Iranian infertile couples' strategies to manage social interactions after unsuccessful treatments with assisted reproductive technologies

Many infertile couples feel vulnerable after failed treatment cycles and find insensitive remarks or inappropriate support distressing. They fear that the stress of failed treatment cycles may affect their marriage and lead to marriage breakdown. This study explored the strategies a sample of infertile couples used to manage social interactions after unsuccessful treatment with assisted reproductive technologies. A descriptive qualitative study was conducted with 34 participants including nine infertile couples, nine infertile women and two infertile men with primary infertility, two relatives, and three fertility clinic staff. The participants were selected through purposive sampling at an infertility centre in Iran, between 2016 and 2017. Data were collected using semi-structured face-to-face interviews and analysed by qualitative content analysis approach. Participants found some social interactions after failed assisted reproductive treatment cycles to be distressing and painful. They described tolerating painful emotions which cause them sadness and sorrow as well as feeling embarrassed. As a result, they found they needed to maintain their adopting concealment strategies with their families through not permitting speculation, selective disclosure, not giving details and hiding the truth. This study showed that social interactions following failed assisted reproductive cycles can be upsetting for infertile couples. Couples use different strategies to manage potentially distressing social interactions. Healthcare providers and psychologists may provide a space for safe social interactions in order to help couples to use appropriate strategies in these circumstances

Maternal Exposure to Air Pollution and Fetal Abnormalities

BACKGROUND AND OBJECTIVE: Congenital anomalies are the main causes of neonatal mortality and morbidity. We performed this systematic review study to investigate the association between mothers’ exposure to air pollution during pregnancy by combining for a variety of air pollutants and anomaly defect outcomes. METHODS: The databases of PubMed, Scopus, Cochrane, Google Scholar, SID, IranMedex and Magiran until May  2018 and reference section of relevant articles, were searched to identify both English and Persian studies on Ambient Air Pollution and Congenital Anomalies. RESULTS: A total of 28 articles from 245 articles were lastly included. The results of studies showed significant association between first trimester exposures to Carbon monoxide (CO), Particulate matter <10 microns (PM10), PM2.5, Ozone (O3), sulfur dioxide( SO2), nitrogen oxide (NO2) and increased risk of specific congenital heart defects , particularly ventricular septal defect (VSD) , tetralogy of fallot (TF), atrial septal defects (ASD), and patent ductus arteriosus (PDA). Also, SO2,  NO2, CO and PM10 were significantly associated with cleft palate (CP) with or without cleft palate (CL ± CP)  . Some studies show that Air Pollution exposure was associated with neural tube defects, Omphalocele, and Urogenital defects. CONCLUSION: We found some evidence for an effect of ambient air pollutants on congenital anomalies such as congenital heart defects and cleft palate with or without cleft, but confirmation of these associations will be needed in future studies