Search

The National Survey of Australian Secondary Students and Sexual Health (SSASH) is a periodic survey of sexual health among school-aged young people in Australia. The survey began in 1992 and, in this report, we present findings from the seventh iteration. The SSASH survey reports on a range of issues related to sexual identity and experiences, STI and HIV prevention, and relationships and sexuality education (RSE) and provides information about the progress of key priority areas in the Fourth National Sexually Transmissible Infections Strategy (Australian Department of Health, 2018).

This thesis is submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Victoria, Australia.

This is a project that studies the correlation between egg quality and mitochondrial function, investigates the mtDNA integrity in different mouse models that have defective mitochondria, and most important, explores if there is any mitochondrial sorting during early development.

Hastening environmental decline means many fish species are now vulnerable to extinction. This thesis examines the reproductive biology of native fish, and develops assisted breeding methods to aid in the conservation of fish species in Australia.

This thesis provides a comprehensive analysis of access to egg freezing, a method of fertility preservation. The evidence presented in this thesis reveals that current policies governing egg freezing are outdated, do not permit fair access to egg freezing, and suggest an update of policy needs to be further considered.

My thesis examined how obesity affects fertility, both how it impacts the mother and the baby. Enriched in the uterine fluid of obese women are Advanced Glycation Endproducts, a proinflammatory modification of sugars and proteins, which are formed when foods are browned during cooking- the golden colour on a morning slice of toast. When in the uterine fluid Advanced Glycation Endproducts compromise the development of the early embryo and how it interacts with the mother. Elevated AGEs are detrimental to fertility, and in the clinic, preconception reduction of uterine AGEs may improve the fertility of obese women.

This thesis uses a mouse model of Chlamydia infection to investigate the impacts of infection and inflammation on the ovary. In a new and striking finding, Chlamydia infection can persist in the ovary long-term and cause damage to the quantity and quality of oocytes within the ovary. This is the first time this sexually transmitted infection has been associated with infertility specific to the ovary. This has major implications for female reproductive health outcomes.

This project investigated mitochondrial damage in mouse oocytes after radiotherapy and chemotherapy. The protection of MitoQ, a mitochondrial targeted antioxidant, against toxic cancer treatments in ovaries was examined as well.

This presentation summarises the views of women from a general practice setting on intrauterine contraception

A thesis submitted in total fulfilment of the requirements for the degree of Master of Science by Research to Molecular Proteomics, Baker Heart and Diabetes Research Institute, and, Department of Physiology, Anatomy and Microbiology, College of Science, Health and Engineering, La Trobe University, Victoria, Australia.

The age-related decrease in female fertility occurs because of ovarian ageing, which is when the number of healthy ovarian follicles stored in the ovary declines as women get older. The factors that control the rate of age-associated follicle depletion is unknown. However, preliminary data from mouse models suggest that inflammation may be a causative factor in the ovarian ageing process. The goal of this thesis is to determine if inflammation contributes to ovarian ageing, with a focus on follicle number. In the long term, the information gained from this study will help us to develop new strategies to improve reproductive health for women in advanced reproductive age.

This thesis investigated the contractile effect of oxytocin on the prostate and epididymis of rat and human ex vivo using live imaging. While only having a slight effect in most of the epididymis oxytocin evoked a uniquely forceful contractile response in the most distal part of the epididymis. This response was comparable to the one induced by noradrenaline. Oxytocin significantly increased contractions in the human prostate. These results substantiate the physiological involvement of oxytocin in male sexual function. In addition, this thesis provides the first insight into the fine structure of the human prostatic duct system, using several investigative approaches.

© 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Background: We know very little about the microbiota inhabiting the upper female reproductive tract and how it impacts on fertility. Aims: This pilot study aimed to examine the vaginal, cervical and endometrial microbiota for women with a history of infertility compared to women with a history of fertility. Materials and methods: Using a retrospective case–control study design, women were recruited for collection of vaginal, cervical and endometrial samples. The microbiota composition was analysed by 16S ribosomal RNA (rRNA) gene amplification and endometrial expression of selected human genes by quantitative reverse transcription polymerase chain reaction. Results: Sixty-five specimens from the reproductive tract of 31 women were successfully analysed using 16S rRNA gene amplicon sequencing (16 controls and 15 cases). The dominant microbial community members were consistent in the vagina and cervix, and generally consistent with the endometrium although the relative proportions varied. We detected three major microbiota clusters that did not group by tissue location or case–control status. There was a trend that infertile women more often had Ureaplasma in the vagina and Gardnerella in the cervix. Testing for the expression of selected genes in the endometrium did not show evidence of correlation with case–control status, or with microbial community composition, although Tenascin-C expression correlated with a history of miscarriage. Conclusions: There is a need for further exploration of the endometrial microbiota, and how the microbiota members or profile interplays with fertility or assisted reproductive technologies.

