Essential facts Infertility means a couple cannot conceive, despite having regular unprotected sex. It is estimated that infertility affects one in seven heterosexual couples in the UK. The charity Infertility Network UK supports people who have been affected emotionally. PMID:24894231
Health Matters, the Australian Broadcasting Corporation's online gateway to health issues, presents this in-depth feature on infertility. Readers will find a detailed introduction to "the different kinds of infertility, what can be done, the costs involved, and the tricky ethical and legal issues that can crop up." The feature also includes a number of useful links, recommended reading, and an indispensable glossary of terms.
Infertility is a common condition, affecting 15% of couples trying to conceive. The infertility evaluation includes an assessment of both the female and the male partner to discern the factors contributing to their difficulty in conceiving. The basic evaluation includes a careful history of both partners, physical examination of the female partner, investigation of ovulatory function and tubal status, and semen analysis. A more detailed investigation is performed as dictated by individual factors. PMID:23182553
McLaren, Janet F
... if you have fertility problems. When it is possible to find the cause, treatments may include medicines, surgery, or assisted reproductive technologies. Happily, two-thirds of couples treated for infertility are able to have babies. NIH: National Institute of Child Health and Human Development
... Organizations Resources: FAQs › FAQs - The Psychological Component of Infertility -- written by the ASRM Mental Health Professional Group ( ... Professional in your area ) Q1. What impact does infertility have on psychological well being? Infertility often creates ...
Diagnosis and treatment of infertility, once a purely empirical process, can now be based on rational exclusion of alternatives. The author reviews the drug treatment of infertility, emphasizing ovulation induction. He also discusses the endocrine treatment of men, drug treatment of endometriosis, and antibiotic treatment of infections. The author recommends referral to a specialist when more invasive drugs, such as gonadotrophins or gonadotrophin-releasing hormone or analogue, are indicated, if the couple continues to be infertile, or when the physician suspects endometriosis.
Infertility is defined as a failure to conceive in a couple trying to reproduce for a period of two years without conception. Approximately 15 percent of couples are infertile, and among these couples, male factor infertility accounts for approximately 50 percent of causes. Male infertility is a multifactorial syndrome encompassing a wide variety of disorders. In more than half of
Chlamydia trachomatis has for long been considered to be a major contributor to tubal infertility. However, the scientific evidence based on human clinical research is weak. C. trachomatis is associated with pelvic inflammatory disease, and pelvic inflammatory disease is associated with tubal infertility. But no interventional trial nor well-conducted study or large cohort study has assessed the risk of infertility given an undiagnosed or untreated genital chlamydial infection. We suggest that the many well established registers in Denmark serve to further elucidate the evidence. PMID:23050685
Andersen, Berit; Ostergaard, Lars
Whether antiphospholipid antibodies (aPL) play a pathogenic role in infertility is highly controversial. aPL have been suggested to represent one potential etiology of infertility, specifically in patients with unexplained implantation failure following in vitro fertilization (IVF). The rationale is appealing, as it represents a logical extension of the demonstrated pathogenicity of aPL in contributing to recurrent spontaneous abortion, where mechanisms
Lisa R. Sammaritano
... Society for Reproductive Medicine Endometriosis: Does It Cause Infertility? This fact sheet was developed in collaboration with ... a surgical procedure called laparoscopy. Does endometriosis cause infertility? If you have endometriosis, it may be more ...
... Research Information Clinical Trials Resources and Publications What infertility treatments are available? Skip sharing on social media links Share this: Page Content Treatments for infertility can range from medications to embryo implantation through ...
We examined 118 men with infertility. Among them we identified phenotypic syndromes associated with infertility in 4 and chromosomal abnormalities in 16. Further molecular genetic study of 98 infertile men found that microdeletions in AZFc-locus had 3, pathological AR allele had 2, CFTR gene mutation had 4 of them. In 37 infertile men an increased DNA fragmentation index (>20%) was found. PMID:24850600
The purpose of this pictorial review is to discuss causes of female infertility, in particular, those etiologies in which imaging plays a key role in detection. Included are disorders of cervical, ovarian, fallopian tube, and uterine origin. We also discuss the role of various imaging modalities including hysterosalpingography, pelvic ultrasonography, hysterosonography, and pelvic MR imaging in elucidating the cause of female infertility. Radiologists need to know the conditions to be aware of when these patients are sent for diagnostic imaging, as well as how to direct further management, if necessary, should an abnormality be detected. PMID:24072384
Sadow, Cheryl A; Sahni, V Anik
Excessive amounts of reactive oxygen species (ROS) cause a state of oxidative stress, which result in sperm membrane lipid peroxidation, DNA damage and apoptosis, leading to decreased sperm viability and motility. Elevated levels of ROS are a major cause of idiopathic male factor infertility, which is an increasingly common problem today. Lycopene, the most potent singlet oxygen quencher of all carotenoids, is a possible treatment option for male infertility because of its antioxidant properties. By reacting with and neutralizing free radicals, lycopene could reduce the incidence of oxidative stress and thus, lessen the damage that would otherwise be inflicted on spermatozoa. It is postulated that lycopene may have other beneficial effects via nonoxidative mechanisms in the testis, such as gap junction communication, modulation of gene expression, regulation of the cell cycle and immunoenhancement. Various lycopene supplementation studies conducted on both humans and animals have shown promising results in alleviating male infertility-lipid peroxidation and DNA damage were decreased, while sperm count and viability, and general immunity were increased. Improvement of these parameters indicates a reduction in oxidative stress, and thus the spermatozoa is less vulnerable to oxidative damage, which increases the chances of a normal sperm fertilizing the egg. Human trials have reported improvement in sperm parameters and pregnancy rates with supplementation of 4-8 mg of lycopene daily for 3-12 months. However, further detailed and extensive research is still required to determine the dosage and the usefulness of lycopene as a treatment for male infertility. PMID:24675655
Durairajanayagam, Damayanthi; Agarwal, Ashok; Ong, Chloe; Prashast, Pallavi
In this report, emphasis is placed on major research developments in the reproductive sciences, their impact on the health of individuals as well as on that of society, and on current trends that may provide new opportunities for future research in fertility and infertility. In the first section, major developments in the reproductive sciences are…
Orgebin-Crist, Marie-Claire; And Others
Excessive amounts of reactive oxygen species (ROS) cause a state of oxidative stress, which result in sperm membrane lipid peroxidation, DNA damage and apoptosis, leading to decreased sperm viability and motility. Elevated levels of ROS are a major cause of idiopathic male factor infertility, which is an increasingly common problem today. Lycopene, the most potent singlet oxygen quencher of all carotenoids, is a possible treatment option for male infertility because of its antioxidant properties. By reacting with and neutralizing free radicals, lycopene could reduce the incidence of oxidative stress and thus, lessen the damage that would otherwise be inflicted on spermatozoa. It is postulated that lycopene may have other beneficial effects via nonoxidative mechanisms in the testis, such as gap junction communication, modulation of gene expression, regulation of the cell cycle and immunoenhancement. Various lycopene supplementation studies conducted on both humans and animals have shown promising results in alleviating male infertility—lipid peroxidation and DNA damage were decreased, while sperm count and viability, and general immunity were increased. Improvement of these parameters indicates a reduction in oxidative stress, and thus the spermatozoa is less vulnerable to oxidative damage, which increases the chances of a normal sperm fertilizing the egg. Human trials have reported improvement in sperm parameters and pregnancy rates with supplementation of 4–8 mg of lycopene daily for 3–12 months. However, further detailed and extensive research is still required to determine the dosage and the usefulness of lycopene as a treatment for male infertility.
Durairajanayagam, Damayanthi; Agarwal, Ashok; Ong, Chloe; Prashast, Pallavi
The purpose of this review is to integrate understanding of epidemiology and infertility. A primer on epidemiologic science and an example disease for which the design of epidemiologic investigations is readily apparent are provided. Key features of infertility that limit epidemiologic investigation are described and a survey of available data on the epidemiology of infertility provided. Finally, the work that must be completed to move this area of research forward is proposed, and, with this new perspective of "infertility as a disease," improvements envisioned in public health that may be gained through improved understanding of the epidemiology of male infertility. PMID:24286777
Winters, Brian R; Walsh, Thomas J
Major difficulties exist in the accurate and meaningful diagnosis of male reproductive dysfunction, and our understanding of the epidemiology and etiology of male infertility has proven quite complex.The numerous spermatozoa produced in mammals and other species provides some degree of protection against adverse environmental conditions represented by physical and chemical factors that can reduce reproductive function and increase gonadal damage even resulting in testicular cancer or congenital malformations. The wide fluctuations of sperm production in men, both geographical and temporal, may reflect disparate environmental exposures, occurring on differing genetic backgrounds, in varying psychosocial conditions, and leading to the diversified observed outcomes.Sperm analysis is still the cornerstone in diagnosis of male factor infertility, indeed, individually compromised semen paramaters while adequately address therapeutic practices is progressively flanked by additional tests. Administration of drugs, IUI, correction of varicocele, and, to a certain extent, IVF although they may not be capable of restoring fertility itself often result in childbearing. PMID:24782020
Palermo, Gianpiero D; Kocent, Justin; Monahan, Devin; Neri, Queenie V; Rosenwaks, Zev
Forty couples who attended the Infertility clinic of Government Royapettah Hospital, Madras, were included in the study and compared with matched controls who had off springs. All 80 persons were administered the M.H.Q. and the E.P.I. Psychosocial data was recorded and a clinical psychiatric evaluation was done. 51 out of 80 in the study group had psychiatric problems, predominantly depression and anxiety. These problems increased with increasing duration of childless marriage. 40 % of the infertile group had psychosexual dysfunction such as premature ejaculation and erectile disturbances as opposed to 2.5% in the controls. Presence of vaginisms, dysmenorrhea and sexual dissatisfaction were more in the women of the study group. 15 males bad oligospermia/azospermia. PMID:21927198
Thara, R; Ramachandran, V; Hassan, P P
SUMMARY Forty couples who attended the Infertility clinic of Government Royapettah Hospital, Madras, were included in the study and compared with matched controls who had off springs. All 80 persons were administered the M.H.Q. and the E.P.I. Psychosocial data was recorded and a clinical psychiatric evaluation was done. 51 out of 80 in the study group had psychiatric problems, predominantly depression and anxiety. These problems increased with increasing duration of childless marriage. 40 % of the infertile group had psychosexual dysfunction such as premature ejaculation and erectile disturbances as opposed to 2.5% in the controls. Presence of vaginisms, dysmenorrhea and sexual dissatisfaction were more in the women of the study group. 15 males bad oligospermia/azospermia.
Thara, R.; Ramachandran, V.; Hassan, P.P. Mohammed
The modern diagnostic evaluation of the infertile couple reflects a growing reliance on assisted reproductive technologies and the trend toward a more evidence-based medical practice. The recommended evaluation no longer includes some of the traditional diagnostic tests, applies other tests more selectively, and includes a new test that helps to define a couple's prognosis and best choice of treatment. All tests are easily performed, allowing clinicians to complete a basic but still thorough evaluation quickly and easily. PMID:22828101
Fritz, Marc A
BACKGROUND: Approximately 15 percent of all the couples are involuntarily childless in reproductive ages. The ability to reproduce and give birth to a child is an important part of the human beings life; thus, infertility can cause anxiety for the infertile people. Therefore, this study aimed to investigate men's experiences from male infertility. METHODS: This was a descriptive phenomenological study. The data were collected using in-depth interview of ten infertile men. The interviews were taped and then transcribed on the paper for analyzing through seven-step Colaizzi method. Considering that in qualitative studies, study population is not considered, therefore there was no limitation in location for collecting the data and the participants selected from the infertile men of the society. RESULTS: Four main concepts were obtained in association with infertility phenomenon: individual stress, challenges in communication, problems associated with treatment process and the effects of beliefs and religious attitude. CONCLUSIONS: According to the results of this study, it seems that all the different life aspects of infertile were affected by infertility. Thus, designing and conducting conductive and supportive programs plays an important role for providing better care for infertile men.
Fahami, Fariba; Quchani, Samaneh Hosseini; Ehsanpour, Soheila; Boroujeni, Ali Zargham
Background/Objective: Tarlov cysts or spinal perineurial cysts are uncommon lesions. These are mostly incidental findings on magnetic resonance imaging or myelograms. The objectives of this study were to describe Tarlov cysts of the sacral region as a potential cause for retrograde ejaculations and review available management options. Methods: Case report and literature review. Results: A 28-year-old man presented with back pain and retrograde ejaculations resulting in infertility. After microsurgical excision of large perineurial cysts, back pain resolved, but semen quality showed only marginal improvement. Later, the couple successfully conceived by intrauterine insemination. To the best of our knowledge, this is the first reported case of Tarlov cyst associated with retrograde ejaculation and infertility. Conclusions: Despite being mostly asymptomatic and an incidental finding, Tarlov cyst is an important clinical entity because of its tendency to increase in size with time. Tarlov cysts of the sacral and cauda equina region may be a rare underlying cause in otherwise unexplained retrograde ejaculations and infertility. Microsurgical excision may be a good option in a select group of patients.
Singh, Pankaj Kumar; Singh, Vinay Kumar; Azam, Amir; Gupta, Sanjeev
Classically, the diagnosis of adenomyosis has only been possible on a hysterectomy specimen, usually in women in their late fourth and fifth decades, and, therefore, evaluating any relationship with infertility was simply not possible. As a consequence, to this day, no epidemiologic data exists linking adenomyosis to a state of subfertility. Today, new imaging techniques have enabled a noninvasive diagnosis at a much earlier time and a number of single-case or small series reports have appeared showing that medical, surgical, or combined treatment can restore fertility in women with adenomyosis, an indirect proof of an association. At the functional level, several anomalies found in the so-called junctional zone, or inner myometrium, in adenomyosis patients have been shown to be associated with poor reproductive performance, mainly through perturbed uterine peristalsis. Additional evidence for an association comes from experimental data: in baboons, adenomyosis is associated with lifelong primary infertility, as well as to endometriosis. Finally, indirect proof comes from studies of the eutopic and ectopic endometrium in women with adenomyosis proving the existence of an altered endometrial function and receptivity. In conclusion, sufficient indirect proof exists linking adenomyosis to infertility to warrant systematic clinical studies. PMID:22242025
Campo, Sebastiano; Campo, Vincenzo; Benagiano, Giuseppe
Male factor infertility, being a complex and heterogeneous disorder, precludes any reliance on a single laboratory test and\\u000a requires broad spectrum assessment. Sociobiological factors also influence the parameters. In this context we examined serum\\u000a concentrations of nine hormones in infertile and fertile male Makkans. Infertility was implicated in 21% of the population\\u000a with correlated abnormalities of gonadotrophins, thyroid, thyroid stimulating
Z. A. Khan; S. S. Al-Ghamdi
In vitro fertilization/embryo transfer (IVF/ART) results have shown significant improvements during the last decade. In the United States the rate of live births per cycle improved gradually to become 27% in 2001. Assisted reproductive techniques (ARTs) are increasingly being used for the treatment of tubal factor infertility. In this review the data are derived largely from our department, where we have treated sufficient numbers of patients and have maintained substantial consistency in our surgical techniques. This 3-part review demonstrates a high success rate of intrauterine pregnancy (IUP) after anastomosis for sterilization reversal. This rate, for those who are < 35 years of age at the time of reversal, is >70%, with most pregnancies occurring within 18 months after surgery. Those who are 35 years of age or more will have a 55% rate of IUP. We note, too, the satisfactory IUP rate (50%) after tubocornual anastomosis for proximal tubal disease. We document the beneficial role of laparoscopic salpingoovariolysis, fimbrioplasty and salpingostomy performed during the initial diagnostic laparoscopy. The IUP rates after salpingoovariolysis and fimbrioplasty are 60% and 50%, respectively. The rates of IUP for salpingostomy are modest in comparison, yet they are 25% for liberal use of salpingostomy during the preliminary laparoscopy. Salpingostomy also provides a beneficial effect upon embryo implantation in both in vivo and in vitro attempts at conception. This stresses the need for an appropriate preliminary investigation and for the subsequent diagnostic laparoscopy to be performed at a center able to perform these procedures. The evidence suggests that surgery should retain its place in the treatment of tubal infertility. Surgery and ART are complementary approaches that can be used singly or in combination to improve the outcome for couples with tubal infertility. PMID:16674012
Gomel, Victor; McComb, Peter F
For years, the management and treatment of male factor infertility has been ‘experience’ and not ‘evidence’ based. Although not evidence-based, current clinical practice involves extensive use of assisted reproductive techniques (ART). Where specific treatments are not indicated or have failed, ART have become popular adjunctive treatments for alleviating male factor infertility. According to the limited evidence available, intrauterine insemination (IUI)
Although male reproductive functions are impaired in about half of the infertile couples seeking offspring, even today the examination and treatment of the male partner continues to be neglected. Despite the lack of evidence for a "sperm crisis", so highly touted in the press, the public remains worried, while the fact that male fertility declines beyond the age of 40 years and is accompanied by increasing genetic risks for the offspring goes largely unnoticed. In addition to a thorough physical examination supplemented by imaging techniques such as ultrasonography of the scrotal organs, semen analysis according to WHO guidelines, hormone determinations, and cyto- and molecular genetic analyses form part of the routine investigation of the infertile male. Few disorders have become subjects of rational treatment, such as hypogonadotropic hypogonadism with gonadotropins or GnRH, treatment of sexually transmitted diseases by antibiotics, and microsurgical reconstruction of blocked seminal ducts. Early treatment of maldescended testes in boys or changing lifestyle (e.g., discontinuation of smoking) are important preventive measures. In the age of evidence-based medicine, most empirical treatments have been demonstrated to be ineffective. Thus, pregnancy rates from patients with varicocele who underwent long-practiced surgical or radiologic interventional therapy were not different from those of patients receiving counseling. At present, in cases of non-obstructive azoospermia or severe oligoasthenoteratozoospermia, intracytoplasmic sperm injection (ICSI) using single sperm derived from semen or extracted from testicular biopsy tissue (TESE) represents the most successful treatment modality, although it remains symptomatic and not curative. PMID:24337123
Objective To evaluate whether intake of protein from animal and vegetable origin is associated with ovulatory infertility. Study Design 18,555 married women without a history of infertility were followed as they attempted a pregnancy or became pregnant during an eight year period. Dietary assessments were related to the incidence of ovulatory infertility. Results During follow-up, 438 women reported ovulatory infertility. The multivariate-adjusted relative risk [RR] (95% CI; P, trend) of ovulatory infertility comparing the highest to the lowest quintile of animal protein intake was 1.39 (1.01 – 1.90; 0.03). The corresponding RR (95% CI; P, trend) for vegetable protein intake was 0.78 (0.54 – 1.12; 0.07). Further, consuming 5% of total energy intake as vegetable protein rather than as animal protein was associated with a more than 50% lower risk of ovulatory infertility (P = 0.007). Conclusions Replacing animal sources of protein with vegetable sources of protein may reduce ovulatory infertility risk.
Chavarro, Jorge E.; Rich-Edwards, Janet W.; Rosner, Bernard A.; Willett, Walter C.
\\u000a Patients with severe male factor are more likely to be carriers of chromosomal abnormalities both in their sperm and in their\\u000a lymphocytes. These abnormalities include numerical alterations, structural alterations, and Y chromosome microdeletions. Gene\\u000a mutations that cause male infertility and studies identifying polymorphic regions that, in conjunction with environmental\\u000a factors, may be associated with male infertility have been described. Until
The causes of spermatogenetic failure found in most cases of non-ohstmctive azoospermia or severe oligospermia remain largely unclear. It is estimated that in about 30% of the cases, male infertility is due to genetic causes, including chromosomal abnormalities, Y chromosome microdeletions, gene mutations, etc. Klinefelter's syndrome and microdeletions in the Y chromosome long arm (Yq) represent the most frequent molecular genetic cause of severe infertility. Gene mutations involved in male infertility include the cystic fibrosis transmembrane conductance regulator (CFTR) gene, androgen receptor (AR) gene, insulin-like factor 3 (INSL3) gene and leucine-rich repeat-containing G-protein coupled receptor 8 (LGR8) gene. CFTR mutations cause cystic fibrosis, absence of vas deferens and non-obstructive azoospermia. The AR gene mutations are responsible for the androgen insensitivity syndrome and spermatogenetic damage. And INSL3 and LGR8 gene mutations have been associated with abnormalities in testis descent and cryptorchidism. Meta-analyses have revealed a significant association between the polymorphism and male infertility only for partial AZFc deletion, CAG repeat length in the AR gene and methylenetetrahydrofolate reductase (MTHFR) gene. This paper mainly reviews the genetic causes of male infertility and the genetic polymorphisms possibly associated with male infertility. PMID:19004117
Xia, Xin-Yi; Yang, Bin; Cui, Ying-Xia; Huang, Yu-Feng
To evaluate Leydig cell function in men with idiopathic oligospermic infertility and its eventual role in their infertility, plasma LH, testosterone (T), 17-hydroxyprogesterone (170HP), and estradiol levels as well as plasma T/LH and 170HP/T ratios were measured in 103 such men, subdivided into different groups according to their plasma FSH levels. The results were compared to results in normal young fertile men, the subgroup of men with idiopathic oligospermic infertility who within 12 months after consultation succeeded in impregnating their partner, infertile men with a history of undescended testes (excryptorchid men), and men with Klinefelter's syndrome. As a tentative parameter of androgen insensitivity, an androgen insensitivity index [LH (IU/L) X T (nMol/L)] was calculated. Although all men with idiopathic infertility had plasma T and LH levels within the normal range, LH levels increased and T/LH ratios decreased with increasing FSH levels, while the 170HP/T and estradiol/T ratios were independent of the FSH levels and T/LH ratios. The decreased T/LH ratios in the presence of normal T levels suggest compensated Leydig cell insufficiency, which possibly contributes to the infertility. Indeed, none of the men (n = 12) with normal FSH levels but a T/LH ratio lower than 1.50 achieved fatherhood within 12 months of follow-up, although all other hormonal parameters were within the normal range. During the same period 25 men with T/LH ratios greater than 1.50 succeeded in impregnating their partners (P less than 0.05). In infertile excryptorchid men and even more so in men with Klinefelter's syndrome, plasma T levels and T/LH ratios were significantly decreased, the decrease being greater than in patients with idiopathic azospermia with similar FSH levels. None of the excryptorchid men with normal FSH levels but T/LH ratios below 1.50 fathered a child during the follow-up study. We suggest that the T/LH ratio is an additional useful prognostic parameter of infertility. Plasma T levels were increased in 15% of patients with idiopathic infertility, but increased plasma LH together with increased T levels (increased androgen resistance index) were found in only 1 man. An increased index, however, was found in 6 azoospermic excryptorchid men and 4 of 28 men with Klinefelter's syndrome. Taken together these data suggest that this index is not a reliable parameter of androgen resistance. PMID:2891722
Giagulli, V A; Vermeulen, A
The evaluation of the infertile couple is usually a lengthy investigation in which all possible etiologic factors in both partners have to be considered. Optimal and cost-effective investigation requires adequate recognition of significant historical data and physical findings. Males without stigmata of endocrinopathies or general medical illnesses require an analysis of their semen as the minimum initial step of evaluation. Those suspected of deficient androgen production and/or action and those with abnormal sperm counts, motility, and/or morphology need assessment of their serum concentrations of selected reproductive hormones. When these initial investigations are negative and there are no demonstrable etiologic female factors underlying the state of infertility, specialized sperm function and sperm allergy testing needs to be performed. The initial investigation of the female partner is best served by assessing the frequency of ovulation and adequacy of corpus luteum function. Women without ovulatory defects should be assessed for the presence of the hostile cervical mucus and structural anomalies of the reproductive tract. Investigations of patients with menstrual dysfunctions should be based upon the presence or absence of hirsutism, changes in body weight, and evidence of other endocrinopathies or medical illnesses. Following the identification and normalization of causes of anovulation, further work-up of patients who remain infertile is similar to those with regular menstrual cycles. The diagnosis of idiopathic infertility is essentially by exclusion of all other causes. Algorithms for the diagnostic evaluation of most infertile couples are provided. PMID:3042389
Swerdloff, R S; Wang, C; Kandeel, F R
Infertility is defined as the inability of a couple to conceive despite trying for a year, and it affects approximately 15% of the reproductive-age population. It is considered a genetically lethal factor, as the family lineage stops at that individual with no progeny produced. A genetic defect associated with an infertile individual cannot be transmitted to the offspring, ensuring the maintenance of reproductive fitness of the species. However, with the advent of assisted reproductive techniques (ART), we are now able to overcome sterility and bypass nature’s protective mechanisms that developed through evolution to prevent fertilization by defective or deficient sperm.
Hwang, Kathleen; Yatsenko, Alexander N.; Jorgez, Carolina J.; Mukherjee, Sarmistha; Nalam, Roopa Lata; Matzuk, Martin M.; Lamb, Dolores J.
Reviews literature on infertility with a focus on myths and misunderstandings about the causes of infertility; a description of the crisis of infertility including common psychological responses; the additional psychological complexity introduced by medical procedures and reproductive technology; and suggestions for mental health counselors.…
Forrest, Linda; Gilbert, Mary S.
Using data from a random sample of 580 midwestern women, the authors explore the association between lifetime infertility and life satisfaction. Past research shows lower life satisfaction among those seeking help for infertility. The authors find no direct effects of lifetime infertility, regardless of perception of a problem, on life…
McQuillan, Julia; Stone, Rosalie A. Torres; Greil, Arthur L.
Since the identification of thyroid hormone receptors on the testes, thyroid has been suggested to have a significant impact on the male reproductive tract, spermatogenesis, and male fertility. Several research articles on the role of thyroid in spermatogenesis or male infertility have been published in the last three decades. We conducted an exhaustive literature search was conducted in order to create an up-to-date review of literature. This review aims to discuss the impact of thyroid on testicular development, spermatogenesis, hypo- or hyper- thyroidism and male infertility, and the management of thyroid related abnormal semen profile. The literature revealed that thyroid significantly impacts testicular development and that abnormal thyroid profile affects semen quality and male fertility by compromising testicular size, sperm motility and ejaculate volume. A clear link exists between thyroid hormones, testicular development and spermatogenesis. Thyroid disease negatively affects spermatogenesis and consequently may cause male infertility. In such cases, infertility is reversible, but more studies need to be conducted, especially in post-pubertal males to cement the current findings. PMID:21622096
Rajender, Singh; Monica, Marie Gray; Walter, Lee; Agarwal, Ashok
This is a screening study for chlamydial infections (1153 patients females). In the number of 272 cases (23.59%) chlamydial infection was confirmed by ELISA blood tests. We purpose to determine the risk factors for tubal infertility, because Chlamydia trachomatis (CT) is the most important cause of pelvic inflammatory disease (PID) and permanent tubal damage. High correlations (correlation coefficient-"r") of chlamydial infection with hygienic level (r=0.51), avoided use of condoms (r=0.58) or number of abortions (r=0.65) were noticed. Results with primary prevention through sexual education have been disappointing, so is necessary preventing or limiting sequelae of chlamydial infection, such as PID and tubal infertility. PMID:15832986
Veghe?, Simina; Lupa?cu, Ivona; Solomi?chi, Valeria; Duca, Elena; Fochi, Mihaela
Male infertility, affecting around half of the couples with a problem to get pregnant, is a very heterogeneous condition. Part of patients are having a defect in spermatogenesis of which the underlying causes (including genetic ones) remain largely unknown. The only genetic tests routinely used in the diagnosis of male infertility are the analyses for the presence of Yq microdeletions and/or chromosomal abnormalities. Various other single gene or polygenic defects have been proposed to be involved in male fertility. Yet, their causative effect often remains to be proven. The recent evolution in the development of whole genome-based techniques may help in clarifying the role of genes and other genetic factors involved in spermatogenesis and spermatogenesis defects. PMID:24768008
Stouffs, Katrien; Seneca, Sara; Lissens, Willy
Both men and women make antibodies against human sperm. For a complete diagnostic evaluation of an infertile couple, we must test the two serum samples, plus her cervical mucus and his sperm cells. The antibody factor occurs in 9% of men and in 12-15% of women from infertile couples, and at various titers. The standard, or classical, methods for antibody detection in serum include several agglutination methods: Gelatin Agglutination Test (GAT), Tumbe-Slide Agglutination Test (TSAT), Tray Agglutination Test (TAT), and Capillary Tube Agglutination Test (CTAT), plus the immobilization (Isojima). There are also newer methods; passive hemagglutination, radiolabel-antiglobulin, ATR-release cytotoxicity, hemadsorption, indirect immunobead, and ELISA. The genital secretions must also be studied. Sperm cells are judged to be antibody-coated by use of the Mixed Anti-Globulin Reaction (MAR) test or the Immunobead Test (IBT). Cervical mucus is dissolved with bromelin and tested. PMID:2979817
Purpose: Our purpose was to determine the ratio of protamine 1 to protamine 2 in human spermatozoa and relate it to in vitro fertilization\\u000a rates (IVF) and standard semen parameters.\\u000a \\u000a \\u000a Methods: Couples who had been clinically diagnosed as having male-factor infertility and had undergone IVF treatment were grouped\\u000a according to IVF rates and pregnancy outcome. Protamines were extracted and separated
K. K. Khara; M. Vlad; M. Griffiths; Co R. KENNEDY
For years, the management and treatment of male factor infertility has been ‘experience' and not ‘evidence' based. Although not evidence-based, current clinical practice involves extensive use of assisted reproductive techniques (ART). Where specific treatments are not indicated or have failed, ART have become popular adjunctive treatments for alleviating male factor infertility. According to the limited evidence available, intrauterine insemination (IUI) may be considered as a first-line treatment in a couple in which the female partner has a normal fertility status and at least 1×106 progressively motile spermatozoa are recovered after sperm preparation. If no pregnancy is achieved after 3–6 cycles of IUI, optimized in vitro fertilization (IVF) can be proposed. When less than 0.5×106 progressively motile spermatozoa are obtained after seminal fluid processing or sperm are recovered surgically from the testis or epididymis, intracytoplasmic sperm injection (ICSI) should be performed. Although the outcome of no other ART has ever been scrutinized as much before, no large-scale ‘macroproblems' have as yet been observed after ICSI. Yet, ICSI candidates should be rigorously screened before embarking on IVF or ICSI, and thoroughly informed of the limitations of our knowledge on the hereditary aspects of male infertility and the safety aspects of ART.
Although the male reproductive function is impaired in about half of infertile couples, the evaluation of male infertility is underrated or neglected even today. In addition to a physical examination and imaging techniques, semen analysis as well as endocrine and genetic analyses should be part of the routine investigation. Few disorders have become subjects of rational treatment of the infertile male, even though, as examples, hypogonadotropic hypogonadism is treatable by gonadotropins and obstructive azoospermia by reconstructive surgery. Early treatment of maldescended testes and sexually transmitted diseases can prevent infertility. Similar pregnancy rates from patients with varicocele following surgery or counseling demonstrate the important role of the physician in the treatment of infertility. In the age of evidence-based medicine, most empirical treatments have been demonstrated to be ineffective. Instead, symptomatic treatment by assisted reproductive techniques has become a central tool to overcome otherwise untreatable male infertility. PMID:24079474
Nieschlag, Eberhard; Lenzi, Andrea
Infertility is one of the most serious social problems facing advanced nations. In general, approximate half of all cases of infertility are caused by factors related to the male partner. To date, various treatments have been developed for male infertility and are steadily producing results. However, there is no effective treatment for patients with nonobstructive azoospermia, in which there is an absence of mature sperm in the testes. Although evidence suggests that many patients with male infertility have a genetic predisposition to the condition, the cause has not been elucidated in the vast majority of cases. This paper discusses the environmental factors considered likely to be involved in male infertility and the genes that have been clearly shown to be involved in male infertility in humans, including our recent findings.
Miyamoto, Toshinobu; Tsujimura, Akira; Miyagawa, Yasushi; Koh, Eitetsu; Namiki, Mikio; Sengoku, Kazuo
Summary A study was undertaken to determine whether the positive correlation betweenChlamydia trachomatis antibodies and tubal infertility, noted by workers in other countries, also applied to infertile women in Northern Ireland.\\u000a Ninety-one infertile women and 106 fertile controls were tested for current cervical infection withC. trachomatis and for evidence of past chlamydial infection. The incidence ofC. trachomatis infection of the cervix
R. N. Roberts; A. J. Quinn; W. Thompson; R. D. Maw; D. E. Wyatt; R. B. Beattie
This manuscript reviews research from the past year on the ethical and psychosocial impact of infertility on women and men. We discuss several issues surrounding ovarian stimulation, particularly high-order multiple births, egg banking (especially for research purposes), and diminished ovarian reserve. We also present recent work on distress and counseling, which includes greater attention to subgroups of infertile women. More research on issues confronting men has emerged recently, and we outline these with regard to their relationships with infertile women, or as the infertility patient. Last, we outline some ethical issues posed by newer procedures of fertility preservation and uterine transplant.
Leyser-Whalen, Ophra; Temple, Jeff R.
