We use monthly birth data collected by the Human Fertility Database to analyze the impact of the COVID-19 pandemic on birth trends until September 2022 in 38 higher-income countries. We also present estimates of the monthly total fertility rate adjusted for seasonality. Our analysis reveals that the pandemic led to distinct swings in births and fertility rates. The initial pandemic shock was associated with a fall in births in most countries, with the sharpest drop in January 2021. Next, birth rates showed a short-term recovery in March 2021, following the conceptions after the end of the first wave of the pandemic. Most countries reported a stable or slightly increasing number of births in the subsequent months, especially in autumn 2021. Yet another, quite unexpected, downturn in births started in January 2022, linked with the conceptions in spring 2021 when the pandemic measures were mostly eased out and vaccination was gaining momentum. Taken together and contrary to some initial expectations, the coronavirus pandemic did not bring a lasting “baby bust” in most of the analyzed countries. Especially the Nordic countries, the Netherlands, Germany, and the United States experienced an improvement in their birth dynamics in 2021 compared with the prepandemic period. 

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/padr.12544

Pandemic Roller‐Coaster? Birth Trends in Higher‐Income Countries During the COVID‐19 Pandemic

Undernourishment and associated health issues are some mammoth challenges that the world currently faces. The poorly design food supply chain (FSC) is considered a root cause of high undernourishment cases worldwide. Since all processes and stages in a supply chain are strongly connected, a slight delay or glitch can trigger a butterfly effect resulting in significant socio-economic losses. The FSC is vital to providing human essentials and a source of bread earning; rank at the top in global industries and any disturbance results in high unemployment and leading social evils like crime and violence in society. Recognize the same; this study examines the impact of food supply chain disruption on undernourished cases in selected Asian countries. Using Generalized Methods of Moments (GMM) estimator, this study provides two key findings. First, a higher intensity of COVID-19 cases translates into higher undernourishment due to direct and indirect effects from higher stringency measures. Secondly, government financial allocations to combat COVID-19 and economic growth significantly mitigate the prevalence of undernourishment. Interestingly, a higher crime index is linked with higher undernourished cases supporting the proposition of socio-economic disorder. These results propose broad policy implications for governments, food regulatory authority, donor agencies, and Non-Governmental Organizations by strengthening the food supply chain and thus reduces undernourishment cases. 

Disruption in food supply chain and undernourishment challenges: An empirical study in the context of Asian countries

Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by chronic ovulation dysfunction and overabundance of androgens; it affects 6-20% of women of reproductive age. PCOS involves various pathophysiological factors, and affected women usually have significant insulin resistance (IR), which is a major cause of PCOS. IR and compensatory hyperinsulinaemia have differing pathogeneses in various tissues, and IR varies among different PCOS phenotypes. Genetic and epigenetic changes, hyperandrogenaemia, and obesity aggravate IR. Insulin sensitization drugs are a new treatment modality for PCOS. We searched PubMed, Google Scholar, Elsevier, and UpToDate databases in this review, and focused on the pathogenesis of IR in women with PCOS and the pathophysiology of IR in various tissues. In addition, the review provides a comprehensive overview of the current progress in the efficacy of insulin sensitization therapy in the management of PCOS, providing the latest evidence for the clinical treatment of women with PCOS and IR. 

/pdf/insulin-resistance-in-polycystic-ovary-syndrome-across-15llz4lm.pdf

Insulin resistance in polycystic ovary syndrome across various tissues: an updated review of pathogenesis, evaluation, and treatment

