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Background: The initial COVID‐19 pandemic response−related effects on conceptions following the use of assisted reproductive technologies (ART), and on changes in the maternal characteristics of women who conceived during the early vs. pre‐pandemic period, have been understudied. Objectives: To examine the effects of ART clinic closures in the United States (US) in March 2020 on the frequency of ART‐conceived live births, multiple births and stillbirths; and to describe changes in the characteristics of women who conceived in the early pandemic period. Methods: Population‐based cohort study including all births in the US from January 2015 to December 2020 (22,907,688 live births; 134,537 stillbirths). Interrupted time series (ITS) methodology was used to estimate rate ratios (RR) of expected versus observed rates in December 2020 (i.e., among births conceived mainly in March 2020). Demographic and clinical characteristics were compared between mothers who conceived in March 2020 versus March 2015–2019. Results: Overall, 1.1% of live births and 1.7% of stillbirths were conceived by ART. ART‐conceived live births decreased by 57.0% in December 2020 (observed vs. expected RR 0.43, 95% confidence interval [CI] 0.40, 0.45), and these declines occurred in all subgroups of women. Multiple births also declined in December 2020. Stillbirth rates increased in December 2020 in ART‐conceived births (RR 2.55, 95% CI 1.63, 3.92) but remained unchanged in the non‐ART group. Maternal characteristics of women who conceived in the early pandemic versus pre‐pandemic period differed and included an increased prevalence of pre‐pregnancy obesity class 3 and chronic hypertension. Conclusions: The early pandemic closure of ART clinics resulted in a substantial decline in ART‐conceived live births and multiple births in December 2020 and an increase in the proportion of stillbirths among ART‐conceived births. Women who conceived in the early pandemic period also had an increased prevalence of obesity and chronic hypertension. [ABSTRACT FROM AUTHOR]

Simple Summary: Developing and raising replacement beef heifers requires a large capital investment for producers. Therefore, it is imperative to discover traits and management practices to eliminate subfertile heifers prior to breeding and pregnancy determination. In this study, four years of data was analyzed from a centralized heifer development yard in the Midwest of the United States. The objective of this study was to analyze various heifer physical characteristics and management practices in order to quantify their impact on pregnancy and date of conception. Physical measurements can be used to improve the ability to select and develop heifers for improved reproductive longevity. Veterinarians have an opportunity to work with their clients to utilize this information to select replacements that fit the ranch environment. This should result in increased reproductive efficiency and cost optimization for the replacement heifer enterprise. Developing and raising replacement heifers requires a large capital investment for producers. Therefore, it is imperative to discover traits and management practices to eliminate subfertile heifers prior to breeding and pregnancy determination. In this study, four years of data was analyzed from a centralized beef heifer development yard in the Midwest of the United States. The objective of this study was to analyze various heifer physical characteristics and management practices in order to quantify their impact on pregnancy and date of conception. Logistic regression models were built to investigate risk factors associated with conception to artificial insemination (AI), pregnancy by natural service after AI exposure, and pregnancy in the first 21-days of the breeding season. Age at entry, average daily gain from entry to breeding, pelvic width, and year were associated with AI pregnancy (p < 0.05). On the second model, average daily gain from entry to yearling weight, weight at breeding, weight at pregnancy diagnosis, and age at AI were significantly associated with pregnancy. There were no associations with reproductive tract score with any of the response variables analyzed. These results indicate there are physical measurements that can be used to improve the ability to select and develop heifers for improved reproductive performance. [ABSTRACT FROM AUTHOR]

Many lesbian, gay, bisexual, transgender (trans), queer, and other sexual and gender minority (LGBTQ+) people desire to conceive children. Yet, LGBTQ+ peoples' experiences are scant in reproductive health literature, particularly around pregnancy loss—a stigmatized and distressing pregnancy outcome. Informed by minority stress theory, this qualitative study aimed to explore the experiences of multi-level stigma and resilience among LGBTQ+ people in the context of conception, pregnancy, and loss. Seventeen semi-structured individual interviews (25–70 minutes) were conducted (2019) with a purposive sample of LGBTQ+ people in the United States (U.S.) who had experienced pregnancy loss (n = 14) or in an intimate partnership in which a pregnancy was lost (n = 3) in the last two years. Transcribed interviews were analyzed thematically. Participants described the profound sadness of pregnancy loss due to unique challenges of LGBTQ+ conception. Multiple types of stigma manifested at intrapersonal (e.g., anticipated sexual stigma upon disclosure), interpersonal (e.g., unsolicited advice about conception decisions), and structural levels (e.g., differential requirements to access conception compared to heterosexual/cisgender couples). Resilience was also seen individually (e.g., purposeful disclosure of conception, pregnancy, and loss), relationally (e.g., connecting with other LGBTQ+ community members), and collectively (e.g., creating/engaging in LGBTQ+-specific conception, pregnancy, and loss online spaces). LGBTQ+ people experience minority stressors of multi-level stigmatization throughout the pregnancy process, which limits their access to social support after experiencing pregnancy loss. However, individual, relational, and collective resilience strategies abound in response. Thus, minority stress theory can also be applied to recognize strengths-based and affirming approaches to reproductive healthcare for LGBTQ+ people. [ABSTRACT FROM AUTHOR]

Sexual intimacy characterized by desire is a critical component of the cultural ideal of successful marriage in the contemporary United States. How, then, does the experience of sexual intimacy in committed relationships change when its primary purpose is to promote conception? Through in‐depth interviews with 52 women married to men in the United States who recently attempted—and often struggled—to conceive through sexual intercourse with their spouses, this study finds that sex for the purpose of pregnancy becomes a highly rationalized project in which participants attempt to perfect their timing and promote the best chance for conception. In these married heterosexual couples, women manage the project of sex for the purpose of pregnancy and dictate to their husbands when they need to have sex. Using the third shift as a theoretical framework, this article demonstrates how sex for pregnancy becomes a gendered chore involving emotion work, cognitive labor, and body work. This research contributes to our understanding of household labor, sexual intimacy, and reproduction. [ABSTRACT FROM AUTHOR]

Sexual intimacy characterized by desire is a critical component of the cultural ideal of successful marriage in the contemporary United States. How, then, does the experience of sexual intimacy in committed relationships change when its primary purpose is to promote conception? Through in‐depth interviews with 52 women married to men in the United States who recently attempted—and often struggled—to conceive through sexual intercourse with their spouses, this study finds that sex for the purpose of pregnancy becomes a highly rationalized project in which participants attempt to perfect their timing and promote the best chance for conception. In these married heterosexual couples, women manage the project of sex for the purpose of pregnancy and dictate to their husbands when they need to have sex. Using the third shift as a theoretical framework, this article demonstrates how sex for pregnancy becomes a gendered chore involving emotion work, cognitive labor, and body work. This research contributes to our understanding of household labor, sexual intimacy, and reproduction. [ABSTRACT FROM AUTHOR]

Background: Previous investigations of time-to-pregnancy recognition have analysed data from national surveys and clinics, but this has not been investigated in the context of digital fertility applications. Timely pregnancy recognition can help individuals in health and pregnancy management, reducing maternal and foetal risk and costs, whilst increasing treatment options, availability, and cost. Methods: This dataset contained 23,728 pregnancies (conceived between June 2018 and December 2022) from 20,429 participants using a Food and Drug Administration (FDA) cleared fertility app in the United States. Most participants (with non-missing information) identified as Non-Hispanic White, and one-third reported obtaining a university degree. We used two-tailed Welch's t-test, Mann-Whitney U-test, and two-tailed Z-tests to compare time to pregnancy recognition between those using the app to conceive or contracept. Results: Participants using an app to conceive recognised pregnancy on average at 31.3 days from last menstrual period (LMP) compared to 35.9 days among those using the app to prevent pregnancy. Conclusion: Generalisability is limited, as all participants were using a fertility app and had relatively homogenous sociodemographic characteristics.