Infertility in the developing world has been relatively neglected as an international health problem and a topic of social scientific and epidemiological inquiry. In this study, we examine factors placing poor urban Egyptian men and women at risk of infertility, and we explore the sociocultural and political-economic contexts in which these health-demoting factors are perpetuated. Our approach to the problem of Egyptian infertility attempts an explicit merging of ethnographic and epidemiological research designs, methods of data collection and analysis, and interpretive insights to provide improved understanding of the factors underlying infertility in the urban Egyptian setting. PMID:7973866
Inhorn, M C; Buss, K A
... Genetic disorder catalog Conditions > CATSPER1-related nonsyndromic male infertility On this page: Description Genetic changes Inheritance Diagnosis ... April 2010 What is CATSPER1-related nonsyndromic male infertility? CATSPER1 -related nonsyndromic male infertility is a condition ...
Epigenetic modifications characterized by DNA methylation, histone modifications, and chromatin remodeling are important regulators in a number of biological processes, including spermatogenesis. Several genes in the testes are regulated through epigenetic mechanisms, indicating a direct influence of epigenetic mechanisms on the process of spermatogenesis. In the present article, we have provided a comprehensive review of the epigenetic processes in the testes, correlation of epigenetic aberrations with male infertility, impact of environmental factors on the epigenome and male fertility, and significance of epigenetic changes/aberrations in assisted reproduction. The literature review suggested a significant impact of epigenetic aberrations (epimutations) on spermatogenesis, and this could lead to male infertility. Epimutations (often hypermethylation) in several genes, namely MTHFR, PAX8, NTF3, SFN, HRAS, JHM2DA, IGF2, H19, RASGRF1, GTL2, PLAG1, D1RAS3, MEST, KCNQ1, LIT1, and SNRPN, have been reported in association with poor semen parameters or male infertility. Environmental toxins/drugs may affect fertility via epigenetic modifications. For example, 5-aza-2'-deoxycytidine, an anticancer agent, causes a decrease in global DNA methylation that leads to altered sperm morphology, decreased sperm motility, decreased fertilization capacity, and decreased embryo survival. Similarly, Endocrine disruptors, such as methoxychlor (an estrogenic pesticide) and vinclozolin (an anti-androgenic fungicide) have been found by experiments on animals to affect epigenetic modifications that may cause spermatogenic defects in subsequent generations. Assisted reproduction procedures that have been considered rather safe, are now being implicated in inducing epigenetic changes that could affect fertility in subsequent generations. Techniques such as intracytoplasmic sperm injection (ICSI) and round spermatid injection (ROSI) may increase the incidence of imprinting disorders and adversely affect embryonic development by using immature spermatozoa that may not have established proper imprints or global methylation. Epigenetic changes, in contrast to genetic aberrations, may be less deleterious because they are potentially reversible. Further research could identify certain drugs capable of reversing epigenetic changes. PMID:21540125
Rajender, Singh; Avery, Kelsey; Agarwal, Ashok
Although the exact incidence of infertility in Canada is unknown, mathematical models predict that approximately 10% to 15% of couples will fail to achieve a pregnancy after one year of unprotected intercourse. The diagnosis requires assessment of both male and female partners. During the initial visit, a comprehensive history should be elicited and a thorough physical examination performed. The couple should receive complete information about the proposed diagnostic evaluation, and any misinformation that may have been gained from friends and the media should be corrected. When the primary evaluation and treatment has failed to result in a pregnancy, the couple should be referred to a specialist.
Infertility in the developing world has been relatively neglected as an international health problem and a topic of social scientific and epidemiological inquiry. In this study, we examine factors placing poor urban Egyptian men and women at risk of infertility, and we explore the sociocultural and political-economic contexts in which these health-demoting factors are perpetuated. Our approach to the problem
Marcia C. Inhorn; Kimberly A. Buss
Infertile couples' (N=131) consideration of options for dealing with infertility (medical help, adoption, fostering, alternative medicine, and focusing on other life goals) is studied. Options were related to specific motivations including altruistic motives for adoption or foster care. Results, timing of choices, and motivations are discussed.…
van Balen, Frank; Verdurmen, Jacqueline; Ketting, Evert
Concerns persist about a possible link between infertility and risk of autism spectrum disorders (ASD). Interpretation of existing studies is limited by racial/ethnic homogeneity of study populations and other factors. Using a case-control design, we evaluated infertility history and treatment documented in medical records of members of Kaiser…
Grether, Judith K.; Qian, Yinge; Croughan, Mary S.; Wu, Yvonne W.; Schembri, Michael; Camarano, Loretta; Croen, Lisa A.
Infertility affects more than 10% of the world's population. In developing countries, there are severe social, psychological and economic consequences for infertile men and women. All of the cited references are compiled from primary peer-reviewed research articles that were conducted through one-to-one interviews or focus groups in countries of developing regions, such as Africa, Asia and the Middle East. The following paper seeks to raise awareness of the consequences of infertility in developing nations and identify infertility as an under-observed, but significant public health issue. It is proposed that education programmes tailored to each society's specific religious beliefs and grounded traditions must be implemented in order to reverse the social stigma, detrimental psychological effects, and loss of economic security that results from infertility. PMID:23327901
... are implanted in the woman's uterus. Zygote intrafallopian transfer (ZIFT) or Tubal Embryo Transfer is similar to IVF. Fertilization occurs in the ... fallopian tube instead of the uterus. Gamete intrafallopian transfer (GIFT) involves transferring eggs and sperm into the ...
The sociocultural aspects of infertility among members of the matrilineal ethnic group Macua are studied. Strategies applied by infertile women, the use of traditional healers versus modern hospital, and explanations given for infertility are presented. Solutions attempted, social consequences of infertility, and recommendations for culturally…
Findings of an anthropological study of socio-cultural aspects of infertility among members of the matrilineal ethnic group Macua in the north of Mozambique are presented. Infertile women apply various strategies to have a child. Traditional healers are visited much more often than the modern hospital, and the explanations the infertile women themselves give for their infertility more often originated from
Synopsis Endometriois has been associated with infertility, however the mechanism by which it affects fertility are still not fully understood. This manuscript reviews the proposed mechanisms of endometriosis pathogenesis, it affects on fertility and treatments of endometriosis-associated infertility. Theories on etiology of disease include retrograde menstruation, coelomic metaplasia, altered immunity, stem cells, and genetics. Endometriosis affects gametes and embryos, the fallopian tubes and embryo transport, and the eutopic endometrium; these abnormalities likely all impact fertility. Current treatment options of endometriosis-associated infertility include surgery, superovulation with IUI, and IVF. We also discuss potential future treatments for endometriosis related infertility such as stem cells transplantation and immune therapy.
Macer, Matthew Latham
... the American Society for Reproductive Medicine Endometriosis and Infertility: Can Surgery Help? This fact sheet was developed ... Stage 4). This scoring system correlates with pregnancy success. With more minimal endometriosis, removing or destroying endometriosis ...
Infertility is rarely due only to the male or female partner. Usually each partner's fertility is in some way diminished. Male infertility may be related to deficiencies in spermatogenesis or sperm transport. Accurate diagnosis can be achieved only by a careful evaluation including precise semen analyses and, where indicated, gonadotropin and other assays. Treatment may be specific for physical or endocrine deficits, but is often empirical. Factors other than the sperm count, such as emission of sperm mainly at the beginning of ejaculation, low seminal volume with good quality sperm, excessive seminal viscosity, pyospermia, and idiopathic oligospermia, may be responsible for infertility. These may respond to simple measures. Understanding and empathy for the infertile couple is of the utmost importance.
Vallely, John F.
Objective: To analyze the efficacy and cost-effectiveness of alternative treatments for unexplained infertility.Design: Retrospective analysis of 45 published reports.Setting: Clinical practices.Patient(s): Couples who met criteria for unexplained infertility. Women with Stage I or Stage II endometriosis were included.Intervention(s): Observation; clomiphene citrate (CC); gonadotropins (hMG); IUI; and GIFT and IVF.Main Outcome Measure(s): Clinical pregnancy rate.Result(s): Combined pregnancy rates per initiated cycle,
DavidS Guzick; MichaelW Sullivan; G. David Adamson; MarcelleI Cedars; RichardJ Falk; EdwinP Peterson; MichaelP Steinkampf
The evaluation of the infertile male continues to be a clinical challenge of increasing significance with considerable emotional and financial burdens. Many physiological, environmental and genetic factors are implicated; however, the etiology of suboptimal semen quality is poorly understood. This review focuses on the diagnostic testing currently available, as well as future directions that will be helpful for the practicing urologist and other clinicians to fully evaluate the infertile male.
Hwang, Kathleen; Lipshultz, Larry I.; Lamb, Dolores J.
Studies on the impact of subclinical hypothyroidism in infertility are scarce and this seeks to determine the proportion of infertile Nigerian women with hyperprolactinaemia that had subclinical hypothyroidism. Serum prolactin and thyroid stimulating hormone were determined using ELECSYS 1010 auto analyzer. Two hundred infertile women were evaluated and 67(33.7%) had hyperprolactinaemia. Subclinical hypothyroidism was observed in 14.9% of women with hyperprolactinaemia, 4.5% and 10.5% of women with primary and secondary infertility, while hyperprolactinaemia was observed in 29.9% and 70.1% in primary and secondary infertility respectively. Mean levels of thyroid stimulating hormone and prolactin were higher in secondary infertility than primary infertility. Subclinical hypothyroidism and hyperprolactinaemia were higher in secondary infertility than primary infertility. The ratio of proportions between hypothyroidism and hyperprolactinaemia was 1:7. PMID:22314984
Emokpae, M A; Osadolor, H B; Omole Ohonsi, A
Crop production is often restricted by the availability of essential mineral elements. For example, the availability of N, P, K, and S limits low-input agriculture, the phytoavailability of Fe, Zn, and Cu limits crop production on alkaline and calcareous soils, and P, Mo, Mg, Ca, and K deficiencies, together with proton, Al and Mn toxicities, limit crop production on acid soils. Since essential mineral elements are acquired by the root system, the development of crop genotypes with root traits increasing their acquisition should increase yields on infertile soils. This paper examines root traits likely to improve the acquisition of these elements and observes that, although the efficient acquisition of a particular element requires a specific set of root traits, suites of traits can be identified that benefit the acquisition of a group of mineral elements. Elements can be divided into three Groups based on common trait requirements. Group 1 comprises N, S, K, B, and P. Group 2 comprises Fe, Zn, Cu, Mn, and Ni. Group 3 contains mineral elements that rarely affect crop production. It is argued that breeding for a limited number of distinct root ideotypes, addressing particular combinations of mineral imbalances, should be pursued.
White, Philip J.; George, Timothy S.; Dupuy, Lionel X.; Karley, Alison J.; Valentine, Tracy A.; Wiesel, Lea; Wishart, Jane
The etiopathogenesis of testicular failure remains unknown in about half of the cases and is referred to as "idiopathic infertility". "Idiopathic" testicular failure is of probable genetic origin since the number of genes involved in human spermatogenesis is likely thousands and only a small proportion of them have been identified and screened in infertile men. In parallel with studies aimed to identify mutations with a clear cause-effect relationship in spermatogenesis candidate genes, there is an increasing interest towards genetic susceptibility factors to male infertility. Despite many efforts, only a few clinically relevant polymorphisms have been identified. This is mainly related to the multifactorial nature of male infertility and to the inappropriate study design of the majority of the studies. The most promising polymorphisms are in genes involved in the endocrine regulation of spermatogenesis and on the Y chromosome, the "gr/gr" deletions. Polymorphisms are generally considered as co-factors. Their final effect on testis function and fertility is probably modulated by the genetic background of each individual and/or by the presence of certain environmental factors. In this review, recent findings concerning some of the most widely studied polymorphisms and male infertility will be discussed. PMID:17612870
Krausz, Csilla; Giachini, Claudia
BACKGROUND: Surrogacy arrangements are multifaceted in nature, involving multiple controversial aspects and engaging ethical, moral, psychological and social issues. Successful treatment in reproductive medicine is strongly based on the mutual agreement of both partners, especially in Iran where men often make the final decision for health-related problems of this nature. AIM: The aim of the following study is to assess the attitudes of Iranian infertile couples toward surrogacy. SETTING AND DESIGN: This descriptive study was conducted at the infertility clinic of Hamadan university of medical sciences, Iran. MATERIALS AND METHODS: The study sample consisted of 150 infertile couples selected using a systematic randomized method. Data collection was based on responses to a questionnaire consisting of 22 questions. STATISTICAL ANALYSIS: P <0.05 were considered to be statistically significant. RESULTS: While 33.3% of men and 43.3% of women surveyed insisted on not using surrogacy, the overall attitudes toward surrogacy were positive (53.3% of women and 54.6% of men surveyed). CONCLUSION: Although, there was not a significant difference between the overall positive attitudes of infertile women and men toward surrogacy, the general attitude toward using this method is not strongly positive. Therefore, further efforts are required to increase the acceptability of surrogacy among infertile couples.
Kian, Ensiyeh Mohebbi; Riazi, Hedieh; Bashirian, Saeid
Evidence suggests that human semen quality may have been deteriorating in recent years. Most of the evidence is retrospective, based on analysis of data sets collected for other purposes. Measures of male infertility are needed if we want to monitor the biological capacity for males to reproduce over time or between different populations. We also need these measures in analytical epidemiology if we want to identify risk indicators, risk factors, or even causes of an impaired male fecundity-that is, the male component in the biological ability to reproduce. The most direct evaluation of fecundity is to measure the time it takes to conceive. Since the time of conception may be missed in the case of an early abortion, time to get pregnant is often measured as the time it takes to obtain a conception that survives until a clinically recognized pregnancy or even a pregnancy that ends with a live born child occurs. A prolonged time required to produce pregnancy may therefore be due to a failure to conceive or a failure to maintain a pregnancy until clinical recognition. Studies that focus on quantitative changes in fecundity (that does not cause sterility) should in principle be possible in a pregnancy sample. The most important limitation in fertility studies is that the design requires equal persistency in trying to become pregnant and rather similar fertility desires and family planning methods in the groups to be compared. This design is probably achievable in exposure studies that make comparisons with reasonable comparable groups concerning social conditions and use of contraceptive methods. PMID:12894315
Pasqualotto, Fábio Firmbach; Locambo, Cristhiany Victor; Athayde, Kelly Silveira; Arap, Sami
... and male infertility is unknown. What are the genetic changes related to sensorineural deafness and male infertility? ... Center . Where can I find general information about genetic conditions? The Handbook provides basic information about genetics ...
... Advances Supported Networks, Programs & Initiatives Genetic Cause of Infertility Associated with Uterine Fibroids Skip sharing on social ... To determine whether TSC genes were involved in infertility related to fibroids, scientists funded by the Fertility ...
BACKGROUND Worldwide more than 70 million couples suffer from infertility, the majority being residents of developing countries. Negative consequences of childlessness are experienced to a greater degree in developing countries when compared with Western societies. Bilateral tubal occlusion due to sexually transmitted diseases and pregnancy-related infections is the most common cause of infertility in developing countries, a condition that is potentially treatable with assisted reproductive technologies (ART). New reproductive technologies are either unavailable or very costly in developing countries. This review provides a comprehensive survey of all important papers on the issue of infertility in developing countries. METHODS Medline, PubMed, Excerpta Medica and EMBASE searches identified relevant papers published between 1978 and 2007 and the keywords used were the combinations of ‘affordable, assisted reproduction, ART, developing countries, health services, infertility, IVF, simplified methods, traditional health care'. RESULTS The exact prevalence of infertility in developing countries is unknown due to a lack of registration and well-performed studies. On the other hand, the implementation of appropriate infertility treatment is currently not a main goal for most international non-profit organizations. Keystones in the successful implementation of infertility care in low-resource settings include simplification of diagnostic and ART procedures, minimizing the complication rate of interventions, providing training-courses for health-care workers and incorporating infertility treatment into sexual and reproductive health-care programmes. CONCLUSIONS Although recognizing the importance of education and prevention, we believe that for the reasons of social justice, infertility treatment in developing countries requires greater attention at National and International levels.
Ombelet, Willem; Cooke, Ian; Dyer, Silke; Serour, Gamal; Devroey, Paul
The main purpose of imaging evaluation in male infertility is to identify and treat correctable causes of infertility, such as obstruction of the seminal tract. Various imaging modalities are available to evaluate men with obstructive infertility including scrotal ultrasonography, transrectal ultrasound (TRUS), vasography, magnetic resonance imaging, seminal vesicle aspiration, seminal tract washout, and seminal vesiculography. To date the most reliable and accurate diagnostic technique for obstructive infertility is unclear. In this review article, we report the role of these modalities in diagnosis of obstructive infertility. Scrotal sonography is the initial modality, and if patient results indicate non obstructive azoospermia as varicocele or testicular pathology they will be treated according to standard protocols for management of these pathologies. If the patient findings indicate proximal obstructive azoospermia, they can be managed by vasoepididymostomy. If the scrotal ultrasound is normal, TRUS is the second imaging modality. Accordingly, they are classified into patients with criteria of obstructive infertility without urogenital cysts where TRUS-guided aspiration and seminal vesiculography can be performed and transurethral resection of the ejaculatory ducts (TURED) will be the management of choice. In patients with urogenital cyst, TRUS-guided cyst aspiration and opacification are performed. If the cyst is communicating with the seminal tract, management will be transurethral incision of the cyst. If the cyst is not in communication, the obstruction may be relieved after cyst aspiration. If the obstruction is not relieved, TURED will be the management of choice. Sperm harvested during aspiration may be stored and used in assisted reproduction techniques. If the results of TRUS are inconclusive or doubtful, endorectal magnetic resonance imaging should be performed to serve as a “detailed map” for guiding corrective operative interventions.
Donkol, Ragab H
The diagnostic methods of tubal factor in infertility have been presented in this paper. In details have been discussed PJ, PK, HSG and pelvic examination. These examinations themselves constitute the basic ones in infertility. We turned our attention into technical details and possible mistakes which may occur at the time of performing them, these misinterpretations may lead to absolutely wrong conclusion and diagnosis. Authors have wide experience in performing the discussed examinations and this allows them to share their opinions. Over the years several thousand of PK and HSG examinations have been carried out and also 1000 laparoscopies. PMID:8112631
Korzon, T; Mielnik, J; Go?ciniak, W; Muczy?ska, I; Lozyk, J
Background Infertility is one of the most difficult life experiences that a couple might encounter. Infertility as a bio-psycho-social phenomenon, could influence all aspects of life. While paying special attention to the psychological aspects of infertility in couples; many studies have investigated the non-clinical aspects of infertility, however, they rarely have evaluated the psychosocial development of infertile versus fertile men. We aimed to study the effects of infertility on psychosocial development in men. Methods In fact, we designed the study based on “Erikson's theory of psychosocial development”. We focused on the relationship between psychosocial development and some self-conceived indices. For this purpose, we divided the participants volunteers into two groups of cases (80 infertile men) and controls (40 fertile men) and asked them to complete a 112 (questions questionnaire based on “self description”). The statistical analysis was performed by SPSS (version 13) using independent t-test, Pearson correlation coefficient and analysis of covariance. A p-value <0.05 was considered significant. Results Data analysis showed significant inter and intra group differences. Infertile and fertile groups showed significant differences in trust, autonomy, generativity and integrity stages (p < 0.05). Infertile intergroup analysis represents us to higher scores in positive than negative stages. Conclusion Infertility as a phenomenon had its own effects on the psychosocial development of infertile men. However, good coping skills are powerful tools to manage these myriad of feelings surrounding infertile men.
Akhondi, Mohammad Mehdi; Binaafar, Sima; Ardakani, Zohreh Behjati; Kamali, Kourosh; Kosari, Haleh; Ghorbani, Behzad
Ovarian, endometrial and breast cancers are associated with several risk factors, such as low parity, infertility, early age at menarche, and late age at menopause. Frequently most of these risk factors coexist in infertile patients and some studies suggested that the different infertility causes can be involved in cancer risk development. In particular case–control and cohort studies investigated the possible
I. Cetin; V. Cozzi; P. Antonazzo
BACKGROUND: Unexplained infertility is one of the most common diagnoses in fertility care. The aim of this study was to evaluate the outcome of current fertility management in unexplained infertility. METHODS: In an observational, longitudinal, multicentre cohort study, 437 couples were diagnosed with unexplained infertility and were available for analysis. They were treated according to their prognosis using standing national
M. Brandes; C. J. C. M. Hamilton; J. O. van der Steen; J. P. de Bruin; R. S. Bots; W. L. D. M. Nelen; J. A. M. Kremer
Unexplained infertility constitutes around 15% of patients presenting with infertility. A lack of agreement exists among infertility specialists with regard to the diagnostic tests to be performed and their prognostic value as well as criteria of normality. It seems that serum progesterone for detection of ovulation, hysterosalpingography and or laparoscopy for tubal patency and semen analysis are the basic tests
Mohamed A. Aboulghar; Ragaa T. Mansour; Gamal I. Serour; Hesham G. Al-Inany
Women and men diagnosed with infertility experience a variety of infertility-related stressors, including changes to their family and social networks, strain on their sexual relationship, and difficulties and unexpected challenges in their relationship. Infertility stress is linked with depression and psychological distress, and can lead to…
Peterson, Brennan D.; Eifert, Georg H.
Tests the hypothesis that women who have experienced infertility report higher psychological distress. Examines whether roles or resources condition the effects of infertility or whether its effects are limited to childless women. Infertility combined with involuntary childlessness is associated with significantly greater distress. For women in…
McQuillan, Julia; Greil, Arthur L.; White, Lynn; Jacob, Mary Casey
In recent years Chlamydia trachomatis has emerged as a significant cause of acute salpingitis and reproductory failure. In this study, 85 women suffering from primary infertility and 85 parous women as control group were screened for C. trachomatis genital infection by means of cell culture and antigen detection on genital samples as well as the detection of anti-chlamydial antibodies in
G. Gorini; F. Milano; P. Olliaro; A. Regazzetti; E. G. Rondanelli
... asrm.org PATIENT FACT SHEET Diagnostic Testing for Male Factor Infertility When a couple has trouble having a baby, there's about a 50-50 chance that the man has a problem contributing to the pregnancy. He might: • Produce too few sperm to fertilize ...
Infertile men are frequently affected by physical abnormalities that might be detected on routine general and genital examinations. These structural abnormalities might damage or block the testes, epididymis, seminal ducts or other reproductive structures and can ultimately decrease fertility. Physical deformities are variable in their pathological impact on male reproductive function; some render men totally sterile, such as bilateral absence
Rajender Singh; Alaa J. Hamada; Laura Bukavina; Ashok Agarwal
... for infertility in women with PCOS include 1 : Weight loss . Women with PCOS who lose weight are more likely to have restored ovulation and ... women who are still not ovulating after losing weight and trying fertility medicines. Studies of women with PCOS have shown that ovarian drilling results in an ...
A complete breeding soundness evaluation is essential for assessment of the infertile male dog. Cryptorchidism, a sex-limited autosomal recessive trait, is more common as a unilateral condition. Azoospermia is an ejaculate consisting of seminal plasma but lacking sperm; repeated semen collections in the presence of an estrual bitch will rule out inadequate experience and lack of sexual stimulation. Both carnitine
M. A. Memon
This study explored the coping processes of couples experiencing infertility. Participants included 420 couples referred for advanced reproductive treatments. Couples were divided into groups based on the frequency of their use of eight coping strategies. Findings suggest that coping processes, which are beneficial to individuals, may be…
Peterson, Brennan D.; Newton, Christopher R.; Rosen, Karen H.; Schulman, Robert S.
Background Infertility is a global reproductive health issue that affects many individuals and couples. Despite the high prevalence of infertility in Ghana, no study has been done on the experiences of infertile couples in Northern Ghana. This study therefore explored the experiences of infertile couples in Northern Ghana using the Upper West Region as a case study. Methods We interviewed fifteen childless couples, forty-five couples with children, and eight key informants using a semi-structured interview guide. We also carried out three focus group discussions; one for childless women, one for women with children and one for men with children. The data were transcribed, coded, arranged and analyzed for categories and themes. Results Infertile couples are socially stigmatised and excluded from leadership roles in their communities. Couples without children are denied membership in the ancestral world thereby losing the opportunity to live again. Both males and females are engaged in sex with multiple partners to prove their fertility. Conclusions Both men and women suffer from the social effects of childlessness. The desire to have biological children in a pronatalist society results in unhealthy practices. Health policy makers and gender advocates should be more concerned about infertility.
Background The desire of many young women to become parents may be influenced by the premium placed on children by society. In Africa, children are highly valued for social, cultural and economic reasons. Infertile and childless women in Africa are therefore confronted with a series of societal discrimination and stigmatization which may lead to psychological disorders such as anxiety and depression. Even though some research has been done on the prevalence of infertility in Ghana, very little is known about the psychological impact of childlessness among infertile women. The present study aimed to examine prevalence and severity of depression in relation to age, type of infertility and duration of infertility in Ghanaian infertile women. Methods A total of 100 infertile women who met the selection criteria and had agreed to participate in the study were interviewed using the Beck Depression Inventory questionnaire from December 2012 to April 2013 at the Tamale Teaching Hospital, Tamale/Ghana. Data concerning socio-demographic characteristics such as age, monthly income, duration of infertility, marital status, educational level, number of previous conception, number of previous children, religion, as well as occupation of the respondents were recorded. Results The prevalence of depression among the women was 62.0% with the level of depression showing a significant positive correlation with age of the women and the duration of infertility. The level of depression was significantly higher among subjects with low or no formal education and among the unemployed. Women with primary infertility also presented with high depression scores as measured by BDI. Conclusions In conclusion, the prevalence of depression among the infertile women is high, especially among infertile women age 26 and above, those who are less educated, those with primary infertility, as well as those who have been diagnosed as infertile for more than 3 years. Interventions to decrease and prevent the development of severe depression among these patients should be considered.
Background: Assisted reproductive technology (ART) provide the hope of pregnancy for infertile women, but do not always turn this hope into reality. Objective: The purpose of this study was to explore the lived experience of infertile women from increasing and decreasing factors of hope in infertile women with failure in infertility treatment. Materials and Methods: Using a qualitative research design (Phenomenology study), 23 subjects were selected who had experienced infertility failure visited by gynecologist (Rasekh Infertility center) in 2012. The data were collected through semi structured interviews and analyzed using interpretive research strategies of phenomenology by Collizi's seven-stage method. Results: Totally 96 codes were identified. The data arranged in two categories. The factors decreasing and increasing hope in infertility treatments. Totally 5 themes and 20 sub themes were extracted. The increasing factors which emerged from the data contain "spiritual source", "family interaction and support" and "information through the media", and decreasing factors contain "nature of treatments" and "negatively oriented mind".
Mosalanejad, Leili; Parandavar, Nehle; Gholami, Morteza; Abdollahifard, Sareh
The routine assessment of an infertile man with varicocele must comprise complete clinical interview including the patient's medical and reproductive history, physical examination and at least two sperm counts. Imaging examinations are not indicated to characterize the varicocele, except when physical examination is inconclusive. However; scrotal ultrasound can be useful in infertile men to detect concomitant diseases, especially testicular tumours. Treatment of varicocele must be proposed when all of the following conditions are present: 1) the varicocele is palpable; 2) the couple's infertility is documented; 3) there is no female infertility problem or this problem is potentially curable; 4) there is at least one abnormality of spermatic parameters on the sperm count. Treatment can also be proposed in men with palpable varicocele and spermatic abnormalities on the sperm count, even when they do not have any immediate plans to have a child. Young men with varicocele and a normal sperm count must be followed by sperm counts every one or two years. Treatment of varicocele must also be proposed to adolescents with varicocele and ipsilateral a reduction of testicular volume. Adolescents with varicocele associated with a normal-sized testis must be reviewed annually to measure testicular volume and/or sperm count when it can be performed. Surgery or percutaneous embolization are two possible treatment options for varicocele provided they are performed by a well trained and experienced operator. The treatment of varicocele can be considered to be first-line treatment in a patient with moderate oligo-astheno-teratospermia with no associated female infertility factor. IVF with or without ICSI can be considered to be first-line treatment in the presence of an independent female infertility factor requiring the use of these techniques. Concomitant treatment of varicocele can be considered to improve semen fertility. Persistence or relapse of varicocele can be treated by surgery or percutaneous embolization provided spermatic venography is performed to identify the site of persistent venous reflux. After treatment of varicocele, a sperm count must be performed approximately every three months for one year or until pregnancy is achieved. PMID:17373231
Wagner, Laurent; Tostain, Jacques
Background: Different success rate of Intracytoplasmic Sperm injection (ICSI) has been observed in various causes of infertility. In this study, we evaluated the relation between ICSI outcome and different causes of infertility. We also aimed to examine parameters that might predict the pregnancy success rate following ICSI. Materials and Methods: This cross sectional study included1492 infertile women referred to Infertility Center of Royan Institute between 2010 and 2011. We assigned two groups including pregnant (n=504) and non-pregnant (n=988), while all participants underwent ICSI cycles. All statistics were performed by SPSS program. Statistical Analysis was carried out using Chi-square and t test. Logistic regression was done to build a prediction model in ICSI cycles. Results: The overall clinical pregnancy rate in our study was 33.9% (n=1492). There was a statistically significant difference in mean serum concentration on day 3 after application of luteinizing hormone (LH) between the pregnant and the non-pregnant groups (p<0.05). However, There were no significant differences between two groups in the serum concentrations on day 3 after application of the following hormones: folliclestimulating hormone (FSH), thyroid-stimulating hormone (TSH), and metoclopramidestimulated prolactin (PRL) . We found no association between different causes of infertility and clinical outcomes . The number of metaphase II (MII) oocytes, embryo transfer, number of good embryo (grade A, B, AB), total dose of gonadotropin, endometrial thickness, maternal age, number of previous cycle were statistically significant between two groups (p<0.05). Conclusion: Our results indicate that ICSI in an effective option in couples with different causes of infertility. These variables were integrated into a statistical model to allow the prediction for the chance of pregnancy following ICSI cycles. It is required that each infertility center gather enough information about the causes of infertility in order to provide more information and better assistance to patients. Therefore, we suggest that physicians prepare adequate training and required information regarding these procedures for infertile couples in order to improve their knowledge.
Ashrafi, Mahnaz; Jahanian Sadatmahalleh, Shahideh; Akhoond, Mohammad Reza; Ghaffari, Firouzeh; Zolfaghari, Zahra
Male infertility can be treated by surgical procedures (e.g., varicocelectomy) or by administration of drugs if causal factors (e.g., seminal tract infections) are detected. In more severe cases, methods of assisted fertilization often have to be applied, but even these have only a limited success rate. Recent studies have demonstrated that disturbances of sperm DNA integrity (determined by the acridine orange test) can explain certain cases of fertilization failure and failure to achieve pregnancy following in vitro fertilisation with intracytoplasmic sperm injection. The evaluation of DNA integrity should be considered when diagnosing male infertility as it has been shown to be an independent factor and can be used as a supplement to standard semen analysis. Analysis of DNA integrity may, therefore, provide further information about altered male fertility and lead to administration of more appropriate therapy. PMID:20948685
There has been a consistent trend towards delayed childbearing in most Western countries. Treatment options for age-related infertility includes controlled ovarian hyperstimulation with intrauterine insemination and in vitro fertilization (IVF). A sharp decline in pregnancy rate with advancing female age is noted with assisted reproductive technologies (ART) including IVF. Evaluation and treatment of infertility should not be delayed in women 35 years and older. No treatment other than oocyte donation has been shown to be effective for women over 40 and for those with compromised ovarian reserve, but its pratice is not easy in France hence the procreative tourism. As an increasing number of couples choose to postpone childbearing, they should be informed that maternal age is an important risk factor for failure to conceive. PMID:20623902
Following a complete history and physical examination, the next step in investigating the male partner of an infertile couple will be to order semen analyses. Even with optimum collection and processing, wide laboratory errors may occur. When the clinician receives a report, interpretation is beset with pitfalls. This article describes the collection and processing of semen samples and discusses how best the information can be used by the practicing clinician.
Taylor, Patrick J.; Martin, Renee H.
This article is the review of the book “Medical & Surgical Management of Male Infertility” edited by Botros RMB Rizk, Nabil Aziz, Ashok Agarwal and Edmund Sabanegh Jr. This book (hardcover) was published by Jaypee Brothers Medical Publishing, New Delhi.London.Philadelphia.Panama on September 2013 (1st edition). The contents of the book and its relevance to medical education are discussed in this invited review.