This thesis addresses how disruptions to signalling pathways within the developing testis can alter fetal germ (sex) cell development. I have demonstrated that altered TGFβ superfamily signalling, particularly the growth factor activin A, can directly affect male fetal germ cells. This research is important in the wider context of declining male fertility and increased testicular cancer rates worldwide. Understanding key developmental processes will aid our understanding of how testicular pathologies may arise.

This thesis examines the effect of ageing on the DNA repair capacity of oocytes by studying the expression of oocyte DNA repair genes and DNA damage response (DDR) in an in vitro fertilisation (IVF) experimental model using controlled levels of sperm DNA damage. It also examined the effect of male and female age on the clinical outcomes of couples presenting with idiopathic infertility at an IVF clinic. The current findings suggests that ageing results in a diminished oocyte DNA repair capacity to amend DNA damage or paternal origin. In the clinical setting, this thesis also showed that male ageing is negatively associated with the clinical outcomes of ARTs in couples with idiopathic infertility independent of female age.

BACKGROUND: Knowledge of family planning (FP) is a key determinant of contraceptive use which ultimately plays a role in attainment of good health and in conduct of clinical research. People living in fishing communities (FCs) have limited access to health services including FP and are targeted for future clinical research but their knowledge of FP and its correlates are scantily known. We determined correlates of knowledge of FP among people living in FCs of L. victoria in Uganda to inform future FP education programs in FCs. METHODS: We conducted a comparative cross-sectional survey among participants aged 15-49 years from Kigungu and Nsazi. Participants were asked if they were aware of any FP method. All those who responded in the affirmative were further asked to mention what FP methods they had heard of or knew. Those who reported knowledge of at least one FP method were asked a series of questions about FP methods and their side effects. Knowledge was categorized into good or poor knowledge based on their mean total score. Poor knowledge constituted a score below the mean while good knowledge constituted a score of more than or equal to the mean total score. To further explore attitudes and perceptions of FP, ten in-depth interviews and four focus group discussions were conducted. RESULTS: Of the 1410 screened participants, 94.5% were aware of at least one FP method. Pills and injectable hormonal methods were the most commonly known methods. Slightly over a third (38%) had good knowledge of FP. Correlates of knowledge of FP were; being female (aOR: 1.92 95% CI: 1.39-2.67), residing in Kigungu (aOR: 4.01 95% CI: 2.77-5.81), being married (aOR: 1.59 95% CI: 1.11-2.28) and currently being in a sexual relationship (aOR: 1.75 95% CI: 1.18-2.60). Concerns about safety and effectiveness of some modern FP methods exist. Misconceptions on effects of FP like sterility, cancers and foetal abnormalities were common. CONCLUSION: FP awareness among people living in FCs of L. Victoria in Uganda is high. However, good knowledge about specific methods tends to be low. Correlates of knowledge of FP include gender, residence, marital status and sexual engagement.

A nationwide ‘Sleep-On-Side When Baby’s Inside’ public health campaign was initiated in New Zealand in 2018. This was in response to evidence that maternal supine late pregnancy going-to-sleep position was an independent risk factor for stillbirth from 28 weeks’ gestation. We plan to evaluate the success of the campaign through two nation-wide surveys of 1) pregnant women in the third trimester and 2) health professionals who provide care for pregnant women.

The production of sperm requires the coordinated action of thousands of genes, including many that are poorly understood. This thesis focused on the role of cysteine-rich secretory proteins, antigen 5, and pathogenesis-related 1 (CAP) superfamily proteins in sperm function. Using a combination of genetic models, state-of-the-art imaging technologies and custom written codes based on fluid mechanics principals. I have defined the role of four CAP proteins in male fertility. This research is relevant to the human reproductive medicine, the agricultural sector wherein assisted reproductive technologies are common, and evolution wherein sperm competition is a major determinant.