Preconception care is an essential component of health, particularly among women and men living with HIV and can optimize medical and psychosocial outcomes. However, there is a paucity of data on this topic, especially when evaluating provider communication with male patients. We conducted a multi-site qualitative study in 7 cities in the United States (US) with 92 providers to assess their attitudes and practices regarding preconceptual counseling, safer conception, and preconception care with their patients living with HIV. Providers were contacted to schedule a phone interview. Recorded interviews were transcribed and coded for a priori and emergent themes. Providers reported infrequent communication with male patients with HIV about their reproductive plans and the use of safer conception, acknowledging they were more likely to initiate such communication with female patients. A small percentage of providers reported talking to all of their patients about reproductive options, including men having sex with men (MSM). Currently, there is no consensus or evidence-based guideline for the delivery of preconception care specific to men. Based on our results, we recommend that providers offer preconception care to all men as part of optimizing family planning and pregnancy outcomes; enhancing reproductive health; preparing men for fatherhood; and in the setting of HIV infection, preventing transmission to an uninfected partner. [ABSTRACT FROM AUTHOR]

The perinatal period involves major developmental transitions which can be conceptualized through a biopsychosocial (BPS; Engel in Science 196:129–136, 1977, 10.1126/science.847460, in The American Journal of Psychiatry 137:535–544, 1980, 10.1176/ajp.137.5.535), systemic (von Bertalanffy, General system theory: Foundations, development, applications, George Braziller, New York, 1968) framework. Thus, no one domain of health in the perinatal period can be understood without exploring how the other domains are both impacted by and impacting the others. As a result of COVID-19, popular media is paying special attention to the biomedical domain of women in the perinatal period as it relates to health outcomes and changes in perinatal healthcare policies; however, considerably less attention is being paid to the other BPS health domains and systemic impacts. This paper will outline U.S. changes in healthcare as a result of the COVID-19 pandemic for individuals, couples, and families within the perinatal period (i.e., family planning and conception, prenatal, labor and delivery, and postpartum) and explore the unique psychosocial, systemic impacts. Recommendations for care, including telehealth and virtual support options, and future directions for research will be provided. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to explore and further elucidate secondary teachers' knowledge of students' conceptions (KOSC) on the topic of evolution by natural selection. Prior research has documented students' natural selection conceptions, but allowing the opportunity for teachers to describe their own students' conceptions can permit more novel dimensions of student conceptions to emerge, especially since teachers possess a specialized knowledge of their students. Using teacher interviews, student artifacts, and video-recorded classroom observations as data sources, the study employed a grounded theory approach to document the KOSC for natural selection from four biology teachers in a high-needs public high school in the southwestern United States. Results indicated the teachers identified student conceptions consistent with prior research, but also identified novel dimensions of KOSC including how students use their everyday experiences to think about natural selection. The teachers' KOSC was then confirmed through classroom observations and student artifacts. The study's findings provide an elaborated framing with which to better understand and leverage student conceptions—which are fundamental in reform-oriented instructional approaches. [ABSTRACT FROM AUTHOR]

Practice guidelines on pre-exposure prophylaxis (PrEP) for HIV serodiscordant couples recommend PrEP when the viral load of the partner living with HIV is either detectable or unknown. However, adherence to combination antiretroviral therapy is inconsistent, and research has found that individuals vulnerable to HIV place value on additional protective barriers. We conducted a prospective cohort study to assess the feasibility, perceptions, and adherence associated with periconceptional PrEP use among females without HIV and their male partners living with HIV across four academic medical centers in the United States. We performed descriptive statistics, McNemar's test of marginal homogeneity to assess discordance in female/male survey responses, and Spearman's correlation to determine associations between dried blood spot levels and female self-reported adherence to PrEP. We enrolled 25 women without HIV and 24 men living with HIV (one male partner did not consent to the study). Women took PrEP for a median of 10.9 months (interquartile range 3.8–12.0) and were generally adherent. In total, 87% of women (20/23) had a dried blood spot with >700 fmol/punch or ≥4 doses/week, 4% (1/23) at 350–699 fmol/punch or 2–3 doses/week, and 9% (2/23) at <350 fmol/punch or <2 doses/week (correlation between drug levels and adherence is based on prior data). Dried blood spot levels closely aligned with self-reported adherence (Spearman's rho = 0.64, p = 0.001). There were 10 pregnancies among 8 participants, 4 of which resulted in spontaneous abortions. There was one preterm delivery (36 5/7 weeks), no congenital abnormalities, and no HIV transmissions. Ten couples (40%) were either lost to follow-up or ended the study early. Overall, women attempting conception with male partners living with HIV in the United States are interested and able to adhere to PrEP as an additional tool for safer conception. [ABSTRACT FROM AUTHOR]

• Pregnancy planners are a priority group for influenza vaccination. • The extent to which influenza vaccination affects fecundability is unclear. • Influenza vaccination was common (47% of females and 37% of males). • Our data indicate no adverse effect of influenza vaccination on fecundability. Although pregnancy planners are a priority group for influenza vaccination in the United States, little is known about the extent to which influenza vaccination affects fecundability. We analyzed data from Pregnancy Study Online (PRESTO), an ongoing preconception cohort study of North American pregnancy planners. During June 2013 to August 2019, 8654 female participants and 2137 of their male partners completed a baseline questionnaire and were followed until reported pregnancy, fertility treatment initiation, loss to follow-up, or 12 menstrual cycles of attempt time, whichever came first. At baseline, male and female participants reported whether they received an influenza vaccination in the past year and the date of vaccination. We used proportional probabilities regression models to estimate fecundability ratios (FR) and 95% confidence intervals (CI) comparing those who did and did not report influenza vaccination, adjusting for demographics, anthropometrics, behavioral factors, and medical history. Influenza vaccination in the past year was more common among female participants than male participants (47% vs. 37%). FRs were 1.04 (95% CI: 0.98–1.10) for female vaccination and 1.03 (95% CI: 0.93–1.14) for male vaccination. Among the 2137 couples with complete data on both partners, for 40% neither partner was vaccinated, 23% had female-only vaccination, 9% had male-only vaccination, and in 28% both partners were vaccinated. Compared with couples in which neither participant was vaccinated, FRs were 1.13 for female-only vaccination (95% CI: 0.99–1.29), 0.94 for male-only vaccination (95% CI: 0.78–1.12), and 1.07 when both partners were vaccinated (95% CI: 0.94–1.21). When restricted to recent vaccination before peak influenza season, results were similar. Our data indicate no adverse effect of influenza vaccination on fecundability. [ABSTRACT FROM AUTHOR]