Ejaculatory dysfunction (EjD), the most prevalent male sexual disorder, is clearly different from erectile dysfunction (ED).\\u000a EjD is divided into 4 categories: premature ejaculation, delayed ejaculation, retrograde ejaculation and anejaculation. EjD-related\\u000a infertility is one of the most serious problems in young patients. If sexual intercourse is achieved successfully without\\u000a any ejaculate sexual partners\\/wives will not be able to conceive. Therefore,
Over recent decades, epidemiological studies have been reporting worrisome trends in the incidence of human infertility rates. Extensive detection of industrial chemicals in human serum, seminal plasma and follicular fluid has led the scientific community to hypothesise that these compounds may disrupt hormonal homoeostasis, leading to a vast array of physiological impairments. Numerous synthetic and natural substances have endocrine-disruptive effects, acting through several mechanisms. The main route of exposure to these chemicals is the ingestion of contaminated food and water. They may disturb intrauterine development, resulting in irreversible effects and may also induce transgenerational effects. This review aims to summarise the major scientific developments on the topic of human infertility associated with exposure to endocrine disruptors (EDs), integrating epidemiological and experimental evidence. Current data suggest that environmental levels of EDs may affect the development and functioning of the reproductive system in both sexes, particularly in foetuses, causing developmental and reproductive disorders, including infertility. EDs may be blamed for the rising incidence of human reproductive disorders. This constitutes a serious public health issue that should not be overlooked. The exposure of pregnant women and infants to EDs is of great concern. Therefore, precautionary avoidance of exposure to EDs is a prudent attitude in order to protect humans and wildlife from permanent harmful effects on fertility.
Marques-Pinto, Andre; Carvalho, Davide
Testicular biopsy findings in 100 infertile men were correlated with the clinical findings. Mild or moderately severe tubular lesions were seen in 57 cases and severe changes in 43. Clinical examination and semen analysis were no guide to the severity of the testicular lesion. Though patients with normal sized testes more commonly had mild tubular lesions, many were severe. Patients with small testes more often had severe lesions but some had only mild tubular changes. Biopsy findings in both aspermic and oligospermic patients ranged from normal to a complete loss of germinal tissue. Testicular biopsy is advocated in infertile men for the complete assessment of the case and for identifying those which are potentially treatable. Patients with a severe lesion can be spared further investigations. The choice and results of treatment are discussed, particularly the surgical treatment of varicocele or obstruction. Only patients with a mild or moderate testicular tubular lesion should participate in future trials with drugs for male infertility. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6FIG. 7FIG. 8FIG. 9FIG. 10
Meinhard, Elizabeth; McRae, C. U.; Chisholm, G. D.
Most male cystic fibrosis (CF) patients are infertile due to obstructive azospermia but little is known about the best time to counsel patients on infertility. All male patients attending the Adult Nottingham CF unit were invited to complete an anonymous questionnaire on infertility. The response rate was 60%. The median age that the patients first became aware of male infertility was 17 years (range 13-24) but the preferred age of receiving this information was 14 years (range 8-16). Patients first learnt about male infertility from the CF team (six patients), parents (five), from written information (two) or unexpectedly (five). Five out of 18 patients had undergone seminal analysis at a median age of 26 years but 17/18 patients felt that this should be offered routinely. Our survey has shown that patients would like infertility discussions at a younger age and routine seminal analysis. PMID:11059956
Rodgers, H C; Baldwin, D R; Knox, A J
A national probability sample reveals two relatively distinct groups of infertile women: those with intent, who have experienced a period of 12 or more months during which they tried to conceive but did not, and those without intent, who had a period of at least 12 months during which they could have conceived and did not but who do not describe themselves as having tried to become pregnant at that time. Those with intent are more likely to identify as having a fertility problem, to be distressed, and to pursue infertility treatment than those without intent, suggesting that many women do not realize that they meet the medical criteria for infertility and may therefore wait longer to get help, therefore lowering their chances of conception.
Greil, Arthur L.; McQuillan, Julia; Johnson, Katherine; Slauson, Katherine; Shreffler, Karina M.
Toxic effect of lead on human reproductive system is a recent concern. Various studies suggest that lead has adverse effect on the reproductive system of both sexes. The present cross-sectional case-control study was done to investigate the blood lead level in women with unexplained infertility. The study was conducted in the Department of Obstetrics and Gynecology and Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from July 2008 - June 2009. A total of 50 women with unexplained infertility (case) ranging from 18-40 years were consecutively included in the study. An equal number of apparently healthy fertile women (control) were included as control. None of the cases and controls was diabetic. Of the infertile women over half (54%) of the patients had primary infertility and 46% secondary infertility. The mean blood level of lead was significantly higher in case group than that in control group (130.0±45.2 vs. 78.3±36.4?g/L, (p<0.001). Correlation between blood lead level and FSH revealed that the two variables had a significantly linear relationship (r=0.213, p=0.033). The correlation coefficient shows that 21% of the variations in FSH can be explained by blood level of lead. Infertile women with absence of the apparent causes of infertility including absence of their male-partner infertility may have unusually high level of lead which could be attributed to infertility. PMID:23982541
Rahman, S N; Fatima, P; Chowdhury, A Q; Rahman, M W
... which interferes with ovulation. In addition to infertility, PCOS symptoms include irregular menstrual periods, excessive body and facial hair, acne, and obesity. Women with PCOS also may experience ...
Infertility has serious consequences especially in Africa where a high premium is place on child bearing. An interviewer-administered questionnaire was administered on 396 consenting women seeking infertility treatment at the gynaecological clinic of the University College Hospital, Ibadan in an attempt to assess the attitude of infertile women in Nigeria to child adoption and its acceptability as a management option for infertility. Most (64%) believed its culturally unacceptable and only 17% will try it as an option. Sustained advocacy, community mobilization and enactment of supportive laws were some of the suggestions made by respondents to improve its uptake. PMID:22314902
Oladokun, A; Arulogun, O; Oladokun, R; Adenike Bello, F; Morhassan-Bello, I O; Bambgoye, E A; Adewole, I F; Ojengbede, O A
A prospective placebo controlled double blind study was conducted in patients attending male infertility clinics of our hospital to evaluate effects of a herbal formulation for male infertility--'Y-virilin'. In phase 1 forty patients with oligospermia with or without asthenospermia were randomly allocated to 2 treatment groups--Treatment Group A i.e. formulation under test and treatment Group B (Placebo). Therapy with these agents was given twice a day for 6 months. In phase 2, 12 patients with azospermia were administered either 'Y virilin' or the placebo (n = 6/Gp). In all patients along with semen analysis (sperm count, percentage of motile sperms and grade of motility) was done monthly for 6 months. Serum FSH levels were estimated before and at the end of therapy. A significant increase in sperm count was observed from 2-3 months in oligospermics receiving Y virilin as compared to basal values (p < 0.05). In Group B the follow-up sperm counts were either comparable to basal values or were lesser. However, the percentage and grade of motility did not differ in two groups at the end of respective treatment. No change was found in mean FSH value. During the therapy period incidence of conception was 20% in treatment Group A and 5% in Group B. Of the azospermic receiving 'Y-virilin' 50% showed a count of 10-20 millions/cmm while none from the placebo group. This study highlights the therapeutic potential of the tested formulation in the patients with infertility. PMID:10740725
Rege, N N; Date, J; Kulkarni, V; Prem, A R; Punekar, S V; Dahanukar, S A
Up to now, the identification of gene mutations causing infertility in humans remains poorly investigated. Temporal progression through meiosis and meiosis specific genes had been extensively characterized in yeast. Recently some mammalian homologous were found. The molecular mechanisms regulating entry into and progression through meiosis in mammals are still unknown. However, disruption of some meiotic genes in mouse showed an essential role of them in meiotic chromosome synapsis and gametogenesis. Moreover, the phenotype of gonads in null mutant mice for some meiotic genes (failure to initiate or blockage in meiosis, lack of gametes or small size of gonads...) could be strikingly similar to clinical observations found in human infertility. The aim of this study was to identify putative mutations in 5 meiotic genes of several clinically well-characterized patients who present unexplained infertility (normal karyotype, women with premature ovarian failure, men with azospermia and without Y micro-deletion). For this purpose, the exons of these 5 genes (DMC1, SPO11, MSH4, MSH5, CCNA1) were all amplified by PCR with specific primers and each amplified-exon was sequenced. Sequences were aligned in comparison to the human corresponding gene available in Genbank. Many heterozygous mutations were found in different genes. Two homozygous mutations were found in MSH4 and DMC1 genes in a young man presenting a testis vanishing syndrome and a woman presenting a premature ovarian failure, respectively. Consequences of such mutations will be examined and verified in model organisms (yeast, mouse) to check the relevance of the mutations in clinical setting. PMID:12478991
Mandon-Pépin, B; Derbois, C; Matsuda, F; Cotinot, C; Wolgemuth, D J; Smith, K; McElreavey, K; Nicolas, A; Fellous, M
Congenital tuberculosis (CTB) due to maternal genitourinary (GU) TB infection is a rare occurrence, as infection of the genital tract in women generally leads to infertility. Increasing availability of assisted reproductive technology creates the potential for CTB to emerge as a significant problem. We describe five infants (two sets of twins and a singleton birth) conceived by in vitro fertilization who developed CTB. All five infants were born to mothers who had immigrated to the United States from India and none had GU TB diagnosed before the birth of their infected infants. PMID:23803676
Flibotte, J J; Lee, G E; Buser, G L; Feja, K N; Kreiswirth, B N; McSherry, G D; Nolan, S M; Tolan, R W; Zhang, H
Background Infertility represents a major challenge to the emotional balance and sexual life of couples, with long-lasting and gender-specific effects. The objective of this study is to explore personality features of infertile patients and detect possible sexual disorders in couples undergoing infertility treatment. Materials and methods In this prospective study 60 infertile couples and 52 fertile control couples were asked to complete standardized and validated questionnaires: the Adjective Check List (ACL) to enquire about personality features and the Female Sexual Function Index (FSFI) or the International Index of Erectile Function (IIEF) to assess sexual functioning of female and male partners. The study population was divided into 3 groups: Group A (N?=?30, recently diagnosed infertile couples) Group B (N?=?30, infertile couples already undergoing Intrauterine Insemination) and Group C (N?=?52, fertile control group). Results Infertile patients did not display any distinguishing personality features. Regarding sexual function, men of all the three groups scored higher in both questionnaires (sexual satisfaction, desire and orgasm) than their female partners. Comparing results between groups, Group A male partners obtained lower scores in all the subscales. Women belonging to Group A and Group B showed an impairment of sexual arousal, satisfaction, lubrification and orgasm when compared to fertile controls. Conclusions Even if at the very first stages of infertility treatment no personality disturbances can be detected, the couples’ sexual life is already impaired with different sexual disorders according to gender.
The present study was designed to evaluate the relationship between serum leptin and infertility in obese young and old men and women. The groups of infertile obese men (n=66) and women (n=30) compared with control obese fertile men (n=60) and women (n=30) with same ages to find the contribution of serum leptin level in causation of fertility. The results revealed that serum leptin were significantly raised in infertile male and female with p<0.001. BMI was also found to be significantly higher (p<0.001) in infertile men and women. Moreover a strong positive correlation was found between BMI and leptin level, and serum leptin and age in both fertile and infertile men and women. The values of correlation coefficients between serum leptin and BMI, and serum leptin and age are statistically significant (r=0.3-0.6, p<0.01-p<0.05). This study has concluded that obesity is associated with infertility in men and women. Sex hormonal imbalance may also be associated BMI and serum leptin in infertility. However further studies are required to determine the exact match by which enhanced BMI and serum leptin levels to female and male infertility. PMID:24374455
Farooq, Reshma; Lutfullah, Sualiha; Ahmed, Mughis
BACKGROUND: The study explores the relationship between serum chlamydia antibody titres (CATs) and detec- tion of tubal damage in infertile women. METHODS: The tubal status and pelvic findings in 1006 women undergo- ing laparoscopy for infertility were related to CAT, which was measured using the whole-cell inclusion immunofluorescence test. RESULTS: A negative correlation between CAT and age was noted. A
Valentine A. Akande; Linda P. Hunt; David J. Cahill; E. Owen Caul; W. Christopher; L. Ford; Julian M. Jenkins
... Clinical Trials Resources and Publications How common is male infertility, and what are its causes? Skip sharing on social media links Share this: Page Content Infertility is defined clinically in women and men who cannot achieve pregnancy after 1 year of having intercourse without using ...
BACKGROUND: Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse. It remains a major clinical and social problem, affecting perhaps one couple in six. Evaluation usually starts after 12 months; however it may be indicated earlier. The most common causes of infertility are: male factor such as sperm abnormalities, female
Remah M Kamel
Background: The purpose of this pilot study was to evaluate the impact of a 6-month cognitive-behavioral therapy for infertile couples. Methods: Seventeen idiopathic infertile couples participated in a therapy program comprised of modules to behaviorally optimize the chance of conception, improve sexual functioning and satisfaction, reduce thoughts of helplessness and, if necessary, improve marital communication skills. Pre- to posttreatment changes
Brunna Tuschen-Caffier; Irmela Florin; Walter Krause; Martin Pook
Reproduction is required for the survival of all mammalian species, and thousands of essential 'sex' genes are conserved through evolution. Basic research helps to define these genes and the mechanisms responsible for the development, function and regulation of the male and female reproductive systems. However, many infertile couples continue to be labeled with the diagnosis of idiopathic infertility or given
Martin M Matzuk; Dolores J Lamb
Male infertility lies at the crossroads of genetic determinants and environmental effects. Although the exact genetic mechanisms of male infertility are still unclear, this disorder is associated with a host of medical diseases, including testicular cancer. Testicular dysgenesis syndrome, the Hiwi protein and chromosome 12 aneuploidy, DNA mismatch repair, and Y-chromosome instability have been postulated as possible connections between male
James M. Hotaling; Thomas J. Walsh
Although media coverage of infertility treatments has increased markedly over the past decade, there is a dearth of empirical information about public perceptions of the ethics of infertility procedures (e.g. artificial insemination, in vitro fertilization, donor eggs, surrogate mothering, and gestational carriers) and about the factors that shape them. Two representative telephone survey samples (930 adults in a Midwestern state,
Karina M. Shreffler; David R. Johnson; Laurie K. Scheuble
Objective: To illustrate the necessity for an enhanced understanding of the genetic basis of male factor infertility, to present a comprehensive synopsis of these genetic elements, and to review techniques being utilized to produce new insights in fertility research. Background: Male factor infertility is a complex disorder that affects a large sector of the population; however, many of its etiologies
Katherine L. O'Flynn O'Brien; Alex C. Varghese; Ashok Agarwal
A clinically significant proportion of couples experience difficulty in conceiving a child. In about half of these cases male infertility is the cause and often genetic factors are involved. Despite advances in clinical diagnostics ?50% of male infertility cases remain idiopathic. Based on this, further analysis of infertile males is required to identify new genetic factors involved in male infertility. This review focuses on cation channel of sperm (CATSPER)-related male infertility. It is based on PubMed literature searches using the keywords 'CATSPER', 'male infertility', 'male contraception', 'immunocontraception' and 'pharmacologic contraception' (publication dates from January 1979 to December 2009). Previously, contiguous gene deletions including the CATSPER2 gene implicated the sperm-specific CATSPER channel in syndromic male infertility (SMI). Recently, we identified insertion mutations of the CATSPER1 gene in families with recessively inherited nonsyndromic male infertility (NSMI). The CATSPER channel therefore represents a novel human male fertility factor. In this review we summarize the genetic and clinical data showing the role of CATSPER mutation in human forms of NSMI and SMI. In addition, we discuss clinical management and therapeutic options for these patients. Finally, we describe how the CATSPER channel could be used as a target for development of a male contraceptive. PMID:20648059
Hildebrand, Michael S; Avenarius, Matthew R; Fellous, Marc; Zhang, Yuzhou; Meyer, Nicole C; Auer, Jana; Serres, Catherine; Kahrizi, Kimia; Najmabadi, Hossein; Beckmann, Jacques S; Smith, Richard J H
A case study of Southwest Airlines, a Fortune 500 company, demonstrates that a well-designed infertility coverage plan can control resource use. This successful model could be used by employers who wish to ensure that their employees have access to high-quality, cost-effective infertility services in a managed-care environment. PMID:19631318
Silverberg, Kaylen; Meletiche, Dennis; Del Rosario, Gina
Specialist infertility practice was studied in a group of 708 couples within a population of residents of a single health district in England. They represented an annual incidence of 1.2 couples for every 1000 of the population. At least one in six couples needed specialist help at some time in their lives because of an average of infertility of 21\\/2
M G Hull; C M Glazener; N J Kelly; D I Conway; P A Foster; R A Hinton; C Coulson; P A Lambert; E M Watt; K M Desai
This contribution discusses new aspects in andrology focusing on infertility, erectile dysfunction (ED), and hypogonadism. Topics such as prostatitis and detection of Chlamydia, idiopathic infertility and PDE5 inhibitors, and ED after GreenLight laser treatment are addressed. PMID:21863409
Weidner, W; Rusz, A; Pilatz, A; Hauptmann, A; Schuppe, H-C
Aim. Ovarian epithelial dysplasia was initially described in material from prophylactic oophorectomies performed in patients at genetic risk of ovarian cancer. Similar histopathological abnormalities have been revealed after ovulation stimulation. Since infertility is also a risk factor for ovarian neoplasia, the aim of this study was to study the relationship between infertility and ovarian dysplasia. Methods. We blindly reviewed 127 histopathological slides of adnexectomies or ovarian cystectomies according to three groups—an exposed group to ovulation induction (n = 30), an infertile group without stimulation (n = 35), and a spontaneously fertile control group (n = 62)—in order to design an eleven histopathological criteria scoring system. Results. The ovarian dysplasia score was significantly higher in exposed group whereas dysplasia score was low in infertile and control groups (resp., 8.21 in exposed group, 3.69 for infertile patients, and 3.62 for the controls). In the subgroup with refractory infertility there was a trend towards a more severe dysplasia score (8.53 in ovulation induction group and 5.1 in infertile group). Conclusion. These results raise questions as to the responsibility of drugs used to induce ovulation and/or infertility itself in the genesis of ovarian epithelial dysplasia.
Chene, Gautier; Penault-Llorca, Frederique; Tardieu, Anne; Cayre, Anne; Lagarde, Nicole; Jaffeux, Patricia; Aublet-Cuvelier, Bruno; Dechelotte, Pierre; Felloni, Bertrand; Pouly, Jean-Luc; Dauplat, Jacques
The role that autoantibodies play in infertility remains uncertain. There are conflicting data regarding the prevalence of autoantibodies in women with endometriosis. Certainly no one has demonstrated an association between the presence of antibodies in women with endometriosis and infertility. Despite intensive study, there is also no consensus on a role of autoantibodies to the zona pellucida as a cause
Bradley J. Van Voorhis; Dale W. Stovall
Background Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse. It remains a major clinical and social problem, affecting perhaps one couple in six. Evaluation usually starts after 12 months; however it may be indicated earlier. The most common causes of infertility are: male factor such as sperm abnormalities, female factor such as ovulation dysfunction and tubal pathology, combined male and female factors and unexplained infertility. Objectives The aim of this study is to provide the healthcare professionals an evidence-based management protocol for infertile couples away from medical information overload. Methods A comprehensive review where the literature was searched for "Management of infertility and/or infertile couples" at library website of University of Bristol (MetaLib) by using a cross-search of different medical databases besides the relevant printed medical journals and periodicals. Guidelines and recommendations were retrieved from the best evidence reviews such as that from the American College of Obstetricians and Gynaecologists (ACOG), American Society for Reproductive Medicine (ASRM), Canadian Fertility and Andrology Society (CFAS), and Royal College of Obstetricians and Gynaecologists (RCOG). Results A simple guide for the clinicians to manage the infertile couples. Conclusions The study deploys a new strategy to translate the research findings and evidence-base recommendations into a simplified focused guide to be applied on routine daily practice. It is an approach to disseminate the recommended medical care for infertile couple to the practicing clinicians.
A male factor exists in 30% of infertile unions. New options, particularly ICSI, have revolutionized its management but should not create an environment wherein the evaluation of the male focuses only on ART outcomes. All men require a thorough assessment for reversible causes of infertility, comorbidities and sexual\\/relationship difficulties consequent upon this diagnosis. Endocrine, genetic and histological evaluations play key
Robert I McLachlan
Recently Mexican Federation of Obstetrics and Gynecology Colleges (Federación Mexicana de Colegios de Obstetricia y Ginecologia, FEMECOG) published the Mexican guideline forthe management of male infertility, which suggests performing genetic laboratory tests as part of diagnosis and management of infertile patients and states that these should receive genetic counseling. This paper reviews the genetic approach proposed by Mexican guideline. A systematic review of medical literature was performed in Pubmed and Web of Knowledge from 1980 to 2012 in order to find reports of genetic variants associated to male infertility in Mexican patients. Also it is discussed the current knowledge of these variants, their clinical implications and finally the guidelines and recommendations for their molecular diagnosis. Most genetic variants in Mexican infertile patients are chromosome abnormalities. In relation to other variants there is only a report of Y chromosome microdeletions, repeated CAG in androgen receptor and more common mutations in CFTR, and other article reporting mutations in CFTR in patients with congenital absence of vas deferens. Little is known about the genetics of Mexican infertile patients apart from chromosome abnormalities. However, the contribution of genetics as etiology of male infertility is taking more relevance and currently the consensual management of infertile male should include the screening of genetic background. This review pretends to be a quick guide for clinicians who want to know about reports of genetic variants related to male infertility in Mexican population and how to approach their diagnosis. PMID:23819425
Piña-Aguilar, Raúl Eduardo; Chima-Galán, María del Carmen; Yerena-de-vega, María de la Concepción A; Regalado-Hernández, Miguel Angel; Sánchez-Guerrero, Cecilia; García-Ortiz, Liliana; Santillán-Hernández, Yuritzi; Moreno-García, Jesús Daniel
Male infertility is directly or indirectly responsible for 60% of cases involving reproductive-age couples with fertility-related issues. Nevertheless, the evaluation of male infertility is often underestimated or postponed. A coordinated evaluation of the infertile male using standardized procedures improves both diagnostic precision and the results of subsequent management in terms of effectiveness, risk and costs. Recent advances in assisted reproductive techniques (ART) have made it possible to identify and overcome previously untreatable causes of male infertility. To properly utilize the available techniques and improve clinical results, it is of the utmost importance that patients are adequately diagnosed and evaluated. Ideally, this initial assessment should also be affordable and accessible. We describe the main aspects of male infertility evaluation in a practical manner to provide information on the judicious use of available diagnostic tools and to better determine the etiology of the most adequate treatment for the existing condition.
Esteves, Sandro C; Miyaoka, Ricardo; Agarwal, Ashok
The mental status of 37 female patients with infertility and that of 37 healthy controls was evaluated using General Health Questionnaire, Present State Examination, and clinical assessment. An interview schedule, designed to elicit information on sociodemographic, psychiatric predisposing, and obstetric factors, was also administered. A significantly higher proportion (29.7%) of the patients was found to have diagnosable psychopathology, mainly depressive episode and generalized anxiety disorder. Compared with the control group, the infertile women experienced poorer marital relationships, had a significant family history of infertility, were more negatively predisposed to child adoption. and had a greater history of surgery and induced abortion. Polygamy was found to have a close association with psychopathology in the sample of infertile women. The implications of these findings and ways of improving the mental status of the infertile woman are discussed. PMID:10098821
Aghanwa, H S; Dare, F O; Ogunniyi, S O
Among the male partners of 1074 infertile couples the mean results of semen analysis were sperm count 78 X 10(6)/ml, seminal volume 4.0 ml, proportion of progressively motile sperm 54%, proportion of sperm with normal morphologic features 81.4% and total motile sperm count 152.3 X 10(6) per ejaculate. After excluding 65 couples who chose donor insemination and 300 with known female causes of infertility, the cumulative pregnancy rates in the remaining 709 couples were higher with increasing sperm density and motility and seminal volume, but the higher rates were significant only when these variables were combined into total motile sperm count per ejaculate. The cumulative pregnancy rates were 20% with a total motile sperm count of 9 X 10(6) or less, 37% with a count of 10 to 19 X 10(6) and 52% with a count of 20 X 10(6) or more (p = 0.001). Counts higher than 20 X 10(6) were not associated with a further improvement in pregnancy rates, but variability in the results was high, which suggests that the test should be repeated as necessary to determine the true range. Although standards for these and other seminal variables are ill defined, the total motile sperm count incorporates the most useful prognostic information from semen analysis, and the associated pregnancy rates can help guide clinical decisions.
Small, D R; Collins, J A; Wilson, E H; Wrixon, W
The spermatogonial stem cells (SSCs) are responsible for the transmission of genetic information from an individual to the next generation. SSCs play critical roles in understanding the basic reproductive biology of gametes and treatments of human infertility. SSCs not only maintain normal spermatogenesis, but also sustain fertility by critically balancing both SSC self-renewal and differentiation. This self-renewal and differentiation in turn is tightly regulated by a combination of intrinsic gene expression within the SSC as well as the extrinsic gene signals from the niche. Increased SSCs self-renewal at the expense of differentiation result in germ cell tumors, on the other hand, higher differentiation at the expense of self-renewal can result in male sterility. Testicular germ cell cancers are the most frequent cancers among young men in industrialized countries. However, understanding the pathogenesis of testis cancer has been difficult because it is formed during fetal development. Recent studies suggest that SSCs can be reprogrammed to become embryonic stem (ES)-like cells to acquire pluripotency. In the present review, we summarize the recent developments in SSCs biology and role of SSC in testicular cancer. We believe that studying the biology of SSCs will not only provide better understanding of stem cell regulation in the testis but eventually will also be a novel target for male infertility and testicular cancers.
Singh, Shree Ram; Burnicka-Turek, Ozanna; Chauhan, Chhavi; Hou, Steven X.
We studied a prospective cohort of 434 couples in Northern California and found that 13% did not pursue any form of infertility treatment after their initial consultation. While age, education, and financial concerns remain important for patients in choosing whether to pursue infertility treatment, depressive symptoms may also be a barrier to achieving reproductive goals.
Eisenberg, Michael L.; Smith, James F.; Millstein, Susan G.; Nachtigall, Robert D.; Adler, Nancy E.; Pasch, Lauri A.; Katz, Patricia P.
Various factors cause spermatogenesis arrest in men and, in a large number of cases, the underlying reason still remains unknown. Little attention is paid to determining the genetic defects of varicocele-related infertility. The objective of our present study was to investigate the chromosomal abnormalities and Y chromo- some microdeletions in infertile men of South Indian origin with var- icocele and
LAKSHMI RAO; ARVIND BABU; MURTHY KANAKAVALLI; VENKATA PADMALATHA; AMARPAL SINGH; PRASHANT KUMAR SINGH; MAMATA DEENADAYAL; LALJI SINGH
Background Although there is little information available to quantify the use of complementary and alternative medicine (CAM), growing evidence suggests that CAM prevalence among patients seeking infertility treatment is increasing worldwide. There are many products available on the market and many infertile patients demand information about CAM from their health care providers. This paper investigates the prevalence of CAM use among infertile couples in Jordan. Additionally, trends and factors contributing to CAM use for infertility treatment among these couples have been evaluated. Methods A face-to-face questionnaire inquiring demographic information, use of CAM for medical conditions, in general, and types of CAM used for infertility treatment, in specific, was completed by one thousand twenty one infertile patients attending at two types of facilities; in vitro Fertilization (IVF) centers at both public and private hospitals and infertility private clinics. Both types of facilities were distributed in different areas of Amman, the capital city of Jordan. The study was conducted between May and August 2012. Results Our results show that CAM therapies for infertility treatment were encountered in 44.7% of the study sample. The vast majority of CAM users were females. The most commonly used CAM therapies were herbs and spiritual healing. A clear correlation between the use of CAM for infertility versus the use of CAM for other chronic medical conditions has been found. Conclusions The prevalence of CAM use for infertility treatment in Jordan is relatively high, particularly among young females, well educated and with a low income, in consistence with the studies reported elsewhere. Herbs and spiritual healing are widely used among patients in adjunct to conventional medical interventions. As CAM use is prevalent among patients, there is a clear need for health providers to become more aware of this phenomenon and for further research in this field.
In this study over a 10-year period, 1584 patients complaining of infertility of more than 1 year duration were evaluated for their laparoscopic findings in relation to the presence or not of chronic pelvic pain (CPP). Infertility was the only complaint in 1215 cases (group 1), whereas 369 patients complained of infertility and CPP (group 2). All cases underwent routine infertility investigation and pelvic ultrasonography, followed by diagnostic laparoscopy, with infertility-only cases acting as a control group. At laparoscopy 76.7% of patients with CPP were found with pelvic pathology, compared with only 42.6% of cases without CPP (P < or = 0.0001). Omental-abdominal wall adhesions, advanced endometriosis, endometriomas with adhesions, pelvic venous congestion, and hydrosalpinges with pelvic adhesions were significantly more frequent in cases with CPP. Dysmenorrhoea was the most frequent type of CPP. Cases with CPP and a negative laparoscopy were further investigated using a multidisciplinary approach. In conclusion, chronic pelvic pain can be the result of several pelvic pathologies. Infertile patients with CPP are much more frequently found with an abnormal pelvis in comparison with cases without CPP. Laparoscopy is an invaluable diagnostic tool especially for symptomatic patients and should be used early in their diagnostic infertility work-up. PMID:16569325
Milingos, Spyros; Protopapas, Athanasios; Kallipolitis, George; Drakakis, Petros; Makrigiannakis, Antonios; Liapi, Anthi; Milingos, Dimitrios; Antsaklis, Aris; Michalas, Stylianos
Using data from Wave 1 (2004-2006) of the National Survey of Fertility Barriers (NSFB), a national probability sample of women ages 25-45, we examine online information-seeking among ever-infertile women. Of the 1352 women who met criteria for infertility, 459 (34%) neither talked to a doctor nor went online for information, 9% went online only for information, 32% talked to a doctor but did not go online, and 25% did both. Guided by Chrisman's Health-Seeking Model and previous research on Internet use to obtain health information, we employ multinomial logistic regression to compare these four groups of ever-infertile women. Findings generally support Chrisman's model. Infertile women tend to seek information online as a complement to, rather than as a substitute for, in-person health-seeking. Greater faith in the ability of medical science to treat infertility and greater perceived stigma were associated with higher odds of using the Internet to obtain information about infertility. In general, women who perceived the symptoms of infertility as more salient had higher odds of using both online and in-person or only in-person health-seeking compared to online health-seeking. Women with greater resources had higher odds of using online sources of information. Strong network encouragement to seek treatment was associated with higher odds of in-person health-seeking and combining in-person and online health-seeking compared to only going online or doing nothing. PMID:24355477
Slauson-Blevins, Kathleen S; McQuillan, Julia; Greil, Arthur L
The research deals with experiencing infertility and its consequences in the adoption of a child and focuses on infertile couples that have wished to adopt a child and joined a program preparing them to be foster parents. The results show that most of the infertile couples experience infertility very much as being different from couples with children as well as having to cope with the feelings of deep emotional loss resulting from the inability to reproduce biologically. There is therefore the question whether these facts should be taken into account by the profession (i.e. social workers) when dealing with child adoption as, according to most of the respondents of our survey, the process of coming to terms with infertility and its consequences is an important factor in establishing healthy family relationships and the child's identity within the adoptive family. We concluded from the results of the research that the infertile couples preparation program for adopting a child carried out by the Society of Adoptive Families "Deteljica", is a comprehensive autopoietic social workers' answer to the needs of participants for a successful adoption of a child, as it makes it possible to supply these future adoptive parents with the requisite information and experience and provides support to the entire family upon accepting a child in its midst, while its fundamental attribute is offering help to couples in overcoming the traumas resulting from their infertility. PMID:14746131
Bevc, Viktorija; Jerman, Janja; Ovsenik, Rok; Ovsenik, Marija
The most common cause of male infertility is idiopathic. Standard investigations reveal no abnormality in such cases. The aim of the study was to investigate the levels of sperm DNA damage and seminal oxidative stress and their relationships with idiopathic infertility. The study included 30 normozoospermic infertile men seeking infertility treatment and 20 fertile donors. Semen analysis was performed according
Fatma Ferda Verit; Ayhan Verit; Abdurrahim Kocyigit; Halil Ciftci; Hakim Celik; Mete Koksal
A lipiodol hysterosalpingogram was the routine test for tubal patency as recently as the 1970s. Observational studies, then randomised controlled trials, provided evidence of a fertility enhancing effect of lipiodol. It has been found to improve fertility for women with normal tubal patency, particularly where the woman has a history of endometriosis. Previous successful treatment for infertility with lipiodol is a marker of further successful treatment for infertility in a repeat procedure. Whilst lipiodol is probably effective at flushing debris that could hinder fertility from fallopian tubes, it also exerts immunobiological effects in pelvic peritoneum and on the endometrium that could be responsible for fertility enhancement. Effects of lipiodol on the endometrium that might be important at the time of the implantation window are a reduced expression of osteopontin and an increased number of uterine natural killer cells postlipiodol. The effect of lipiodol uterine bathing for women with endometriosis, repeat in vitro fertilisation (IVF) implantation failure and other reproductive disorders merits further investigation. Lipiodol presents a new, simple, low invasive, inexpensive treatment option for endometriosis-related infertility and might have wider applications. PMID:24138402
Johnson, Neil P
The human zona pellucida is composed of four glycoproteins (ZP1, ZP2, ZP3, and ZP4) and has an important role in reproduction. Here we describe a form of infertility with an autosomal recessive mode of inheritance, characterized by abnormal eggs that lack a zona pellucida. We identified a homozygous frameshift mutation in ZP1 in six family members. In vitro studies showed that defective ZP1 proteins and normal ZP3 proteins colocalized throughout the cells and were not expressed at the cell surface, suggesting that the aberrant ZP1 results in the sequestration of ZP3 in the cytoplasm, thereby preventing the formation of the zona pellucida around the oocyte. PMID:24670168
Huang, Hua-Lin; Lv, Chao; Zhao, Ying-Chun; Li, Wen; He, Xue-Mei; Li, Ping; Sha, Ai-Guo; Tian, Xiao; Papasian, Christopher J; Deng, Hong-Wen; Lu, Guang-Xiu; Xiao, Hong-Mei
Semen quality was estimated in 53 males of proven fertility and 370 males in infertile marriages. The mean sperm count for the fertile males and males in the infertile population was 71.2 million/ml and 46.8 million/ml, respectively. In the series, 49.1 percent of the infertile males had pathological spermograms. There is need for epidemiological studies to identify the causative factors and in cases in which therapeutic recovery cannot be achieved, artificial insemination should be encouraged.
