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The COVID-19 pandemic significantly impacted sexual and reproductive health and rights. Nepal implemented a nationwide lockdown in March 2020, limiting population movement and service access. The 36 clinics run by Marie Stopes Nepal (MSN) closed for varying periods at the beginning of lockdown. This study assesses the impact of lockdown and associated clinic closures on abortion services within MSN's network. An interrupted time-series analysis of clinic-level MSN data compared abortion service use in the pre-closure and post-reopening periods, focusing on the following outcomes: number of abortion care visits, proportion of abortion-related visits, gestational age at time of abortion care and demographics of patients accessing abortion care. Subsequent meta-analyses combined clinic-level results to generate outcome-specific pooled effect estimates. As MSN clinics reopened, during ongoing wider lockdown, weekly visits for abortion care decreased by 37% on average, but abortion increased as a proportion of services post-reopening (OR: 1.53) compared with pre-closure, with no evidence of a change in the proportion of higher gestation abortions. The demographic profile of abortion care clients was altered, with post-reopening clients more likely to have completed primary education (OR: 1.54) and be aged 25 years or older (OR: 1.31) compared with pre-closure clients. COVID-19 lockdown and associated clinic closures reduced the absolute number of abortion services provided within MSN's network, impacting the composition of service provision. Reductions in safe abortion and wider SRH access will have wide-ranging consequences, curtailing crucial reproductive rights. Policy-makers must ensure ongoing abortion access to protect rights and ensure access.

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AIM: The 2019 National Institute for Health and Care Excellence (NICE) guidance on abortion care emphasised the importance of teaching the topic at undergraduate and postgraduate level. This study aimed to investigate the current provision of undergraduate abortion education in UK medical schools. METHODS: Relevant medical ethics and clinical leads from the 33 established UK medical schools were invited to complete surveys on the ethico-legal or clinical aspects, respectively, of their institution's abortion teaching. The surveys explored how abortion is currently taught, assessed the respondent's opinion on current barriers to comprehensive teaching, and their desire for further guidance on undergraduate abortion teaching. RESULTS: Some 76% (25/33) of medical schools responded to one or both surveys. The number of hours spent on ethico-legal teaching ranged from under 1 hour to over 8 hours, with most clinical teaching lasting under 2 hours. Barriers to teaching were reported by 68% (21/31) of respondents, the most common being difficulty accessing clinical placements, lack of curriculum time, and the perception of abortion as a sensitive topic. Some 74% (23/31) of respondents would welcome additional guidance on teaching abortion to medical undergraduates. CONCLUSIONS: Education on abortion, particularly clinical education, varies widely among UK medical schools. Most educators experience barriers to providing comprehensive abortion teaching and would welcome up-to-date guidance on teaching both the clinical and ethico-legal aspects of abortion to medical students. It is essential that medical schools address the barriers to teaching, to ensure all medical students have the knowledge, skills and attitudes to provide competent and respectful abortion-related care once qualified.

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BACKGROUND: Despite abortion being a common part of reproductive healthcare, UK undergraduate medical school abortion education varies widely. We therefore aimed to explore medical students' views on their undergraduate abortion education, including whether it prepared them to be a competent practitioner. METHODS: We conducted in-depth semi-structured interviews with 19 students from five UK medical schools, all of whom had received abortion teaching. The qualitative research followed a quantitative survey of UK undergraduate abortion education; the five medical schools were purposively sampled to encompass a wide variety of teaching approaches. Interviews were transcribed and data were analysed using an inductive thematic approach. RESULTS: Dedicated abortion teaching was highlighted as necessary and valuable, as abortion care is so commonly accessed. Participants felt that abortion education should prepare students to be competent practitioners, with inclusion of clinical placements and an emphasis on non-stigmatising care. Most interviewees felt that the perceived sensitive nature of abortion should act as an incentive to comprehensive teaching. It was suggested that teaching should be inclusive for all, including those with a conscientious objection to abortion. CONCLUSION: The medical students interviewed viewed comprehensive abortion education as an important aspect of their undergraduate curriculum. Conversely to the accompanying quantitative survey of educators, participants believed that the perceived sensitivity of abortion increases the importance of effective teaching that prepares them to provide competent respectful care when they qualify. It is incumbent on medical schools to provide the comprehensive education that students need and the Royal College of Obstetricians and Gynaecologists recommends.

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For many decades, the dogma prevailed that female mammals had a finite pool of oocytes at birth and this was gradually exhausted during a lifetime of reproductive function. However, in 2004, a new era began in the field of female oogenesis. A study was published that appeared to detect oocyte-stem cells capable of generating new eggs within mouse ovaries. This study was highly controversial and the years since this initial finding have produced extensive research and even more extensive debate into their possibility. Unequivocal evidence testifying to the existence of oocyte-stem cells (OSCs) has yet to be produced, meanwhile the spectrum of views from both sides of the debate are wide-ranging and surprisingly passionate. Although recent studies have presented some convincing results that germ cells exist and are capable of creating new oocytes, many questions remain. Are these cells present in humans? Do they exist in physiological conditions in a dormant state? This comprehensive review first examines where and how the dogma of a finite pool was established, how this has been challenged over the years and addresses the most pertinent questions as to the current status of their existence, their role in female fertility, and perhaps most importantly, if they do exist, how can we harness these cells to improve a woman's oocyte reserve and treat conditions such as premature ovarian insufficiency (POI: also known as premature ovarian failure, POF).

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