The purpose of this research was to examine college students' conceptions of learning computer science and approaches to learning computer science and to examine the relationships among these two important constructs and possible moderating factors. Student data (N = 193) were collected using the conceptions of learning computer science and the approaches to learning computer science surveys at one public research institution in the southeastern United States. Data were analyzed with descriptive statistics, Confirmatory Factor Analysis models, internal consistency reliability, Pearson correlations, stepwise multiple regression models, and Multivariate Analysis of Variance models. The results suggest that college students most favorably employ a deep strategy approach for learning computer science in which prior knowledge is activated and meaningful learning strategies are used. College students appear to be more extrinsically motivated to learn computer science than intrinsically. Higher level learning conceptions are associated with a deep strategy approach to learning (e.g., Seeing in a new way) whereas low-level conceptions are associated with a surface strategy (e.g., Memorizing) approach to learning. Male college students have slightly higher conceptions of programming than their female counterparts. The findings are discussed and both limitations and delimitations of the study are enumerated. [ABSTRACT FROM AUTHOR]

International studies of science education, such as the Trends in Mathematics and Science Study (TIMSS), have revealed considerable national disparities in students' achievements in science education. The results have prompted many nations to compare their science education systems and practices to those of others, to gain insights for improvement. Teacher training and professional development are key educational components that have not attracted as much attention as they deserve in international comparative studies. This study compares the conceptions and attitudes of pre-service elementary teachers (PSETs) in Hong Kong and the United States with respect to inquiry science learning and teaching at the beginning of the semester before the start of the science methods course. PSETs' conceptions and attitudes in the two countries were compared by means of a questionnaire with both Likert-type and open-ended questions. Quantitative data were analyzed using exploratory factor analysis and inferential statistics, while qualitative data were analyzed through the systematic categorization of PSETs' responses into broad themes and subthemes to reflect patterns in their conceptions of and attitudes toward inquiry science learning and teaching. The results revealed a complex interplay between PSETs' conceptions of and attitudes toward inquiry science learning and teaching. The results shed light on the effects of sociocultural contexts and have important implications for the design of science methods courses. [ABSTRACT FROM AUTHOR]

The purpose of this exploratory qualitative study was to investigate elementary student teachers' conceptions of teaching life science outdoors. The study involved 99 student teachers who were enrolled in an elementary science methods course at a large public university in the United States of America. The study utilised drawings, and narratives to investigate the nature of these teachers' conceptions. Data analysis revealed that three conceptions of teaching life science were common among the participants: (1) teaching life science is predominantly conceptualised as being situated in the schoolyard, (2) teaching life science outdoors is teacher-directed, and (3) teaching life science outdoors is disconnected from in-class science instruction. Implications include the need for (1) teacher education programmes to provide reflective supports that explicate student teachers' conceptualisation of teaching life science and thus exposing prior frameworks; and (2) teacher educators to examine student teachers' prior frameworks for teaching life science outdoors and provide knowledgeable theory and practice platforms that will serve as frameworks for student teachers to adopt, connect and routinize outdoor life science teaching with in-school teaching of life science. [ABSTRACT FROM AUTHOR]

Objective: To estimate the effects of the Affordable Care Act Medicaid expansion provision that was largely implemented in 2014 on preconception insurance coverage among low-income women.Methods: We used a quasiexperimental, difference-in-difference design to compare changes in preconception insurance coverage among low-income women living in expansion compared with nonexpansion states before and after the Medicaid expansions. Women with family incomes 138% the federal poverty level or less who participated in the Pregnancy Risk Assessment Monitoring System from 2009 to 2015 from states that did or did not expand their Medicaid programs on January 1, 2014, were included. The exposure of interest was the state Medicaid expansion. The primary outcome was insurance status 1 month before conception. We conducted additional subgroup and sensitivity analyses to test the assumptions of the model and the robustness of the findings.Results: The study sample included 30,495 women from eight states that expanded Medicaid under the Affordable Care Act and 26,561 patients from seven states in that did not. The rate of preconception Medicaid coverage was 30.8% prepolicy and 35.6% postpolicy in nonexpansion states and 43.2% prepolicy and 56.8% postpolicy in expansion states. There was a significantly greater increase in Medicaid coverage in expansion states after the policy implementation (adjusted difference-in-difference estimate +8.6% points, 95% CI 1.1-16.0). Rates of preconception uninsurance were 44.2% prepolicy and 34.3% postpolicy in nonexpansion states and 37.4% prepolicy and 23.5% postpolicy in expansion states. There was no significant difference in the changes in uninsurance between the two groups in the postpolicy period (adjusted difference-in-difference estimate -4.1, 95% CI -11.1 to 2.9). Non-Medicaid insurance coverage was 25.3% prepolicy and 30.5% postpolicy in nonexpansion states and 19.4% prepolicy and 19.7% postpolicy in expansion states. Relative to nonexpansion states, there was a significant decrease in non-Medicaid coverage in the expansion states in the postpolicy period (adjusted difference-in-difference estimate -4.7, 95% CI -8.3 to -1.1). The results were robust to alternate model specifications and study period definitions.Conclusion: Medicaid expansion was associated with increased enrollment in Medicaid before pregnancy among low-income women; however, there were no changes in the rates of uninsurance. Additional years of postpolicy data are needed to fully assess the effects of the policy change. [ABSTRACT FROM AUTHOR]

While some epidemiologic studies support the hypothesis that stress can adversely affect fertility, few prospective studies have assessed the association in couples from the general population. We used data from Pregnancy Study Online, a web-based preconception cohort study of pregnancy planners from the United States and Canada (2013–2018), to examine the association between women's and men's perceived stress levels prior to conception and fecundability. Women (aged 21–45 years) and their male partners (aged ≥21 years) who were attempting conception without fertility treatment were eligible. We measured perceived stress using the 10-item Perceived Stress Scale (PSS). We ascertained pregnancy information using bimonthly follow-up questionnaires of female participants. We followed 4,769 couples until self-reported pregnancy, initiation of fertility treatment, loss to follow-up, or 12 menstrual cycles of attempt time, whichever came first. We used proportional probabilities regression models to estimate fecundability ratios and 95% confidence intervals, adjusting for potential confounders. Higher PSS scores among the women were associated with slight reductions in fecundability (comparing PSS scores of ≥25 vs. <10, fecundability ratio = 0.87, 95% confidence interval: 0.74, 1.02). PSS scores among the men were not substantially associated with fecundability. [ABSTRACT FROM AUTHOR]