Anovulatory disorders are a primary cause of female infertility. Polycystic ovarian syndrome is the major cause of anovulation and is generally associated with obesity. Lifestyle changes to encourage weight loss are the initial therapy for overweight and obese patients, followed by clomiphene citrate for ovulation induction. For those patients who fail to ovulate on clomiphene citrate, alternatives, such as letrozole; gonadotropins; and complimentary agents to enhance clomiphene citrate, such as metformin and glucocorticoids, are reviewed. Women with unexplained infertility (no identifiable cause of infertility on a routine evaluation) may benefit from ovulation induction with clomiphene citrate, letrozole, or gonadotropins. PMID:23182557
Propst, Anthony M; Bates, G Wright
To determine the interest of using robotic laparoscopic surgery in the management of female infertility, we reviewed our own activity and searched the Medline database for publications on robotic technology in infertility surgery, with the use of the following search words: robotic laparoscopy, tubal anastomosis, myomectomy, deep infiltrating endometriosis, and adnexal surgery. Robot-assisted laparoscopic surgery has seen rapid progression over the past few years. It has been mostly used for myomectomy, proximal tubal reanastomosis, and deep endometriosis surgery. Despite its increased range of indications, no randomized control studies are available. The place of robotic surgery in the management of infertility remains undetermined. PMID:24559616
Carbonnel, Marie; Goetgheluck, Julie; Frati, Albane; Even, Marc; Ayoubi, Jean Marc
Varicocele is a pathologic enlargement of the pampiniform venous plexus within the spermatic cord, a condition that is a common cause of impaired sperm production and decreased quality of sperm. While varicocele is the most common surgically correctable risk factor for male infertility, not all males with varicocele experience infertility. In fact, most men with varicocele have normal spermatogenesis. Despite its prevalence, the molecular mechanisms of varicocele and its effect on testicular function are yet to be completely understood. We postulate that men with varicocele-associated infertility could have preexisting genetic lesions or defects in molecular mechanisms that make them more susceptible to varicocele-mediated testicular injury affecting spermatogenesis. PMID:24643631
Sheehan, Matthew M; Ramasamy, Ranjith; Lamb, Dolores J
Objective: To determine the cost-effectiveness of infertility treatments.Design: Retrospective cohort study.Setting: Academic medical center infertility practice.Patient(s): All patients treated for infertility in a 1-year time span.Intervention(s): Intrauterine inseminations, clomiphene citrate and IUI (CC-IUI), hMG and IUI (hMG-IUI), assisted reproductive techniques (ART), and neosalpingostomy by laparotomy.Main Outcome Measure(s): All medical charges and pregnancy outcomes associated with the treatments were obtained. Cost-effectiveness
Bradley J. Van Voorhis; Amy E. T. Sparks; Brian D. Allen; Dale W. Stovall; Craig H. Syrop; F. K. Chapler
Women's fertility potential is declining with age because of multiples intrinsic and extrinsic factors such as life style, oxidative stress and/or endocrine disruptors and is affecting the ability of these women to conceive naturally. This declining fertility potential and the late age of motherhood is increasing significantly the number of patients consulting infertility specialists. Different strategies of investigation and management are proposed to patients over 40 in order to overcome their infertility and improve the live birth rate in these patients. Intra Uterine Insemination (IUI) in women over 40 is associated with a low rate of ongoing pregnancy and IUI should not therefore be offered always as the first line of treatment. When the predictive factors are positive IVF/ICSI seem to be good alternatives until 43 years of age. Customized ovarian stimulation and flexible laboratory methods such as in vitro maturation (IVM), preimplantation genetic diagnosis (PGD), embryo vitrification and transfer after thawing in subsequent natural or artificial cycles can improve the success rate of ART in patients over 40. Meanwhile, oocyte and embryos donation remain good options for patient over 40 with a bad prognosis and can lead to successful ongoing pregnancies until 45 years of age. Ovarian tissue cryopreservation, oocyte vitrification at the germinal vesicle (GV) stage or metaphase II stage present a breakthrough for fertility preservation but the ideal age for starting fertility preservation is still debated as well as the minimum number of oocytes to be vitrified in order to optimize the chances of pregnancy when needed at an older age. This manuscript reports the results of our own experience from patients older than 40 in the light of the published data and discusses the different therapeutic alternatives which can be proposed to patients over 40 consulting ART centres. PMID:24679892
Cabry, Rosalie; Merviel, Philippe; Hazout, Andre; Belloc, Stephanie; Dalleac, Alain; Copin, Henri; Benkhalifa, Moncef
Background: Assisted reproductive technology (ART) provide the hope of pregnancy for infertile women, but do not always turn this hope into reality. Objective: The purpose of this study was to explore the lived experience of infertile women from increasing and decreasing factors of hope in infertile women with failure in infertility treatment. Materials and Methods: Using a qualitative research design (Phenomenology study), 23 subjects were selected who had experienced infertility failure visited by gynecologist (Rasekh Infertility center) in 2012. The data were collected through semi structured interviews and analyzed using interpretive research strategies of phenomenology by Collizi's seven-stage method. Results: Totally 96 codes were identified. The data arranged in two categories. The factors decreasing and increasing hope in infertility treatments. Totally 5 themes and 20 sub themes were extracted. The increasing factors which emerged from the data contain "spiritual source", "family interaction and support" and "information through the media", and decreasing factors contain "nature of treatments" and "negatively oriented mind". PMID:24799869
Mosalanejad, Leili; Parandavar, Nehle; Gholami, Morteza; Abdollahifard, Sareh
Background: Infertility is a major life event that brings about social and psychological problems. The type and rate these problems in the context of socio-cultural of different geographical areas and sex of people is different. Objective: The aim of this qualitative study was to explain the psychological consequences of infertility in Iranian infertile women seeking treatment. Materials and Methods: This qualitative study was done using qualitative content analysis on 25 women affected by primary and secondary infertility with no surviving children in 2012. They were purposefully selected with maximum sample variation from a large Fertility Health Research Center in Tehran, Iran. Data were collected using 32 semi-structured interviews and analyzed by the conventional content analysis method. Results: The findings of this study include four main themes: 1. Cognitive reactions of infertility (mental engagement; psychological turmoil). 2. Cognitive reactions to therapy process (psychological turmoil; being difficult to control in some situations; reduced self-esteem; feelings of failure). 3. Emotional-affective reactions of infertility (fear, anxiety and worry; loneliness and guilt; grief and depression; regret). 4. Emotional-affective reactions to therapy process (fear, anxiety and worry; fatigue and helplessness; grief and depression; hopelessness). Conclusion: This study revealed that Iranian infertile women seeking treatment face several psychological-emotional problems with devastating effects on the mental health and well-being of the infertile individuals and couples, while the infertility is often treated as a biomedical issue in Iranian context with less attention on the mental-emotional, social and cultural aspects. This article extracted from Ph.D. thesis. (Seyede Batool Hasanpoor-Azghady)
Hasanpoor-Azghdy, Seyede Batool; Simbar, Masoumeh; Vedadhir, Abouali
Purpose To detect somatic cytogenetic abnormalities and AZF microdeletions in a sample of 187 Turkish infertile men to determine the\\u000a frequencies and the characteristics of our primary male infertility data in order to perform appropriate genetic counseling.\\u000a \\u000a \\u000a \\u000a \\u000a Methods This study included 187 infertile men. Chromosomal studies and screening of AZF deletions was performed by multiplex polymerase\\u000a chain reaction (PCR) analysis using the
Haluk Akin; Huseyin Onay; Emre Turker; Ferda Ozkinay
... It may affect your relationships with others, your perspective on life, and how you feel about yourself. ... and support families during struggles with infertility and adoption, TheAFA.org • Choice Moms: An organization to help ...
Evaluation and surgical treatment of male infertility has evolved and expanded, now leading to more precise diagnoses and tailored treatments with diminished morbidity and greater success. Surgeries for male infertility are divided into four major categories: (i) diagnostic surgery; (ii) surgery to improve sperm production; (iii) surgery to improve sperm delivery; and (iv) surgery to retrieve sperm for use with in vitro fertilization and intracytoplasmic sperm injection (IVF–ICSI). While today we are more successful than ever in treating male infertility, pregnancy is still not always achieved likely due to factors that remain poorly understood. Clinicians treating infertility should advocate for couple-based therapy, and require that both partners have a thorough evaluation and an informed discussion before undergoing specific surgical therapies.
Lopushnyan, Natalya A; Walsh, Thomas J
Gordon Research Conference: Mammalian Gametogenesis and Embryogenesis New London, CT, July 1-6, 2000 Molecular Analysis of Human Spermatozoa: Potential for Infertility Research David Miller 1, David Dix2, Robert Reid 3, Stephen A Krawetz 3 1Reproductive ...
Introduction Endometriosis is defined as overgrowth of endometrial tissue outside the uterine cavity. Endometriosis may be asymptomatic or associated with dysmenorrheal symptoms, dyspareunia, pelvic pain, abnormal uterine bleeding and infertility. The aim of this study was to explore the risk factors related to endometriosis among infertile Iranian women. Material and methods In this case control study, infertile women referred for laparoscopy and infertility workup to two referral infertility clinics in Tehran, Iran were studied. According to the laparoscopy findings, women were divided into case (women who had pelvic endometriosis) and control (women with normal pelvis) groups. The case group was divided into two subgroups: stage I and II of endometriosis were considered as mild while stage III and IV were categorized as severe endometriosis. A questionnaire was completed for each patient. Results Logistic regression showed that age, duration of infertility, body mass index (BMI), duration of menstrual cycle, abortion history, dyspareunia, pelvic pain and family history of endometriosis are independent predictive factors for any type of endometriosis. In addition, it was shown that education, duration of infertility, BMI, amount and duration of menstrual bleeding, menstrual pattern, dyspareunia, pelvic pain and family history of endometriosis are independent predictive factors of severe endometriosis. The AUCs for these models were 0.781 (0.735-0.827) and 0.855 (0.810-0.901) for any type of endometriosis and severe endometriosis, respectively. Conclusions It seems that any type of endometriosis and severe ones could be predicted according to demographic, menstrual and reproductive characteristics of infertile women.
Malekzadeh, Farideh; Amirchaghmaghi, Elham; Kashfi, Fahimeh; Akhoond, Mohammad Reza; Saei, Maryam; Mirbolok, Mohammad Hossein
Genetic factors contribute upto 15%–30% cases of male infertility. Formation of spermatozoa occurs in a sequential manner with mitotic, meiotic, and postmeiotic differentiation phases each of which is controlled by an intricate genetic program. Genes control a variety of physiologic processes, such as hypothalamus–pituitary–gonadal axis, germ cell development, and differentiation. In the era of assisted reproduction technology, it is important to understand the genetic basis of infertility to provide maximum adapted therapeutics and counseling to the couple.
Shamsi, M. B.; Kumar, K.; Dada, R.
Although methylenetetrahydrofolate reductase, a folate enzyme gene, has been associated with idiopathic male infertility, few studies have examined other folate-related metabolites and genes. We investigated whether idiopathic male infertility is associated with variants in folate, vitamin B12 (B12) and total homocysteine (tHcy)-related genes and measured these metabolites in blood. We conducted a case–control study that included 153 men with idiopathic
Laurel E Murphy; James L Mills; Anne M Molloy; Cong Qian; Tonia C Carter; Helena Strevens; Dag Wide-Swensson; Aleksander Giwercman; Richard J Levine
Transgenic mice with male infertility, the c-ros knockout (KO) and GPX5-Tag2 transgenic mouse models, are compared. Both exhibit severely angulated sperm flagella explaining the infertility. As angulated spermatozoa are swollen cells, a failure in volume regulation is indicated. Differences between genotypes were also found: caudal spermatozoa from c-ros KO, but not GPX5-Tag2, could fertilise eggs in vitro; flagellar angulation occurred
Trevor G Cooper; Ching-Hei Yeung; Andrea Wagenfeld; Eberhard Nieschlag; Matti Poutanen; Ilpo Huhtaniemi; Petra Sipilä
Infertility and recurrent spontaneous abortion (RSA) are heterogeneous conditions that have been frequently explained with\\u000a an immunological pathomechanism. A deeper insight into apparently unexplained infertility and RSA shows increasing evidences\\u000a supporting both alloimmune and autoimmune mechanisms, in which natural killer (NK) cells and autoantibodies seem to play a\\u000a relevant role. Successful pregnancy is considered as Th1–Th2 cooperation phenomenon, with a
Caterina De Carolis; Carlo Perricone; Roberto Perricone
Objective: To analyze sperm performance in a group of patients with male immunologic infertility treated with IVF-ET.Design: Retrospective clinical study.Setting: Patients attending a private IVF clinic.Patient(s): The study group comprised seven men with significant levels of surface-bound antisperm antibodies treated in nine IVF cycles. The control group comprised nine couples with female tubal infertility and no indication of male factor
Mónica H. Vazquez-Levin; Judith A. Notrica; Ester Polak de Fried
Male infertility accounts for almost half of infertility cases worldwide. A subset of infertile men exhibit reduced testosterone and enhanced levels of estradiol (E2), though it is unclear how increased E2 promotes deterioration of male fertility. Here, we utilized a transgenic mouse strain that overexpresses human CYP19, which encodes aromatase (AROM+ mice), and mice with knockout of Esr1, encoding estrogen receptor ? (ER?KO mice), to analyze interactions between viable Leydig cells (LCs) and testicular macrophages that may lead to male infertility. In AROM+ males, enhanced E2 promoted LC hyperplasia and macrophage activation via ER? signaling. E2 stimulated LCs to produce growth arrest-specific 6 (GAS6), which mediates phagocytosis of apoptotic cells by bridging cells with surface exposed phosphatidylserine (PS) to macrophage receptors, including the tyrosine kinases TYRO3, AXL, and MER. Overproduction of E2 increased apoptosis-independent extrusion of PS on LCs, which in turn promoted engulfment by E2/ER?-activated macrophages that was mediated by AXL-GAS6-PS interaction. We further confirmed E2-dependant engulfment of LCs by real-time 3D imaging. Furthermore, evaluation of molecular markers in the testes of patients with nonobstructive azoospermia (NOA) revealed enhanced expression of CYP19, GAS6, and AXL, which suggests that the AROM+ mouse model reflects human infertility. Together, these results suggest that GAS6 has a potential as a clinical biomarker and therapeutic target for male infertility. PMID:24762434
Yu, Wanpeng; Zheng, Han; Lin, Wei; Tajima, Astushi; Zhang, Yong; Zhang, Xiaoyan; Zhang, Hongwen; Wu, Jihua; Han, Daishu; Rahman, Nafis A; Korach, Kenneth S; Gao, George Fu; Inoue, Ituro; Li, Xiangdong
Male infertility accounts for almost half of infertility cases worldwide. A subset of infertile men exhibit reduced testosterone and enhanced levels of estradiol (E2), though it is unclear how increased E2 promotes deterioration of male fertility. Here, we utilized a transgenic mouse strain that overexpresses human CYP19, which encodes aromatase (AROM+ mice), and mice with knockout of Esr1, encoding estrogen receptor ? (ER?KO mice), to analyze interactions between viable Leydig cells (LCs) and testicular macrophages that may lead to male infertility. In AROM+ males, enhanced E2 promoted LC hyperplasia and macrophage activation via ER? signaling. E2 stimulated LCs to produce growth arrest–specific 6 (GAS6), which mediates phagocytosis of apoptotic cells by bridging cells with surface exposed phosphatidylserine (PS) to macrophage receptors, including the tyrosine kinases TYRO3, AXL, and MER. Overproduction of E2 increased apoptosis-independent extrusion of PS on LCs, which in turn promoted engulfment by E2/ER?-activated macrophages that was mediated by AXL-GAS6-PS interaction. We further confirmed E2-dependant engulfment of LCs by real-time 3D imaging. Furthermore, evaluation of molecular markers in the testes of patients with nonobstructive azoospermia (NOA) revealed enhanced expression of CYP19, GAS6, and AXL, which suggests that the AROM+ mouse model reflects human infertility. Together, these results suggest that GAS6 has a potential as a clinical biomarker and therapeutic target for male infertility.
Yu, Wanpeng; Zheng, Han; Lin, Wei; Tajima, Astushi; Zhang, Yong; Zhang, Xiaoyan; Zhang, Hongwen; Wu, Jihua; Han, Daishu; Rahman, Nafis A.; Korach, Kenneth S.; Gao, George Fu; Inoue, Ituro; Li, Xiangdong
Background The purpose of this study was to evaluate the fallopian tube of women with infertility and to observe whether there are any significant differences in the Hysterosalpingogram findings with regard to prevalence of tubal block in women with primary and secondary infertility. Methods A retrospective study of unilateral and bilateral tubal obstruction in Hysterosalpingogram of women with primary and secondary infertility was carried out. Results The frequencies of tubal obstruction were about 19% in women with primary infertility and 29% in secondary infertility. Chlamydia antigen positivity rate was similar in both groups. Ectopic pregnancy (p<0.01) and previous pelvic surgery (p<0.001) were higher in women with secondary infertility. Conclusion Tubal obstruction is a cause of female infertility according to this study. Bilateral tubal obstruction was similar in primary and secondary infertility groups and previous pelvic surgery may be the cause of tubal obstruction in the secondary infertility group.
Al Subhi, Taimoora; Al Jashnmi, Ruqaiya Nasser; Al Khaduri, Maha; Gowri, Vaidyanathan
Mechanisms of cAMP/PKA-induced meiotic arrest in oocytes are not completely identified. In cultured, G2/M-arrested PDE3A-/- murine oocytes, elevated PKA activity was associated with inactivation of Cdc2 and Plk1, and inhibition of phosphorylation of histone H3 (S10) and of dephosphorylation of Cdc25B (S323) and Cdc2 (Thr14/Tyr15). In cultured WT oocytes, PKA activity was transiently reduced and then increased to that observed in PDE3A-/- oocytes; Cdc2 and Plk1 were activated, phosphorylation of histone H3 (S10) and dephosphorylation of Cdc25B (S323) and Cdc2 (Thr14/Tyr15) were observed. In WT oocytes, PKAc were rapidly translocated into nucleus, and then to the spindle apparatus, but in PDE3A-/- oocytes, PKAc remained in the cytosol. Plk1 was reactivated by incubation of PDE3A-/- oocytes with PKA inhibitor, Rp-cAMPS. PDE3A was co-localized with Plk1 in WT oocytes, and co-immunoprecipitated with Plk1 in WT ovary and Hela cells. PKAc phosphorylated rPlk1 and Hela cell Plk1 and inhibited Plk1 activity in vitro. Our results suggest that PKA-induced inhibition of Plk1 may be critical in oocyte meiotic arrest and female infertility in PDE3A-/- mice.
Shen, Weixing; Ahmad, Faiyaz; Hockman, Steven; Ma, John; Omi, Hitoshi; Raghavachari, Nalini
BACKGROUND We examine variation in fertility-specific distress (FSD) and general distress according to different experiences of infertility among 1027 US women who have experienced infertility within the previous 10 years. METHODS General distress was measured by a short form of the Center for Epidemiological Studies-Depression. Multiple regression analysis was conducted on self-report data (based on a telephone interview) from a probability-based sample of US women aged 25–45 years. We compare women with infertility who have had a prior pregnancy (secondary infertility, n = 628) to women with infertility with no prior pregnancies (primary infertility, n = 399). We further distinguish between women with infertility who were actually ‘trying’ to become pregnant (the infertile with intent) with those who met the medical definition of infertile but did not describe themselves as trying to become pregnant (infertile without intent). RESULTS Both types of infertility (primary versus secondary) (? = 0.31*) and intentionality (infertile with and without intent) (? = 0.08*) are associated with FSD. These associations persist when we control for resource and demographic variables, life course variables, social support and social pressure variables. General distress does not vary by infertility type or intentionality. CONCLUSIONS Results reveal variation in women's recalled experiences of infertility and that FSD is more sensitive to effects of different experiences than general distress. Women with primary infertility who were explicitly trying to become pregnant at the time of the infertility episode stand out as a particularly distressed group. Caregivers should be aware that the emotional needs of women with primary infertility may differ from those with secondary infertility.
Greil, Arthur L.; Shreffler, Karina M.; Schmidt, Lone; McQuillan, Julia
Background: Infertility is accompanied by numerous psychological and social problems. Infertile couples are more anxious and emotionally distressed than other fertile people. Previous studies suggested that infertility is more stressful for women than men. Objective: The purpose of this study was to determine the status of general health of infertile couples. Materials and Methods: This cross-sectional study evaluated general health of 150 infertile couples attending to Yazd Research and Clinical Center for Infertility that were selected consequently. The data were gathered by the researchers, based on face to face interview before and after three months of treatment by two questionnaires. The first questionnaire had questions on demographic information and the second one was the General Health Questionnaire-28 (GHQ-28). This questionnaire has four sub- scales areas. All data were transferred directly to SPSS 15 and analyzed. Results: The mean age of women was 28.3 and men were 32.4 years. The scores for all sub- scales of GHQ in women were more than men. There was significant difference between age and general health at physical symptoms scales (p=0.002), anxiety and sleep disorders (p=0.003). The age group 25-29 years had higher scores (more than 7) than other age groups. There was significant difference between the scale of social dysfunction and results of treatment. Conclusion: Our results, similar to the previous studies have revealed negetive social and mental effects of infertility on women is more than men, so there is need that they be educated specially.
Baghianimoghadam, Mohammad Hosein; Aminian, Amir Hossein; Baghianimoghadam, Behnam; Ghasemi, Nasrin; Abdoli, Ali Mohammad; Seighal Ardakani, Najmeh; Fallahzadeh, Hosein
Testicular microlithiasis (TM) in infertility is an uncommon pathologic condition of unclear etiology that is characterized by calcium deposits within the seminiferous tubules. Nanobacteria (NB), as novel microorganisms mediating tissue calcification, have been discovered in some diseases. In this study, we hypothesized that NB may participate in the pathogenesis of TM, particularly in infertility. Seventeen infertility patients with TM detected by scrotal color Doppler ultrasonography and 17 infertility patients without TM as controls were enrolled in the study. The NB were isolated and cultured from semen samples and urine samples. After 3 to 6 weeks of culture, 10 of 17 (58.8%) semen samples and 2 urine samples from infertile patients with TM showed the growth of white granular microbes that firmly attached to the bottom of the culture flask and were visible to the naked eye. In the control group, only 1 of 17 (5.9%) semen samples from infertile patients without TM showed the growth of white granular microbes. The cultured microbes were identified by indirect immunofluorescent staining (IIFS), transmission electron microscopy (TEM), and 16s rRNA gene expression. IIFS and TEM revealed NB to be coccoid and 100 to 500 nm in diameter. The BLAST result revealed that the 16s rRNA gene sequence from the cultured microbes was 97% the same as that of the known NB. Our results showed that NB may be linked to the development of TM, which may provide a potential target for the diagnosis and treatment of infertility with TM. PMID:19779212
Zhang, Qing-Hua; Lu, Gen-Sheng; Shen, Xue-Cheng; Zhou, Zhan-Song; Fang, Qiang; Zhang, Xin; Li, Long-Kun; Jin, Xi-Yu; Song, Bo
Background and Aim: Throughout a woman's life, hormonal influences affect therapeutic decision making in periodontics. A woman undergoing infertility treatment is given drugs to stimulate the ovaries, which lead to sustained higher levels of female sex hormones. The differing levels of these hormones, either in infertile women or in women undergoing therapy for infertility or in women who have conceived and delivered naturally could suggest a differing periodontal status amongst these three groups. Hence, this cross-sectional study was undertaken to assess and compare the periodontal status in the above three groups. Materials and Methods: 180 women including 60 women undergoing treatment for infertility (Group I), 60 women in whom infertility treatment had not yet been initiated (Group II) and 60 women who had conceived and delivered naturally (Group III-control group), of age range 25-35 years, were included. Clinical parameters including oral hygiene index simplified (OHI-S), gingival index, sulcus bleeding index (SBI) and clinical attachment loss (CAL) were assessed by a single examiner. Results: Despite similar OHI-S scores (P > 0.05) in all groups, women of Group I had significantly higher gingival inflammation and SBI (P < 0.05) as compared to women of Group II and Group III. Furthermore, the women in Group I and Group II had statistically higher CAL (P < 0.05) as compared with the control group. Conclusion: Within the limits of this study, it can be concluded that altered hormonal levels in infertile women undergoing assisted reproductive therapy and infertile women not undergoing this treatment can lead to increased attachment loss, suggesting that these women may require constant periodontal monitoring. PMID:24748299
Lalasa, Godavarthi; Murthy, K Raja V; Pavankumar, Sandhya; Raju, Gottimukkala Atchyuta Rama
This paper examines the experiences of women with infertility in two Nigerian communities with different systems of descent and historically different levels of infertility. First, the paper focuses on the life experiences of individual women across the two communities and second, it compares these experiences with those of their fertile counterparts, in each community. In doing this, women who are childless are distinguished from those with subfertility and compared with high-fertility women. The research is based on interdisciplinary research conducted among the Ijo and Yakurr people of southern Nigeria, which included a survey of approximately 100 childless and subfertile women and a matching sample of 100 fertile women as well as in-depth ethnographic interviews with childless and subfertile women in two communities: Amakiri in Delta State and Lopon in Cross River State. The findings indicate that while there are variations in the extent to which childlessness is considered to be problematic, the necessity for a woman to have a child remains basic in this region.
LARSEN, ULLA; HOLLOS, MARIDA; OBONO, OKA; WHITEHOUSE, BRUCE
Background Body Image as a multidimensional entity is related to both physical and psychological aspects of the image one has of his or her own body. Lack/absence of an acceptable body image is one of the reasons of mental distress in infertile individuals. Methods In this study, an equal number (No=120) of fertile and infertile men attending Avicenna Infertility Clinic (AIC) were enrolled. The participants were compared in regard to body image variables based on the "Multidimensional Body-Self Relations Questionnaire (MBSRQ)" consisting of 10 subscales. Data was analyzed by SPSS, version 11.5, using Chi square and independent t-tests. Results Fertile men had a more positive body image as compared to infertile individuals. Significant statistical differences were observed when body image subscales were compared in both groups; in other words appearance evaluation, appearance orientation, Novy, health evaluation, health orientation, illness orientation, body satisfaction, overweight preoccupation and self-classified weight showed differences, while no significant difference was observed in regard to fitness orientation. Conclusion It seems that the ability and efficiency of body image is affected by infertility leading to dissatisfaction of one's body image.
Akhondi, Mohammad Mehdi; Dadkhah, Asghar; Bagherpour, Ahmad; Ardakani, Zohreh Behjati; Kamali, Kourosh; Binaafar, Sima; Kosari, Haleh; Ghorbani, Behzad
Endometriosis, PCOS, and unexplained infertility are currently the most common diseases rendering large numbers of women infertile worldwide. Oxidative stress, due to its deleterious effects on proteins and nucleic acids, is postulated to be the one of the important mechanistic pathways in differential expression of proteins and in these diseases. The emerging field of proteomics has allowed identification of proteins involved in cell cycle, as antioxidants, extracellular matrix (ECM), cytoskeleton, and their linkage to oxidative stress in female infertility related diseases. The aim of this paper is to assess the association of oxidative stress and protein expression in the reproductive microenvironments such as endometrial fluid, peritoneal fluid, and follicular fluid, as well as reproductive tissues and serum. The review also highlights the literature that proposes the use of the fertility related proteins as potential biomarkers for noninvasive and early diagnosis of the aforementioned diseases rather than utilizing the more invasive methods used currently. The review will highlight the power of proteomic profiles identified in infertility related disease conditions and their linkage with underlying oxidative stress. The power of proteomics will be reviewed with regard to eliciting molecular mechanisms for early detection and management of these infertility related conditions.
Gupta, Sajal; Sharma, Rakesh; Agarwal, Ashok
The relation between asymptomatic endometriosis and infertility was investigated in a randomised double blind placebo controlled trial of the impact of treating the endometriosis with gestrinone. The 12 month cumulative conception rate in those patients treated with gestrinone was 25% (5/20) and in those given placebo 24% (4/17). These same patients were divided into those in whom no visible endometriosis was present at the second laparoscopy and those in whom residual disease was present and the 12 month cumulative conception rates were 25% (4/16) and 30% (6/20) respectively. None of these rates differed significantly, and they compared with a rate of 23% (6/26) in a control group of patients with unexplained infertility. Those patients in whom the disease was eliminated did not return to normal fertility, though all other causes of infertility were excluded. This study failed to show any impact of treatment or the absence or presence of asymptomatic endometriosis on future fertility compared with patients with unexplained infertility. The findings therefore question any causal role of the disease in infertility.
Thomas, E J; Cooke, I D
Concerns exist regarding reproductive health, including potential infertility, among young adults with military-related occupational exposures. This study evaluated infertility diagnoses in a large population of healthy young adults in relation to prior s...
C. J. Sevick G. R. Gumbs I. G. Jacobson M. A. Ryan T. C. Smith
... May Help Women Fight a Leading Cause of Infertility: Study Letrozole improves pregnancy rates in women with ... Wednesday, July 9, 2014 Related MedlinePlus Pages Female Infertility Medicines Polycystic Ovary Syndrome WEDNESDAY, July 9, 2014 ( ...
There is no question that therapy for a varicocele in cases of male infertility improves the ejaculate quality. New data provide hints for an additional influence on the pregnancy rates in infertile partnerships. PMID:21898279
Weidner, W; Pilatz, A; Rusz, A; Altinkilic, B
Predicting infertility is central to reproductive biology, medicine and evolutionary biology. In-vitro studies suggest that oxidative sperm damage causes infertility. Oxidative sperm damage can be reduced via two fundamental pathways: the removal of oxygen radicals by antioxidants, or the interference with cell metabolism to reduce the formation of oxygen radicals. Oxidative damage protection of spermatozoa should evolve frequently, especially during female sperm storage. However, in-vivo evidence linking oxidative protection and fertility is rare. We show that the intra-sperm production rate of oxygen radicals and the sperm metabolic rate were reduced in female bedbugs, Cimex lectularius, compared to males, and females laid fertile eggs. Females became infertile when sperm oxygen radicals and sperm metabolic rate increased to male levels. Our results link female fitness to sublethal sperm damage, imply adaptive benefits of interfering with sperm metabolism and offer the hypothesis that polyandry may serve to replace low-quality sperm.
Reinhardt, Klaus; Ribou, Anne-Cecile
Biophysical analysis of semen was performed in fifty-eight Nigerian male partners of infertile marriages. Sperm count concentration was significantly higher (P < 0.001) in oligospermics compared to normospermics as expected. However, there was no significant difference in sperm volume or motility percentage between the normospermics and the oligospermics; of course, no sperms were seen in the azoospermics. Biochemical analyses of serum zinc, copper, magnesium, and manganese by atomic absorption spectrophotometry  were further correlated in fifty-two patients. There were no statistically significant differences observed in the serum levels of zinc, magnesium, and copper among the normospermics, oligospermics, and azoospermics. The normospermic infertile patients, however, exhibited higher serum manganese when compared with oligospermics and azoospermics (P < 0.001). This finding suggests a potential role for manganese in the evaluation of infertile males. PMID:10457793
Adejuwon, C A; Ilesanmi, A O; Ode, E O; Akinlade, K S
At present, it is estimated that fibroids may be associated with infertility in 5 to 10% and are possibly the sole cause of infertility in 1 to 3%. Their effects on fertility remain debated. The aim of this review of published studies between January 1990 and November 2010 was to clarify the relation between myoma and fertility, and to assess the role of myomectomy in infertile patients. In assisted reproduction technology and spontaneous conception, hysteroscopic sub-mucous myoma resection increased pregnancy rates. Intramural fibroids appear to decrease fertility, but the myomectomy does not improve assisted reproduction technology and spontaneous fertility. More high-quality studies are needed to conclude toward the value of myomectomy for intramural fibroids. Subserosal fibroids do not affect fertility outcomes, and removal does not confer benefit. PMID:22056193
Bendifallah, S; Brun, J-L; Fernandez, H
The investigation of male infertility is assuming greater importance, with male factors implicated as a causal factor in up to half of infertile couples. Following routine history, examination and blood tests, imaging is frequently utilised in order to assess the scrotal contents for testicular volume and morphology. Additionally, this may give indirect evidence of the presence of possible reversible pathology in the form of obstructive azoospermia. Further imaging in the form of transrectal ultrasound and MRI is then often able to categorise the level of obstruction and facilitate treatment planning without resort to more invasive imaging such as vasography. Ultrasound guidance of therapy such as sperm or cyst aspiration and vasal cannulation may also be performed. This article reviews the imaging modalities used in the investigation of male infertility, and illustrates normal and abnormal findings that may be demonstrated.
