Reproductive medicine has been transformed by assisted reproductive technologies (ART), providing multiple options for infertile couples to conceive biological offspring. The medical and legal frameworks, governing the practice of embryologists in ART, focus on the ethical and safe handling of gametes and embryos. Embryologists play a crucial role in the success of ART procedures, requiring technical expertise and a thorough understanding of legal and ethical considerations. The importance of quality control, safety protocols, and sterility in ART laboratories is essential to ensure optimal embryo development and patient well-being. The legal responsibilities of an embryologist under the Assisted Reproductive Technology (Regulation) Act, 2021 in India are required. This review emphasizes the importance of record-keeping, patient confidentiality, informed consent, and adherence to legal and ethical standards to minimize the risk of malpractice claims. Overall, this narrative review provides a detailed overview of the medical, legal, and ethical frameworks governing embryologists’ practice in ART, underscoring the significance of responsible and ethical conduct in this rapidly advancing field.

Objective: To explore the experiences of contraceptive use, reasons for discontinuation, and future intent to use modern contraceptives among married men in West Bengal, India.

Methods: A community-based cross-sectional qualitative study was conducted among married men (n=10), aged 18 to 50 years by in-depth face-to-face interviews using a predesigned interview guide. The results were transcribed, coded and analysed recognising major themes.

Results: The study identified the following themes as a rationale for men’s limited involvement in contraception: insufficient knowledge and education about contraception, cultural and religious barriers, misconceptions, economic hardships, gender-based disparities, and a shortage of male healthcare workers, along with a reluctance to seek help. Limited overall awareness about the specific role of men in reproductive health was also believed to hinder men’s meaningful involvement in fertility regulation issues.

Conclusions: Several challenges are identified among married males related to effective contraception use and the findings emphasize the importance of comprehensive education, culturally sensitive strategies, and improving access and affordability of contraceptives to overcome such barriers. These steps are essential for enabling informed reproductive health decisions and improving reproductive health outcomes.

Objective: To assess comprehensive abortion care (CAC) services uptake and barriers to it in selected representative units of the three tier health care in the district of Malda in West Bengal, India.

Methods: We conducted community-based, concurrent, parallel mixed methods study. Quantitative assessment of knowledge of primary health care workers on CAC and appropriate infrastructure assessment was done. Qualitative methods were used to identify themes affecting uptake of quality care among stakeholders.

Results: A total of 48 staff nurses and 133 auxiliary nurses and midwives were included in the study. About half of nurses (of total 48) who were second tier health care provider and two thirds (of total 133) of first tier health care provider had incorrect knowledge about legality of abortion. Only 40% mothers seeking abortion were accompanied to subcentre by primary health care worker. At the third tier health care site, physicians insisted on necessity of refresher training. Suboptimal uptake of available CAC services was due to lack of enabling environment. Lack of updated training across health care workers was observed.

Conclusions: Health care providers at the community level were unaware of facilities available for mothers seeking abortion. Higher level health care providers were unsure of specific knowledge about legal permissibility and sterilization of apparatus for abortion. At the highest level, more training on medical methods of abortion was required. The problems identified are amenable to correction, and some administrative and service-related provision on appropriate measures may lead to immediate success.

Objective: To explore the associations between income levels, employment risk, lifestyles, occupational stress, and male fertility.

Methods: This cross-sectional study analyzed 294 men seeking fertility treatment at fertility clinics in Terengganu, Pahang, and Kuala Lumpur from November 2021 to June 2023. Data were collected through structured questionnaires covering income levels, lifestyles, employment risks, occupational stress, and semen quality. Multinomial logistic regression was employed to assess predictors of semen quality, with crude and adjusted odds ratios (OR) reported.

Results: The lower-income group exhibited higher odds of having abnormal semen quality compared to normal semen quality. Specifically, these participants were more likely to experience azoospermia [crude OR 6.68, 95% confidence interval (CI) 1.84- 52.63; adjusted OR 6.26, 95% CI 1.76-51.38], indicating a link between low income and infertility issues. Lifestyle factors did not show significant associations with semen abnormalities after adjustment. High employment risks had significant associations with oligozoospermia after adjustment (crude OR 5.50, 95% CI 2.14-14.11; adjusted OR 5.15, 95% CI 1.93-13.71), while high occupational stress was linked to asthenozoospermia (crude OR 2.26, 95% CI 1.09-4.68; adjusted OR 2.25, 95% CI 1.07-4.69).