For the past two decades, the National Cancer Institute (NCI) has supported the involvement of patient advocates in both internal advisory activities and funded research projects to provide a patient perspective. Implementation of the inclusion of patient advocates has varied considerably, with inconsistent involvement of patient advocates in key phases of research such as concept development. Despite this, there is agreement that patient advocates have improved the patient focus of many cancer research studies. This commentary describes our experience designing and pilot testing a new framework for patient engagement at SWOG, one of the largest cancer clinical trial network groups in the United States and one of the four adult groups in the NCI's National Clinical Trials Network (NCTN). Our goal is to provide a roadmap for other clinical trial groups that are interested in bringing the patient voice more directly into clinical trial conception and development. We developed a structured process to engage patient advocates more effectively in the development of cancer clinical trials and piloted the process in four SWOG research committees, including implementation of a new Patient Advocate Executive Review Form that systematically captures patient advocates' input at the concept stage. Based on the positive feedback to our approach, we are now developing training and evaluation metrics to support meaningful and consistent patient engagement across the SWOG clinical trial life cycle. Ultimately, the benefits of more patient-centered cancer trials will be measured in the usefulness, relevance, and speed of study results to patients, caregivers, and clinicians. [ABSTRACT FROM AUTHOR]

In an effort to place the recent Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report publications regarding conception options for mixed-status couples with human immunodeficiency virus (HIV) in perspective, we review the historical evolution of conception options for mixed-status couples with HIV with particular focus on the potential need for fertility treatment and the feasibility of accessing such treatment. [ABSTRACT FROM AUTHOR]

Objective: To determine if regular use of marijuana has an impact on time to pregnancy.Design: Retrospective review of cross-sectional survey data from male and female respondents aged 15-44 years who participated in the 2002, 2006-2010, and 2011-2015 National Survey of Family Growth.Setting: Not applicable.Participant(s): The National Survey of Family Growth is a nationally representative population-based sample derived from stratified multistage area probability sampling of 121 geographic areas in the U.S. Our analytic sample was participants who were actively trying to conceive.Intervention(s): Exposure status was based on the respondents' answers regarding their marijuana use in the preceding 12 months.Main Outcome Measure(s): The main outcome was estimated time to pregnancy, which was hypothesized before analysis to be delayed by regular marijuana use.Result(s): A total of 758 male and 1,076 female participants responded that they were actively trying to conceive. Overall, 16.5% of men reported using any marijuana while attempting to conceive, versus 11.5% of women. The time ratio to pregnancy for never smokers versus daily users of marijuana in men was 1.08 (95% confidence interval 0.79-1.47) and in women 0.92 (0.43-1.95), demonstrating no statistically significant impact of marijuana use on time to pregnancy.Conclusion(s): Our study suggests that neither marijuana use nor frequency of marijuana use was associated with time to pregnancy for men and women. [ABSTRACT FROM AUTHOR]

We know little about the relationship between the macroeconomy and birth outcomes, in part due to the methodological challenge of distinguishing effects of economic conditions on fetal health from effects of economic conditions on selection into live birth. We examined associations between state-level unemployment rates in the first 2 trimesters of pregnancy and adverse birth outcomes, using natality data on singleton live births in the United States during 1990-2013. We used fixed-effect logistic regression models and accounted for selection by adjusting for state-level unemployment before conception and maternal characteristics associated with both selection and birth outcomes. We also tested whether associations between macroeconomic conditions and birth outcomes differed during and after (compared with before) the Great Recession (2007-2009). Each 1 -percentage-point increase in the first-trimester unemployment rate was associated with a 5% increase in odds of preterm birth, while second-trimester unemployment was associated with a 3% decrease in preterm birth odds. During the Great Recession, however, first-trimester unemployment was associated with a 16% increase in odds of preterm birth. These findings increase our understanding of the effects of the Great Recession on health and add to growing literature suggesting that macro-level social and economic factors contribute to perinatal health. [ABSTRACT FROM AUTHOR]

Importance: Despite lack of evidence of their utility, biomarkers of ovarian reserve are being promoted as potential markers of reproductive potential.Objective: To determine the associations between biomarkers of ovarian reserve and reproductive potential among women of late reproductive age.Design, Setting, and Participants: Prospective time-to-pregnancy cohort study (2008 to date of last follow-up in March 2016) of women (N = 981) aged 30 to 44 years without a history of infertility who had been trying to conceive for 3 months or less, recruited from the community in the Raleigh-Durham, North Carolina, area.Exposures: Early-follicular-phase serum level of antimüllerian hormone (AMH), follicle-stimulating hormone (FSH), and inhibin B and urinary level of FSH.Main Outcomes and Measures: The primary outcomes were the cumulative probability of conception by 6 and 12 cycles of attempt and relative fecundability (probability of conception in a given menstrual cycle). Conception was defined as a positive pregnancy test result.Results: A total of 750 women (mean age, 33.3 [SD, 3.2] years; 77% white; 36% overweight or obese) provided a blood and urine sample and were included in the analysis. After adjusting for age, body mass index, race, current smoking status, and recent hormonal contraceptive use, women with low AMH values (<0.7 ng/mL [n = 84]) did not have a significantly different predicted probability of conceiving by 6 cycles of attempt (65%; 95% CI, 50%-75%) compared with women (n = 579) with normal values (62%; 95% CI, 57%-66%) or by 12 cycles of attempt (84% [95% CI, 70%-91%] vs 75% [95% CI, 70%-79%], respectively). Women with high serum FSH values (>10 mIU/mL [n = 83]) did not have a significantly different predicted probability of conceiving after 6 cycles of attempt (63%; 95% CI, 50%-73%) compared with women (n = 654) with normal values (62%; 95% CI, 57%-66%) or after 12 cycles of attempt (82% [95% CI, 70%-89%] vs 75% [95% CI, 70%-78%], respectively). Women with high urinary FSH values (>11.5 mIU/mg creatinine [n = 69]) did not have a significantly different predicted probability of conceiving after 6 cycles of attempt (61%; 95% CI, 46%-74%) compared with women (n = 660) with normal values (62%; 95% CI, 58%-66%) or after 12 cycles of attempt (70% [95% CI, 54%-80%] vs 76% [95% CI, 72%-80%], respectively). Inhibin B levels (n = 737) were not associated with the probability of conceiving in a given cycle (hazard ratio per 1-pg/mL increase, 0.999; 95% CI, 0.997-1.001).Conclusions and Relevance: Among women aged 30 to 44 years without a history of infertility who had been trying to conceive for 3 months or less, biomarkers indicating diminished ovarian reserve compared with normal ovarian reserve were not associated with reduced fertility. These findings do not support the use of urinary or blood follicle-stimulating hormone tests or antimüllerian hormone levels to assess natural fertility for women with these characteristics. [ABSTRACT FROM AUTHOR]