The following study used a liberal feminist lens to address a gap in the literature on contraceptive method use and romantic relationships by examining the association between contraceptive method use and both relationship satisfaction and balance of power. Specifically, it surveyed married women between the ages of 20-49 using either oral contraceptives (OCs) or natural family planning (NFP). Relationship satisfaction was measured using the Couple Satisfaction Index (CSI-4). Balance of power in the relationship was measured using the Relationship Balance Assessment (RBA). It was hypothesized that women using NFP would report higher relationship satisfaction and greater balance of power than women using OCs. Instead, results of the multiple regression analyses indicated that women using NFP experienced significantly lower rates of balance of power in their relationship. There was no significant difference in relationship satisfaction between groups. Additionally, control variables of religious importance and number of children were found to be associated with balance of power. Controls of age and religious importance were found to be associated with relationship satisfaction. Clinical implications, strengths and limitations, and future directions for research were discussed.

This thesis sought to examine the interplay of key molecular processes involved in the pathogenesis of cancer. Ground-breaking re-emergence of Nodal/Cripto was detected in endometrial cancer patient samples compared to healthy controls. Interestingly blockade of Nodal/Cripto activities, using monoclonal antibody treatment significantly reversed the carcinogenic behaviour of cellular models. This thesis also examined another molecule, with important functions within the female reproductive tract, the Interferon Epsilon. It was demonstrated that Interferon Epsilon treatment of aggressive endometrial cancer cells dramatically reduced cell growth. These findings could be utilized in the potential development of novel therapeutic agents for endometrial cancer.

The spiny mouse is a small rodent that displays remarkable physiological traits: they can regenerate skin without scarring, they have a human-like hormone profile, and they are the only known rodent with a menstrual cycle. During my PhD I explored early development in this species. I assembled a reference transcriptome and mapped gene expression during the 2-cell, 4-cell and 8-cell stages of embryo development. Ultimately, I found that the spiny mouse is a more accurate model of human embryo development in the earliest stages compared to lab mice. This work provides novel insight into the biological mechanisms that govern the creation of new life.

Supplemental Tables S1-S5 from:Toll-like receptor-4 antagonist (+)-naloxone elicits sexually dimorphic attenuation of inflammation-induced fetal programming in miceChin P-Y, Dorian C, Sharkey DJ, Hutchinson MR, Rice KC, Moldenhauer LM, Robertson SA.

Polycystic ovary syndrome (PCOS) is associated with increased risk of adverse pregnancy and birth outcomes, however this may be most related to the conditions associated with PCOS rather than PCOS per se. Current evidence on pregnancy and birth outcomes is poor and uncertain, mostly due to inclusion of selected populations and inclusion of multiple outcomes of interest with different sort of risk factors and confounders. To address the knowledge gaps in this area, future research should target community-based women with medically diagnosed PCOS status and defined PCOS phenotype and should focus on pathophysiologically related outcomes at each study.

Most mammalian testes originate in the stomach then descend during early life to reside in the scrotum, where the temperature is 2–7 °C lower than the body temperature. Elevation above the scrotal temperature can cause the death of the heat-sensitive spermatogenic cells. Although the physiological and cellular responses of the testes to heat stress have been well established, the molecular mechanisms that control these responses remain mostly unknown. In this thesis, the impact of heat on genes and proteins in the testis was investigated using two different heat exposure models: acute mild heat and surgical translocation to the abdomen in the adult rat. These studies have identified a number of molecules that are affected by the heat in the testis.

Oxygen free radicals are created during the IVF process. These have the potential to damage DNA in human eggs and embryos thereby reducing pregnancy rates after IVF. Melatonin has the ability to reduce the effects of oxygen free radicals. In the Melatonin in Assisted Reproductive Technology trial, I found that, while oral melatonin can increase levels of melatonin in follicular fluid, this does not significantly improve IVF success rates.

Preeclampsia is a life-threatening complication of human pregnancy that is associated with wide-spread damage to endothelial cells, which cover all of the maternal blood vessels. HtrA4 is a protein that is specifically produced by the placenta and is found to be highly elevated in preeclampsia, especially in early-onset subtype. This PhD study demonstrated that HtrA4 has a detrimental effect on endothelial cells, including circulating endothelial progenitor cells, which are involved in repair. It was also found that HtrA4 can cleave receptors on endothelial cell surface to block normal cellular function. Therefore, HtrA4 may contribute to the pathogenesis of early-onset preeclampsia.

