Carolina Rodrigues de Mendonça

Sexual dysfunction in infertile women: A systematic review and meta-analysis

OBJECTIVE This study aimed to assess the prevalence of sexual dysfunction and Female Sexual Function Index (FSFI) score in women with infertility. STUDY DESIGN A systematic search of the literature was conducted using PubMed, EMBASE, IBECS, and LILACS. The search was limited to articles published from January 2000 to September 2016, without language restriction. Data were analyzed using Stata 12.0. Random effects meta-analyses in weighted mean difference (WMD) were performed for six comparative studies (infertility versus fertility). Heterogeneity was estimated using I2. Moreover, to explore the heterogeneity sources among the studies, meta-regression analyses were also performed. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation guidelines, and risk of bias, with a graphic funnel. RESULTS Meta-analysis was performed in 11 of 13 comparative studies. The result indicated a significant association between an increase in sexual dysfunction and infertility in women (WMD=-0.16, 95% confidence interval=-0.254 to -0.084, p<0.001), and high heterogeneity between studies was noted (I2=98.6%, p<0.000). Meta-regression analysis did not indicate heterogeneity (I2=0.00%). We also performed a meta-analysis of individual FSFI domains in 10 studies. Infertile women had problems with lubrication, orgasm, and satisfaction. Meta-regression analysis also showed that heterogeneity had no influence on the final results of all the analyses. CONCLUSIONS Infertility was associated with an increase in female sexual dysfunction. The most affected areas of sexual function were lubrication, orgasm, and satisfaction.

Função sexual de mulheres submetidas à reprodução assistida

PURPOSE To evaluate sexual function in women undergoing assisted reproductive techniques. METHODS This is a case-control study including 278 women assisted in Human Reproduction services and at the Gynecology Clinic of the University Hospital, Federal University of Goiás, Brazil. The women were divided into a study group (168 infertile women) and a control group (110 fertile women), and they answered the Female Sexual Function Index (FSFI) questionnaire used the assess the sexual function. We calculated the odds ratio (OR) for the chance of sexual dysfunction in infertile women (p<0.05). RESULTS Out of the analyzed women, 33.09% reported sexual dysfunction, with no difference in the FSFI score between groups (p=0.29). The prevalence of sexual dysfunction was of 36.30% among infertile women and 28.18% among fertile women; however, there was no difference between FSFI scores (p=0.36). The desire and arousal domains were significantly different among infertile women (p=0.01). Infertile women had the same chances of having sexual dysfunction as fertile women (OR=1.4, 95%CI 0.8-2.4; p=0.2). CONCLUSION There were no differences between infertile and fertile women. Infertile women undergoing assisted reproduction techniques require professional approach to sexual health regarding desire and arousal.

Folic acid does not improve semen parametrs in subfertile men: A double-blin, randomized, placebo-controlled study

Objective: It is thought that oral supplementation with antioxidants might reduce damage caused by reactive oxygen species in the seminal fluid, and as a consequence it increases the fertilizing capacity of spermatozoa due to improvement of sperm parameters. Methods: The aim of this research is to evaluate the effect of folic acid supplementation, by semen analysis, in 49 subfertile men with the median age being 35.3 years (±7.7). The experimental group (n= 23) received 5mg of folic acid daily and the control group (n= 26) received placebo, both groups were treated for three months. In order to confirm the condition of sub-fertility, two spermogram were performed with an interval of 15 days between the first and the second test. Moreover, sexual intercourse and masturbation abstinence were required for two to five days before collecting the semen samples (according to the WHO recommendations). Pre and post-intervention examination was performed in the same laboratory by two professionals, according to the WHO criteria, 1999. The chi-square test was applied for both groups.

Adaptation and validation of body maps for musculoskeletal pain location in patients with severe obesity

Background Although a variety of instruments implement body maps for the precise identification of pain symptoms, no instrument has been validated for use in people with obesity. This study reports the adaptation and validation of body maps for musculoskeletal pain location in people with obesity. Methods Nine key anatomical regions were highlighted based on the original images of the Nordic Musculoskeletal Questionnaire body maps. Adult silhouettes were generated from photographs of men and women with obesity. The body dimensions were adjusted to take into account the different body fat distribution patterns of people with obesity. The validity of the images was assessed by 12 experts. Subsequently, a data collection stage was performed with 58 patients with severe obesity from both sexes. The reproducibility of the images was tested by comparison with the original images. Results The results of the validation pilot study indicated that the adapted images facilitated the location of musculoskeletal pain in men and women with obesity. The reproducibility of the original and adapted versions of the body maps indicated good agreement for pain over the last 12 months and 7 days (80% vs. 79.7%). Pain scores in the last 12 months indicated good and high sensitivity and specificity for all body areas (60.9% vs. 89.1%). Considering pain in the last 7 days, high sensitivity and specificity for all areas of the body (85.1% vs. 70.1%). Conclusions The body maps developed in this study are reliable and valid to identify the location of pain in people with obesity.