Polycystic ovary syndrome (PCOS), the most common endocrinopathy in women is characterized by polycystic ovaries, chronic anovulation and hyperandrogenism. The treatment in PCOS is mainly symptomatic and involves lifestyle interventions and medications such as Metformin, Oral contraceptives and Antiandrogens. However, the management of PCOS is challenging and current interventions are not able to deal with outcomes of this syndrome. This review encompasses latest pharmacotherapeutic and non-pharmacotherapeutic interventions currently in use to tackle various symptomatic contentions in PCOS. Our focus has been mainly on novel therapeutic modalities for treatment/management of PCOS, like use of newer insulin sensitizers viz., Inositols, Glucagon-like peptide-1(GLP-1) agonists, Dipeptidyl pepdidase-4 (DPP-4) inhibitors, and sodium-glucose transport protein 2 (SGLT2) inhibitors. Also, evidence suggesting the use of vitamin D, statins, and Letrozole as emerging therapies in PCOS have been summarized in this review. Additionally, novel cosmetic techniques like electrolysis, laser and use of topically applied eflornithine to tackle the most distressing feature of facial hirsutism associated with PCOS, non-pharmacological therapy like acupuncture and the role of herbal medicine in PCOS management have also been discussed.

Polycystic ovarian syndrome-current pharmacotherapy and clinical implications.

Polycystic ovary syndrome (PCOS) is defined as a kind of endocrine and metabolic disorder that affects female individuals of reproductive age. Lifestyle modifications, including diet modifications, exercise, and behavioral modification, appear to alleviate the metabolic dysfunction and improve the reproductive disorders of PCOS patients (particularly in obese women). Therefore, lifestyle modifications have been gradually acknowledged as the first-line management for PCOS, especially in obese patients with PCOS. However, the mechanism of lifestyle modifications in PCOS, the appropriate composition of diet modifications, and the applicable type of exercise modifications for specific female populations are rarely reported. We conducted a systematic review and enrolled 10 randomized controlled trials for inclusion in a certain selection. In this review, we summarized the existing research on lifestyle modifications in PCOS. We aimed to illustrate the relationship between lifestyle modifications and PCOS (referring to hyperandrogenism, insulin resistance as well as obesity) and also considered the priorities for future research. These results might be an invaluable tool to serve as a guide in lifestyle modifications as the intervention for PCOS and other related endocrine disorders.

/pdf/life-modifications-and-pcos-old-story-but-new-tales-1a4w0f3n.pdf

Life Modifications and PCOS: Old Story But New Tales

Epidemiology On December 8, 2019, the first case of coronavirus disease 2019 (COVID-19) was reported in Wuhan, China [1]. Chinese health authorities notified the World Health Organization (WHO) on December 31, 2019, and by January 30, 2020, WHO designated the outbreak as a Public Health Emergency of International Concern [2]. By June 10, 2020, over 7 million confirmed cases and over 400,000 deaths had been recorded across 213 countries and territories [3]. In outbreaks, epidemics, and pandemics, epidemiologists aim to quantify the spread of a disease within a population across space and time. In addition, epidemiologists aim to quantify the rate of disease transmission. This information is then used to inform prevention and mitigation strategies. Although aggressive prevention strategies may be disruptive and costly, such measures may ultimately reduce the burden of morbidity and mortality within a population, as has been demonstrated in previous pandemics, such as the 1918–1920 influenza and the 2009 influenza A (H1N1) pandemics [4, 5]. The first tier of response is containment to prevent the spread of disease before it has a chance to take hold in the community [6]. This may include contact tracing, surveillance in the community through widespread testing, and quarantine measures. However, once a disease has spread through the community, the second tier, mitigation strategies, are necessary to reduce transmission. Interventions include social distancing measures; closure of schools, workplaces, and community facilities; travel restrictions; and individual-level hygiene measures, such as wearing a mask and washing hands [6]. Without mitigation efforts in place, healthcare systems risk being stretched beyond capacity in, for example, intensive care unit (ICU) beds, personal protective equipment (PPE), and ventilators for treating patients with COVID-19. This is why countries who were in the mitigation phase of the pandemic conducted communication campaigns imploring individuals to engage in behaviors to “flatten the curve.” Beyond the mitigation tier, state-level actors may put lockdowns in place to further curb transmission.