The rate of testicular cancer is increasing. Although we don’t understand exactly how it develops. We know that receptors for one particular growth factor, activin A, are present on testis cancer cells. Activin A signalling may influence the migration of these cells; as indicated by upregulation of important migratory molecules (CXCL12, CCL17), their receptors (CXCR4, CXCR7) and enzymes (MMP2 and MMP9). We hypothesized that activin A influences these molecules, thereby stimulating testicular cancer progression. The demonstration that activin A changes the levels of these important molecules during a critical period of development highlights the importance of understanding this mechanism, which may underpin testicular cancer formation.

This thesis details the discovery of the only naturally menstruating rodent, the spiny mouse. While reproduction in every other rodent is dictated by the environment and, importantly, the lining of the womb is not shed, the spiny mouse behaves like humans, and cyclically menstruates. The menstrual cycle lasts only 9 days, although shares many aspects with the 28-day human cycle. Each animal is unique in the length and heaviness of their menstrual period, the degree of inflammation and fluctuation of physical parameters (i.e. food consumption and body weight). This world first discovery advocates for the spiny mouse to be recognized for its extraordinary potential in studying women’s reproductive health and menstrual associated conditions.

Background: NICE Guidelines recommend that equal access to treatment should be given to every patient, however there are many reports of inequality across the country in accessing these treatments.Aims:To identify differences in policy for NHS funding of In-Vitro Fertilisation (IVF) across England.To identify how policy differences affect activity.Method: This study is a dataset analysis, looking at the 209 CCGs in England. All data on funding is from the period 2012-2014. This data was transformed and then used to investigate the relationship between policy, activity and funding of IVF across the country.Outcomes: Most CCGs (61.2%) offer only 1 NHS-funded cycles35% of CCGs in the North of England offer 3 cycles - this is the highest for any area of the country8% of CCGs in the Midlands and the East offer 0 cyclesThe correlation co-efficient between the number of cycles offered and the number of NHS-funded cycles carried out is 0.095.43 IVF cycles per 1000 people were carried out in Hertfordshire and the South Midlands - the most active region of the country per capita77.9% of IVF cycles carried out in the region of Cheshire, Warrington and Wirral were NHS-funded - the highest of any regionDiscussion: The discussion analyses these results in further detail and through the inclusion of a divided coloured map of England, helps to further illustrate the regional bias. Apparent from this is that the North of England prioritises IVF funding more than any other region, and thereby a greater proportion of NHS-funded cycles take place here than anywhere else in the countryReferences: A.Borini, Fertility Fairness; HFEA: I.Messinis, NICE; The Online Recruitment Resource: Your FertilityThis work was presented at Fertility 2018, the UK's largest annual conference which focuses on fertility and reproductive medicine. The link to the conference's abstract booklet is linked in the Reference section below.

Lecture given by Doctor Bernard Jégou, Director of the INSERM Groupe d'etude de la Reproduction chez le Male, Université de Rennes, France at the Waite Campus, University of Adelaide, 16.9.1994This lecture is part of the Campus Seminars and Distinguished Lecturer Series, Waite Campus, University of Adelaide, 1991 – 1997. https://figshare.com/projects/Campus_Seminars_and_Distinguished_Lecturer_Series_Waite_Campus_University_of_Adelaide/17756

A PCR assay, using three primer pairs, was developed for the detection of Ureaplasma urealyticum , parvo biovar, mba types 1, 3, and 6, in cultured clinical specimens. The primer pairs were designed by using the polymorphic base positions within a 310- to 311-bp fragment of the 5′ end and upstream control region of the mba gene. The specificity of the assay was confirmed with reference serovars 1, 3, 6, and 14 and by the amplified-fragment sizes (81 bp for mba 1, 262 bp for mba 3, and 193 bp for mba 6). A more sensitive nested PCR was also developed. This involved a first-step PCR, using the primers UMS-125 and UMA226, followed by the nested mba -type PCR described above. This nested PCR enabled the detection and typing of small numbers of U. urealyticum cells, including mixtures, directly in original clinical specimens. By using random amplified polymorphic DNA (RAPD) PCR with seven arbitrary primers, we were also able to differentiate the two biovars of U. urealyticum and to identify 13 RAPD-PCR subtypes. By applying these subtyping techniques to clinical samples collected from pregnant women, we established that (i) U. urealyticum is often a persistent colonizer of the lower genital tract from early midtrimester until the third trimester of pregnancy, (ii) mba type 6 was isolated significantly more often ( P = 0.048) from women who delivered preterm than from women who delivered at term, (iii) no particular ureaplasma subtype(s) was associated with placental infections and/or adverse pregnancy outcomes, and (iv) the ureaplasma subtypes most frequently isolated from women were the same subtypes most often isolated from infected placentas.