This Article seeks to explain the puzzle of the divergence of American law from the rest of the common law world through the lens of legal theory. I argue that there are four competing ideal-type theories of the authority of the common law: reason, practice, custom, and will. The reason view explains the authority of the common law in terms of correspondence to the demands of pure practical reason; the practice view sees the authority of the common law as derived from the expertise of practitioners (especially judges and practiceoriented academics) who try to develop the common law as a slowly changing, historically binding tradition; the custom view sees the authority of the common law as derived from its correspondence to contemporaneous norms and values; and the will view sees the authority of the common law (like that of all other law) as derived from the acts of a sovereign. These competing views imply different answers to various questions (such as the relationship between statutes and the common law, or the role of judges in the legal system). They also lead to very different attitudes towards the idea of a single, supranational common law: generally speaking, the first two approaches are more sympathetic to common law convergence than the latter two. I argue that these days English common law is close to the second, practice-based conception of common law authority, whereas American law adopts a combination of the third and fourth conceptions. This explains why American common law is largely uninterested in maintaining commonality with other common law jurisdictions, as well as many other differences between American and English common law. [ABSTRACT FROM AUTHOR]

Antiretroviral pre-exposure prophylaxis (PrEP) is a promising HIV prevention strategy for HIV serodiscordant couples (HIV-infected male, uninfected female) seeking safer conception. However, most research on PrEP for safer conception has focused on couples in sub-Saharan Africa; little is known about the perspectives or experiences of heterosexual couples in the United States. We conducted qualitative interviews with six couples (six women and five of their male partners) receiving PrEP for conception services at an urban safety net hospital in the US Northeast. In-depth interview guides explored couple relationships and contextual factors and attitudes, perceptions, and decision-making processes surrounding PrEP for safer conception. Thematic analyses focused on identifying the following emergent themes. We found that couple relationships were situated within broader social and cultural contexts of immigration, family, and community that shaped their experiences with HIV and serodiscordant relationship status. Despite strong partner support within relationships, HIV stigma and disapproval of serodiscordant relationships contributed to couples' feelings of social isolation and subsequent aspirations to have 'normal' families. By enabling 'natural' conception through condomless sex, PrEP for safer conception provided a sense of enhanced relationship intimacy. Couples called for increasing public awareness of PrEP through positive messaging as a way to combat HIV stigma. Findings suggest that relationship dynamics and broader social contexts appear to shape HIV serodiscordant couples' fertility desires and motivations to use PrEP. However, increased public awareness of PrEP for safer conception may be needed to combat HIV stigma at the community level. [ABSTRACT FROM AUTHOR]

By the end of 2014, a total of 955,081 persons in the United States (299.5 per 100,000 population) had received a diagnosis of human immunodeficiency virus type 1 (HIV-1) infection (1). The annual estimated number of HIV infections and incidence rate in the United States decreased from 2010 to 2014, and the survival rate has increased over time (1). Effective highly active antiretroviral therapy (HAART) is helping persons with HIV to live longer, healthier lives. Many of these persons, including an unknown percentage in discordant relationships (i.e., one partner is HIV-infected, and the other is HIV-uninfected), might wish to have their own biologic children. When the female partner is HIV-infected and the male partner is not, a discordant couple can undergo autologous sperm intrauterine inseminations to achieve conception without placing the man at risk for infection. However, for HIV-discordant couples in which the man is HIV-infected and the woman is not, strategies to minimize the risk for sexual transmission are needed. In 1988, CDC recommended against insemination with semen from HIV-infected men (2). Since 1988, new information has emerged regarding prevention of HIV transmission in HIV-discordant couples. This report reviews laboratory and epidemiologic information regarding the prevention of HIV transmission for HIV-discordant couples, in which the male is HIV-infected and the female is HIV-uninfected, who would like to attempt conception. [ABSTRACT FROM AUTHOR]

OBJECTIVE These descriptive findings extend Holland's (2013) marriage typology by linking the timing of marriage, childbearing, and cohabitation, and apply it to a range of European countries and the United States. The meaning of marriage is organized around six ideal types: Direct Family-Forming, Post-Cohabitation Family-Forming, Conception-Related Legitimizing, Birth-Related Legitimizing, Reinforcing, and Capstone marriage. METHODS I present descriptive tabulations of data from the Harmonized Histories, covering 17 European countries and the United States, to highlight continuity and change in the context of marriage across the life course, cohorts, and countries. RESULTS Although smaller shares of women entered marriage at each age across cohorts, there is increasing diversity in the timing and context of marriage. Family-Forming marriage continues to be the majority marriage experience, but Direct Family-Forming marriage has declined and Post-Cohabitation Family-Forming marriage has increased in many contexts. Conception-Related Legitimizing marriages became more important in Central and Eastern Europe but less common in Western, Northern, and Anglo-Saxon countries. Limited evidence of growth in post-first-birth marriages suggests that childbearing intentions or a first conception continue to be important triggers for marriage, although this may be changing in Nordic, Anglo-Saxon, and some Western European countries. CONCLUSIONS While most people who marry do so prior to or in the absence of a first conception, increasingly marriage is not the first step in the family-building process. Still, for many women in diverse country contexts, marriage continues to be very closely linked to initiating childbearing. [ABSTRACT FROM AUTHOR]

The article discusses U.S. reproduction and family law, with a particular focus on U.S. Constitution's norms regarding reproductive laws related to children conceived through sexual intercourse. U.S. reproduction law concerning testing for sexually transmitted diseases in sperm donors, including testing for the HIV virus, is discussed.

In 1971, Judith Jarvis Thomson published what was then and still often is regarded as a trailblazing philosophical defense of a woman's right to have a lawful abortion. It is time to revisit Thomson's paper. The aim here is not to engage Thomson's pro-choice conclusions, which are indeed mistaken, but to show that her question--to what extent can abortion be morally justified, assuming that it is the deliberate killing of one person by his or her mother--is the question today in American law concerning abortion. Pro-life people and groups argue among themselves about the prudence of political efforts to roll back Roe v. Wade by personhood initiatives, that is, by seeking to enact laws expressly recognizing that a human being with an equal right not to killed comes to be at fertilization, thereafter to pursue abortion restrictions as a matter of equal protection for all against unjustified uses of lethal force. Many if not most pro-life activists and bodies oppose such efforts as precipitous and almost certainly politically counterproductive. This article argues that, on the contrary, the unborn are already recognized as persons with a right not to be killed, and that the constitutional question of equal protection of unborn persons is already in the courts. Thomson's question is, in other words, ripe and urgent, and it has been brought to the fore not by direct attack upon abortion rights, but indirectly by and through the many feticide laws enacted across the country since around the year 2000. [ABSTRACT FROM AUTHOR]