Ammar, T; Sidhu, P S; Wilkins, C J
It is often presumed that infertility is not a problem in resource-poor areas where fertility rates are high. This is challenged by consistent evidence that the consequences of childlessness are very severe in low-income countries, particularly for women. In these settings, childless women are frequently stigmatized, isolated, ostracized, disinherited and neglected by the family and local community. This may result in physical and psychological abuse, polygamy and even suicide. Attitudes among people in high-income countries towards provision of infertility care in low-income countries have mostly been either dismissive or indifferent as it is argued that scarce healthcare resources should be directed towards reducing fertility and restricting population growth. However, recognition of the plight of infertile couples in low-income settings is growing. One of the United Nation's Millennium Development Goals was for universal access to reproductive health care by 2015, and WHO has recommended that infertility be considered a global health problem and stated the need for adaptation of assisted reproductive technology in low-resource countries. This paper challenges the construct that infertility is not a serious problem in resource-constrained settings and argues that there is a need for infertility care, including affordable assisted reproduction treatment, in these settings. It is often presumed that infertility is not a problem in densely populated, resource-poor areas where fertility rates are high. This presumption is challenged by consistent evidence that the consequences of childlessness are very severe in low-income countries, particularly for women. In these settings, childless women are frequently stigmatized, isolated, ostracized, disinherited and neglected by the family and local community. This may result in physical and psychological abuse, polygamy and even suicide. Because many families in low-income countries depend on children for economic survival, childlessness and having fewer children than the number identified as appropriate are social and public health matters, not only medical problems. Attitudes among people in high-income countries towards provision of infertility care in low-income countries have mostly been either dismissive or indifferent as it is argued that scarce healthcare resources and family planning activities should be directed towards reducing fertility and restricting population growth. However, recognition of the plight of infertile couples in low-income settings is growing. One of the United Nation's Millennium Development Goals was for universal access to reproductive health care by 2015, and WHO has recommended that infertility be considered a global health problem and stated the need for adaptation of assisted reproduction technology in low-resource countries. In this paper, we challenge the construct that infertility is not a serious problem in resource-constrained settings and argue that there is a need for infertility care, including affordable assisted reproduction treatment, in these settings. PMID:23260034
Hammarberg, Karin; Kirkman, Maggie
Eight patient with male infertility due to isolated or combined with other defects anomaly--round-headed spermatozoa, have been studied. Five of them have been studied. Five of the patients have been sporadic cases, whereas three cases have been familial ones. 100% of the spermatozoa in ejaculates from the patients with familial infertility had morphology of round-headed spermatozoa with lack of any proteolytic activity. In the patients with sporadic infertility the round-headed spermatozoa represented between 60 and 95% of the ejaculated cells. All of the patients were studied by chromosomal analyses (G-banding) and revealed normal male karyotypes 46, XY. The ratio affected: unaffected males in the 8 families studied implicates a monogenetic mode of inheritance (Coefficient of heredity 0.57) of the sperm anomaly. The distribution of the affected males in the three pedigrees with familial character of globozoospermia supports X-linked, sex-restricted dominant, or autosomal recessive modes of inheritance. PMID:10360046
Stanislavov, R; Ganev, V
MicroRNAs (miRNAs) are small non-coding single stranded RNA molecules that are physiologically produced in eukaryotic cells to regulate or mostly down-regulate genes by pairing with their complementary base-sequence in related mRNA molecules in the cytoplasm. It has been reported that other than its function in many physiological cell processes, dysregulation of miRNAs plays a role in the development of many diseases. In this short review, the association between miRNAs and some male reproductive disorders is surveyed. Male factor Infertility is a devastating problem from which a notable percentage of couples suffer. However, the molecular mechanism of many infertility disorders has not been clearly elucidated. Since miRNAs have an important role in numerous biological cell processes and cellular dysfunctions, it is of interest to review the related literature on the role of miRNAs in the male reproductive organs. Aberrant expression of specific miRNAs is associated with certain male reproductive dysfunctions. For this reason, assessment of expression of such miRNAs may serve as a suitable molecular biomarker for diagnosis of those male infertility disorders. The presence of a single nucleotide polymorphism (SNP) at the miRNAs’ binding site in its targeted mRNA has been reported to have an association with idiopathic male infertility. Also, a relation with male infertility has been shown with SNP in the genes of the factors necessary for miRNA biogenesis. Therefore, focusing on the role of miRNAs in male reproductive disorders can further elucidate the molecular mechanisms of male infertility and generate the potential for locating efficient biomarkers and therapeutic agents for these disorders.
Khazaie, Yahya; Nasr Esfahani, Mohammad Hossein
Objective To estimate the effects of financial access and other individual characteristics on the likelihood that a woman pursues infertility treatment and the choice of treatment type. Data Source/Study Setting The 1995 National Survey of Family Growth. Study Design We use a binomial logit model to estimate the effects of financial access and individual characteristics on the likelihood that a woman pursues infertility treatment. We then use a multinomial logit model to estimate the differential effects of these variables across treatment types. Data Collection/Extraction Method This study analyzes the subset of 1,210 women who meet the definition of infertile or subfecund from the 1995 National Survey of Family Growth. Principal Findings We find that income, insurance coverage, age, and parity (number of previous births) all significantly affect the probability of seeking infertility treatment; however, the effect of these variables on choice of treatment type varies significantly. Neither income nor insurance influences the probability of seeking advice, a relatively low cost, low yield treatment. At the other end of the spectrum, the choice to pursue assisted reproductive technologies (ARTs)—a much more expensive but potentially more productive option—is highly influenced by income, but merely having private insurance has no significant effect. In the middle of the spectrum are treatment options such as testing, surgery, and medications, for which “financial access” increases their probability of selection. Conclusions Our results illustrate that for the sample of infertile of subfecund women of childbearing age studied, and considering their options, financial access to infertility treatment does matter.
Farley Ordovensky Staniec, J; Webb, Natalie J
Infertility is a problem of global proportions, affecting on average 8–12 percent of couples worldwide. In some societies, however—particularly those in the “infertility belt” of sub-Saharan Africa—as many as one-third of all couples are unable to conceive. Factors causing high rates of tubal infertility in parts of the developing world include sexually transmitted, postpartum, and postabortion infections; however, male infertility,
Marcia C. Inhorn
Idiopathic male infertility can be diagnosis in approximately one-third of infertile males. The empirical medical treatment with or without assisted reproductive techniques appears common in male infertility practice. This type of management can be classified as hormonal treatment including gonadotropins, antiestrogens, and aromatase inhibitors and support with antioxidant supplements such as carnitine, lycopene, glutathione, and vitamin E. This review investigates the evidence of commonly used empirical medical management of male infertility when there is no demonstrable diagnosis. PMID:24919031
Gudeloglu, Ahmet; Brahmbhatt, Jamin V; Parekattil, Sijo J
Nowadays, the efficiency of the infertility treatment is relatively low. One of the cues to counteract this problem relies on the optimum selection of spermatozoa. We developed a new method (sperm selection assay (SSA)) based on the chemical attraction of spermatozoa that are at the best functional state. Additionally, the SSA leads spermatozoa to complete and/or acquire the competence to fertilize the egg. These effects are equally observed either in normal or subfertile semen samples. Those capabilities of SSA may improve the success of current infertility treatment. PMID:23893154
Giojalas, Laura C
The inability to conceive a child is most often viewed as a private matter, but public health perspectives and skills can contribute greatly to our knowledge about infertility, and the development of effective and rational public policy for prevention, access to health care, and regulation of new technologies. We offer a primer of public health aspects of infertility in an effort to encourage the broad spectrum of public health professionals to become more knowledgeable about these topics and join in the national debate about preventive strategies, cost-benefit assessment, resource allocation, and ethics. Images p494-a p495-a p499-a p506-a
Fidler, A T; Bernstein, J
A 32-year-old man was referred to our hospital for primary infertility of a 4.5-year duration. Neither character nor intelligence disorders were observed. Bilateral testes measured 16 ml each. Sperm density was 0-0.1 x 10(6)/ml on 3 separate occasions. Endocrine examinations were all within normal limits. Maturation arrest was found on testicular biopsy. Karyotyping showed 47, XYY inversion. Polymerase chain reaction revealed no deletion of the azoospermic factor (AZF) gene on the Y chromosome. This is the 6th case reported in the Japanese literature of the 47XYY syndrome presenting with male infertility. PMID:9250495
Murakami, J; Baba, K; Minagawa, N; Kono, S; Yajima, M; Iwamoto, T
The association between varicoceles and male infertility has been known since the 1950s; however, the pathophysiology of the process remains uncertain. The primary proposed hypotheses involve hyperthermia, venous pressure, testicular blood flow, hormonal imbalance, toxic substances, and reactive oxygen species. It is difficult to identify a single or dominant factor, and it is likely that many of these factors contribute to the infertile phenotype seen in clinical practice. Moreover, patient lifestyle and genetic factors likely affect patient susceptibilities to the varicocele insult. While the current studies have weaknesses, they provide building blocks for futures studies into the pathophysiology of the varicocele.
Eisenberg, Michael L.; Lipshultz, Larry I.
Infertility in famale is one of the most important sequela of genital infection with Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum. In the present study the frequency of these bacteries was studied in 125 infertile female by direct and indirect immunofluorscence tests and culture method and compared with 250 normal population. Mycoplasma hominis was isolated from 32 (35.6%) of infertile
N Badami; MH Salari
BACKGROUND: A new technique called transvaginal hydrolaparoscopy (THL) was recently developed for the exploration of the tubo-ovarian structures in infertile patients without obvious pelvic pathology. This study was performed to investigate the usefulness of THL to evaluate Chlamydia trachomatis tubal infertility. METHODS: Forty-one women with primary and secondary infertility participated in this study. Fourteen had past C. trachomatis infection. In
Hiroaki Shibahara; Hiroyuki Fujiwara; Yuki Hirano; Tatsuya Suzuki; Hiromi Obara; Satoru Takamizawa; Sadayoshi Idei; Ikuo Sato
Despite the great number of studies conducted to examine the impact of infertility on the psychological status of women undergoing infertility treatment, little is known about the psychological impact of infertility when it is due to male or female factors and its role in the cause of higher levels of anxiety and stress. The aim of this cross?sectional study was
Katerina Lykeridou; Kleanthi Gourounti; Anna Deltsidou; Dimitrios Loutradis; Grigorios Vaslamatzis
Infertility in females is multifactorial in origin. Though hysterolaparoscopy is the gold-standard investigation, USG is usually the first-line investigation. MRI has expanded the usefulness of imaging in female infertility. This pictorial essay reviews the role of imaging in the evaluation of female infertility.
Chronic endometritis has been related to infertility and recurrent abortion. It is usually asymptomatic, and the diagnosis is rarely clinically suspected. We performed a prospective study to evaluate both the role of diagnostic hysteroscopy in the detection of chronic endometritis in infertile patients and Chlamydia trachomatis is a potential etiologic factor. Fifty consecutive patients who sought treatment for infertility in
Fernanda Polisseni; Eduardo A. Bambirra; Aroldo F. Camargos
Purposes To investigate the frequencies of AZF microdeletions and chromosomal abnormalities in infertile men from Northeastern China.\\u000a Moreover, to compare the prevalence of these abnormalities with other countries and regions in the world.\\u000a \\u000a \\u000a \\u000a \\u000a Methods 305 infertile men were enrolled. A complete semen analysis and reproductive hormones were measured according to standard methods.\\u000a Multiplex polymerase chain reaction (PCR) amplification using nine specific sequence-tagged
Rui-Xue Wang; Chao Fu; Ya-Ping Yang; Rong-Rong Han; Yuan Dong; Ru-Lin Dai; Rui-Zhi Liu
Most men with spinal cord injury (SCI) are infertile. Erectile dysfunction, ejaculatory dysfunction and semen abnormalities contribute to the problem. Treatments for erectile dysfunction include phosphodiesterase type 5 inhibitors, intracavernous injections of alprostadil, penile prostheses, and vacuum constriction devices. In anejaculatory patients who wish to father children, semen retrieval is necessary. Penile vibratory stimulation is recommended as the first line
Charles M. Lynne; Emad Ibrahim; Dana A. Ohl; Jens Sønksen; Nancy L. Brackett
This article describes the influence of ideological values on couples' experience of infertility. Contextual issues are considered in terms of how they influence medical decision making as well as emotional factors. Strength-based counseling interventions that attend to couples' diverse values are described. Last, implications for counselors,…
Burnett, Judith A.; Panchal, Krishna
In elongating spermatids, human sperm chromatin undergoes a complex compaction in which the transition proteins are extensively replaced by the protamine proteins. Several human studies demonstrate that expression of the protamine proteins is altered in some men with male infertility. For this study, we screened the PRM1 (protamine 1) gene for mutations in a large cohort of 281 men seeking infertility treatment. We identified the c.102G>T transversion that results in an p.Arg34Ser amino acid change in two men. One of these patients presented with oligozoospermia associated with increased sperm DNA fragmentation. The second individual was normospermic but together with his partner sought treatment for idiopathic couple infertility. We also identified a novel missense mutation (c.119G>A, p.Cys40Tyr) in a man with oligoasthenozoospermia. These mutations were not observed in control populations. Interestingly, we also detected variants both 5' and 3' to the PRM1 open-reading frame specifically in infertile individuals. Four individuals with unexplained severe oligozoospermia were heterozygote for a c.-107G>C change that is located at -15 bp from the transcription initiation site of the gene. This mutation may influence PRM1 expression. In addition, a c.*51G>C variant was detected in the 3'UTR of PRM1 specifically in a man with severe oligoasthenozoospermia. PMID:17494104
Ravel, C; Chantot-Bastaraud, S; El Houate, B; Berthaut, I; Verstraete, L; De Larouziere, V; Lourenço, D; Dumaine, A; Antoine, J M; Mandelbaum, J; Siffroi, J P; McElreavey, K
The mental status of 37 female patients with infertility and that of 37 healthy controls was evaluated using General Health Questionnaire, Present State Examination, and clinical assessment. An interview schedule, designed to elicit information on sociodemographic, psychiatric predisposing, and obstetric factors, was also administered. A significantly higher proportion (29.7%) of the patients was found to have diagnosable psychopathology, mainly depressive
H. S. Aghanwa; F. O. Dare; S. O. Ogunniyi
Throughout the 1980s and 1990s the crude human birth rate (live births per 1000 population) declined, indicating reduced fertility and suggesting a potential decline in fecundity (the potential to conceive). Detection of environmental contaminants in human tissues, together with reports of a global decline in semen quality, further fueled speculation that human infertility rates are increasing and environmental toxicants are
Warren G. Foster; Michael S. Neal; Myoung-Soek Han; Miguel M. Dominguez
Infertility creates challenges affecting various aspects of couples' intimate lives. Practices regarding reproduction are often shaped by cultural messages. Culturally sensitive treatment methods help counselors provide effective therapy to couples with fertility problems. This article describes cultural influences, challenges, and counseling…
Burnett, Judith A.
Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperitoneal surgery, diabetes, congenital spinal abnormalities, multiple sclerosis and spinal cord injury. Erectile dysfunction can be managed by an increasingly invasive range of treatments
Mikkel Fode; Sheila Krogh-Jespersen; Nancy L Brackett; Dana A Ohl; Charles M Lynne; Jens Sønksen
There has been a tremendous increase in the use of mobile phones in the past decade and concerns are growing about the possible hazardous effects of radio-frequency electromagnetic waves (EMW) emitted by these devices on human health. Preliminary studies, though with limitations in study design, suggest a possible link between cell phone use and infertility. A recent study found that
Fnu Deepinder; Kartikeya Makker; Ashok Agarwal
Objective: This study examines the relationship between body mass and the risk of spontaneous abortion in a large cohort of patients who received infertility treatment.Research Methods and Procedures: This is a retrospective study using data on pregnancies (n = 2349) achieved after treatment in a tertiary medical center from 1987 to 1999. One pregnancy per subject was included, and the
Jim X. Wang; Michael J. Davies; Robert J. Norman; Jim Wang
Sirolimus is an immunosupressor of the mammalian target of rapamycin inhibitors (mTOR-I) group. Recent studies have emphasized a potential impact of sirolimus on male gonadal function. We report our clinical experience with sirolimus-induced gonadal dysfunction and infertility in both male and female kidney transplant patients. Of the 170 kidney transplant patients, nine (5.3%) patients (six males and three females) were receiving sirolimus. Follow-up data for two male patients were not available. The one unmarried female patient developed amenorrhea post-transplantation and had resumption of her menstrual cycles after discontinuation of sirolimus. The remaining six married patients (four males and two females), who all had fathered or conceived children in the pre-transplantation period, developed gonadal dysfunction and infertility on average 5-12 months after transplantation. Sirolimus was discontinued in all four male patients with full recovery of the oligo/azospermia and restoration of fertility. Both married female patients developed amenorrhea post-transplantation. Sirolimus was discontinued in one female patient with resumption of her menstrual cycles. In this small population of patients treated with sirolimus, the prevalence rate of reversible gonadal dysfunction and infertility was significant in both males and females. Infertility secondary to sirolimus is under-diagnosed and should be studied further. PMID:19774480
Boobes, Yousef; Bernieh, Bassam; Saadi, Hussein; Raafat Al Hakim, M; Abouchacra, Samra
A study was conducted in 32 couples in the age group of 21-43 years, who had primary infertility ranging from 1-12 years. The female partner was given Evecare syrup at a dose of 2 teaspoonfuls for 6 months. The male partner was given Speman tablet at a dose of 2 tablets, twice daily for the same period. The females were
Nalini Ball; Kempe Gowda; Bangalore S. K. Shenoy; Geetha Bellyappa; V. Vijay Kumar
There is now substantial evidence that coeliac sprue is associated with infertility both in men and women. In women it can also lead to delayed menarche, amenorrhoea, early menopause, recurrent abortions, and a reduced pregnancy rate. In men it can cause hypogonadism, immature secondary sex characteristics and reduce semen quality. The real mechanism by which coeliac sprue produces these changes
K. S. Sher; V. Jayanthi; C. S. J. Probert; C. R. Stewart; J. F. Mayberry
Clinical trials in infertility choose from a variety of outcomes including change in some surrogate marker of gamete quality to healthy live birth. Incomplete reporting of outcomes makes it difficult to compare studies and to determine the clinical impact of infertility treatments. In this Views and Reviews, we explore the merits of collecting various outcomes of interest in infertility trials from the vantage point of infertility specialists, an obstetrician, and a pediatrician. These articles support more complete reporting of maternal, paternal, fetal, and infant outcomes from infertility trials to improve patient care and ultimately public health. PMID:24786738
Legro, Richard S; Wu, Xiaoke
Hysterosalpingography is the gold standard in assessing the patency of the fallopian tubes, which is among the most common causes of female factor infertility, making this technique the most frequent first-choice imaging modality in the assessment of female infertility. Ultrasonography and magnetic resonance imaging are typically used for evaluation of indeterminate or complicated cases of female infertility and presurgical planning. Imaging also plays a role in the detection of the secondary causes of ovarian factor infertility, including endometriosis and polycystic ovarian syndrome. PMID:24210439
Kaproth-Joslin, Katherine; Dogra, Vikram
The study examined the epidemiology and causes of infertility in Tomsk, Western Siberia, using methodological approaches recommended by WHO and was based on the findings for a randomly selected sample of 2000 married women aged 18-45 years. Among the respondents, 333 couples were considered infertile since they had not conceived after 12 months or more of unprotected intercourse. This group of infertile couples was offered comprehensive clinical investigations but only 186 couples completed them. The infertility rate in Tomsk was 16.7%, being caused by diseases of the female reproduction system in 52.7% of the couples and by male reproductive diseases in 6.4%. In 38.7% of couples, both spouses suffered from infertility, while in 2.2% of cases the cause of infertility was not determined. Among the causes of female infertility, secondary infertility dominated (12.9% of all the women questioned), while primary infertility affected 3.8% of the women. The most frequent causes of female infertility were disturbances to tubal patency (36.5%) and pelvic adhesions (23.6%). Endocrine pathology was found in 32.8% of cases. The most frequent cause of male infertility was inflammatory disease of male accessory glands (12.9%). In 8.6% of cases infection resulted in obstructive azoospermia. Varicocele was registered in 11.3% of cases, and idiopathic pathospermia in 20.9%. Inflammatory complications among females were 4.2 times more frequent than among males.
Philippov, O. S.; Radionchenko, A. A.; Bolotova, V. P.; Voronovskaya, N. I.; Potemkina, T. V.
Ninety five men who accompanied their wives to the fertility clinic of a Nigerian teaching hospital (index group) were compared with 95 matched controls using the Hospital Anxiety and Depression Scale (HADS). Their rates of significant anxiety symptoms (24.2%) and depressive symptoms (20.0%) were higher than the corresponding rates of 13.7% and 9.5% for the controls. The higher rate of significant depressive symptoms in the infertility group was significant (p < 0.05). Their mean scores on the two subscales of HADS (anxiety and depressive subscales) were also significantly higher (p < 0.001). Results of multiple regression analysis indicated that lower anxiety symptoms were predicted by age group among subjects in the index group, indicating that belonging to higher age groups was associated with lower anxiety symptoms. In addition, lower anxiety symptoms were predicted by 'being very religious'. However, higher anxiety symptoms were predicted by previous exposure to couple counselling. On the predictors of depressive symptoms, lower symptoms were predicted by age group and religiosity while higher symptoms were predicted by respondents' previous exposure to couple counselling and higher number of wives. Other factors investigated such as level of education, duration of infertility, attitude towards child adoption, pressure from extended family members on account of infertility, expectation of the respondents on the possible outcome of treatment and the result of semen analysis were not observed as predictors of anxiety and/or depressive symptoms. The observations on emotional distress among these men, together with previous observations that counselling/support received from gynecological consultations is usually inadequate indicates that the quality of psychological support that is available to them needs to be improved and modified. Involvement of mental health professionals (psychiatrists and clinical psychologists) in the provision of psychological couple counselling for infertility-related emotional distress could improve the quality of support provided. The establishment of special counselling units in hospitals providing treatment for infertility is advocated. PMID:19722430
Fatoye, F O; Eegunranti, B A; Owolabi, A T; Fatoye, G K
Gene targeting of the sperm nuclear proteins, the protamines, in mice leads to haploinsufficiency, abnormal chromatin compaction, sperm DNA damage, and male infertility. In order to investigate whether changes in amount or structure of the protamines could be a cause of human infertility, we sequenced the protamine genes of infertile men whose sperm appeared phenotypically similar to those of protamine deficient mice. We identified a heterozygous single nucleotide polymorphism (SNP) in the protamine (PRM1) gene in three infertile men (10% of the total infertile men analysed). This SNP disrupts one of the highly conserved arginine clusters needed for normal DNA binding. To rapidly screen for this SNP in infertile patients, we developed a simple PCR restriction fragment length polymorphism assay. This is the first report of a SNP in the PRM1 gene that appears associated with human male infertility. PMID:16199539
Iguchi, N; Yang, S; Lamb, D J; Hecht, N B
This study investigates the prevalence of Chlamydia trachomatis antibodies in 164 infertile women who underwent diagnostic laparoscopy and dye insufflation as part of routine infertility investigations. C. trachomatis antibodies were found in 36 (22%) of 164 infertile women, which was significantly more than the prevalence of antibodies in a control group (22 of 200, 11%). C. trachomatis antibodies were found in 25 (35.7%) of 70 infertile women who had laparoscopically verified peripheral tubal disease. This was significantly more than the prevalence of C. trachomatis antibodies in infertile women with normal fallopian tubes (6 of 52, 11.5%). The prevalence of C. trachomatis antibodies in infertile patients with laparoscopically verified cornual disease was similar to those without cornual disease. C. trachomatis was not isolated from any of the patients studied. This study confirms that past chlamydial salpingitis is associated with the development of peripheral fallopian tube obstruction with resultant infertility. PMID:6500077
Kane, J L; Woodland, R M; Forsey, T; Darougar, S; Elder, M G
Infertility is common in Africa. Anthropological studies conducted on the continent have found infertile women to have higher risks of marital instability and possibly more sex partners than fertile women. Findings are reported from a study conducted during 1994 and 1995 in a hospital in northwest Tanzania to determine the prevalence of HIV infection among infertile women. Women presenting with infertility problems to the outpatient clinic were interviewed, examined, and blood was drawn. Women who came to deliver in the hospital, excluding primiparae, comprised the control group. A total of 154 infertile and 259 fertile women were included in the study, all age 24 years and older. 18.2% of infertile women and 6.6% of fertile women were infected with HIV. Data on past sex behavior indicated that infertile women had more marital breakdowns, more lifetime sex partners, and a higher level of exposure to sexually transmitted diseases. PMID:9169179
Favot, I; Ngalula, J; Mgalla, Z; Klokke, A H; Gumodoka, B; Boerma, J T
Background Infertility is a complex issue that affects individuals and groups, and also it has serious implications for the mental and social well-being of those involved. The aim of this review was to assess marital relationship in the context of infertility, using data from infertile individuals or both couples. Methods A literature search was undertaken using multiple databases (Medline, PsycInfo and Scopus) to identify and synthesize all relevant literature published from 1990 to 2011. All studies in the systematic review were confirmed using specific inclusion criteria; the methodological quality of these studies were examined according to a checklist. Results Of the potential 794 articles, 18 studies were included in the final analysis, of which 6 were graded as high quality and 12 as moderate. The results indicated male factor infertility did not have a negative marital impact. In addition, infertile male participants expressed higher marital satisfaction than their wives. Infertile females had significantly less stable marital relationship compared to fertile females, which was associated with their socio-demographics and treatment experience. For infertile couples, the infertile subjects or their partners’ marital relationship was affected by either member's infertility, experience specifically coping strategies. Moreover other factors such as sexual satisfaction, age of the infertile couples, education level, and congruency of couples’ perceptions of infertility were associated with the quality of martial relationship. Conclusion Although the review can provide an outline of marital relationship in infertility, future studies should focus on the perspective from both infertile couple, across a range of different infertility types, including extended sample sizes and longitudinal study designs. In addition, more consideration should be given to qualitative study.
Tao, Peng; Coates, Rosemary; Maycock, Bruce
Folic acid supplements are commonly used by infertile women which leads to a positive folate status. However, the effect of folic acid supplements on pregnancy outcome in women with unexplained infertility has not been well investigated. This study evaluated folic acid supplement use and folate status in women with unexplained infertility in relation to IVF pregnancy outcome. In addition, use of folic acid supplements and folate status were compared between women with unexplained infertility and fertile, nonpregnant control women. Women with unexplained infertility used significantly more folic acid supplements and had higher median total folic acid intake from supplements compared with fertile control women (both P<0.001). Women with unexplained infertility also had significantly higher median plasma folate and lower median plasma homocysteine concentrations than fertile women (both P<0.001), but folic acid supplementation or folate status were not related to pregnancy outcome in women with unexplained infertility. In conclusion, folic acid supplementation or good folate status did not have a positive effect on pregnancy outcome following infertility treatment in women with unexplained infertility. Folate is one of the B vitamins which has been suggested to be related to infertility. Folic acid is an artificial form of folate which is commonly used in dietary supplements. Folic acid supplementation has been shown to increase folate concentrations and decrease concentrations of the amino acid homocysteine in the blood. Folic acid supplementation is commonly used by infertile women, but the effect on pregnancy outcome in women with a diagnosis of unexplained infertility has not been thoroughly investigated. In the present study, folic acid supplement use and folate status (concentrations of folate and homocysteine) in women with unexplained infertility were evaluated in relation to pregnancy outcome. In addition, the use of folic acid supplements and folate status were compared between women with unexplained infertility and fertile control women. Our results showed that women with unexplained infertility used considerably more folic acid supplements and had higher total folic acid intake from supplements compared with fertile control women. Women with unexplained infertility had better blood folate and homocysteine concentrations than fertile women, but folic acid supplementation or folate status were not related to pregnancy outcome following the infertility treatment. In conclusion, high folic acid intake or good folate status did not increase the possibility of a birth of a healthy baby after infertility treatment in women with unexplained infertility. PMID:24745837
Murto, T; Skoog Svanberg, A; Yngve, A; Nilsson, T K; Altmäe, S; Wånggren, K; Salumets, A; Stavreus-Evers, A
Background Indonesia has high levels of biological need for infertility treatment, great sociological and psychological demand for children, and yet existing infertility services are underutilized. Access to adequate comprehensive reproductive health services, including infertility care, is a basic reproductive right regardless of the economic circumstances in which individuals are born into. Thus, identifying and implementing strategies to improve access to assisted reproductive technology (ART) in Indonesia is imperative. The principle objectives of this article are to improve our understanding of infertility patients’ patterns of health seeking behaviour and their patterns of access to infertility treatment in Indonesia, in order to highlight the possibilities for improving access. Methods An interviewer-administered survey was conducted with 212 female infertility patients recruited through three Indonesian infertility clinics between July and September 2011. Participants were self-selected and data was subject to descriptive statistical analysis. Results Patients identified a number of barriers to access, including: low confidence in infertility treatment and high rates of switching between providers due to perceived treatment failure; the number and location of clinics; the lack of a well established referral system; the cost of treatment; and patients also experienced fear of receiving a diagnosis of sterility, of vaginal examinations and of embarrassment. Women’s age of marriage and the timing of their initial presentation to gynaecologists were not found to be barriers to timely access to infertility care. Conclusions The findings based on the responses of 212 female infertility patients indicated four key areas of opportunity for improving access to infertility care. Firstly, greater patient education about the nature and progression of infertility care was required among this group of women. Secondly, increased resources in terms of the number and distribution of infertility clinics would reduce the substantial travel required to access infertility care. Thirdly, improvements in the financial accessibility of infertility care would have promoted ease of access to care in this sample. Finally, the expansion of poorly developed referral systems would also have enhanced the efficiency with which this group of patients were able to access appropriate care.
Background: Tubal factor remains a common cause of infertility. The association of HIV infection and tubal infertility is a cause for concern. Objective: To determine hysterosalpingographic tubal abnormalities and HIV infection among patients with tubal infertility. Results: Over a 4-year period, 207 patients were analyzed. Of these, 174 (84.1%) presented with secondary infertility and 33 (15.9%) with primary infertility. The
Adebiyi Gbadebo Adesiyun; C. A. Ameh; A. Eka
Background Awareness of infertility risk factors is an essential first step to safeguard future fertility. Whereas several studies have examined university students’ awareness of female fertility and related risk factors, the topic of male infertility has not been well examined. The objective of this study was to assess young men and women’s awareness, knowledge and perceptions of infertility, male and female infertility risk factors and assisted reproductive technologies (ART). Methods Semi-structured interviews were conducted in 2008 with a multi-ethnic sample of sixteen male and twenty-three female Ottawa university students, followed by qualitative data analysis to identify major themes. Interview topics included awareness of male and female infertility risk factors, infertility diagnosis/treatments and personal options in the event of future infertility. Results Participants were generally familiar with infertility as a biomedical health problem, could identify sex-specific risk factors but overestimated fertility of women in their thirties and ART success rates. Reproductive health knowledge gaps and confusion of the physiological life-stage of menopause with infertility were apparent. Most participants would pursue in vitro fertilization or international adoption in the event of personal infertility. Some participants wished to use a ‘natural’ approach and were concerned with potential side effects of ART-related medications. Conclusions The general awareness of infertility in young adults is promising and supports the potential uptake for health promotion of fertility preservation. This study underscores the continued need for comprehensive sexual and reproductive health education and promotion for adolescents and young adults.
Infertility is a distressing health condition that has diverse effects on couples' lives. One of the most affected aspects of life in infertile women is sexual function, which is a key factor in physical and marital health. The goal of this study was to evaluate sexual function according to the type of infertility in comparison with controls. In this study, 191 women with primary infertility and 129 with secondary infertility along with 87 age-matched healthy controls were enrolled. They were asked to fill a valid and reliable FSFI (Female Sexual Function Index). Age, partner age and duration of marriage were significantly different between the primary and secondary infertility groups. The score of each FSFI domain was significantly higher in the control group, and the only significant difference between primary and secondary infertility groups was in the desire domain. Multiple linear regression analysis between the total FSFI score as a dependent variable and age, partner age, Body Mass Index and marriage duration as independent variables showed that age is a dependent predictor of FSFI in the primary group. We found significant negative correlation between total FSFI score and age, partner age and marriage duration (r1=-0.21 and P<0.001, r2=-0.14 and P=0.01, r3=-0.19 and P<0.001). Sexual dysfunction is high in all infertile women, and women with secondary infertility suffer more from impaired sexual function compared with those with primary infertility. PMID:24430276
Davari Tanha, F; Mohseni, M; Ghajarzadeh, M
Background A cross sectional study was designed to survey the relationship between anxiety/depression and duration/cause of infertility, in Vali-e-Asr Reproductive Health Research Center, Tehran, Iran. Methods After obtaining their consents, 370 female patients with different infertility causes participated in, and data gathered by Beck Depression Inventory(BDI) and Cattle questionnaires for surveying anxiety and depression due to the duration of infertility. This was studied in relation to patients' age, educational level, socio-economic status and job (patients and their husbands). Results Age range was 17–45 years and duration and cause of infertility was 1–20 years. This survey showed that 151 women (40.8%) had depression and 321 women (86.8%) had anxiety. Depression had a significant relation with cause of infertility, duration of infertility, educational level, and job of women. Anxiety had a significant relationship with duration of infertility and educational level, but not with cause of infertility, or job. Findings showed that anxiety and depression were most common after 4–6 years of infertility and especially severe depression could be found in those who had infertility for 7–9 years. Conclusions Adequate attention to these patients psychologically and treating them properly, is of great importance for their mental health and will improve quality of their lives.
