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      Lactancia materna en mujeres que concibieron mediante tratamientos de fertilidad: una revisión sistemática Translated title: Breastfeeding in women who conceived using fertility treatments: a systematic review

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          Abstract

          Resumen Las mujeres sometidas a tratamientos de fertilidad (TF) presentan necesidades de atención médica y procesos de toma de decisiones antes y después del parto que pueden influir sobre los comportamientos de lactancia materna (LM). Esta revisión examinó el efecto de los TF (invasivos como inyección intracitoplasmática y/o fecundación in vitro, y menos invasivos como medicación y/o inseminación intrauterina) sobre el inicio, duración y exclusividad de la LM a partir de los estudios observacionales que compararon algún resultado de LM en función del modo de concepción (TF versus concepción espontánea). El efecto de los TF sobre el inicio, duración y exclusividad de la LM fue pequeño o no significativo y en ocasiones contradictorio. La evidencia es limitada debido al bajo número de artículos incluidos con calidad suficiente. Por ello se recomienda, hasta que se tengan más y mejores estudios al respecto, un apoyo individualizado a cada diada madre-hijo según sus características.

          Translated abstract

          Abstract Women subjected to fertility treatment present needs requiring medical attention and decision-making processes before and after delivery that might influence their behaviour in maternal breastfeeding. This review examined the effect of fertility treatments on the start, duration and exclusiveness of maternal lactation based on all the observational studies that compared some result of maternal lactation according to the form of conception. Two reviewers extracted the data and evaluated the risk of bias. The effect of fertility treatments on the results of maternal lactation was small or not significant, and on occasions contradictory. The evidence is limited due to the low number of articles of sufficient quality included. For the time being, fertility treatments do not seem to influence the start, duration and exclusiveness of maternal lactation, but until more and better studies are available, individualized support is recommended for each mother-child dyad according to its characteristics.

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          Most cited references35

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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            PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews

            Background Qualitative systematic reviews are increasing in popularity in evidence based health care. Difficulties have been reported in conducting literature searches of qualitative research using the PICO search tool. An alternative search tool, entitled SPIDER, was recently developed for more effective searching of qualitative research, but remained untested beyond its development team. Methods In this article we tested the ‘SPIDER’ search tool in a systematic narrative review of qualitative literature investigating the health care experiences of people with Multiple Sclerosis. Identical search terms were combined into the PICO or SPIDER search tool and compared across Ovid MEDLINE, Ovid EMBASE and EBSCO CINAHL Plus databases. In addition, we added to this method by comparing initial SPIDER and PICO tools to a modified version of PICO with added qualitative search terms (PICOS). Results Results showed a greater number of hits from the PICO searches, in comparison to the SPIDER searches, with greater sensitivity. SPIDER searches showed greatest specificity for every database. The modified PICO demonstrated equal or higher sensitivity than SPIDER searches, and equal or lower specificity than SPIDER searches. The modified PICO demonstrated lower sensitivity and greater specificity than PICO searches. Conclusions The recommendations for practice are therefore to use the PICO tool for a fully comprehensive search but the PICOS tool where time and resources are limited. Based on these limited findings the SPIDER tool would not be recommended due to the risk of not identifying relevant papers, but has potential due to its greater specificity.
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              Fertility and infertility: Definition and epidemiology

              Infertility is a disease characterized by the failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercourse. It is estimated to affect between 8 and 12% of reproductive-aged couples worldwide. Males are found to be solely responsible for 20-30% of infertility cases but contribute to 50% of cases overall. Secondary infertility is the most common form of female infertility around the globe, often due to reproductive tract infections. The three major factors influencing the spontaneous probability of conception are the time of unwanted non-conception, the age of the female partner and the disease-related infertility. The chance of becoming spontaneously pregnant declines with the duration before conception. The fertility decline in female already starts around 25-30 years of age and the median age at last birth is 40-41 years in most studied populations experiencing natural fertility. The disease-related infertility may affect both genders or be specific to one gender. The factors affecting both genders' fertility are hypogonadotrophic hypogonadism, hyperprolactinemia, disorders of ciliary function, cystic fibrosis, infections, systemic diseases and lifestyle related factors/diseases. Premature ovarian insufficiency, polycystic ovary syndrome, endometriosis, uterine fibroids and endometrial polyps may play a role in female infertility. Male infertility may be due to testicular and post-testicular deficiencies. Semen decline that has been observed over the years, endocrine disrupting chemicals and consanguinity are other factors that may be involved.
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                Author and article information

                Journal
                asisna
                Anales del Sistema Sanitario de Navarra
                Anales Sis San Navarra
                Gobierno de Navarra. Departamento de Salud (Pamplona, Navarra, Spain )
                1137-6627
                August 2020
                : 43
                : 2
                : 235-244
                Affiliations
                [1] Valencia orgnameHospital Universitario y Politécnico La Fe orgdiv1Escuela de Enfermería
                [2] San Vicente del Raspeig Valencia orgnameUniversidad de Alicante orgdiv1Facultad de Ciencias de la Salud orgdiv2Departamento de Enfermería Spain
                Article
                S1137-66272020000200013 S1137-6627(20)04300200013
                10.23938/assn.0870
                18aa63a9-7c1f-4ebb-b8f8-920c7b94bd72

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 01 May 2020
                : 28 May 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 10
                Product

                SciELO Spain

                Categories
                Revisiones

                Lactancia materna,Infertilidad,Técnicas reproductivas asistidas,Atención posnatal,Revisión sistemática,Systematic review,Postnatal care,Assisted reproductive techniques,Infertility,Breast feeding

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