Ureaplasmas are the microorganisms most frequently isolated from the amniotic fluid of pregnant women and can cause chronic intrauterine infections. These tiny bacteria are thought to undergo rapid evolution and exhibit a hypermutatable phenotype; however, little is known about how ureaplasmas respond to selective pressures in utero. Using an ovine model of chronic intra-amniotic infection, we investigated if exposure of ureaplasmas to sub-inhibitory concentrations of erythromycin could induce phenotypic or genetic indicators of macrolide resistance. At 55 days gestation, 12 pregnant ewes received an intra-amniotic injection of a non-clonal, clinical U. parvum strain, followed by: (i) erythromycin treatment (IM, 30 mg/kg/day, n=6); or (ii) saline (IM, n=6) at 100 days gestation. Fetuses were then delivered surgically at 125 days gestation. Despite injecting the same inoculum into all ewes, significant differences between amniotic fluid and chorioamnion ureaplasmas were detected following chronic intra-amniotic infection. Numerous polymorphisms were observed in domain V of the 23S rRNA gene of ureaplasmas isolated from the chorioamnion (but not the amniotic fluid), resulting in a mosaic-like sequence. Chorioamnion isolates also harboured the macrolide resistance genes erm(B) and msr(D) and were associated with variable roxithromycin minimum inhibitory concentrations. Remarkably, this variability occurred independently of exposure of ureaplasmas to erythromycin, suggesting that low-level erythromycin exposure does not induce ureaplasmal macrolide resistance in utero. Rather, the significant differences observed between amniotic fluid and chorioamnion ureaplasmas suggest that different anatomical sites may select for ureaplasma sub-types within non-clonal, clinical strains. This may have implications for the treatment of intrauterine ureaplasma infections.

Recently we reported the presence of bacteria within follicular fluid. Previous studies have reported that DNA fragmentation in human spermatozoa after in vivo or in vitro incubation with bacteria results in early embryo demise and a reduced rate of ongoing pregnancy, but the effect of bacteria on oocytes is unknown. This study examined the DNA within mouse oocytes after 12 hours’ incubation within human follicular fluids (n = 5), which were collected from women undergoing in vitro fertilization (IVF) treatment. Each follicular fluid sample was cultured to detect the presence of bacteria. Terminal deoxynucleotidyl transferase mediated dUTP nick-end labeling (TUNEL) was used to label DNA fragmentation in ovulated, non-fertilized mouse oocytes following in vitro incubation in human follicular fluid. The bacteria Streptococcus anginosus and Peptoniphilus spp., Lactobacillus gasseri (low-dose), L. gasseri (high-dose), Enterococcus faecalis, or Propionibacterium acnes were detected within the follicular fluids. The most severe DNA fragmentation was observed in oocytes incubated in the follicular fluids containing P. acnes or L. gasseri (high-dose). No DNA fragmentation was observed in the mouse oocytes incubated in the follicular fluid containing low-dose L. gasseri or E. faecalis. Low human oocyte fertilization rates (