Background: Female physicians may experience unique challenges regarding fertility and family planning. We sought to determine childbearing patterns and decision-making among American female physicians. Materials and Methods: In 2012-2013, we surveyed a random sample of 600 female physicians who graduated medical school between 1995 and 2000. Primary outcome measures included fertility and childbearing history, reflections regarding decision-making, perceptions of workplace support, and estimations of childbearing potential. Results: Response rate was 54.5% (327/600). A majority (82.0%) of the sample were parents, 77.4% had biological children with an average of 2.3 children. Average age at medical school graduation was 27.5 years, at completion of training (completion of medical school, residency, and/or fellowship) was 31.6 years, and at first pregnancy was 30.4 years. Nearly one quarter (24.1%) of respondents who had attempted conception were diagnosed with infertility, with an average age at diagnosis of 33.7 years. Among those with infertility, 29.3% reported diminished ovarian reserve. When asked what they would do differently in retrospect, most respondents (56.8%) would do nothing differently regarding fertility/conception/childbearing, 28.6% would have attempted conception earlier, 17.1% would have gone into a different specialty, and 7.0% would have used cryopreservation to extend fertility. Fewer of those whose first pregnancy was in medical school perceived substantial workplace support (68.2%) than those whose first pregnancies followed training (88.6%). Conclusions: A substantial proportion of female physicians have faced infertility or have regrets about family planning decisions and career decision-making. Combining a medical career with motherhood continues to pose challenges, meriting further investigation and targeted support. [ABSTRACT FROM AUTHOR]

The Genetics Society of America (GSA) Medal recognizes researchers who have made outstanding contributions to the field of genetics in the past 15 years. The 2018 GSA Medal has been awarded to Mariana Wolfner of Cornell University for her work on reproductive processes that occur around the time of fertilization. This includes characterization of seminal proteins in Drosophila melanogaster, which has uncovered a wealth of information about sexual conflict in evolution. [ABSTRACT FROM AUTHOR]

Objectives We sought to evaluate preconception counseling (PCC) through a qualitative examination of the experiences of couples with serodiscordant human immunodeficiency virus (HIV) status desiring pregnancy. Methods Patients involved in HIV-serodiscordant relationships who received PCC between January 2013 and January 2015 were recruited to participate in 40-minute semistructured telephone interviews. Participants were asked about their experiences with PCC and the impact of counseling on their knowledge of safer conception strategies and reproductive decisions. Two researchers independently coded interview transcripts, and delineated common ideas to generate emerging themes from participants' responses. Results Eleven respondents completed the interviews, including nine women and two men. Six respondents were HIV positive. Our thematic analysis revealed that patients gained knowledge and confidence through PCC that conception was both possible and safe. They had varied reactions to assisted reproductive technologies that correlated with income level, and explored complicated weighing of personal risk of HIV transmission. Patients reported major challenges including poor access to PCC, difficulty identifying peak fertility periods, and lack of long-term conception follow-up. Discussion PCC is a valuable resource for patients involved in HIV-serodiscordant relationships. We recommend the following opportunities for improvement: developing practical safer conception clinical and counseling guidelines for HIV-affected couples, increasing patient access to and awareness of PCC services, distributing more helpful resources to identify peak fertility, and providing long-term support for patients. [ABSTRACT FROM AUTHOR]

Background: In response to inconsistent findings, we investigated associations between maternal serum 25-hydroxyvitamin D [25(OH)D] concentrations and infant birthweight for gestational age (BW/GA), including potential effect modification by maternal race/ethnicity and infant sex.Methods: Data from 2558 pregnant women were combined in a nested case-control study (preterm and term) sampled from three cohorts: the Omega study, the Pregnancy, Infection and Nutrition study, and the Pregnancy Outcomes and Community Health study. Maternal 25(OH)D concentrations were sampled at 4 to 29 weeks gestation (80% 14-26 weeks). BW/GA was modelled as sex and gestational age-specific birthweight z-scores. General linear regression models (adjusting for age, education, parity, pre-pregnancy body mass index, season at blood draw, and smoking) assessed 25(OH)D concentrations in relation to BW/GA.Results: Among non-Hispanic Black women, the positive association between 25(OH)D concentrations and BW/GA was of similar magnitude in pregnancies with female or male infants [beta (β) = 0.015, standard error (SE) = 0.007, P = 0.025; β = 0.018, SE = 0.006, P = 0.003, respectively]. Among non-Hispanic White women, 25(OH)D-BW/GA association was observed only with male infants, and the effect size was lower (β = 0.008, SE = 0.003, P = 0.02).Conclusions: Maternal serum concentrations of 25(OH)D in early and mid-pregnancy were positively associated with BW/GA among non-Hispanic Black male and female infants and non-Hispanic White male infants. Effect modification by race/ethnicity may be due, in part, to overall lower concentrations of 25(OH)D in non-Hispanic Blacks. Reasons for effect modification by infant sex remain unclear. [ABSTRACT FROM AUTHOR]

Background The life course perspective suggests a pathway may exist among maternal exposure to stressful life events prior to conception (PSLEs), infant birth weight and subsequent offspring health, whereby PSLEs are part of a 'chains-of-risk' that set children on a certain health pathway. No prior study has examined the link between PSLEs and offspring health in a nationally representative sample of US mothers and their children. We used longitudinal, nationally representative data to evaluate the relation between maternal exposure to PSLEs and subsequent measures of infant and toddler health, taking both maternal and obstetric characteristics into account. Methods We examined 6900 mother-child dyads participating in 2 waves of the nationally representative Early Childhood Longitudinal Study-Birth Cohort (n=6900). Infant and toddler health outcomes assessed at 9 and 24 months included overall health status, special healthcare needs and severe health conditions. Adjusted path analyses examined associations between PSLEs, birth weight and child health outcomes. Results In adjusted analyses, PSLEs increased the risk for very low birth weight (VLBW, <1500 g), which, in turn, predicted poor health at both 9 and 24 months of age. Path analyses demonstrated that PSLEs had small indirect effects on children's subsequent health that operated through VLBW. Conclusions Our analysis suggests a chains-of-risk model in which women's exposure to PSLEs increases the risk for giving birth to a VLBW infant, which, in turn, adversely affects infant and toddler health. Addressing women's preconception health may have important downstream benefits for their children, although more research is needed to replicate these findings. [ABSTRACT FROM AUTHOR]

Purpose: Given reportedly high clustering but limited validity of retrospectively reported time-to-pregnancy (TTP), we assessed within-woman clustering for retrospectively reported TTPs alone and including gold-standard prospectively observed TTPs among women with 2 or more retrospectively reported and 1 or more prospectively observed TTPs. We further investigated whether past trying times inform future trying time among women with 1 or more retrospectively reported and 1 or more prospectively observed TTPs.Methods: Five hundred one couples attempting pregnancy were prospectively observed until human chorionic gonadotropin pregnancy or 12 months of trying. Women reported TTP for past planned pregnancies. Clustering as measured by the frailty variance was estimated using discrete Cox frailty models, adjusted for age, body mass index, smoking at each attempt. Utility of past attempts to inform future attempts was assessed with discrete Cox models and relative risk regression, adjusted for enrollment age, body mass index, smoking.Results: Seventy-five women with 2 or more prior pregnancies contributed 180 retrospective and 91 prospective TTPs for frailty modeling. Retrospectively reported TTP clustering was high (frailty variance = 0.89) but substantially lower when including prospectively observed TTPs (frailty variance = 0.42). Among 202 women with 1 or more prior pregnancies, past trying times did not inform future trying time.Conclusions: TTP recall rather than TTP may account for clustering. Past trying times may not inform future trying times. [ABSTRACT FROM AUTHOR]