/pdf/contraception-access-during-the-covid-19-pandemic-2gtyu6m2fg.pdf

Contraception access during the COVID-19 pandemic

Lifestyle modification is widely considered to be the cornerstone of polycystic ovary syndrome (PCOS) treatment. However, 45% of women with PCOS have reported that they have never been provided information about lifestyle management. This highlights a significant gap in knowledge and is reflective of the lack of evidence-based guidance for lifestyle modification. While more detailed and comprehensive studies are being performed, it is necessary for health professionals to develop effective action plans utilizing the available evidence. This chapter aims to provide a comprehensive review of the current data regarding the impact of lifestyle modifications on the disease course of PCOS.

Lifestyle Modifications in PCOS.

Purpose of review Disparate healthcare outcomes are ubiquitous and occur across all fields of medicine, specifically for racial and ethnic minorities. Within reproductive health, minority women face disparate access to care, particularly infertility services, poor outcomes of fertility treatment, alarmingly higher rates of maternal morbidity and mortality as well as higher rates of preterm birth, lower live birth rates when they conceive spontaneously or when they conceive with assisted reproductive technology. The objective of this review is to highlight factors contributing to the persistent racial/ethnic disparities in in vitro fertilization (IVF) outcomes. Recent findings Recent studies document poorer outcomes after IVF treatment. Black women have been shown to have lower live birth rates following IVF treatment for more than 15 years. Summary In an effort to better understand these negative outcomes, scientists and clinicians have investigated possible biological contributing factors including the vaginal microbiome, differences in oocyte quality, embryo viability, endometrial factors, and hormonal differences. Multiple social/cultural factors also play a role including access to care, particularly for people with low income, patient (mis)education, and medical racism/bias.

Factors contributing to persistent disparate outcomes of in vitro fertilization treatment.

It is important to closely examine trends in reproduction during a pandemic because it provides not only the foundation for an improved future response but also crucial insights regarding the disparate impact across different races and socioeconomic classes. The coronavirus disease 2019 pandemic is a prime example of the impact a pandemic can have on a nation's reproductive health. Contraception and abortion access became more difficult with more barriers to access, likely contributing to increasing unintended pregnancy rates. Underrepresented minorities and vulnerable populations were disproportionately affected by the virus on their reproductive health as well as by the virus itself. As the first ever messenger ribonucleic acid vaccine in conjunction with the lack of inclusion of pregnant and peripartum women in initial studies and conflicting and misinformation on social media, the initial role of the coronavirus disease 2019 vaccine in women of reproductive age was unclear. Further research inclusive of this group of women has led to the consensus by major medical societies to recommend vaccination of women regardless of pregnancy or lactating status. Examining these topics in depth will lead to the development of strategies that can be employed to mitigate the negative effects on reproductive health during the current pandemic and can also be applied to future strategic plans to prevent similar negative outcomes. 

http://www.fertstertreviews.org/article/S2666571922000056/pdf

The impact of coronavirus on reproduction: contraceptive access, pregnancy rates, pregnancy delay, and the role of vaccination

Purpose of review Turner syndrome is the most common sex chromosome abnormality in female individuals, affecting 1/2000–1/2500 female newborns. Despite the high incidence of this condition, the mechanisms underlying the development of multiorgan dysfunction have not been elucidated. Recent findings Clinical features involve multiple organ systems and include short stature, dysmorphic facial features, delayed puberty and gonadal failure, cardiac and renal abnormalities, audiologic abnormalities, and a high prevalence of endocrine and autoimmune disorders. Paucity of available genotype/phenotype correlation limits the ability of clinicians to provide accurate guidance and management. Given the advent of robust genetic testing and analysis platforms, developments in the genetic basis of disease are materializing at a rapid pace. Summary The objective of this review is to highlight the recent advances in knowledge and to provide a framework with which to apply new data to the foundational understanding of the condition.

Novel insights in Turner syndrome

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