Psychological Issues among Women Undergoing Fertility Treatment in a Specialist Fertility Hospital, South East Nigeria

Introduction: In Nigeria, a major reason for marriage is procreation and married couples look forward to having children within a year or two of marriage. The inability to achieve conception and subsequently have a child among couples may lead to psychological complications. Objective: This study assessed the psychological impact of infertility and its management on women receiving treatment at a Fertility Specialist Hospital in a poor resource setting. Methods: This was a cross-sectional study of 376 consenting married women who sought and received fertility treatment at a private Fertility Specialist Hospital, located at Abakaliki, South-East Nigeria between May 1, 2017 and May 31, 2022. Socio-demographic and Structured questionnaires were administered to the participants over a 5-year period. Results: The mean age of the women at presentation was 36.9 (±7.2 SD) years. The majority of the women (227) presented with secondary infertility accounting for 60.4%, while the rest had primary infertility (χ2 = 16.18, P = 0.001). Male-only factor infertility accounted for 22.9% of all the infertility cases, female-only factor 21.3% while both (male and female factors co-existing) accounted for 52.7% of all the cases. The commonest cause of infertility in the study was poor sperm parameters (176) accounting for 46.8% of cases, tubal factor 19.1% and anovulatory factor 22.3% (χ2 = 214.21, P = 0.001). Three hundred and thirty four (88.8%) felt depressed, 266 (70.7%) felt guilty about the past, and 222 (59.0%) had suicidal tendencies because of the infertility ordeal. Two hundred and fifty one (66.8%) felt inferior, 237 (63.0%) cried often and 174 (46.3%) were socially withdrawn. However, 10.4% of the women felt satisfied and well. These negative psychological feelings were statistically significant. Concerning the effect on marriage, the closeness of couples was reduced significantly in 57.7%, 62.8% had reduced coital intimacy, 79.3% had frequent quarrel and misunderstanding, 27.9% had threats of divorce while 4.5% had actually divorced and 11.% separated. However, there was no negative effect of infertility in 8.8% of couples. Conclusion: Psychological issues associated with infertility and its management in women include feelings of depression, guilt feelings, suicidal ideation, weeping episodes, social withdrawal, feelings of inferiority, reduced libido, and poverty of intimacy with frequent quarrels and misunderstanding. Women appear to bear more of the psychological issues associated with infertility. Early marriage on the part of the women, preservation of their reproductive youthful ages, and a better understanding of the concept of infertility by the couple will not only reduce the prevalence of infertility but will also reduce the dangerous psychological issues associated with infertility.

Effect of Nitrogenous Fertilizer Treatment on Mineral Metabolism in Grazing Yaks

To assess the impact of N fertilization on contents of mineral elements in herbage and the effect of increased forage S on the copper metabolism of grazing yaks, study was conducted during the summer grazing season （2005, 2006, and 2007）. Pasture replicates （20 ha; n=3 per treatment） received the same fertilizer treatment in each growing season, consisting of i） 90 kg N ha^-1 from quickly available nitrogen, ii） 90 kg N ha^-1 from ammonium nitrate, iii） 90 kg N ha^-1 from ammonium sulfate, and iv） control （no fertilizer）. Forage sampling was collected at 60 days intervals following fertilization （10 samples per pasture） for Cu, Mo, Mn, Se, Fe, Zn, Ca, and P. To determine the effect of fertilizer treatment on mineral metabolism in grazing yaks, liver and blood samples were collected at the start and end of the study period in 2005, 2006, and 2007. Ammonium sulfate fertilization increased （P 〈 0.01） forage S concentration. Plant tissue N concentrations were increased by N fertilization, regardless of source in 2005, 2006, and 2007. Yaks grazing S fertilization pastures had lower （P〈0.05） liver and blood Cu concentrations at the end of the study period in 2005, 2006, and 2007, compared with urea, ammonium nitrate, and control. Nominal increases in forage in vitro organic matter digestibility were realized by fertilization, regardless of N source in each year.