Background Fertility counselling and treatment can help women achieve their desired family size; however, disparities exist in the utilisation of this care. Methods This study examines the persistence of a racial disparity in visiting a doctor for help getting pregnant by estimating the direct effect of this association using data from the Furthering Understanding of Cancer Health and Survivorship in Adult Women's Study, a population-based cohort study. This cohort included 1073 reproductive age women (22-45 years) with 28% reporting infertility. We fit log binomial models to quantify the magnitude of the racial difference in reported care seeking after adjustment for hypothesised mediators using inverse probability weighting. Results Compared with white women, black women were less likely to visit a doctor in the total population [adjusted risk ratio ( RR) 0.57, 95% confidence interval ( CI) 0.41, 0.80] and in the subgroup of women with infertility [ RR 0.75, 95% CI 0.56, 0.99]. In addition, black women waited twice as long, on average, before seeking help compared with white women. Conclusions There were notable racial differences in visiting a doctor for help getting pregnant in this study although reports of infertility were similar by race. These differences may be mitigated through improved communication about the range of counselling and treatment options available. [ABSTRACT FROM AUTHOR]

State laws dictating 'informed consent' about surgical and chemical abortions sometimes ensnare emergency contraceptives (EC), as the science surrounding EC shows. Courts evaluating mandated disclosures gravitate to professional norms rather than the information most women would value: basic factual information about EC so that they can decide for themselves whether to use these drugs. [ABSTRACT FROM AUTHOR]

The Platform of the U.S. Republican Party in 2012 contains a promise to overturn the landmark Supreme Court decision, Roe. v. Wade, that laws prohibiting abortion are incompatible with the constitutional right to privacy of pregnant women. The Republican vice presidential nominee, Congressman Paul Ryan, opposes that decision as a matter of conviction. Congressman Ryan says that human life begins at conception, though he adds that abortion should be legal if a woman's pregnancy results from rape or incest, or if the life of the mother is at stake. Despite his reputation among Republicans as an astute thinker, Congressman Ryan's reasoning about abortion is faulty. [ABSTRACT FROM AUTHOR]

Objective: This study sought to determine childbearing patterns and decision making among female otolaryngologists., Study Design: Anonymous survey., Setting: An anonymous survey was sent in 2020 to female otolaryngologists identified through their membership with the American Academy of Otolaryngology-Head and Neck Surgery., Methods: Data were analyzed concerning individual fertility and childbearing history, reflections regarding decision making, perceptions of workplace support, and estimations of objective childbearing potential., Results: There were 398 responses. The mean age at first pregnancy was 32.3 years. Almost one-third of respondents who attempted to conceive (30.4%) were diagnosed with infertility. Of those who had their first pregnancy during training, 55% reported having substantial workplace support, as opposed to 70% of those whose first pregnancies followed completion of training ( P = .01). When asked what they would do differently in retrospect, most women with infertility (65.0%) would have attempted conception earlier; 41 (41.0%) would have used cryopreservation to extend fertility; and 14 (14.0%) would have gone into a different specialty., Conclusion: Female otolaryngologist respondents have children later in life than the general population, and a substantial proportion face infertility or have regrets about family planning decisions and career decision making. Increased awareness, further investigation, and targeted programs are needed to support the growing number of female otolaryngologists who desire both a career and a family.

Background: To identify predictors of conceiving a pregnancy, over a 6-month observation period, among young black males attending clinics that diagnose and treat sexually transmitted infections). Methods: A convenience sample was recruited from clinics in three U.S. cities. Young black males aged 15-23 years (n = 286) who reported recent (past 2 months) penetrative sex and had not conceived a pregnancy at enrollment were eligible. At baseline and 6-month follow-up, participants completed self-interview surveys and provided a urine sample for gonorrhea and chlamydia testing. Associations of conceiving a pregnancy with demographic, behavioral, and psychosocial predictors were assessed using bivariate and adjusted logistic regression models. Results: At the 6-month follow-up 11.5% conceived a pregnancy during the observation period. Bivariate analysis indicated testing positive for chlamydia and/or gonorrhea at study enrollment significantly increased odds of conceiving a pregnancy ( p = 0.01). Enrollment in school was a protective factor ( p < 0.04). Adjusted logistic regression modeling demonstrated that males with a history of arrest were three times more likely to conceive a pregnancy (adjusted odds ratio [AOR] = 3.63, 95% confidence interval [CI] = 1.71-7.77; p = 0.001). For every added unit of agreement that ''somebody wants to be pregnant with your child,'' odds of conceiving during the observation period increased by 37% (AOR = 1.53, 95% CI = 1.19-1.98; p < 0.001). Conclusion: Findings suggest incident conceptions among a clinic-based sample of young black males occurred at a high rate, regardless of age. The clinic setting provides a unique opportunity to intervene with this population of would-be fathers, potentially making a valuable contribution to overall efforts to remedy racial disparities in adolescent/young adult pregnancy rates. [ABSTRACT FROM AUTHOR]

The article discusses the legal rights of donor-conceived children in America, and it mentions U.S. constitutional rights, the laws associated with donor conception in the country, and the concept of double disclosure. Parental rights and children's interests are mentioned, along with respect for familial autonomy and various aspects of U.S. family and health laws. Sperm and egg (ovum) donations are examined, along with the nation's fertility industry and assisted reproductive technology.

Objectives. We determined whether and to what extent a woman's exposure to stressful life events prior to conception (PSLEs) was associated with preterm birth and whether maternal age modified this relationship. Methods. We examined 9350 mothers and infants participating in the first wave of the Early Childhood Longitudinal Study, Birth Cohort, a nationally representative sample of US women and children born in 2001, to investigate the impact of PSLEs on preterm birth in the United States. We estimated the effect of exposure on preterm birth with weighted logistic regression, adjusting for maternal sociodemographic and health factors and stress during pregnancy. Results. Of the women examined, 10.9% had a preterm birth. In adjusted analyses, women aged 15 to 19 years who experienced any PSLE had over a 4-fold increased risk for having a preterm birth. This association differed on the basis of the timing of the PSLE. Conclusions. Findings suggest that adolescence may be a sensitive period for the risk of preterm birth among adolescents exposed to PSLEs. Clinical, programmatic, and policy interventions should address upstream PSLEs, especially for adolescents, to reduce the prevalence of preterm birth and improve maternal and child health. [ABSTRACT FROM AUTHOR]

Objectives. We sought to determine if and to what extent a woman's exposure to stressful life events prior to conception (PSLEs) were associated with subsequent infant birth weight by using a nationally representative sample of US women. Methods. We examined 9350 mothers and infants participating in the first wave of the Early Childhood Longitudinal Study, Birth Cohort in 2001. Weighted regressions estimated the effect of exposure on very low and low birth weight, adjusting for maternal sociodemographic and health factors and stress during pregnancy. Results. Twenty percent of women experienced any PSLE. In adjusted analyses, exposed women were 38% more likely to have a very low birth weight infant than nonexposed women. Furthermore, the accumulation of PSLEs was associated with reduced infant birth weight. Conclusions. This was the first nationally representative study to our knowledge to investigate the impact of PSLEs on very low and low birth weight in the United States. Interventions aimed to improve birth outcomes will need to shift the clinical practice paradigm upstream to the preconception period to reduce women's exposure to stress over the life course and improve the long-term health of children. [ABSTRACT FROM AUTHOR]

