitochondrial impairment, DNA damage response, and major signaling pathways, including SIRT1/Nrf2, PI3K/Akt/mTOR, MAPK, and FOXO. In addition, we highlight the impact of senescence-associated secretory phenotype and inflammatory mediators on amplifying LC dysfunction and contributing to male subfertility. Emerging therapeutic strategies are also discussed, including antioxidant-based compounds, nanoformulations, and targeted pharmacological agents that modulate redox balance, inflammation, apoptosis, and steroidogenesis. Collectively, these insights deliver a mechanistic framework for emerging novel interventions directed at preserving LC function and improving male reproductive health.