Analysis of the Application Effect and Value of Dydrogesterone in The Treatment of Preeclampsia for Fetal Preservation

Objective: To analyze the application effect and value of dydrogesterone in the fertility preservation treatment of preeclampsia. Methods: Forty cases of patients with preeclampsia admitted to our hospital between January 2023 and January 2024 were divided randomly into a control group and an observation group of 20 cases each. The control group applied progesterone to preserve the fetus, and the observation group applied dydrogesterone. The symptom relief time, hormone levels before and after treatment, as well as adverse drug reactions, and the effect of fetal preservation between the two groups were compared. Results: The time to relieve vaginal bleeding, abdominal pain. and lumbago in the observation group was shorter than that in the control group (P < 0.05). After treatment, the progesterone levels and incidence of adverse drug reactions in the observation group were lower than those in the control group (P < 0.05). The success rate of fertility preservation in the observation group was higher than that in the control group (P < 0.05). Conclusion: In the treatment of fetal preservation of preeclampsia, the application of dydrogesterone positively alleviated vaginal bleeding, abdominal pain, and lumbago, with mild adverse reactions and a good effect on fetal preservation.

Perception of the Psychosocial Aspects of Subfertility by Parents Following Successful Medically Assisted Conception: A Qualitative Study

Nearly 5% of new-borns in the Netherlands are now born following Medically Assisted Conception (MAC), a steadily increasing number. Our qualitative study explored the subjective impact of subfertility and fertility treatment for parents who successfully achieve pregnancy following MAC and make health professionals more aware of the psychological needs of those clients. The study was based on the constructive/interpretative paradigm using a constant comparison/grounded theory design. Two men and nine women in the Netherlands who conceived as a result of MAC were interviewed in 2011. Our findings show that MAC-parents were exposed to a range of emotions such as disappointment, hope and uncertainty during the subfertile period, and these feelings were even felt after successful fertility treatment. The relationship and social support from friends and others in the same position were very important. Regarding the relationship with the partner during the subfertile period, the main thing the couple have to do is to keep talking with one another. Although they did not always agree on all issues, it was found that maintaining the communication strengthened the links between them by the end of the process. We concluded that the feelings and emotions during fertility treatment play a big role during the subfertile period and remain important during pregnancy and even after childbirth. Subfertile clients want maternity care providers to ask those who successfully achieve pregnancy following MAC about their experiences during fertility treatment, check that they still are receiving adequate social support, and involve the partner in prenatal checks.

Physical-biological Collaborative Prevention and Control of Facility Strawberry Continuous Cropping Diseases

The aim was to develop green strawberry varieties,control soil-borne diseases from facility strawberry continuous cropping,improve the safety and quality of strawberries and promote the healthy and stable development of the strawberry industry. Based on the production practices in recent years,we summarized the physical-biological collaborative prevention and control technology for the disease of facility strawberry continuous cropping facilities,established the technical goals,the main types of soil-borne diseases,and the physical-biological collaborative control prevention and control technologies,mainly including the specific methods and technical points of solar high temperature disinfection technology and biological bacterial fertilizer（ agent） treatment technology.

Influence of long-term different fertilization on soil weed seed bank diversity of a paddy soil under rice/rape rotation

A long-term fertilized paddy field under rice/rape rotation in the Taihu Lake Region was selected to investigate the dynamics of soil weed seed diversity.Four fertilizer treatments were performed,including non-fertilizer(NF),chemical fertilizer only(CF),chemical fertilizer combined with pig manure(CMF)and chemical fertilizer plus crop stalk(CSF).We recorded the seed numbers and crop yields,estimated the weed seed bank density and identified the kinds of weed seeds in the top-soil(0-15 cm)in the study area using a stereomicroscope.Based on the records,we analyzed the effect of long-term fertilization on soil weed seed bank diversity and the rela-tionship between weed seed diversity and crop yields.Comparing the four treatments,it was found that in the cultivating seasons of both rice and rape,the density of soil weed seed bank was the lowest with the treatment of chemical fertilizer plus crop stalk.Whereas,the total number of species and the weed seed bank diversity was the highest.Furthermore,the crop yields were at maximum and kept constant with this treatment.There was a definite correlation between fertilizer treatment and soil weed seed bank diversity and crop yields.It was concluded that balancing the fertilizer management was helpful in main-taining soil weed seed bank diversity,increasing crop yields and alleviating crop yield fluctuation.Therefore,among the four fertilizer treatments,chemical fertilizer plus rice crop stalk treatment was the best one to stimulate the productivity of agricultural ecosystems and simulta-neously protect biodiversity.