Background Low-dose aspirin ( LDA) has been proposed to improve pregnancy outcomes in couples experiencing recurrent pregnancy loss. However, results from studies of LDA on pregnancy outcomes have been inconsistent, perhaps because most studies evaluated LDA-initiated post-conception. The purpose of the Effects of Aspirin in Gestation and Reproduction ( EAGeR) trial was to determine whether preconception-initiated LDA improves livebirth rates in women with one to two prior losses. Methods We performed a multicentre, block randomised, double-blind, placebo-controlled trial. Study participants were recruited using community-based advertisements and physician referral to four university medical centres in the US (2006-12). Eligible women were aged 18-40 years actively trying to conceive, with one to two prior losses. Participants were randomised to receive daily LDA (81 mg/day) or a matching placebo, and all were provided with daily 400-mcg folic acid. Follow-up continued for ≤6 menstrual cycles while attempting to conceive. For those who conceived, treatment was continued until 36 weeks gestation. The primary outcome was the cumulative livebirth rate over the trial period. Results There were 1228 women randomised (615 LDA, 613 placebo). Participants had a mean age of 28.7, were mostly white (95%), well educated (86% more than high school education), and employed (75%) with a household income >$100 000 annually (40%). The characteristics of those in the treatment and placebo arms were well balanced. Conclusions We describe the study design, recruitment, data collection, and baseline characteristics of participants enrolled in EAGeR, which aimed to determine the effect of LDA on livebirth and other pregnancy outcomes in these women. [ABSTRACT FROM AUTHOR]

Prenatal diagnosis in the setting of a twin pregnancy is challenging. The frequency of abnormalities is higher in twin than in singleton pregnancies, particularly in monozygotic pregnancies. The finding of an abnormality in one twin with a normal co-twin occurs in about 85% of cases of abnormality and raises difficult management decisions. Determination of chorionicity is pivotal in further management as vascular anastamoses in monochorionic pregnancies influence the outcome as well as the interventions which are possible. Options include expectant management of the pregnancy or selective fetocide. The latter carries risks to the pregnancy of miscarriage and preterm labour. These risks are higher in monochorionic than dichorionic pregnancies. In addition death of one twin of a monochorionic pair can result in death or organ damage in the co-twin. The method of selective fetocide also differs depending on chorionicity. In dichorionic twins, intracardiac injection of KCl is the method of choice, while in monochorionic pregnancies, cord occlusion by either laser coagulation or bipolar coagulation is used. Extensive counselling of parents is necessary prior to prenatal diagnosis, and especially prior to any intervention. [ABSTRACT FROM AUTHOR]

BACKGROUND In the U.S. today, premarital first births occur disproportionately to women with low education and income. We lack studies of whether this education gradient was present in cohorts born earlier. OBJECTIVE We examine education differences in the proportion of U.S. white and black women who: (a) experienced a premarital conception taken to term resulting in a first birth, and (b) had a premarital first birth by age 35. Among those experiencing a premarital conception, we examine the association between education and whether women married before the birth. We examine these patterns for birth cohorts born between 1925 and 1959. METHODS We use the 1980, 1985, 1990, and 1995 June Fertility Supplements from the U.S. Current Population Survey to examine cohorts of women born between 1925 and 1959. The survey asked women the dates of their first marriage and their first birth, allowing us to determine premarital conceptions taken to term, and whether the resulting first births occurred within or outside of first marriage. We present descriptive information on the proportion of black and white women in each cohort who experienced the events of interest by age 35. RESULTS For all cohorts, women with low education were generally more likely than their more educated counterparts to experience premarital conceptions and premarital first births. For blacks, but not whites, who experienced a premarital conception that was taken to term, those with more education were more likely to marry before the birth. CONCLUSIONS In the U.S., the concentration of premarital conceptions and premarital first births among less educated women was present for cohorts extending back to those born in 1925. [ABSTRACT FROM AUTHOR]

Abstract: This study examines whether communication and culturally embedded concepts influence cross-cultural similarities and differences in marital role conceptions. Young adults from the US, China, South Korea, Japan, India and Malaysia responded to a series of open-ended questions about marriage and marital roles. Analytic induction methods produced categories across six topics (good wife/bad wife, good husband/bad husband, good marriage/bad marriage). Results showed even greater variation in marital role conceptions than hypothesized. Only East Asians nominated a family home focus more and only Chinese and Koreans considered respectfulness and gentleness more for the good wife role than did US participants. Loving/caring nominations did not differ across the cultural groups except for greater nominations by US participants for the good marriage and good wife role conceptions, and proportions of controlling/abusive behaviors did not differ except for the Indian group''s higher nominations for the bad wife role. Communication expectations for marital roles showed some cross cultural similarity, as both US and Asian participants rated communication characteristics as more important than attractiveness/ability characteristics, but only for the good wife/husband roles. [Copyright &y& Elsevier]

BACKGROUND As ages at first birth have steadily risen in the industrial west over the last several decades, the phenomenon of ‘delayed childbearing’ has come under research scrutiny by demographers, medical specialists and social scientists. In this study, we specifically explore the perceived advantages and disadvantages of postponed conception as well as participants’ retrospective opinions on the ‘optimal age’ for parenting. METHODS To this end, we examined a cohort purposely chosen to epitomize delayed childbearing, i.e. men and women who used IVF to conceive at the very end of their reproductive capability. In-depth qualitative interviews were conducted between 2009 and 2011 with 46 couples and 15 individual self-selected US women and men who had used IVF to conceive their first child when the woman was aged 40 or older at the time of delivery. Although the demographics of this cohort were consistent with others who use IVF in the USA, their median income was 3–4 times higher than that of the average US family, which may bias their largely positive parenting experiences. RESULTS Most women and men believed that childbearing later in life resulted in advantages for themselves and their families. These included having established careers with financial security and career-time flexibility, enhanced emotional preparedness, committed co-parenting relationships and a positive overall family experience. The main disadvantage was the unexpected difficulty in conceiving that culminated in the use of IVF and resulted in a smaller family than desired, although many expressed feeling ‘lucky’ to have children at all. Other disadvantages were lack of energy for parenting, less available lifetime to spend with children and anticipated stigma as older parents. CONCLUSIONS These disadvantages appear to have influenced conception and parenting experiences so that in hindsight the majority of participants identified the optimal age for first-time parenting as 5–10 years earlier than they had conceived. This age range was imagined to maximize the financial and emotional advantages of later parenting while minimizing the impact of age-related infertility, diminished energy, anticipated health issues and the social stigma of appearing too old to parent. [ABSTRACT FROM PUBLISHER]