Background: Intra-amniotic infection accounts for 30% of all preterm births (PTB), with the human Ureaplasma species being the most frequently identified microorganism from the placentas of women who deliver preterm. The highest prevalence of PTB occurs late preterm (32-36 weeks) but no studies have investigated the role of infectious aetiologies associated with late preterm birth. Method: Placentas from women with late PTB were dissected aseptically and samples of chorioamnion tissue and membrane swabs were collected. These were tested for Ureaplasma spp. and aerobic/anaerobic bacteria by culture and real-time PCR. Western blot was used to assess MBA variation in ureaplasma clinical isolates. The presence of microorganisms was correlated with histological chorioamnionitis. Results: Ureaplasma spp. were isolated from 33/466 (7%) of placentas by culture or PCR. The presence of ureaplasmas, but not other microorganisms, was associated with histological chorioamnionitis (21/33 ureaplasma-positive vs. 8/42 other bacteria; p= 0.001). Ureaplasma clinical isolates demonstrating no MBA variation were associated with histological chorioamnionitis. By contrast, ureaplasmas displaying MBA variation were isolated from placentas with no significant histological chorioamnionitis (p= 0.001). Conclusion: Ureaplasma spp. within placentas delivered late preterm (7%) is associated with histological chorioamnionitis (p = 0.001). Decreased inflammation within chorioamnion was observed when the clinical ureaplasma isolates demonstrated variation of their surface-exposed lipoproteins (MBA). This variation may be a mechanism by which ureaplasmas modulate and evade the host immune response. So whilst ureaplasmas are present intra-amniotically they are not suspected because of the normal macroscopic appearance of the placentas and the amniotic fluid.

Our previous study reported microorganisms in human follicular fluid. The objective of this study was to test human follicular fluid for the presence of microorganisms and to correlate these findings with the in vitro fertilization (IVF) outcomes. In this study, 263 paired follicular fluids and vaginal swabs were collected from women undergoing IVF cycles, with various causes for infertility, and were cultured to detect microorganisms. The cause of infertility and the IVF outcomes for each woman were correlated with the microorganisms detected within follicular fluid collected at the time of trans-vaginal oocyte retrieval. Microorganisms isolated from follicular fluids were classified as: (1) ‘colonizers’ if microorganisms were detected within the follicular fluid, but not within the vaginal swab (at the time of oocyte retrieval); or (2) ‘contaminants’ if microorganisms detected in the vagina at the time of oocyte retrieval were also detected within the follicular fluid. The presence of Lactobacillus spp. in ovarian follicular fluids was associated with embryo maturation and transfer. This study revealed microorganisms in follicular fluid itself and that the presence of particular microorganisms has an adverse affect on IVF outcomes as seen by an overall decrease in embryo transfer rates and pregnancy rates in both fertile and infertile women, and live birth rates in women with idiopathic infertility. Follicular fluid microorganisms are a potential cause of adverse pregnancy outcomes in IVF in both infertile women and in fertile women with infertile male partners.

Background: Preterm birth is a major cause of neonatal morbidity and mortality, with 75% of preterm births occurring late preterm. Previous studies have investigated the microbial diversity within placentas delivered early preterm but there has been no investigation of the prevalence of bacteria, particularly Ureaplasma spp. in late preterm placentas. Method: Women giving birth late preterm (320 – 366 weeks of gestation) in Cincinnati were recruited for this study. Samples of chorioamnion were collected aseptically at the time of delivery, shipped to QUT and tested for Ureaplasma spp. and other bacteria by culture and/or PCR assays. The presence of bacteria was correlated with adverse pregnancy outcomes, including histological chorioamnionitis (tissue sections read by US pathologists). Results: To date, Ureaplasma spp. have been detected in 15/270 (5.5%) of placentas by culture and 19/270 (7%) by PCR. Ureaplasma presence correlated with histological chorioamnionitis (12/19%; 63%). However, the presence of other bacteria was not associated with chorioamnionitis (5%). Chorioamnionitis was unevenly distributed in ethnic groups, with a higher incidence in African-Americans’ (6/7; 86%), compared to Caucasians’ (6/12; 50%) who were colonised with ureaplasmas. Conclusion: This study is the first to report the prevalence of ureaplasmas in women (7%) who deliver late preterm. Ureaplasma spp. were associated with a higher incidence of chorioamnionitis (63% compared to 15% for non-infected women). This data strongly suggests that ureaplasmas are a cause of late preterm deliveries and African-American women are at greater risk of chorioamnionitis.

