The effects of urogenital infection on male fertility are controversial. The object of this study was to assess whether contact between E. coli, one of the bacteria encountered most frequently in semen cultures, and sperm was involved in decreasing motility of the sperm. Sperm from healthy donors were therefore incubated at two concentrations (1.10(7) and 4.10(7) ml-1) with bacteria (10(4) and 10(6) bacteria ml-1 respectively). Sperm motility was assessed as a function of time. The endotoxin effect was also evaluated. Aliquots of the sperm were used as controls. The motility of a population of 10(6) sperm ml-1 was reduced significantly more by the presence of 10(6) ml-1 E. coli than a sperm population four times more numerous. Since the endotoxin had no effect on sperm motility, it is possible this phenomenon is due to bacterial adherence to the sperm. From this study, it is therefore probable that the presence of E. coli in semen decreases sperm motility, but that this depends on the sperm:bacterial ratio ml semen-1.

Objective: The Hyde Amendment and related policies limit or prohibit Medicaid coverage of abortion services in the United States. Most research on cost-related abortion barriers relies on clinic-based samples, but people who desire abortions may never make it to a healthcare center. To examine a novel, pre-abortion population, we analyzed a unique qualitative dataset of posts from Reddit, a widely used social media platform increasingly leveraged by researchers, to assess financial obstacles among anonymous posters considering abortion. Methods: In February 2020, we used Python to web-scrape the 250 most recent posts that mentioned abortion, removing all identifying information and usernames. After transferring all posts into NVivo, a qualitative software package, the team identified all datapoints related to cost. Three qualitatively trained evaluators established and applied codes, reaching saturation after 194 posts. The research team used a descriptive qualitative approach, using both inductive and deductive elements, to identify and analyze themes related to financial barriers. Results: We documented multiple cost-related deterrents, including lack of funds for both the procedure and attendant travel costs, inability to afford desired abortion modality (i.e., medication or surgical), and for some, consideration of self-managed abortion options due to cost barriers. Conclusions: Findings from this study underscore the centrality of cost barriers and third-party payer restrictions to stymying reproductive health access in the United States. Results may contribute to the growing evidence base and building political momentum focused on repealing the Hyde Amendment.

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In contrast with previous studies, we report a complication rate associated with peripheral line use in pregnant and postpartum women that appears similar to that in non-pregnant populations.

Importance Genital lichen planus is a debilitating disorder that lacks definitive recommendations regarding diagnosis and treatment. Objective The aim of this study was to present best practices from available evidence for the diagnosis and treatment of genital lichen planus. Evidence Acquisition We conducted a narrative review of the literature on genital lichen planus by searching PubMed using the following search terms: “vulvar lichen planus” OR (vulvar diseases[mesh] OR vulva[mesh]) AND lichen planus[mesh] OR vulvar[ti] AND “lichen planus”[ti]. We included all languages and years in the search. Results The search resulted in 273 citations that we reviewed for relevancy and selected 60 as the foundation for this review that focuses on genital sites. Diagnosis can be made without biopsy, and when a biopsy is taken, the pathologic findings may be nonspecific. Topical ultrapotent corticosteroids are most commonly used as first-line treatment of genital lichen planus. Conclusions and Relevance When patients present with genital lichen planus, a complete review of systems and a thorough physical examination should be performed because of the prevalence of extragenital sites. Treatment of genital disease should start with a topical, ultrapotent steroid, and follow-up visits should occur to ensure improvement and to monitor for adverse drug reactions and malignancy. Target Audience Obstetricians, gynecologists, and family physicians. Learning Objectives After reading this article, readers should be able to differentiate between lichen planus and other common vulvar dermatoses on physical examination; evaluate a patient for nongenital manifestations of lichen planus; assess if a vulvar biopsy is necessary for diagnosis; and construct a management plan for patients affected by genital lichen planus.