Ramezanzadeh, Fatemeh; Aghssa, Malek Mansour; Abedinia, Nasrin; Zayeri, Farid; Khanafshar, Navid; Shariat, Mamak; Jafarabadi, Mina
Women with prior pregnancy but no live birth are inconsistently termed as either 'primary infertile' or 'secondary infertile' in psychosocial studies of infertile women. The goal of this study was to discover whether infertile women who had experienced pregnancies but no live births were more similar in attitudes and behaviour to infertile women who had not experienced pregnancies or to those who had live births. We used the National Survey of Fertility Barriers (NSFB), which contains self-reported data from a probability-based sample of US women aged between 25 and 45, to accomplish our goal. In this cross-sectional analysis, infertile women who had not experienced pregnancies were compared on the basis of fertility-specific distress (FSD) and medical help-seeking for infertility to women who had had pregnancies with live births and women with pregnancies but no live births. Women were interviewed by telephone in their homes. Data of 1,027 women who had had an infertility episode within the past 10 years were analysed using multiple regression and logistic regression. Infertile women who had never been pregnant experience higher levels of FSD and were more likely to seek treatment than infertile women who had been pregnant, regardless of the outcome of the pregnancy. PMID:21732891
Greil, Arthur L; Johnson, Katherine M; McQuillan, Julia; Lacy, Naomi
Quality management according to ISO 9001:2008 guidelines includes infertility care quality assessment and improvement. This study aimed to describe the development process of a questionnaire for infertility management. A literature review, qualitative interviews with experts and patients resulted in a content-valid and face-valid questionnaire. Three cross-sectional surveys were performed in 2004, 2007 and 2008 in a tertiary university infertility centre. First (2004), the questionnaire – measuring eight a-priori dimensions of infertility management – was tested. Second (2007), improvement projects for infertility management were evaluated. Third (2008), factor analysis was performed and internal consistency was documented. The developed patient questionnaire to evaluate infertility management and pre-set desired levels of agreement served to set targets for and assess quality improvement projects. The final patient questionnaire to evaluate infertility management within an ISO framework was valid and reliable and contained 14 items covering four dimensions of infertility management: Telephone Access, Reception, Information and Patient-centeredness. ISO 9001:2008-certified infertility centres can evaluate infertility management with this 14-item questionnaire. This top-down approach to evaluate the patients’ perspective on quality aspects selected by health professionals can be complementary to the bottom-up approach evaluating the patients’ complete experiences of quality of care. PMID:22285240
Van den Broeck, Uschi; Spiessens, Carl; Dancet, Eline; Bakelants, Els; Vrancken, Annelies; Demyttenaere, Koen; Enzlin, Paul; D'Hooghe, Thomas
Objective. To study incidence of abnormal hysteroscopic findings according to age. Methods. We retrospectively studied 557 consecutive office hysteroscopies in patients referred for incapacity to conceive lasting at least 1 year or prior to in vitro fertilization. Rates of abnormal findings were reviewed according to age. Results. In 219 cases, hysteroscopy showed an abnormality and more than a third of our population had abnormal findings that could be related to infertility. Rates of abnormal findings ranged from 30% at 30 years to more than 60% after 42 years. Risk of abnormal finding was multiplied by a factor of 1.5 every 5 years. Conclusion. Our data are an additional argument to propose office hysteroscopy as part of first-line exams in infertile woman, regardless of age.
Koskas, Martin; Mergui, Jean-Luc; Yazbeck, Chadi; Uzan, Serge; Nizard, Jacky
Objective. To study incidence of abnormal hysteroscopic findings according to age. Methods. We retrospectively studied 557 consecutive office hysteroscopies in patients referred for incapacity to conceive lasting at least 1 year or prior to in vitro fertilization. Rates of abnormal findings were reviewed according to age. Results. In 219 cases, hysteroscopy showed an abnormality and more than a third of our population had abnormal findings that could be related to infertility. Rates of abnormal findings ranged from 30% at 30 years to more than 60% after 42 years. Risk of abnormal finding was multiplied by a factor of 1.5 every 5 years. Conclusion. Our data are an additional argument to propose office hysteroscopy as part of first-line exams in infertile woman, regardless of age. PMID:20396413
Koskas, Martin; Mergui, Jean-Luc; Yazbeck, Chadi; Uzan, Serge; Nizard, Jacky
The assessment of the fallopian tubes patency is an important moment in the investigation for infertility. Vaginal sonographic hydrotubation was assessed in the evaluation of uterine configuration and tubal patency. In addition, technique using "agitated" saline during transvaginal sonography was evaluated. Ultrasound was more effective in detecting abnormalities of both interstitial and distal parts of the tube compared with hysterosalpingography. Sonohysterosalpingography is cheaper, may be performed in the office and also the pelvic irradiation is avoided. PMID:14756031
Lupa?cu, Ivona; Veghe?, Simina; Solomi?chi, Valeria; David, Cristina; Boian, Iuliana
Sirolimus is an immunosupressor of the mammalian target of rapamycin inhibitors (mTOR-I) group. Recent studies have emphasized\\u000a a potential impact of sirolimus on male gonadal function. We report our clinical experience with sirolimus-induced gonadal\\u000a dysfunction and infertility in both male and female kidney transplant patients. Of the 170 kidney transplant patients, nine\\u000a (5.3%) patients (six males and three females) were
Yousef Boobes; Bassam Bernieh; Hussein Saadi; M. Raafat Al Hakim; Samra Abouchacra
48,XXYY syndrome is a rare form of sex chromosomal aneuploidy. Usually considered as a variant of Klinefelter syndrome because of shared features (azoospermia, tall stature, hypergonadotropic hypogonadism), it is a separate entity because diagnostic is currently made in prepubertal boy with neuro-psychological disorders. We here report the case of a 48,XXYY patient consulting for adult infertility and the indication to perform testicular sperm extraction is discussed. PMID:24934769
Roche, C; Sonigo, C; Benmiloud-Tandjaoui, N; Boujenah, J; Benzacken, B; Poncelet, C; Hugues, J-N
Our purpose was to define the best way of treating tubal infertility caused by endometriosis. We have studied 24 patients with tubal infertility caused by endometriosis; the etiology has been laparoscopically established in the 2nd Clinic of Obstetrics and Gynecology Ia?i. The endometriosis score (r-AFS) was used to establish the therapy. We performed laparoscopic treatment when endometriosis was visible. Postoperative medical therapy (Diphereline, 3 months) was indicated; patients with ,,unpigmented endometriosis" received the same medical therapy. The rate of pregnancies in patients that had benefit of combined therapy: surgical and medical (n=9) was superior (44.4%) to that obtained in patients that were only surgical treated (n=15): 26.6% (Spearman correlation--0.6595, p < 0.0012). Endometriosis is an important etiological factor in female infertility. The pathway is mechanic as well as chemical and it justifies the combined therapy. There are better results, as fertility prognosis in patients with endometriosis that receive both, surgical and medical therapy. PMID:16607747
Veghe?, Simina; Lupa?cu, Ivona; David, Cristina; Vi?an, Valeria; Vasiliu, Veronica
Oligo- and azoospermia are severe forms of male infertility. However, known genetic factors account only for a small fraction of the cases. Recently, whole-exome sequencing in a large consanguineous family with inherited premature ovarian failure (POF) identified a homozygous frameshift mutation in the STAG3 gene leading to a premature stop codon. STAG3 encodes a meiosis-specific subunit of the cohesin complex, a large proteinaceous ring with DNA-entrapping ability that ensures sister chromatid cohesion and enables correct synapsis and segregation of homologous chromosomes during meiosis. The pathogenicity of the STAG3 mutations was functionally validated with a loss-of-function mouse model for STAG3 in oogenesis. However, and since none of the male members of this family was homozygous for the mutant allele, we only could hypothesized its putative involvement in male infertility. In this report, we show that male mice devoid of Stag3 display a severe meiotic phenotype that includes a meiotic arrest at zygonema-like shortening of their chromosome axial elements/lateral elements, partial loss of centromeric cohesion at early prophase and maintenance of the ability to initiate but not complete RAD51- and DMC1-mediated double-strand break repair, demonstrating that STAG3 is a crucial cohesin subunit in mammalian gametogenesis and supporting our proposal that STAG3 is a strong candidate gene for human male infertility. PMID:24608227
Llano, Elena; Gomez-H, Laura; García-Tuñón, Ignacio; Sánchez-Martín, Manuel; Caburet, Sandrine; Barbero, Jose Luis; Schimenti, John C; Veitia, Reiner A; Pendas, Alberto M
The Hippocratic text 'On the winds, waters and places' contains a fairly long description of an ancient Scythian tribe, the nomadic Sauromats. In this tribe the gender roles appear to have been inverted to some degree. The virgin women fight from horseback with swords, bows and arrows, and are not allowed to marry before they have killed three enemies. The married women are often infertile. The Hippocratic author ascribes this to the pronounced fatness of these women. Many men suffer from impotence and as a consequence dress as women, talk like them and carry out feminine household work. The Hippocratic author emphasises that the male impotence and the female infertility stem from the cold, damp climate and the Scythians' way of living, particularly the men spending most of their time riding. In contrast Herodotus states that the male impotence is Aphrodite's revenge because the Scythians ravaged her temple in Ascalon many years earlier. The difference between the Hippocratic emphasis on natural explanations for all natural phenomena, including health and disease and the occasional divine intervention promoted by Herodotus is underlined. There seems to be no plausible modern explanation for the impotence and infertility as described by the Hippocratic author. PMID:22332473
Infertile men have higher levels of semen reactive oxygen species (ROS) than do fertile men. High levels of semen ROS can cause sperm dysfunction, sperm DNA damage and reduced male reproductive potential. This observation has led clinicians to treat infertile men with antioxidant supplements. The purpose of this article is to discuss the rationale for antioxidant therapy in infertile men and to evaluate the data on the efficacy of dietary and in vitro antioxidant preparations on sperm function and DNA damage. To date, most clinical studies suggest that dietary antioxidant supplements are beneficial in terms of improving sperm function and DNA integrity. However, the exact mechanism of action of dietary antioxidants and the optimal dietary supplement have not been established. Moreover, most of the clinical studies are small and few have evaluated pregnancy rates. A beneficial effect of in vitro antioxidant supplements in protecting spermatozoa from exogenous oxidants has been demonstrated in most studies; however, the effect of these antioxidants in protecting sperm from endogenous ROS, gentle sperm processing and cryopreservation has not been established conclusively.
Zini, Armand; Al-Hathal, Naif
Infertility in men is a common condition. At the core of the medical evaluation of the male partner in a couple who are unable to conceive is the history and physical examination. Special attention should be directed to the patient’s developmental history and any use of testosterone products. The physical examination focuses on the genitals, and includes assessments of the size and consistency of the testicles, epididymis, vas deferens, and presence of varicoceles. Although many sophisticated tests are available, semen analysis is still the most important diagnostic tool used to assess fertility, and includes parameters such as sperm count, motility and viability. Treatment of male factor infertility can involve targeted agents, in the case of specific conditions such as hypogonadotropic hypogonadism, or it can be empirical—using medical therapy or assisted conception techniques—for patients in whom no underlying cause has been identified. Although an all-encompassing treatment for male factor infertility has not yet been developed, the field offers many promising avenues of research.
Hwang, Kathleen; Walters, R. Chanc; Lipshultz, Larry I.
Although myomectomy is widely accepted in women of childbearing age who wish to retain their fertility, the extent to which myomas affect fertility and whether their removal improves this remain unclear. This study aimed to elucidate the favourable surgical approach in women with uterine myomas and infertility. This retrospective, follow-up study was carried out in three centres in Germany. Data on women who had undergone myomectomy via laparoscopy, laparotomy or conversion to laparotomy in 2000-04 were collected and analysed. Fertility outcome after myomectomy was assessed by follow-up postal questionnaire in a subgroup of women with myoma-associated infertility. Data on 159 women with otherwise unexplained infertility were included (mean age 35 years (range 17-47), mean number of myomas 2.4 (range 1-8) and mean myoma size 6.1 cm (range 0.5-20)). Women who underwent laparoscopy had fewer complications. 39.6% (63/159) of women completed the questionnaire, which showed that the pregnancy rate after myomectomy was 46% in this group. No uterine rupture occurred. Laparoscopy is associated with fewer postoperative complications and since no preoperative or intraoperative factors seem to influence the fertility outcome in women with uterine myomas, it is the treatment of choice in these patients. PMID:21247253
Hackethal, Andreas; Westermann, Anne; Tchartchian, Garri; Oehmke, Frank; Tinneberg, Hans-Rudolf; Muenstedt, Karsten; Bojahr, Bernd
Transgenic mice with male infertility, the c-ros knockout (KO) and GPX5-Tag2 transgenic mouse models, are compared. Both exhibit severely angulated sperm flagella explaining the infertility. As angulated spermatozoa are swollen cells, a failure in volume regulation is indicated. Differences between genotypes were also found: caudal spermatozoa from c-ros KO, but not GPX5-Tag2, could fertilise eggs in vitro; flagellar angulation occurred more within the epididymis of GPX5-Tag2 than c-ros KO mice; the osmotic pressure of cauda epididymidal fluid was lower only in GPX5-Tag2 mice; angulation of caudal sperm from c-ros KO, but not GPX5-Tag2 mice, decreased upon demembranation. These observations indicate that GPX5-Tag2 mice express an earlier, more severe defect. Gene chip analyses of the epididymides revealed decreased expression of the CRES (cystatin-related epididymal-spermatogenic) and MEP17 (murine epididymal protein 17) genes in both genotypes. Further analysis could pinpoint genes essential for epididymal regulation of sperm volume, explain infertility and suggest modes of male contraception. PMID:15109745
Cooper, Trevor G; Yeung, Ching-Hei; Wagenfeld, Andrea; Nieschlag, Eberhard; Poutanen, Matti; Huhtaniemi, Ilpo; Sipilä, Petra
Imaging plays a key role in the diagnostic evaluation of women for infertility. The pelvic causes of female infertility are varied and range from tubal and peritubal abnormalities to uterine, cervical, and ovarian disorders. In most cases, the imaging work-up begins with hysterosalpingography to evaluate fallopian tube patency. Uterine filling defects and contour abnormalities may be discovered at hysterosalpingography but typically require further characterization with hysterographic or pelvic ultrasonography (US) or pelvic magnetic resonance (MR) imaging. Hysterographic US helps differentiate among uterine synechiae, endometrial polyps, and submucosal leiomyomas. Pelvic US and MR imaging help further differentiate among uterine leiomyomas, adenomyosis, and the various müllerian duct anomalies, with MR imaging being the most sensitive modality for detecting endometriosis. The presence of cervical disease may be inferred initially on the basis of difficulty or failure of cervical cannulation at hysterosalpingography. Ovarian abnormalities are usually detected at US. The appropriate selection of imaging modalities and accurate characterization of the various pelvic causes of infertility are essential because the imaging findings help direct subsequent patient care. PMID:19755600
Steinkeler, Jill A; Woodfield, Courtney A; Lazarus, Elizabeth; Hillstrom, Mary M
Management of polycystic ovary syndrome (PCOS) usually spans a woman's reproductive years. While treatment of androgenic symptoms is often a primary concern, periodically, the regimen has to be modified because of a desire for pregnancy. At this time the couple should be evaluated for factors that may contribute to infertility and this should include semen analysis. However, for many, anovulation is likely to be the cause of infertility and ovulation induction is generally required. The premise on which ovulation induction in PCOS is based is two-fold: increasing ovarian exposure to follicle stimulating hormone (FSH) and/or correcting hormonal derangements. Potential differences in pathogenesis, evidenced clinically by phenotypic diversity, would suggest that treatment should be individualized. After a brief overview of factors relating to infertility, this paper outlines treatments available for ovulation induction in women with PCOS and provides a critical appraisal of management options. These options include the use of clomiphene citrate, insulin sensitizers, and the combination. Protocols for ovulation induction with FSH injections are outlined and the relative risks of multiple gestation and severe ovarian hyperstimulation syndrome of these various protocols discussed. The use of aromatase inhibitors and the occasional use of glucocorticoids are briefly reviewed, and indications for in vitro fertilization and laparoscopic ovarian diathermy outlined. Pregnancy outcome in this patient population is also discussed. PMID:21178917
We are maintaining two obese mutant rat strains (WNIN/Ob and WNIN/GR-Ob) in our animal facility since 1997. These rat colonies are perpetuated by crossing heterozygous littermates, since the obese phenotypes of both genders turned out be infertile. The present study revealed the reasons for this infertility. The male obese rats, though appeared normal in terms of sperm count, sperm motility and testis histology, however found wanting in terms of libido. This appeared to be due to low circulating testosterone levels seen in these animals, which should also account for low testis and accessory gland weights seen in them. The females exhibited delayed puberty, in terms of days taken for opening of vagina, irregular oestrus cycles and had small ovaries and short and stumpy uterine horns. The FSH peak observed in control lean animals during oestrus stage of the sexual cycle and also the E2 peak of normal oestrus cycle was conspicuously absent in these animals. They also showed elevated levels of progesterone throughout the sexual cycle. Thus the infertility seen in these mutants could be attributed to their abnormal gonadosteroid levels and the resulting anatomical and physiological defects.
Harishankar, Nemani; Ravinder, Punjal; Nair, K. Madhavan; Giridharan, Nappanveettil
Male factors are implicated in up to 50% of couples being evaluated and treated for infertility with advanced assisted reproductive technologies. Genetic abnormalities, including sperm chromosome aneuploidy as well as structural aberrations, are one of the major causes of infertility. The use of chromosome-specific DNA probes labeled with fluorochromes, particularly the combination with multiple probes, has been used to indirectly study the sperm chromosome by fluorescent in situ hybridization (FISH). Clinically, this technique is also used to assess the sperm of men recovering from gonadotoxic treatment. Recent advances in this technology facilitate the evaluation of sperm aneuploidy. Sperm FISH is a widely used screening tool to aid in counseling couples with severe male factor infertility, especially in cases of prior repeated in vitro fertilization/intracytoplasmic sperm injection failure or recurrent pregnancy loss. Automation of FISH imaging and analysis, as well as the development of emerging techniques such as comparative genomic hybridization, will all contribute to the promise of future diagnostic approaches aimed at improving the quality, ease, and efficiency of aneuploidy analysis.
Hwang, Kathleen; Weedin, John W.; Lamb, Dolores J.
Introduction Intrauterine fetal bone retention is a rare complication and the bony fragments probably work like an intrauterine contraceptive device resulting in secondary infertility. Among the scarcely reported cases in the literature, there was no report described the retention of a large number of fetal bones with nearly intact morphology. Case presentation The present report described an unusual case of fetal bone retention in a 30-year-old infertile Chinese woman who had a surgical termination of a 15-week pregnancy 9 years ago. The routine B-ultrasound diagnosed intrauterine foreign bodies. A hysteroscopy was performed which showed a large number of intrauterine bony fragments, with clear fetal skeletal outline and intact morphology. The detected residual fetal bones were removed under hysteroscopy, assisted by B-ultrasound scanning. The patient was pregnant 5 months later. The present case confirms the importance of routine examination of the intactness of the fetus after abortion, particularly when it happens in pregnancies of more than 12 weeks. Once diagnosed, the detected residual fetal bones should be removed by surgery, mainly under hysteroscopy. Conclusions The retention of fetal bone may cause infertility, and removal of the residual bone may restore fertility. The improvement in hysteroscopy made it feasible to diagnose and remove the bones. The present case highlights the importance of examining the intactness of the removed fetus.
Yq microdeletions are the leading genetic cause of male infertility and its detection in clinically relevant for appropriate genetic counseling. The objective of this study was to determine the frequency of Y microdeletion in a group of Tunisian infertile men and to compare the prevalence of these abnormalities with other countries and other Tunisian reported series. Totally, 105 Tunisian idiopathic infertile men (74 azoospermic and 31 severe oligozoospermic) were screened for the presence of Y chromosome microdeletions. The screening of Yq microdeletions was performed by two multiplex PCRs using six STS markers recommended by the EAA/EMQN. No microdeletions were detected in the men with severe oligozoospermia. In the azoospermic group, 2/74 (2.7%) patients showed Y chromosome microdeletions. Both had complete deletion of the AZFc region. No microdeletion was identified in the AZFa region or in the AZFb region. The estimated frequency of Y chromosome microdeletions in the present survey was similar to some other reports but lower than that of previous reports in Tunisian populations. PMID:24876144
Hammami, Wajih; Kilani, Olfa; Ben Khelifa, Mariem; Ayed, Wiem; Abdelhak, Sonia; Bouzouita, Abderrezzak; Zhioua, Fethi; Amouri, Ahlem
Background. The prevalence of infertility in Pakistan is 22% with primary infertility at 4% and secondary infertility at 18%. This study explored perceptions and experiences of women in Karachi, Pakistan regarding the causes, treatment-seeking behavior for and consequences of secondary infertility. Methods. Focus group discussions and in-depth interviews with married women explored their perceptions and experiences for issues related to secondary infertility. Results. The knowledge of women about the causes and scientific treatment options for infertility was limited resulting in inclination for traditional unsafe health care. Infertility was stated to result in marital instability, stigmatization and abuse specially for women with no live child. Conclusions. Since infertility can have a serious effect on both the psychological well-being and the social status of women in Pakistan, effective interventions are the need of the day. There is a dire need for health education and counseling to be integrated into infertility management plans.
Sami, Neelofar; Saeed Ali, Tazeen
The study reported in this paper explores how infertile women cope with infertility using their religious and spiritual beliefs. In total, 30 infertile women affiliated to different denominations of Christianity and Islam were interviewed in the UK and Iranian fertility clinics using grounded theory. The categories which emerged included governing ones' 'Self' through gaining control of emotions, adopting religious coping strategies, and handling the burden of infertility peacefully, which all related to the core category of 'relying on a higher being'. We argue that infertile women employ a variety of religious and spiritual coping strategies which are associated with adaptive health outcomes. Further scientific inquiry is required to investigate how religion and spirituality promote adaptation to infertility. PMID:24869428
Latifnejad Roudsari, Robab; Allan, Helen T; Smith, Pam A
In male mice heterozygous for a null apolipoprotein B (apoB), allele infertility was noticed. These data led us to investigate a pos- sible role of APOB gene polymorphism and male infertility in humans. In this case-control study, we searched for an association between the insertion\\/deletion (I\\/D) polymorphism of the APOB gene and male infertility in 560 Slovene Caucasian men. The
B. Peterlin; B. Zorn; M. Volk; T. Kunej
Objective: To compare the diagnostic accuracy, pain scores, and procedure length of outpatient hysteroscopy (OHS), hysterosalpingography (HSG), and saline infusion hysterosonography (SIS) for evaluation of the uterine cavity of infertile women.Design: Prospective, randomized, investigator-blind study.Setting: Tertiary infertility clinic.Patient(s): Forty-six consecutive infertile women.Intervention(s): Outpatient HSG, OHS, and SIS, followed by operative hysteroscopy (HS).Main Outcome Measure(s): Uterine abnormalities, procedure length, and subjective
Samuel E Brown; Charles C Coddington; John Schnorr; James P Toner; William Gibbons; Sergio Oehninger
Tubal factor infertility accounts for a large portion of female factor infertility. The most prevalent cause of tubal factor infertility is pelvic inflammatory disease and acute salpingitis. The diagnosis of tubal occlusion can be established by a combination of clinical suspicion based on patient history and diagnostic tests, such as hysterosalpingogram, sonohysterosalpingography, and laparoscopy with chromopertubation. Depending on several patient factors, tubal microsurgery or more commonly in vitro fertilization with its improving success rates are the recommended treatment options. PMID:23182560
Dun, Erica C; Nezhat, Ceana H
Disability is a complex phenomenon. It reflects an interaction between features of a person's body and features of the society in which he or she lives. International Classification of Functioning, Disability and Health (ICF), lays stress on the functional as well as the structural problem of a person. All the definitions of disability also include the disorders of the reproductive and endocrine system. So infertility and impotency should also be included in the category of disability. It affects the participation in areas of life and can have a disabling affect on an individual. Like any other disability the couple has to adapt and integrate infertility in their sense of self thus infertility comes as a major life crisis. Medically, infertility, in most cases, is considered to be the result of a physical impairment or a genetic abnormality. Socially, couples are incapable of their reproductive or parental roles. On social level, infertility in most cultures remains associated with social stigma and taboo just like the social model of disability. Couples who are unable to reproduce may be looked down upon due to social stigmatisation. Infertility can lead to divorces and separation leading to a broken family life. Without labelling infertility as a disability, it is difficult for the people to access services and welfare benefits offered by the government. Infertility treatments are highly sophisticated so they are very expensive and are even not covered by insurance and government aid. In the light of all this it becomes imperative to categorise infertility as disability.
Khetarpal, Abha; Singh, Satendra
Studies on infertility in the Netherlands have little information on migrant Ghanaian women, even though Ghanaians are the third largest migrant group in Amsterdam. An exploratory study on the unmet needs, attitudes, and beliefs of migrant Ghanaian women with infertility problems living in the Netherlands, and the kinds of treatment they sought was undertaken in 1999. Qualitative data were collected from 12 women with primary or secondary infertility through narratives and 20 key informant interviews. The women described seeking treatment for infertility in Ghana, the Netherlands and other European countries, included use of infertility drugs, surgery, donor insemination and in vitro fertilisation. Illegal migrant women are not entitled to treatment paid by the national health system, and being of low income they cannot afford to pay directly for this or to obtain private health insurance. Herbalists and spiritual healers in both Amsterdam and Ghana were regularly consulted, especially for their willingness to address the social and spiritual aspects of infertility. To produce a pregnancy where male infertility was suspected, transfer of sexual rights to another man in the husband/partner's family, or a healer or priest, was a practical remedy that kept male infertility hidden. This study revealed difficulties experienced in clinical settings due to language barriers and cultural differences. Ghanaian women living in the Netherlands need much more information on the causes of infertility and their options. PMID:11424241
Yebei, V N
The 677T allele of the MTHFR gene has been suggested to represent a factor of risk for male infertility. In order to confirm this association, we investigated the presence of the 677T allele in 93 Italian infertile patients, selected after the exclusion of other possible genetic causes of infertility, and in 105 Italian fertile controls. The homozygous 677TT genotype was present in 20.4% of patients and 27.6% of controls. These results do not support an association between the MTHFR 677T allele and male infertility in Italy. PMID:14594111
Stuppia, L; Gatta, V; Scarciolla, O; Colosimo, A; Guanciali-Franchi, P; Calabrese, G; Palka, G
Objective To determine predictors of low birth weight (LBW) and preterm delivery (PTD) in singleton pregnancies conceived by women with and without a history of infertility. Design Retrospective cohort study. Setting Eleven infertility clinics in Northern California. Patients Three groups of women who carried singleton pregnancies to ? 20 weeks gestation: 542 infertile women who conceived after treatment, 441 infertile women who conceived spontaneously, and 1008 fertile women for comparison. Interventions Chart review. Main Outcome Measures Association of LBW or PTD with infertility treatment, maternal age, parity, obesity, or development of gestational diabetes. Results Infertile women who conceived with treatment were more likely to be obese, develop gestational diabetes, and have ovarian, ovulatory, or male factor infertility than infertile women who conceived spontaneously. Infertile women who conceived after treatment had 1.61 (95% CI 1.08– 2.41) times greater odds of having a LBW infant. Nulliparity was an independent predictor of LBW 1.54 (95% CI 1.09– 2.16) and PTD (OR 1.72, 95% CI 1.20–2.49) in all three groups after controlling for maternal age, history of infertility, infertility treatment, obesity, and gestational diabetes. Conclusions Nulliparous women and women with a history of infertility who conceive a singleton after treatment may be at increased odds for having a LBW infant. Infertile women do not appear to be at increased odds for PTD.
Camarano, Loretta; Alkon, Abbey; Nachtigall, Robert D.; Schembri, Michael; Weiss, Sandra; Croughan, Mary S.
Introduction The very particular natures of infertility problem and infertility care make them different from other medical problems and services in developing countries. Even after the referral to specialists, the family physicians are expected to provide continuous support for these couples. This place the primary care service at the heart of all issues related to infertility. The aim of the work: to improve family physicians' attitude and practice about the approach to infertility management within primary care setting. Methods This study was conducted in the between June and December 2010. The study sample comprised 100 family physician trainees in the family medicine department and working in family practice centers or primary care units. They were asked to fill a questionnaire about their personal characteristics, attitude, and practice towards support, investigations, and treatment of infertile couples. Results Hundred family physicians were included in the study. They were previously received training in infertility management. Favorable attitude scores were detected among (68%) of physicians and primary care was considered a suitable place for infertility management among (77%) of participants. There was statistically significant difference regarding each of age groups, gender and years of experience with the physicians? attitude. There was statistically significant difference regarding gender, perceiving PHC as an appropriate place to manage infertility and attitude towards processes of infertility management with the physicians? practice. Conclusion Favorable attitude and practice were determined among the study sample. Supporting the structure of primary care and evidence-based training regarding infertility management are required to improve family physicians' attitude and practice towards infertility management.
Eldein, Hebatallah Nour
Spermatogenesis involves the aggregated action of up to 2300 genes, any of which, could, potentially, provide targets for diagnostic tests of male factor infertility. Contrary to the previously proposed common variant hypothesis for common diseases such as male infertility, genome-wide association studies and targeted gene sequencing in cohorts of infertile men have identified only a few gene polymorphisms that are associated with male infertility. Unfortunately, the search for genetic variants associated with male infertility is further hampered by the lack of viable animal models of human spermatogenesis, difficulty in robustly phenotyping infertile men and the complexity of pedigree studies in male factor infertility. In this review, we describe basic genetic principles involved in understanding the genetic basis of male infertility and examine the utility and proper clinical use of the proven genetic assays of male factor infertility, specifically Y chromosome microdeletions, chromosomal translocations, karyotype, cystic fibrosis transmembrane conductance regulator mutation analysis and sperm genetic tests. Unfortunately, these tests are only able to diagnose the cause of about 20% of male factor infertility. The remainder of the review will be devoted to examining novel tests and diagnostic tools that have the potential to explain the other 80% of male factor infertility that is currently classified as idiopathic. Those tests include epigenetic analysis of the spermatozoa and the evaluation of rare genetic variants and copy number variations in patients. Success in advancing to the implementation of such areas is not only dependent on technological advances in the laboratory, but also improved phenotyping in the clinic. PMID:24711280
Hotaling, J; Carrell, D T
A thorough understanding of the genetic basis of male infertility has eluded researchers in spite of significant efforts to identify novel genetic causes of the disease, particularly over the past decade. Approximately half of male factor infertility cases have no known cause; however, it is likely that the majority of idiopathic male factor infertility cases have some unidentified genetic basis. Well-established genetic causes of male infertility are limited to Y chromosome microdeletions and Klinefelter's syndrome, together accounting for 10-20% of cases of severe spermatogenic failure. In addition to these, several genetic polymorphisms have been demonstrated to be significantly associated with male infertility. The discovery of new genetic associations with male infertility has been hampered by two primary factors. First, most studies are underpowered because of insufficient sample size and ethnic and phenotypic heterogeneity. Second, most studies evaluate a single gene, an approach that is very inefficient in the context of male infertility, considering that many hundreds of genes are involved in the process of testicular development and spermatogenesis. Significant recent advances in microarray and next-generation sequencing technologies have enabled the application of whole-genome approaches to the study of male infertility. We recently performed a pilot genome-wide association study (GWAS) for severe spermatogenic failure, and several additional male infertility GWAS have since been published. More recently, genomic microarray tools have been applied to the association of copy number variants with male infertility. These studies are beginning to shed additional light on the genetic architecture of male infertility, and whole-genome studies have proven effective in identifying novel genetic causes of the disease. This review will discuss some of the recent findings of these whole-genome studies as well as future directions for this research that will likely be the most productive moving forward. PMID:24574159
Aston, K I
Background Infertility is a significant disability, yet there are no reliable estimates of its global prevalence. Studies on infertility prevalence define the condition inconsistently, rendering the comparison of studies or quantitative summaries of the literature difficult. This study analyzed key components of infertility to develop a definition that can be consistently applied to globally available household survey data. Methods We proposed a standard definition of infertility and used it to generate prevalence estimates using 53 Demographic and Health Surveys (DHS). The analysis was restricted to the subset of DHS that contained detailed fertility information collected through the reproductive health calendar. We performed sensitivity analyses for key components of the definition and used these to inform our recommendations for each element of the definition. Results Exposure type (couple status, contraceptive use, and intent), exposure time, and outcomes were key elements of the definition that we proposed. Our definition produced estimates that ranged from 0.6% to 3.4% for primary infertility and 8.7% to 32.6% for secondary infertility. Our sensitivity analyses showed that using an exposure measure of five years is less likely to misclassify fertile unions as infertile. Additionally, using a current, rather than continuous, measure of contraceptive use over five years resulted in a median relative error in secondary infertility of 20.7% (interquartile range of relative error [IQR]: 12.6%-26.9%), while not incorporating intent produced a corresponding error in secondary infertility of 58.2% (IQR: 44.3%-67.9%). Conclusions In order to estimate the global burden of infertility, prevalence estimates using a consistent definition need to be generated. Our analysis provided a recommended definition that could be applied to widely available global household data. We also summarized potential biases that should be considered when making estimates of infertility prevalence using household survey data.