Background: Ureaplasmas are the most prevalent bacteria isolated from preterm deliveries and the prognosis for neonates varies depending on the gestation at delivery. Ureaplasmas vary their surface-exposed antigen (MBA, a virulence mechanism) during chronic intra-amniotic infections, but it is not known when changes first occur during gestation. Method: U. parvum serovar 3 (2x10e7CFU) was injected intra-amniotically (IA) into six experimental cohorts of pregnant ewes (of n=7), 3 days (d) or 7d before delivery at either: 100d, 124d or 140d gestation (term=145d). Control ewes received IA 10B broth. Fetuses were delivered surgically and ureaplasmas cultured from amniotic fluid (AF), chorioamnion, fetal lung (FL) and umbilical cord. Ureaplasmas were tested by western blot to demonstrate MBA variation. Results: The highest number of ureaplasmas were recovered from FL at 100d gestation after 3 days of infection (p

Surrogacy has produced some positive outcomes creating an opportunity for otherwise childless couples to live their dream of parenthood. However it has also been problematic, particularly where the surrogate mother fails to relinquish a child born as a result of the surrogacy arrangement. This article examines whether a surrogate mother, who is genetically related to the child she delivers, is less likely to relinquish the child than one who has no genetic ties. An examination of empirical evidence provides support for this argument. Legislation and case law in three jurisdictions, Australia, the United States and the United Kingdom, is examined to determine which, if any, of these jurisdictions take into account the existence, or otherwise, of a genetic link between the surrogate mother and the child she bears. The article concludes that surrogacy legislation should, subject to exceptional circumstances, encourage surrogacy arrangements where the child and the surrogate are not genetically related.

The recent Supreme Court decision of Queensland v B [2008] 2 Qd R 562 has significant implications for the law that governs consent and abortions. The judgment purports to extend the ratio of Secretary, Department of Health and Community Services (NT) v JWB and SMB (1991) 175 CLR 218 (Marion’s Case) and impose a requirement of court approval for terminations of pregnancy for minors who are not Gillick-competent. This article argues against the imposition of this requirement on the ground that such an approach is an unjustifiable extension of the reasoning in Marion’s Case. The decision, which is the first judicial consideration in Queensland of the position of medical terminations, also reveals systemic problems with the criminal law in that State. In concluding that the traditional legal excuse for abortions will not apply to those which are performed medically, Queensland v B provides further support for calls to reform this area of law.

Background: We have developed a sheep model of intrauterine ureaplasma infection. We aimed to examine the capability of ureaplasmas in the amniotic fluid to infect the fetus and alter fetal development...

Previous studies have measured cytokine expression within follicular fluid collected at the time of trans-vaginal oocyte retrieval and compared the profiles with the aetiology of infertility and/or successful or unsuccessful assisted reproductive technology (ART) outcomes. Seventy-one paired follicular fluid and vaginal swab specimens collected from ART patients were cultured to detect microorganisms and then were tested for the presence of cytokines by multiplex fluorescence bead assays. Specimen selection was based on two criteria: whether the follicular fluid specimen was colonised (with microorganisms prior to oocyte retrieval) or contaminated by lower genital tract microflora at the time of oocyte retrieval and; the aetiology of infertility...

EDITORIAL COMMENT: We accepted this paper for publication because it gives important information about the frequency of colonization of the lower and upper genital tract of pregnant women with Ureaplasma urealyticum. Although the authors discuss adverse pregnancy outcome they did not mention perinatal mortality or morbidity due to infection with Ureaplasma urealyticum although they note that there were 4 of the 16 preterm deliveries where there was evidence of chorioamnionitis. We have previously published a paper from the Toowoomba Base Hospital group on Ureaplasma urealyticum chorioamnionitis associated with 2 perinatal deaths and 1 case of severe chorioamnionitis where the infant survived (A). We refer readers to the Editorial Comment that accompanied this paper. Summary: We investigated Ureaplasma urealyticum genital tract colonization rates in an Australian population to determine whether colonization was associated with adverse pregnancy outcome. Women attending an antenatal clinic were evaluated for lower genital tract colonization at their first antenatal visit (162 women) and at 28 weeks' gestation (120 women). Placentas from 92 women were cultured. U. urealyticum was the predominant isolate from the lower (57.4%) and upper (17.4%) genital tract in this population of pregnant women. U. urealyticum was a persistent colonizer during mid-trimester of pregnancy (in 88% of women colonized) whereas M. hominis, G. vaginalis, and Group B streptococcus were present as transient flora of the lower genital tract. Lower genital tract colonization during pregnancy was not directly associated with adverse pregnancy outcome. However preterm delivery in afebrile, asymptomatic women, could possibly be associated with chorioamnionitis (4 of 16 preterm births). Screening of women with a history of preterm birth may prevent upper genital tract infections and preterm delivery.