Conclusions: The findings underscore the influence of socioeconomic and occupational factors on male fertility, showing associations between lower income levels, high-risk occupations, and semen abnormalities. In contrast, lifestyle factors did not show significant associations with semen abnormalities after adjustment. Nevertheless, the current findings should be further confirmed through more extensive studies focusing on abnormal semen and lifestyle factors.

Objective: To compare the clinical efficacy of mifepristonemisoprostol medical management versus surgical curettage for first-trimester missed miscarriage, and to establish evidence-based sonographic cutoff values predictive of incomplete abortion requiring surgical intervention.

Methods: We retrospectively analyzed a cohort of 702 women diagnosed with first-trimester missed miscarriage between January 2020 and May 2023. Demographic characteristics and ultrasound parameters were systematically recorded. Receiver operating characteristic (ROC) curve analysis was performed to establish optimal sonographic cutoff values for predicting incomplete abortion requiring surgical intervention.

Results: 146 patients received medical treatment (mifepristone and misoprostol) and 556 underwent surgical curettage. At the 1-month follow-up, the medical group showed significantly greater endometrial thickness and longer postoperative bleeding duration than the surgical group (P<0.05). The menstrual volume reduction rate (23.56%) was significantly lower in the medical group than in the surgical group. The incomplete abortion rate was higher in the medical group (17.12%, 25/146) than in the surgical group (2.88%, 16/556). Among the medical group, 14 patients (9.59%) required curettage due to incomplete abortion, while 11 cases resolved spontaneously after prolonged medication. ROC curve analysis identified two cut-off values indicating the need for surgical intervention: endometrial thickness >1.21 cm at 24 h post-medical abortion, and residual mass diameter >0.95 cm at 7 days post-medical abortion.

Conclusions: Medical management of first-trimester missed miscarriage using mifepristone-misoprostol demonstrates comparable efficacy to surgical curettage. An endometrial thickness >1.21 cm at 24 h or residual tissue diameter >0.95 cm at 7 days post-medical abortion should prompt consideration of incomplete abortion.

Objective: To evaluate the antioxidant activity of Kaempferia (K.) parviflora rhizome extract and study its protective effect against male reproductive impairment induced by fenitrothion.

Methods: The phytochemicals and antioxidant properties of K. parviflora ethanolic extract were assessed. Twenty-four male mice aged 4-weeks-old were assigned into four groups. Groups 1 to 4 respectively received extra virgin olive oil (served as the vehicle control), 20 mg/kg body weight (bw) of fenitrothion, 50 mg/kg bw of K. parviflora ethanolic extract, and 50 mg/kg bw of K. parviflora ethanolic extract plus 20 mg/kg bw of fenitrothion. Upon completion of 28 days of continuous feeding treatment, the mice were subjected to mating evaluation and the assessment of epididymal sperm quality, lipid peroxidation, testosterone level and histological evaluation.

Results: Eight phytochemical compounds were detected in the ethanolic extract of K. parviflora via GC-MS. The extract exhibited a DPPH radical scavenging activity with an EC50 value of (0.870±0.007) mg/mL. Mice fed with fenitrothion in group 2 displayed an increase in relative testis weight, lipid peroxidation levels and a significant reduction in all sperm parameters (sperm concentration, progressive motility, and viability), as well as serum testosterone levels compared to the control mice in group 1 (P<0.05). On the other hand, mice fed with K. parviflora ethanolic extract in group 3 showed a significant increase in serum testosterone levels compared to group 1. Mice co-administered with K. parviflora ethanolic extract and fenitrothion in group 4 exhibited a significant improvement in testosterone levels, sperm concentration, motility, and viability compared to the mice administered only with fenitrothion in group 2 (P<0.05). Histological analysis of testicular tissue from group 4 further revealed improved testicular morphology in comparison to fenitrothion-treated mice.

Conclusions: Eight bioactive compounds were identified in K. parviflora ethanolic extract and the extract exhibited antioxidative properties. Fenitrothion administration impairs testicular function, reducing sperm parameters and testosterone while increasing lipid peroxidation. However, K. parviflora ethanolic extract coadministration alleviates oxidative stress, improves sperm parameters and testosterone levels, and enhances testicular morphology. These findings suggest that K. parviflora ethanolic extract has the therapeutic potential in mitigating male reproductive adverse effects induced by fenitrothion.