Infertile men exhibit an aberrant protamine-1 (Prm1) to protamine-2 (Prm2) ratio at both the mRNA and protein level. We therefore investigated whether male infertility could be related to the amount of Prm1 and Prm2 mRNA by applying real time quantitative PCR following RNA extraction from routinely Bouin-fixed and paraffin-embedded testicular biopsies. Samples (n = 51) were normalized to the same amount and similar size of tissue sections. The threshold cycle (C(T)) representing a measure of the initial number of mRNA copies was significantly (P < 0.001) higher for Prm1, but not Prm2, and thus the amount of Prm1 mRNA was lower in men with at least qualitatively normal spermatogenesis (Prm1: 29.88 +/- 2.99; Prm2: 34.28 +/- 2.26) and impaired spermatogenesis (Prm1: 31.89 +/- 2.54; Prm2: 35.59 +/- 2.09) compared with men with obstructive azoospermia and quantitatively normal spermatogenesis (Prm1: 29.04 +/- 1.02; Prm2: 34.91 +/- 1.40). In addition, the Prm1 - Prm2 C(T) difference (deltaC(T)) was significantly (P < 0.001) decreased in these two groups. A negative correlation (r = -0.504; P < 0.001) was demonstrated between the score for efficiency of spermatogenesis and the C(T) for Prm1. These data suggest that the decreasing amount of Prm1 and, as a consequence, the aberrant Prm1:Prm2 mRNA ratio plays an important role for male infertility and may serve as a possible predictive factor for the outcome of ICSI. PMID:12771233
Steger, Klaus; Fink, Ludger; Failing, Klaus; Bohle, Rainer M; Kliesch, Sabine; Weidner, Wolfgang; Bergmann, Martin
The effect of infertility on the psychological well-being of couples has been the subject of increasing attention in recent years. The frustration of couples of a relatively young age (ie, in their fourth decades) provokes not only anxiety and depression but also negative effects on the relationships. The objective of this study was to evaluate the effect of a diagnosis of male infertility on anxiety and depression in the men themselves and in fertile female spouses. The prospective cross-sectional study consisted of 264 participants, 72 males diagnosed with nonobstructive azoospermia (NOA) and their fertile spouses and 60 fertile couples attending our university between January 1, 2009, and April 30, 2010. The Beck Anxiety Inventory, Beck Depression Inventory (BDI), and hormone levels were measured during initial and follow-up visits. In NOA men, follicle-stimulating hormone and luteinizing hormone were positively associated with anxiety, in contrast to testosterone, which was inversely associated with anxiety. After the diagnosis of NOA, producing no testicular sperm, the panic intensity among men increased significantly, whereas their spouses exhibited less panic. By contrast, fertile female partners of NOA men reported higher BDI scores after the initial diagnosis of azoospermia, whereas their partners recorded higher levels of depression after the absence of testicular sperm was discovered. Insomnia was the most common complaint for both sexes after the diagnosis of azoospermia. Hormonal abnormalities had a negative effect on the quality of life. Physicians and clinicians should acknowledge the immense psychosocial effect of the diagnosis of male infertility on both males and their fertile female partners. PMID:21546616
Bak, Chong Won; Seok, Hyun Ha; Song, Seung-Hun; Kim, Eun Sun; Her, Young Sun; Yoon, Tae Ki
Background SOX9 is a widely expressed transcription factor playing several relevant functions during development and essential for testes differentiation. It is considered to be the direct target gene of the protein encoded by SRY and its overexpression in an XX murine gonad can lead to male development in the absence of Sry. Recently, a family was reported with a 178 kb duplication in the gene desert region ending about 500 kb upstream of SOX9 in which 46,XY duplicated persons were completely normal and fertile whereas the 46,XX ones were males who came to clinical attention because of infertility. Methods and results We report a family with two azoospermic brothers, both 46,XX, SRY negative, having a 96 kb triplication 500 kb upstream of SOX9. Both subjects have been analyzed trough oligonucleotide array-CGH and the triplication was confirmed and characterised through qPCR, defining the minimal region of amplification upstream of SOX9 associated with 46,XX infertile males, SRY negative. Conclusions Our results confirm that even in absence of SRY, complete male differentiation may occur, possibly driven by overexpression of SOX9 in the gonadal ridge, as a consequence of the amplification of a gene desert region. We hypothesize that this region contains gonadal specific long-range regulation elements whose alteration may impair the normal sex development. Our data show that normal XX males, with alteration in copy number or, possibly, in the critical sequence upstream to SOX9 are a new category of infertility inherited in a dominant way with expression limited to the XX background.
Vetro, Annalisa; Ciccone, Roberto; Giorda, Roberto; Patricelli, Maria Grazia; Della Mina, Erika; Forlino, Antonella
The role of laparoscopy in assisted reproduction is disputed by many. A rising problem of infertility is battled by an increasing number of centres for reproductive medicine in the region. Nevertheless, there is a large number of indications and conditions where laparoscopic surgery should not be avoided as a therapeutic choice or an aid in assisted reproductive techniques (ART). The number of centres where laparoscopic surgery is performed is significantly higher than the number of reproductive centres; a number of gynaecologists educated in laparoscopic gynaecology is growing, making it more available for patients. PMID:22634902
Sijanovi?, Siniša; Vidosavljevi?, Domagoj; Sijanovi?, Ivanka
Nineteen ewes were injected subcutaneously with the agent of enzootic ovine abortion, Chlamydia psittaci serovar 1, at 50 days gestation. Placental and fetal tissues were examined at 15 days postinfection and thereafter at ten day intervals. Placental infection was detected at 15 days postinfection. Only postinoculation sera collected from postinfected ewes contained antibodies reactive to C. psittaci. Five (26%) chlamydial infected ewes experienced inapparent fetal loss before day 105 of gestation. This finding is significant since C. psittaci infection in sheep is commonly associated with abortion and not infertility.
Papp, J R; Shewen, P E; Gartley, C J
The case of a 28 year old male with normal male phenotype, in whom repeated seminal analysis showed complete azoospermia, is presented. Peripheral blood culture for chromosome studies revealed 46 chromosomes with XX constitution. Polymerase chain reaction (PCR) analysis of genomic DNA failed to detect the presence of the sex-determining region of the Y chromosome (SRY). A literature review of all SRY-negative XX males with normal male phenotype showed that this case is the sixth reported case but the first to be diagnosed during the investigations of infertility. The frequency, aetiology and diagnosis of this rare syndrome are also reviewed. PMID:11278224
Abusheikha, N; Lass, A; Brinsden, P
In the last and most productive years of his life, George Orwell struggled with pulmonary tuberculosis, dying at the dawn of the era of chemotherapy. His case history illustrates clinical aspects of tuberculosis with contemporary relevance: the role of poverty in its spread, the limited efficacy of monotherapy, the potential toxicity of treatment, and the prominence of cachexia as a terminal symptom. Orwell's ordeals with collapse therapy may have influenced the portrayal of the tortures of Winston Smith in the novel 1984. I discuss unifying diagnoses for Orwell's respiratory problems and apparent infertility, including tuberculous epididymitis, Young syndrome, immotile cilia syndrome, and cystic fibrosis. PMID:16267732
Ross, John J
We measured pulse waves in 22 infertile women from the beginning of in vitro fertilization-embryo transfer (IVF-ET) through to pregnancy testing. The largest Lyapunov exponent (LLE) and autonomic nerve balance in the pregnancy group were significantly lower than that in the non-pregnancy group. In this study, we measured plethysmograms of four women who became pregnant and 18 who did not, ten times from each. We calculated LLE and a value for the autonomic nerve balance; from this analysis, we conclude that a mental state that allows for the possibility of becoming pregnant is necessary for a successful pregnancy.
Takahashi, Yuko; Tomiyama, Tatsuhiro; Matsubayashi, Hidehiko; Tsukamoto, Asami; Oyama-Higa, Mayumi
Synapsis and “synaptic adjustment” were analyzed, using electron microscopy in silver stained surface microspreads of inversion-bearing spermatocytes, in an infertile human male with an inherited pericentric inversion in chromosome 1. Possible reasons for his infertility are discussed.
O. Gabriel-Robez; C. Ratomponirina; Y. Rumpler; B. Le Marec; J. M. Luciani; M. R. Guichaoua
Introduction: Chlamydia trachomatis is one of the most common sexually transmitted infections (STIs) in the world. About 80% of the infected women are asymptomatic, while ascending infections such as pelvic inflammatory disease (PID) and the resultant infertility due to fallopian tube occlusion are common manifestations. Due to the higher prevalence of C. trachomatis infection in infertile than fertile women and
Leili Chamani Tabriz; Rahimi Forooshani; Mohammad Mehdi
BACKGROUND: The objective of the present study was to compare the likelihood of abnormal Chlamydia trachomatis antibody test results with that of abnormal hysterosalpingography (HSG) test results in patients with tubal factor infertility. METHODS: Anti-C. trachomatis immunoglobulin G antibodies were determined prospectively in 295 infertility patients by means of an indirect fluorescent antibody technique. In 48 of the 295 patients
L. M. W. Veenemans; P. J. Q. van der Linden
In developing countries, data about the prevalence of genital Chlamydia trachomatis infections and their sequelae, especially tubal infertility, is scarce. A prospective case-control study was performed enrolling 439 Ghanaian women. The case group included 191 patients with primary or secondary infertility. The control group consisted of 248 healthy pregnant women. First-void urine samples were investigated by PCR, and serum specimens
Jorn Siemer; Oliver Theile; Yaw Larbi; Peter A. Fasching; K. A. Danso; Rolf Kreienberg; Andreas Essig
& This study was conducted to evaluate the preimplantation embryonic potential of adult somatic cells from an infertile man using an interspecies bioassay for quality control and also to create human embryos via somatic cell nuclear transfer (SCNT). Skin tissue was biopsied from infertile man to obtain fibroblast cells. These cells were fused with both enucleated bovine oocytes obtained commercially
P. M. Zavos; K. Illmensee
By asking the question 'What is the optimal medical management of infertility and minor endometriosis?', it is assumed that endometriosis has a detrimental effect on fertility. The published data suggest that oocyte dysfunction may contribute to infertility associated with endometriosis. This is expressed as a reduction in fertilization and implantation rates; implantation rates to a lesser extent, though still significant.
D. J. Cahill
Background In the previous studies, the rate of primary infertility was reported differently. It seems the main reasons are related to the different methods of data collection and information analysis. Therefore, introducing a precise method to determine the infertile couples and the population exposed to the risk of infertility is an important issue to study primary infertility. Methods: The proposed methodology for assessing primary infertility rate has been designed and applied by Avicenna Research Institute in a national survey. Sampling was conducted based on probability proportional to size cluster method. In this survey, after reviewing the former studies, the reproductive history was used as a basis for data collection. Every reproductive event was recorded with a code and a date in the questionnaire. To introduce a precise method, all possible events were considered thoroughly and for each situation, it was determined whether these cases should be considered in numerator, denominator or it should be eliminated from the study. Also in some situations where the correct diagnosis of infertility was not possible, a sensitivity analysis was recommended to see the variability of results under different scenarios. Conclusion: The proposed methodology can precisely define the infertile women and the population exposed to the risk of infertility. So, this method is more accurate than other available data collection strategies. To avoid bias and make a consistent methodology, using this method is recommended in future prevalence studies.
Akhondi, MM; Kamali, K; Ranjbar, F; Shafeghati, S; Ardakani, Z Behjati; Shirzad, M; Eslamifar, M; Mohammad, K; Parsaeian, M
Study design: Male infertility caused by anejaculation is common among patients with spinal cord injury (SCIP). The fertility options for SCIP have improved impressively over the past 10 years. We present the Israeli experience in the treatment of infertility in a large series of SCIP. The issues which are addressed include the treatment of ejaculatory dysfunction, seminal quality and fertility
RJ Heruti; H Katz; Y Menashe; R Weissenberg; G Raviv; I Madjar; A Ohry; Heruti RJ
This paper reports the case-control study of dangerous factors related to infertility in Henan province during 1987-1988. There were two groups. One was a primary infertility group with 319 couples. The other was a normal fertility group with 714 couples, who were neighbours of the first group, among whom the women's age range was within 6 years old. The survey materials were analyzed by SAS programmes in the computer. The methods of analysis were single factor and logistic regression analysis of factors. The results of single factor analysis showed that in male, infertility had a close relationship with eating edible rude cotton seed oil; suffering from Varicocele; hydrocele of tunica vaginalis; sex dysplasia; breast dysplasia; puberty enuresis; parotitis after puberty; familial infertility and working under high temperature conditions. In female, menstrual disorder; a sexuality or pain during coitus; familial infertility; TB and other chronic diseases might be major contributors to the incidence of infertility. The results of logistic regression analysis of the factors related to infertility suggested that in male, eating edible rude cotton seed oil, suffering form varicocele; sex dysplasia; puberty enuresis; and in female, menstrual disorder; TB; consanguineous marriage, lower rate of coitus, frequent contact with pernicious substances might be major dangerous factors causing infertility. The results of the logistic regression analysis were different from those of the single factor analysis because the former not only analyzed the major influence of each factor but also considered the comprehensive effects of the relevant factors. PMID:1934044
Objective: Our intention was to determine whether there is a unique pattern of infertility diagnoses in older infertile couples. Study Design: The design of this study was a retrospective chart review study. It was performed in a tertiary referral reproductive medicine unit. There were 2 groups of patients-couples: group 1, female partner aged 20-29 (n = 105) at presentation; group
J. Heath Miller; Ruth K. Weinberg; Nancy L. Canino; Nancy A. Klein; Michael R. Soules
Objective: To ascertain if there is an association between endometriosis and spontaneous abortion. Design: Prospective cohort study. Setting: Medical School Hospital. Population: 174 infertile women laparoscopically diagnosed with endometriosis and 174 infertile women in which endometriosis was ruled out by laparoscopy, in the same period of time. Main outcome measure: Spontaneous abortion. Non-progressive gestational sac and\\/or histological study. Results: Per
Roberto Matorras; Fernando Rodr??guez; Gloria Gutierrez de Terán; Jose Ignacio Pijoan; Olga Ramón; Francisco Javier Rodr??guez-Escudero
Background. In previous studies, people's knowledge of reproductive health and infertile women's psychological states was surveyed in several countries. However, there has been limited information concerning the psychological states of infertile women seeking treatment and the outcomes of in vitro fertilization (IVF) in China. Methods. Infertile women were asked to complete short questionnaires on the day that their oocytes were retrieved; these questionnaires covered the durations of their infertility, levels of education, sources of pressure, and psychological states. Data concerning IVF outcomes were provided by embryologists and clinicians. The correlations between the duration of infertility and educational level, psychological state and education level, and psychological state and outcome of IVF were analyzed in the cohort study. Results. The duration of infertility in more than half of the females was longer than 5 years. Compared with less-educated women, women with higher levels of education sought treatment earlier and their rates of depressive symptoms were lower. There is an association between negative emotions and outcome of IVF. Conclusions. The survey of the situations of infertile women seeking IVF treatment in China indicates the importance of popularizing knowledge concerning reproductive health. Improving medical conditions, reducing the costs of treatment, and developing social culture will aid in relieving the stress of infertile women and improving assisted reproductive treatment.
Jin, Xuan; Wang, Gongxian; Liu, Sisun; Zhang, Jing; Zeng, Fang; Qiu, Yun; Huang, Xiaojin
INTRODUCTION: Endometrial ossification is an uncommon disease related to secondary infertility and its etiology and pathogenesis are controversial. More than 80% of reported cases occur after pregnancy. CASE PRESENTATION: A 33-year-old Caucasian woman was admitted with a history of secondary infertility and with a regular menstrual cycle. She reported a miscarriage at 12 weeks of gestation 7 years previously and
Julio César Rosa-e-Silva; Ionara Diniz Barcelos; Paula Andrea Navarro; Ana Carolina Japur de Sá Rosa-e-Silva; Antonio Alberto Nogueira; Rui Alberto Ferriani
BACKGROUND: In a study in which 18 503 women who had recently given birth were interviewed, 460 women who had received treatment for infertility (2.6%) were asked to participate in a postal study. The aim was to investigate the experience of women who had undergone treatment for infertility and given birth as a consequence, focusing on perceptions of treatment and
M. Redshaw; C. Hockley; L. L. Davidson
Background: It is the responsibility of health systems to provide quality health care and to protect consumers against impoverishing health costs. In the case of infertility in developing countries, quality care is often lacking and treatment costs are usually covered by patients. Additional financial hardship may be caused by various social consequences. The economic implications of infertility and its treatment have not been systematically explored. Methods: A systematic MEDLINE search was conducted to identify English language publications providing original data from developing countries on out-of-pocket payment (OoPP) for infertility treatment and on other economic consequences of involuntary childlessness. Findings: Twenty one publications were included in this review. Information on OoPP was scant but suggests that infertility treatment is associated with a significant risk of catastrophic expenditure, even for basic or ineffective interventions. Other economic disadvantages, which may be profound, are caused by loss of access to child labour and support, divorce, as well as customary laws or negative attitudes which discriminate against infertile individuals. Women in particular are affected. Conclusion: Pertinent data on OoPP and other economic disadvantages of infertility in developing countries are limited. According to the evidence available, infertility may cause impoverishing health costs as well as economic instability or deprivation secondary to social consequences. Health systems in developing countries do not appear to meet their responsibilities vis-à-vis infertile patients.
Dyer, S. J.; Patel, M.
Approximately 20% of infertile women have ovulatory disorders. In infertile women with ovulatory disorders, the cause of anovulation will guide the selection of an appropriate treatment plan. Advances in reproductive endocrinology allow the generalist obstetrician–gynecologist to provide treatment that results in successful ovulatory stimulation and pregnancy in most women with ovulatory disorders.
Background: Cytomegalovirus (CMV) is a prevalent infection in humans. Recent studies have shown the role of CMV infection in male infertility disorder. Aim: Here we aimed to study the role of CMV infection in men with idiopathic infertility. Materials and Methods: We performed a case-control study of CMV serology in 200 patients attending male infertility clinic of a university hospital. There were 154 men diagnosed with infertility and 46 men without infertility. The patients were asked to donate their sperm, blood, and urine. The presence of CMV infection was studied using quantitative polymerase chain reaction. Results: CMV infection was present in 25 of all the studied participants. Controls had a higher sperm count and sperm motility and sperm morphology compared to patients. There were no significant differences in the studied variables between those with and without CMV infection, nor in patients, neither in controls. Sperm morphology was negatively correlated with cigarette smoking (r=-0.15; p<0.03). Even though the prevalence of CMV infection was higher in patients with infertility in control and patient (5/46 vs. 20/154) respectively, this was not statistically significant. Conclusion: We did not show a significant role for CMV infection in male infertility. Based on the previous studies, it could be assumed that CMV infection is an important part of the male infertility and its treatment would improve the sperm quality, however this was not confirmed by the present study.
Habibi, Masoud; Bahrami, Alireza; Morteza, Afsaneh; Sadighi Gilani, Mohammad Ali; Hassanzadeh, Gholamreza; Ghadami, Mohsen; Choobineh, Hamid
Tubal disease constitutes a major factor in infertility especially in developing countries. This study was undertaken to assess the hysterosalpingographic patterns seen in infertile patients in an urban centre in Lagos. Two hundred and twenty patients who reported from the gynaecology clinic to the radiology department of Lagos State University…
Akinola, R. A.; Akinola, O. I.; Fabamwo, A. O.
Background Infertility has potentially inappropriate effects on quality of life in infertile couples. Various general and specific questionnaires have been structured for assessing different aspects of quality of life in infertile men, women, or couples. The present systematic review was designed to assess these questionnaires and also identify different factors affecting infertile couples based on the aforesaid questionnaires. Methods The research strategy involved general and specific terms in relation to couples's infertility and their quality of life. A review was done for studies published from 1982 to 2012 that were indexed in Medline, ISI Web of Science and Scopus as well as abstract books on this subject. We also corresponded with the authors of the references in related studies for introducing more resources and references. Results In all reviewed studies, different aspects of the quality of life in couples were evaluated including sexual, psychological, social, communicational, environmental, occupational, medical, as well as economical ones. In total, after initial screening of all studies, 10 general and 2 specific questionnaires were retrieved. Although no meta-analysis was found in the review, infertility had a negative effect on quality of life in couples. Conclusion This study revealed that some general questionnaires such as SF-36 and WHO-QOL were mostly used for assessing quality of life in infertile couples and some specific questionnaires such as FERTI-QoL and Fertility Problem Inventory were rarely used. Thus, it seems that the evaluation of quality of life in infertile couples needs valid instruments for measurement.
Mousavi, Seyyed Abbas; Masoumi, Seyyedeh Zahra; Keramat, Afsaneh; Pooralajal, Jalal; Shobeiri, Fatemeh
A hypothesis is proposed to explain the seasonality of births and its variations, that some unrecognized epidemic infertile factors have existed seasonally. In that case, certain women born in a particular low birth rate season must be those who survived these infertile factors in very early stage of their fetal lives. Then in later years, when they become pregnant, they
T. Miura; M. Shimura
We introduce a new instrument for family size, infertility, to investigate the causal relationship between children and female labor force participation. Infertility mimics an experiment where nature assigns an upper bound for family size, independent of a woman's background. This new instrument allows us to investigate the differential labor…
Aguero, Jorge M.; Marks, Mindy S.
Varicocele is one of the leading causes of male infertility, and is present in almost 40% of infertile males. Recent understanding of the role of oxidative stress in male reproduction has led some researchers to postulate oxidative stress as the possible cause of sperm dysfunction in varicocele patients. The objective of the present study was to examine the published literature
Ashok Agarwal; Sushil Prabakaran; Shyam SSR Allamaneni
Background and Objective: The objective of this study is to determine the status of acrosome intactness in different infertile conditions among men who have attended the Mediwave Fertility Research Center, Mysore, South India. Materials and Methods: A total of 70 infertile and 20 control subjects were employed in the study. Infertile subjects were classified into different conditions according to the WHO protocol. The data obtained was statistically analyzed. Results: In the present study, seven different infertile conditions were reported. For the acrosome intactness test, except oligospermia, all other conditions recorded a statistically significant value (P < 0.05) compared with the control group. Conclusions: The present study shows the decreased acrosomal enzyme activity in infertile males compared with fertile males. If diagnosed and treated earlier, it may help in the success of the in vitro fertilization technique.
Sreenivasa, G; Vineeth, VS; Kavitha, P; Malini, Suttur S
Researchers studying infertility from the perspective of anthropology and other the social sciences seldom examine the assumptions embedded in the biomedical definition of infertility. Implicit in the biomedical definition is the assumption that people can be divided straightforwardly into those who are trying to conceive and those who are not trying to conceive. If being infertile implies “intent to conceive,” we must recognize that there are various degrees of intent and that the line between the fertile and the infertile is not as sharp as is usually imagined. Drawing on structured interview data collected from a random sample of Midwestern U.S. women and from qualitative interviews, we demonstrate that that there is a wide range of intent among those classified as infertile according to the biomedical definition. We explore the implications of this for research.
Greil, Arthur L.; McQuillan, Julia
Despite the fact that male factors contribute to approximately 50% of all infertility, the mechanisms underlying their origin are unknown. Currently, clinicians rely primarily on semen analyses to predict male reproductive potential and chart treatment success. Even when invasive procedures are performed, the causes of male infertility frequently remain elusive. Recently, the advent of new technologies has spurred the search for novel male infertility biomarkers, and the detection of genes, proteins or metabolites unique to the infertile male holds much promise. The concept that a cost-effective, non-invasive and accurate set of biomarkers can be identified to diagnose male infertility is tantalizing. This review focuses on the various methodologies employed in the discovery of novel biomarkers along with their findings. Specific attention is paid to recent advances in the fields of genetics, proteomics and metabolomics.
Kovac, Jason R.; Pastuszak, Alexander W.; Lamb, Dolores J.
BACKGROUND: Recent data emphasized the implication of polymerase g (POLG) CAG repeats in infertility, making it a very attractive gene for study. A comparison of POLG CAG repeats in infertile and fertile men showed a clear association between the absence of the usual 10-CAG allele and male infertility, excluding azoospermia. It has also been suggested that the POLG gene polymorphism
I. E. Aknin-Seifer; R. L. Touraine; H. Lejeune; C. Jimenez; J. Chouteau; J. P. Siffroi; K. McElreavey; T. Bienvenu; C. Patrat; R. Levy
This study was aimed at assessing presence and predictors of a trend towards more advanced paternal age at presentation in a cohort of 1283 Caucasian-European infertile couples with male factor infertility (MFI) over a short time frame. Multivariate linear regression analysis tested the association between predictors [namely, partners' age, length of infertility at first presentation, patients' comorbidities as scored with the Charlson Comorbidity Index (CCI) and educational status] and patient's age at presentation. Using anova, patient's age at presentation (F ratio: 2.43; p = 0.024) and patients' educational status (?(2) trend: 142.38; p < 0.001) significantly increased over time. In contrast, length of infertility at first presentation, CCI and partners' age did not significantly change over time (all p ? 0.05). Linear regression analyses showed that CCI, educational status and year of presentation were not correlated with patients' age at presentation (all p ? 0.05), whereas partners' age (? = 0.170; p < 0.001) and length of infertility (? = 0.123; p = 0.004) were independent predictors of delayed fatherhood. These results showed a significant shift towards advanced paternal age, but a non-significant increase of maternal age at first presentation among Caucasian-European infertile couples with MFI over a short time frame. PMID:21696399
Salonia, A; Matloob, R; Saccà, A; Ferrari, M; Gallina, A; Castiglione, F; Abdollah, F; Raber, M; Brigante, C; Candiani, M; Rigatti, P; Montorsi, F
Microorganisms which are present in the human urogenital tract may be involved in the development of inflammatory changes negatively affecting the genitals in both men and women. Pathological conditions due to inflammatory alterations may result in complete loss of fertility. Infections of the urogenital tract are responsible for 15% of all cases of infertility in couples. Negative impact on the human reproduction is mainly caused by direct damage to the genital tract mucosa by metabolic products of microorganisms or by induction of pro-inflammatory responses of the body. Another mechanism is indirect impact of microorganisms on the genital function. Moreover, the effect of bacteria on spermatogenesis and semen quality is important in men. Infections mainly caused by Chlamydia trachomatis or Neisseria gonorrhoeae represent the greatest risk in terms of permanent consequences for human reproduction. As for other sexually transmitted disorders, such as infections caused by Gardnerella vaginalis, urogenital mycoplasmas or ureaplasmas, the link between infection and infertility has been intensively researched. PMID:23768092
Sleha, Radek; Boštíková, Vanda; Salavec, Miloslav; Mosio, Petra; Kusáková, Eva; Kukla, Rudolf; Mazurová, Jaroslava; Spli?o, Miroslav
While the incidence of clinical varicocele is common in infertile men (about 40%), the reasons why varicocele may affect sperm parameters is still unclear. In addition, the improvement of fertility after treatment of varicocele is also a subject of debate. The purpose of this review is to get new insight into the physiopathology of varicocele, its impact on sperm parameters and the effectiveness of varicocele treatment on fertility. Treatment is likely to be effective in infertile men with clinical varicocele and impaired spermatogenesis. Even if it does not systematically lead to an improvement in sperm parameters, it may prevent further sperm degradation. In case of non-obstructive azoospermia, few studies reported a slight improvement in the process of spermatogenesis. The critical role of an adequate methodology in order to establish clinical guidelines needs to be stressed. Indeed, the huge intra-individual variability in sperm production makes the usual analysis of sperm parameters inadequate to measure treatment effectiveness. Regarding the assessment of conception, it requires not only well designed and properly sized studies but also a multivariate analysis for weighing predictive factors of success. Thus, an active scientific research is needed to better identify pathogenic agents and appropriately assess the impact of varicocele treatment. PMID:24183580
Muratorio, C; Meunier, M; Sonigo, C; Massart, P; Boitrelle, F; Hugues, J-N
Two adult male gerenuk (Litocranius walleri walleri) were confirmed infertile with distinctly varying clinical presentations. One animal had unilateral testicular degeneration/hypoplasia, and within 8 mo experienced atrophy/degeneration of the remaining testicle. The second animal had been previously treated with melengesterol acetate (MGA) milled in feed for 1 yr during puberty as part of an aggression-control study. The testes in this individual appeared normal both visually and on palpation; however, repeated semen collection consistently produced ejaculates containing high numbers of immotile spermatozoa, all of a single abnormal morphology: shortened tails, with normal total sperm counts for this species. Both gerenuk had cortisol concentrations within normal ranges for adult male gerenuk. Analysis of serum mineral concentration revealed zinc levels that would be considered low in domestic cattle. Testosterone levels were low for the animal discussed in case 1, but were within normal range for the animal in case 2 compared with other gerenuk. Investigations into endocrine causes, such as abnormal thyroid hormone concentrations and adrenal function, were unrewarding. Both animals discussed in this report are maternally related; therefore, a genetic cause of infertility cannot be ruled out. Further investigation into MGA, as well as the dietary zinc requirements for gerenuk, and resulting effects on spermatogenesis and testicular development are warranted. PMID:18817003
VanderKlok, Carin M; Penfold, Linda M; Siegal-Willott, Jessica; Citino, Scott B
Studies on elevated reactive oxygen species (ROS) levels in granulosa cells (GC) and its subsequent effect on fertilization are limited. Oxidative stress (OS) mediated alterations in GC of infertile women undergoing in vitro fertilization (IVF) and embryo transfer (ET) was investigated. GC were obtained from 28 women with endometriosis (Group A), 26 women with polycystic ovary syndrome (PCOS) (Group B), and 32 women with tubal factor infertility (Group C). GC characteristics including cell count, viability, morphology and number of oocytes retrieved, and oocyte quality were assessed. OS parameters such as ROS, mitochondrial membrane potential (MMP), and DNA fragmentation were also studied and IVF outcome parameters assessed. An ?20 fold increase in GC ROS generation was observed in Group B as compared to Group C. Though not as high as Group B, Group A also showed significantly high ROS levels compared with Group C. More than 100-fold decrease in MMP in Group B compared with Group C was observed. A similar trend was observed in Group A, where MMP decreased 7 fold. Significant apoptosis was evident in Groups A and B supported by depolarization of MMP and significant increase in DNA damage. IVF outcome parameters including fertilization rate, good quality embryo formation rate, and pregnancy outcome were adversely affected in Group B. It is hypothesized that ?20 fold increase in ROS generation in GC of PCOS women plays an adverse role in affecting the IVF success rate. It was of note that the IVF outcome parameters of women with endometriosis were not affected. PMID:23278116
Karuputhula, Narendra Babu; Chattopadhyay, Ratna; Chakravarty, Baidyanath; Chaudhury, Koel
Tubal factor infertility (TFI) represents 36% of female infertility and genital infection by Chlamydia trachomatis (C. trachomatis) is a major cause. Although TFI is associated with host inflammatory responses to bacterial components, the molecular pathogenesis of Chlamydia-induced infertility remains poorly understood. We investigated the hypothesis that activation of specific cysteine proteases, the caspases, during C. trachomatis genital infection causes the disruption of key fertility-promoting molecules required for embryo development and implantation. We analyzed the effect of caspase inhibition on infertility and the integrity of Dicer, a caspase-sensitive, fertility-promoting ribonuclease III enzyme, and key micro-RNAs in the reproductive system. Genital infection with the inflammation- and caspase-inducing, wild-type C. trachomatis serovar L2 led to infertility, but the noninflammation-inducing, plasmid-free strain did not. We confirmed that caspase-mediated apoptotic tissue destruction may contribute to chlamydial pathogenesis. Caspase-1 or -3 deficiency, or local administration of the pan caspase inhibitor, Z-VAD-FMK into normal mice protected against Chlamydia-induced infertility. Finally, the oviducts of infected infertile mice showed evidence of caspase-mediated cleavage inactivation of Dicer and alteration in critical miRNAs that regulate growth, differentiation, and development, including mir-21. These results provide new insight into the molecular pathogenesis of TFI with significant implications for new strategies for treatment and prevention of chlamydial complications. PMID:23303804
Igietseme, Joseph U; Omosun, Yusuf; Partin, James; Goldstein, Jason; He, Qing; Joseph, Kahaliah; Ellerson, Debra; Ansari, Uzma; Eko, Francis O; Bandea, Claudiu; Zhong, Guangming; Black, Carolyn M
This paper explores the experiences of infertile women who occupy a liminal space in society, and argues that the fertility clinic served as a space to tolerate women's experiences of liminality. It provided not only rituals aimed at transition to pregnancy, but also a space where women's liminal experiences, which are caused by the existential chaos of infertility, could be tolerated. The British experience seemed to differ from the American one identified in the literature, where self-management and peer group support are described as strategies used by infertile women to manage infertility. The British women in this study did not appear to draw so much on self-management or peer group support to deal with their experiences of infertility. They appeared to be isolated in their experience. The clinic thus provided a space in which recognition was given to their intensely private experiences of difference from those in the outside fertile world and allowed them to manage these socially unacceptable, culturally taboo and invisible experiences. However, because of its very limited success rate in enabling women to become pregnant, rather than facilitating the transition of status from infertile to fertile woman, the clinic also served to reinforce the liminal experiences of those women who remained infertile. Inadvertently, the clinic offered a way of being in limbo while at the same time reinforcing the liminal experiences of women. PMID:17518825
Background This study examines the relationship between infertile women’s social skills and their perception of their own mothers’ acceptance or rejection, and the role this relationship plays in predicting self-reported depression. Materials and Methods This was a correlational study. 60 infertile women aged 25 to 35 years participated in a self-evaluation. A Social Skills Inventory, Parental Acceptance and Rejection Questionnaire and Beck Depression Inventory were used to measure social skills, acceptance rejection and depression. Data was analyzed by SPSS software, using independent two-sample t test, logistic regression, and ANOVA. Results Findings showed that there are significant differences between depressed and not depressed infertile women in their perceptions of acceptance and rejection by their mothers. Further, women's perceptions of rejection are a more significant predictor of depression among less socially skilled infertile women than among those who are more socially skilled. Less socially skilled women did not show symptoms of depression when they experienced their mothers as accepting. In general the results of this study revealed that poorer social skills were more predictive of depression while good social skills moderate the effect of infertile women’s perceptions of their mothers' rejection. At the same time, the findings showed that infertile women's perceptions of acceptance moderated the effects of poorer social skills in predicting depression. Conclusion Results suggest that the perception of mothers’ rejection and poor social skills are the key factors that make infertile women prone to depression.