An investigation on the best-fit models for sugarcane biomass estimation by linear mixedeffect modelling on unmanned aerial vehicle-based multispectral images:A case study of Australia

Due to the worldwide population growth and the increasing needs for sugar-based products,accurate estimation of sugarcane biomass is critical to the precise monitoring of sugarcane growth.This research aims to find the imperative predictors correspond to the random and fixed effects to improve the accuracy of wet and dry sugarcane biomass estimations by integrating ground data and multi-temporal images from Unmanned Aerial Vehicles(UAVs).The multispectral images and biomass measurements were obtained at different sugarcane growth stages from 12 plots with three nitrogen fertilizer treatments.Individual spectral bands and different combinations of the plots,growth stages,and nitrogen fertilizer treatments were investigated to address the issue of selecting the correct fixed and random effects for the modelling.A model selection strategy was applied to obtain the optimum fixed effects and their proportional contribution.The results showed that utilizing Green,Blue,and Near Infrared spectral bands on models rather than all bands improved model performance for wet and dry biomass estimates.Additionally,the combination of plots and growth stages outperformed all the candidates of random effects.The proposed model outperformed the Multiple Linear Regression(MLR),Generalized Linear Model(GLM),and Generalized Additive Model(GAM)for wet and dry sugarcane biomass,with coefficients of determination(R2)of 0.93 and 0.97,and Root Mean Square Error(RMSE)of 12.78 and 2.57 t/ha,respectively.This study indicates that the proposed model can accurately estimate sugarcane biomasses without relying on nitrogen fertilizers or the saturation/senescence problem of Vegetation Indices(VIs)in mature growth stages.

Pregnancy outcomes after fertility preservation in women with endometrial carcinoma and atypical endometrial hyperplasia:A systematic review and meta-analysis

Objective:The objective of the study was to compare the effects of assisted reproductive technology(ART)and spontaneous pregnancy on pregnancy outcomes in women with endometrial carcinoma(EC)and atypical endometrial hyperplasia(AEH)following fertility-sparing treatments.Methods:Relevant studies published through July 2020 were identified from PubMed and Web of Science literature searches.The pregnancy outcomes of ART and spontaneous pregnancy were summarized and compared for women with complete remission of EC/AEH after fertility-sparing treatments.A subgroup analysis was performed based on whether patients had received in vitro fertilization and embryo transfer(IVF-ET)treatment.The complete remission and recurrence rates of EC/AEH following fertility-sparing treatments were estimated.The effect of pregnancy on recurrence rates of EC/AEH was also calculated.Results:Sixteen observational studies reporting pregnancy outcomes or recurrence with ART or spontaneous pregnancy for women with EC/AEH after fertility-sparing treatments were included.The complete remission rate of EC/AEH was 81.5%(95%CI,78%–85%).Compared with spontaneous pregnancy,the pregnancy rate of ART was significantly higher(66.8%vs.43.7%,OR=2.64,95%CI 1.71–4.05,P<0.00001,I^(2)=14%).Subgroup analysis showed that the pregnancy rate of IVF-ET was significantly higher than that of spontaneous pregnancy(62.7%vs.35.1%,OR=2.85,95%CI 1.44-5.63,P=0.003,I^(2)=29%).The live birth rate of ART was significantly higher than that of spontaneous pregnancy(75.3%vs.47.8%,OR=3.96,95%CI1.76-8.77,P=0.0009,I^(2)=45%).The recurrence rate of EC/AEH was 31%(95%CI 24%–39%).Clinical pregnancy could reduce the recurrence rate of EC/AEH,but there was no significant evidence of an association.Conclusions:ART,especially IVF-ET,could significantly improve pregnancy outcomes in women with EC/AEH receiving fertility-sparing treatments.Following complete remission,ART treatment might be a better option for women with EC/AEH than spontaneous pregnancy.