Abstract The aim of this study was to investigate in a case-control study the associations between idiopathic infertility and antioxidant gene polymorphisms. One hundred ten infertile subjects (58 women and 52 men) with a history of idiopathic infertility and 69 fertile subjects (35 women and 34 men) with no history of infertility were included by three hospital departments of reproductive biology in the NCT01093378 French government clinical trial. Genotyping was assessed by real-time polymerase chain reaction with TaqMan assay. We examined genetic polymorphisms affecting five antioxidant enzymes: manganese superoxide dismutase (MnSOD), myeloperoxidase (MPO), glutathione peroxidase 1 (GPx1), catalase (CAT), and endothelial nitric oxide synthase (eNOS). The presence of at least 1 Ala-MnSOD allele (rs4880) increased significantly the risk of infertility (odds ratio [OR] 2.94; 95% confidence interval [CI], 1.14, 7.60; p=0.03) in male subjects. Moreover, the presence of 2 G-eNOS allele (rs1799983) increased significantly the risk of infertility in both men and women (OR 1.91; 95% CI, 1.04, 3.54; p=0.04). Our observations lead to the hypothesis that the genetic susceptibility modulating oxidative stress may represent a risk factor for male idiopathic infertility. Antioxid. Redox Signal. 21, 565-569. PMID:24444339
Faure, Celine; Leveille, Pauline; Dupont, Charlotte; Julia, Chantal; Chavatte-Palmer, Pascale; Sutton, Angela; Levy, Rachel
Purpose The causes of male infertility are heterogeneous but more than 50% of cases have a genetic basis. Specific genetic defects have been identified in less than 20% of infertile males and, thus, most causes remain to be elucidated. The most common cytogenetic defects associated with nonobstructive azoospermia are numerical and structural chromosome abnormalities, including Klinefelter syndrome (47,XXY) and Y chromosome microdeletions. To refine the incidence and nature of chromosomal aberrations in males with infertility we reviewed cytogenetic results in 668 infertile men with oligozoospermia and azoospermia. Materials and Methods High resolution Giemsa banding chromosome analysis and/or fluorescence in situ hybridization were done in 668 infertile males referred for routine cytogenetic analysis between January 2004 and March 2009. Results The overall incidence of chromosomal abnormalities was about 8.2%. Of the 55 patients with abnormal cytogenetic findings sex chromosome aneuploidies were observed in 29 (53%), including Klinefelter syndrome in 27 (49%). Structural chromosome abnormalities involving autosomes (29%) and sex chromosomes (18%) were detected in 26 infertile men. Abnormal cytogenetic findings were observed in 35 of 264 patients (13.3%) with azoospermia and 19 of 365 (5.2%) with oligozoospermia. Conclusions Structural chromosomal defects and low level sex chromosome mosaicism are common in oligozoospermia cases. Extensive cytogenetic assessment and fluorescence in situ hybridization may improve the detection rate in males with oligozoospermia. These findings highlight the need for efficient genetic testing in infertile men so that couples may make informed decisions on assisted reproductive technologies to achieve parenthood.
Yatsenko, Alexander N.; Yatsenko, Svetlana A.; Weedin, John W.; Lawrence, Amy E.; Patel, Ankita; Peacock, Sandra; Matzuk, Martin M.; Lamb, Dolores J.; Cheung, Sau Wai; Lipshultz, Larry I.
Background Chlamydia trachomatis infection is a worldwide-distributed sexually transmitted infection that may lead to infertility. Objectives This study aims to report the prevalence of Chlamydia trachomatis infection among infertile women in Saudi Arabia. Patients and methods A community-based study carried out at the obstetrics and gynecology clinic at Jazan General Hospital, Saudi Arabia. The study group included 640 Saudi infertile women who were aged between 18 and 40 years and who attended the gynecology clinic for infertility examination throughout 1 year of study (from July 1, 2011 to June 30, 2012). The randomized control group included 100 Saudi fertile women who attended the obstetrics clinic for routine antenatal care. All recruited women were screened for chlamydia infection by enzyme-linked immunosorbent assay (ELISA) for detection of serum-specific antibodies and then retested by the McCoy cell culture technique. Results The prevalence of Chlamydia trachomatis infection among infertile women was high, at 15.0%. The rate of chlamydia infection detected by ELISA was 9.84%, and it was 12.03% by the culture method (P = 0.2443). Conclusion The high prevalence of Chlamydia trachomatis infection among Saudi infertile women demands a national screening program for early detection among infertile couples. ELISA is available as a simple screening test alternative to the culture method.
Kamel, Remah M
The sperm chromatin structure assay (SCSA) parameter DNA fragmentation Index (DFI) is a valuable tool for prediction of fertility in vivo. Clinical data show that a DFI above 30% is associated with very low chance for achieving pregnancy by natural conception or by insemination. Already when DFI is above 20% the chance of natural pregnancy is reduced, this despite normal conventional semen parameters. The aim of the present study was to investigate the prevalence of high DFI in male partners of unexplained infertile couples to further identification of male factors contributing to subfertility. Among 212 consecutive men under infertility investigation, 122 cases with the diagnosis 'unexplained infertility' were identified. For all but three, SCSA data were available. The percentage of couples with diagnosis 'unexplained infertility' in which the male partner has DFI >20% or DFI >30% was calculated. In the group diagnosed with 'unexplained infertility' 17.7% of the men (95% CI 10.8-24.5) presented with 20 ?DFI <30 and 8.4% (95% CI 3.40-13.4) had DFI ?30%. A significant part of men diagnosed as unexplained infertile according to traditional diagnostic methods has remarkably high degrees of fragmented sperm DNA. Apart from adding to our understanding of biology of infertility our finding has clinical implications. Couples in which the DFI of the male partner is high can avoid prolonged attempts to become spontaneously pregnant or referral for intrauterine insemination, both having low chances of leading to conception. PMID:23596042
Oleszczuk, K; Augustinsson, L; Bayat, N; Giwercman, A; Bungum, M
Though widely used, there is uncertainty about the effectiveness and adverse effects of metformin and clomiphene citrate (CC) for infertility in polycystic ovary syndrome (PCOS). A systematic review (SR) of the best available evidence suggests that both CC and metformin are better than placebo for increasing ovulation and pregnancy rates, but CC is more effective than metformin for ovulation, pregnancy and live-birth rates, in PCOS patients with body mass index (BMI) >30. A combination of CC and metformin is superior to either metformin alone or CC alone, depending on the BMI and CC sensitivity of the patient. This SR provides key messages to guide clinicians and consumers on the use of these interventions in different subgroups of women with PCOS. PMID:22939889
Misso, Marie L; Teede, Helena J; Hart, Roger; Wong, Jennifer; Rombauts, Luk; Melder, Angela M; Norman, Robert J; Costello, Michael F
Advanced maternal age, obesity and cigarette smoking are associated with decreased fertility, adverse Assisted Reproductive Technologies (ART) outcomes and fetal and neonatal complications. IVF failures increase dramatically in women aged between 42-43 years. Advanced paternal age is associated with fetal and neonatal adverse outcomes. However, it remains uncertain that advanced paternal age could impair IVF results. Obesity (Body mass index more than 30 kg/m(2)) is associated with lower fecundity, pregnancy complications and adverse ART results. The rate of complications is increasing with higher BMI. Cigarette smoking is associated with longer time to conceive and decreased IVF results. In case of infertility associated with obesity or cigarette smoking, physicians have to inform their patient about the benefits of smoking cessation and weight loss. However, maternal age had to be considered as the main prognosis factor before delaying ART because of dietary or smoking cessation program. PMID:21185491
Dechanet, C; Belaisch-Allart, J; Hédon, B
The roles of inflammation and/or infection of the male accessory sex glands are very important for the potential effects that these conditions may have on male fertility. The clinical andrologist should be aware of the pathophysiological role of the main determinants of sperm damage when these conditions occur, in particular, seminal leukocytes, oxidative stress and cytokines. In addition, it is important to have a good knowledge of the methodologies to be used in clinical practice. This article summarizes the methods used to look for and to identify the micro-organisms responsible for male urogenital tract infections. These include sperm culture, urine culture, urethral swabbing, the Meares-Stamey test and balanopreputial swabbing. Finally, we discuss the role of human papilloma virus infection in male infertility. PMID:24072761
La Vignera, Sandro; Condorelli, Rosita A; Vicari, Enzo; Salmeri, Mario; Morgia, Giuseppe; Favilla, Vincenzo; Cimino, Sebastiano; Calogero, Aldo E
In this study, we aimed to compare the level of zinc, selenium, glutathione peroxidase activity and antioxidant status in following populations of men: severe inflammation in prostate (>10(6) white blood cells in prostate secretion; n=29), severe leukocytospermia, (>10(6) white blood cells in semen; n=31), mild inflammation, (0.2-1M white blood cells in semen or prostate secretion; n=24), non-inflammatory oligozoospermia (n=32) and healthy controls (n=27). Male partners of infertile couples had reduced level of antioxidative activity, selenium and zinc in their seminal plasma. Most importantly, reduced selenium levels were evident in all patient groups regardless of inflammation status. Therefore, these patients might gain some benefit from selenium supplementation. PMID:24462254
Türk, Silver; Mändar, Reet; Mahlapuu, Riina; Viitak, Anu; Punab, Margus; Kullisaar, Tiiu
Intrauterine insemination (IUI) is a widely used fertility treatment for couples with male and/or non-male factor infertility and is a relatively simple and inexpensive procedure. When used for unexplained infertility, IUI combined with ovarian stimulation increases the pregnancy rates, but evidence does not support this to be true when applied for male factor infertility. Recently, the revised World Health Organization laboratory manual for semen criteria provided a new insight for practical guidelines. Further randomized, controlled studies are necessary to develop standardized IUI strategies. The authors reviewed, via literature search, on the indications, prognostic factors, ovarian stimulation protocols, and methods that have been employed for IUI treatment. PMID:24919030
Kim, Yong Jin; Park, Chan Woo; Ku, Seung-Yup
In Bangangté, a Bamiléké kingdom in the Grassfields of Cameroon, local understandings of reproductive illness contrast with standard demographic indicators of high fertility in this region. Bangangté are preoccupied with threats to reproductive health. This article explores the culinary metaphors of building kitchens, choosing, measuring, and mixing ingredients, and slow and skillful cooking in Bangangté notions of procreation and infertility. The violent imagery of plundered kitchens, cannibalistic witchcraft, and theft permeates Bangangté women's accounts of infertility and child loss. The analysis suggests that infertility anxiety in Bangangté reflects women's feelings of vulnerability in the context of rural female poverty and the gender-specific consequences of political change in Cameroon. PMID:7973847
Testicular schistosomiasis caused by Schistosoma mansoni is very rare and more so when associated with primary infertility. A 40 years old man from the Jos Plateau, North Central Nigeria presented with primary infertility after ten years of marriage. Sperm count revealed oligospermia and he also complained of inability to sustain erection. Testicular biopsy revealed several ova of Schistosoma mansoni in the connective tissue of the testes. Cases of infertility in endemic areas especially when there is no supply of potable water should raise suspicion of schistosomiasis among other pathologies and possible hormonal disturbances when the testes are involved. PMID:23515635
Adisa, J; Egbujo, E M; Yahaya, B A; Echejoh, G
We have determined Y-chromosomal DNA haplotypes in 73 infertile European males carrying Y microdeletions and compared them with the haplotypes of 299 infertile males lacking microdeletions. Chromosomes were typed with a set of 11 binary Y markers, which identified 8 haplogroups in the sample. Haplogroup frequencies were compared between 3 microdeletion classes and the non-deleted infertile males. Deletions arise on many different haplotypic backgrounds. No statistically significant differences in frequency were seen, although the small number of AZFa deletions lay predominantly on one branch of the Y haplotype tree. PMID:11097432
Paracchini, S; Stuppia, L; Gatta, V; Palka, G; Moro, E; Foresta, C; Mengua, L; Oliva, R; Ballescà, J L; Kremer, J A; van Golde, R J; Tuerlings, J H; Hargreave, T; Ross, A; Cooke, H; Huellen, K; Vogt, P H; Tyler-Smith, C
Background Spermatozoa morphology is an important and complex characteristic of the fertilization capacity of male germ cells. Morphological abnormalities have been observed to be accompanied by reactive oxygen species (ROS) overproduction and further damage to spermatozoa, ultimately leading to infertility. Therefore, this study aimed to examine the relationship between seminal ROS production and sperm morphology in infertile teratozoospermic patients as well as in healthy men of proven and unproven fertility. Methods Semen samples were collected from 79 patients classified as teratozoospermic and 56 healthy donors (control). Standard semen analysis was performed and spermatozoa morphology was assessed according to the WHO 2010 guidelines. Seminal ROS was measured by chemiluminescence assay. Receiver operating characteristic (ROC) curves were generated, and sensitivity, specificity, cutoff value and area under curve (AUC) were determined. Results Sperm morphology was significantly poor in the Teratozoospermic Group compared with the 3 Donor Groups (P?0.05). Significantly higher levels of ROS (RLU/sec/106 sperm) were seen in the Teratozoospermic group (145.4 (41.5; 555.4) compared to the Donor Groups: All Donors (64.8 (21.1; 198.2), Proven Donors (58.8 (14.2; 79.2) and Proven Donors < 2 years (58.8 (14.2; 79.2) (P?0.05). ROS correlated negatively with sperm concentration in the All Donor group (r?=??0.354; P?=?0.021) as well as in the Teratozospermic group (r ?0.356; P?=?0.002). Using ROC analysis, we established the cutoff values for concentration, morphology and ROS. Conclusions The incidence of teratozoospermia may be directly related to the overproduction of seminal ROS. Therefore, besides sperm concentration and motility, spermatozoa morphology should receive an equally important consideration in the overall assessment of male fertility.
BACKGROUND Recent advances in our understanding of the causes of infertility and of assisted reproductive technology (ART) have led to the development of complex diagnostic tools, prognostic models and treatment options. The Third Evian Annual Reproduction (EVAR) Workshop Meeting was held on 26–27 April 2008 to evaluate evidence supporting current approaches to the diagnosis and management of infertility and to identify areas for future research efforts. METHODS Specialist reproductive medicine clinicians and scientists delivered presentations based on published literature and ongoing research on patient work-up, ovarian stimulation and embryo quality assessment during ART. This report is based on the expert presentations and subsequent group discussions and was supplemented with publications from literature searches and the authors' knowledge. RESULTS It was agreed that single embryo transfer (SET) should be used with increasing frequency in cycles of ART. Continued improvements in cryopreservation techniques, which improve pregnancy rates using supernumerary frozen embryos, are expected to augment the global uptake of SET. Adaptation and personalization of fertility therapy may help to optimize efficacy and safety outcomes for individual patients. Prognostic modelling and personalized management strategies based on individual patient characteristics may prove to represent real progress towards improved treatment. However, at present, there is limited good-quality evidence to support the use of these individualized approaches. CONCLUSIONS Greater quality control and standardization of clinical and laboratory evaluations are required to optimize ART practices and improve individual patient outcomes. Well-designed, good-quality studies are required to drive improvements to the diagnosis and management of ART processes.
Devroey, P.; Fauser, B.C.J.M.; Diedrich, K.
A non-concurrent cohort study of 695 infertile patient-couples was conducted to assess prognostic indicators across and within diagnosis groups, and to evaluate treatment effectiveness. Variables associated with poorer prognosis across and within diagnose...
The azoospermia factor (AZF) region of the human Y chromosome contains essential genes for spermatogenesis. Microdeletions in AZF region has been shown to cause male infertility. The aim of this investigation was to determine the frequency of AZF microdeletions in Jordanian infertile males. A sample of 100 infertile males (36 with azoospermia and 64 with oligozoospermia) was screened for microdeletions using 16 AZF markers and polymerase chain reaction (PCR) technique. Two subjects were found to have microdeletions in AZFc region and one subject has microdeletion that includes AZFb and part of AZFc and AZFa. The three deletions were found in azoospermic subjects (8.3%). No microdeletions were found in oligozoospermic group. The frequency of AZF microdeletions in Jordanian azoospermic infertile males is comparable to that observed in other populations (1%-15%). The results suggest the importance of AZF microdeletion analysis for genetic counseling prior to providing assisted reproduction technique.
Khabour, Omar F; Fararjeh, AbdulFattah S; Alfaouri, Almuthana A
Infertility is more common for non-Hispanic black women, non-Hispanic other race women, and Hispanic women than for non-Hispanic white women, and both infertility and impaired fecundity are more common for high school dropouts and high school graduates with no college than for 4-year college graduates, and for older women compared with women 29 and younger. Older women, non-Hispanic white women,
Marianne Bitler; Lucie Schmidt
Objective: To critically assess the possibility that gonorrhea or chlamydia causes male infertility.Design: Comprehensive literature review structured to evaluate the epidemiologic tenets for causality, including biologic plausibility, strength of association, dose response, consistency, temporality, and treatment effect.Result(s): It is biologically plausible that gonorrhea and\\/or chlamydia could cause male infertility. There is clinical and pathologic evidence linking these pathogens to urethritis,
Roberta B. Ness; Nina Markovic; Catherine L. Carlson; Michael T. Coughlin
The prevalences of antiphospholipid antibodies (APAs) among 1,325 women with a history of unexplained infertility and 676 women experiencing recurrent implantation failure were compared with 789 women experiencing recurrent pregnancy loss and 205 fertile control women. Eight percent and 9% of women with a history of unexplained infertility and recurrent implantation failure had more than one positive APA compared with 1.5% of fertile negative control women and 11% of positive control women experiencing recurrent pregnancy loss. PMID:19962695
Sauer, Ruben; Roussev, Roumen; Jeyendran, Rajasingam S; Coulam, Carolyn B
BACKGROUND: The frequency of defective sperm-zona pellucida (ZP) interaction in teratozoospermic infertile men was investigated. METHODS: Sperm-ZP binding and the ZP-induced acrosome reaction (ZPIAR) were per- formed in 125 infertile men with <5% of their sperm with normal morphology (strict criteria), but with a sperm count >203106\\/ml and total motility >30% in semen. Oocytes that failed to fertilize in clinical
Yi Liu; H. W. Gordon Baker
During the days August 22–24, 2013 has been held in Harbin (China) an International Consensus Conference aimed to improve the quality and the reporting of the randomized controlled trials (RCTs) in infertility and subfertility field. I, as Italian scientist with experience in clinical infertility trials, was invited to have a speech on the Italian experience in RCTs, with particular regard for the surgical trials. Considerations on this subject were particularly interesting to highlight pitfalls and triumphs of research in Italy.
Summary The frequency of hyperprolactinaemia was assessed in 608 consecutive patients (549 women and 59 men) in whom plasma prolactin\\u000a was requested as part of investigation for various reproductive and endocrine disorders, including primary and secondary amenorrhoea,\\u000a galactorrhoea, infertility, oligomenorrhoea, hirsutism, mastalgia, gynaecomastia, Klinefelter syndrome and thyroid disorders.\\u000a \\u000a Of 29 hyperprolactinaemic patients investigated for infertility, 20 became pregnant after bromocriptine during
P. Skrabanek; D. McDonald; E. de Valera; O. Lanigan; D. Powell
BACKGROUND Little is known about the potential risk factors for infant leukemia. With its very young age at diagnosis, exposures occurring in the perinatal period are suspected. Parental infertility and infertility treatment have been studied with regard to childhood cancer in general, but rarely in individual cancer subtypes. METHODS A case–control study of infant leukemia was conducted through the Children's Oncology Group, including cases diagnosed from January 1996 to December 2006 and controls selected through random digit dialing and birth certificate tracing. Maternal phone interviews were conducted to obtain information about infertility, infertility treatment and demographic factors. All cases as well as subgroups defined by mixed lineage leukemia (MLL) translocation status and leukemia subtype were examined. Statistical analysis was performed using multivariate logistic regression models. RESULTS No significant associations between infertility or its treatment and combined infant leukemia were found. In subgroup analyses, there was a significant increase in the risk of MLL? leukemia for children born to women not trying to conceive compared with those trying for <1 year for all types combined [odds ratio (OR) = 1.62, 95% confidence interval (CI) = 1.01–2.59] and for acute lymphoblastic leukemia (OR = 2.50, 95% CI = 1.36–4.61). CONCLUSIONS There were no positive associations between parental infertility or infertility treatment and infant leukemia. While this is the largest study to date, both selection and recall bias may have impacted the results. However, for infant leukemia, we can potentially rule out large increases in risk associated with parental infertility or its treatment.
Puumala, Susan E.; Spector, Logan G.; Wall, Melanie M.; Robison, Leslie L.; Heerema, Nyla A.; Roesler, Michelle A.; Ross, Julie A.
This study was carried out to determine the prevalence of the bacterial agents Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoeae), Mycoplasma hominis (M. hominis) and Ureaplasma urealyticum (U. urealyticum) and the conditions which may play a role in the development of female infertility, in the county of Ia?i in North-Eastern Romania. Cervical and blood samples were collected from 176 infertile women and 45 pregnant women in the third trimester. Classical methods and real time PCR were applied to each cervical sample to detect the presence of these sexually transmitted microorganisms; the ELISA method was applied to blood samples to detect C. trachomatis antibodies (IgA, IgM and IgG). The proportion of C. trachomatis IgG was significantly higher in the infertile group (23.8%) than in the pregnant group (4.4%), p < 0.05. For C. trachomatis antigen (Ag) and N. gonorrhoeae Ag no differences were observed between the two groups. The prevalence of mycoplasma genital infections was higher in the pregnant group (U. urealyticum - 53.3% and M. hominis - 20%) than in the infertile group (U. urealyticum - 39.7% and M. hominis - 7.3%). Higher rate of co-infection with C. trachomatis and mycoplasma were observed among the infertile women (25.7%) than among the pregnant women (7.7%). This combination could be involved in the appearance of pelvic inflammatory disease (PID) and its sequela, including infertility. C. trachomatis IgG determination still remains the gold standard for the diagnosis of PID and should be used as a screening test for the prediction of tubal damage in infertile women. In view of the large number of cases involving the co-existence of genital infections with C. trachomatis, M. hominis and U. urealyticum, it is clearly necessary to perform screening for all three microorganisms among all women of reproductive age but especially those who are infertile. PMID:23529298
Miron, Nora Dumitriu; Socolov, Demetra; Mare?, Mihai; Anton, Gabriela; Nastasa, Valentin; Moraru, Ramona Florina; Virág, Katalin; Anghelache-Lupa?cu, Ivona; Deák, Judit
Recently, infertility treatment-related psychological effects are receiving increased attention. However, whether sexual satisfaction is reduced amongst infertile couples remains to be elucidated. In this study, sexual satisfaction of Japanese infertile couples was assessed using a validated questionnaire designed to assess the male and female partner individually, and the couple as a whole for the first time. This study randomly included 170 infertile couples seen at the outpatient clinic and 170 couples that had recently achieved spontaneous pregnancy. All couples were given the Japanese version of the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). In couples aged 35 years or older, the male partners showed significantly worse sexual satisfaction scores than the female partners. Sexual satisfaction also deteriorated with therapeutic interventions, with mental factors affected more than physical factors. Therapeutic interventions such as timed sexual intercourse and assisted reproductive technology were considered emotionally stressful for infertile couples, with sexual satisfaction accordingly lower in this group than in couples achieving spontaneous pregnancy. GRISS successfully evaluated lower sexual satisfaction associated with infertility, and hence is a useful tool for identifying couples whose sexual satisfaction could be enhanced by counselling or other stress-reduction modalities. PMID:24902628
Shoji, Mayumi; Hamatani, Toshio; Ishikawa, Shoko; Kuji, Naoaki; Ohta, Hiroaki; Matsui, Hideo; Yoshimura, Yasunori
In the last decade the abnormalities in male infertility became the main problem of more than 50% couples. The main reasons of male infertility are abnormal gonadotropin releasing hormone (GnRH) secretion, pituitary gland diseases and presence of testicular genetic defects. The male infertility also may result from chemotherapy, radiotherapy and viral infections. The main genetic factors responsible for male infertility encompass the mutations of genes, which encode important factors of spermatogenesis. Recently mRNAs of numerous genes have been identified in spermatozoa. The first transcripts found in spermatozoa included protamine 1 and 2 (PRM1 and PRM2). Protamines are basic polypeptides, which form complex with DNA in spermatids and spermatozoa. Structure of PRM1 and PRM2 genes and function of these proteins suggest the possible relationship between of protamines expression disorders and male infertility. The PRM1, PRM2 and transition proteins 1 and 2 (TP1 and TP2) play important role in DNA condensation. We attempted to present current knowledge regarding structure and expression regulation of PRM1 and PRM2 genes. We also discussed the effect of disorders of PRM1 and PRM2 expression on male infertility. PMID:16871843
Kempisty, Bartosz; Jedrzejczak, Piotr; Jagodzinski, Pawe? P
Objective To define relationships of androgen excesses to cancer risk. Design Retrospective cohort study. Patients Among 12,193 women evaluated for infertility between 1965-1988 and traced for cancer incidence through 1999, 2,560 had androgen excess or menstrual disorders; among these, 412 met established criteria for PCOS. Main Outcome Cancer incidence. Methods Derivation of standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for cancer risk comparisons with the general population and rate ratios (RRs) for comparisons with other infertility patients. Results Androgen excess/menstrual disorders patients showed significant SIRs for breast (1.31, 95% CIs 1.05-1.62) and uterine (2.02, 1.13-3.34) cancers and melanoma (1.96, 1.12-3.18). Significant associations for breast and uterine cancers were restricted to primary infertility patients (respective SIRs of 1.53 and 3.48). After adjustment for other cancer predictors, the only excess risk was for uterine cancer among primary infertility patients. Compared to women with secondary infertility and no androgen excess/menstrual disorder, those with primary infertility and a disorder had a RR of 1.88 (95% CI 0.82-4.32). Cancer risks among the women with PCOS or androgen excess disorders appeared similar to the more comprehensive group. Conclusions Previous findings linking androgen excess disorders to elevated uterine cancer risks may largely reflect underlying risk profiles.
Brinton, Louise A.; Moghissi, Kamran S.; Westhoff, Carolyn L.; Lamb, Emmet J.; Scoccia, Bert
Estrogen receptor alpha has a central role in human fertility by regulating estrogen action in all human reproductive tissues. Leukemia inhibitory factor (LIF) expression, a cytokine critical for blastocyst implantation, is mediated by estrogen signaling, so we hypothesized that ESR1 gene polymorphisms might be candidate risk markers for endometriosis-related infertility and in vitro fertilization (IVF) failure. We included 98 infertile women with endometriosis, 115 infertile women with at least one IVF failure and also 134 fertile women as controls. TaqMan SNP assays were used for genotyping LIF (rs929271), MDM2 (rs2279744), MDM4 (rs1563828), USP7 (rs1529916), and ESR1 (rs9340799 and rs2234693) polymorphisms. The SNP ESR1 rs9340799 was associated with endometriosis-related infertility (P < 0.001) and also with IVF failure (P = 0.018). After controlling for age, infertile women with ESR1 rs9340799 GG genotype presented 4-fold increased risk of endometriosis (OR 4.67, 95% CI 1.84–11.83, P = 0.001) and 3-fold increased risk of IVF failure (OR 3.33, 95% CI 1.38–8.03, P = 0.007). Our results demonstrate an association between ESR1 rs9340799 polymorphism and infertile women with endometriosis and also with women who were submitted to IVF procedures and had no blastocyst implantation.
Paskulin, Diego Davila; Cunha-Filho, Joao Sabino; Paskulin, Livia Davila; Souza, Carlos Augusto Bastos; Ashton-Prolla, Patricia
Male fertility largely depends on sperm quality, which may be affected by environmental and genetic factors. Recent data emphasised the implication of the polymorphism of mitochondrial DNA polymerase gamma (POLG) CAG repeats in male infertility. In this report, we explored a possible role of the (POLG) gene polymorphism in male infertility in Tunisian men. The polymorphic CAG repeat in the nuclear POLG gene was studied in 339 male subjects (216 patients with infertility (69 azoospermic, 115 oligoasthenoteratospermic and 32 normospermic) and 123 fertile) after DNA amplification by PCR, followed by genotyping using an automatic sequencer. The heterozygous and the homozygous mutant genotypes (10/ ? 10 and ? 10/ ? 10) were significantly more frequent among infertile patients than among fertile controls (11.2% versus 1.6%, P = 1.3 × 10(-3) and 4.6% versus 0.8%, P = 4.2 × 10(-7) respectively). We also found a significant difference between the frequencies of 10/ ? 10 genotype in azoospermic (4.4%) and in oligoasthenoteratospermic (15.6%) infertile patients (P = 2.6 × 10(-2) ). However, the homozygous mutant genotype (? 10/ ? 10) was seen at similar frequencies in azoospermic, normospermic and oligoasthenospermic men (4.4%, 3.1% and 5.2% respectively). Under our conditions, the findings showed an association between POLG CAG repeat polymorphism and male infertility in Tunisian population. PMID:21806654
Baklouti-Gargouri, S; Ghorbel, M; Chakroun, N; Sellami, A; Fakhfakh, F; Ammar-Keskes, L
Phytoestrogens (PEs) are naturally occurring chemical constituents of certain plants. The internal PE exposures, mainly from diet, vary among different populations and in different regions due to various eating habits. To investigate the potential relationship between urinary PE levels and idiopathic male infertility and semen quality in Chinese adult males, 608 idiopathic infertile men and 469 fertile controls were recruited by eligibility screening procedures. Individual exposure to PEs was measured using UPLC-MS/MS as spot urinary concentrations of 6 PEs (daidzein, DAI; equol, EQU; genistein, GEN; naringenin, NAR; coumestrol, COU; and secoisolariciresinol, SEC), which were adjusted with urinary creatinine (CR). Semen quality was assessed by sperm concentration, number per ejaculum and motility. We found that exposures to DAI, GEN and SEC were significantly associated with idiopathic male infertility (P-value for trend=0.036; 0.002; and 0.0001, respectively), while these exposures had stronger association with infertile subjects with at least one abnormal semen parameter than those with all normal semen parameters. Exposures to DAI, GEN and SEC were also related to idiopathic male infertility with abnormal sperm concentration, number per ejaculum and motility (P-value for trend<0.05), while these exposures had stronger association with the infertile men with abnormal sperm number per ejaculum. These findings provide the evidence that PE exposures are related to male reproductive function and raise a public health concern because that exposure to PEs is ubiquitous in China. PMID:23820060
Xia, Yankai; Chen, Minjian; Zhu, Pengfei; Lu, Chuncheng; Fu, Guangbo; Zhou, Xiaojin; Chen, Daozhen; Wang, Honghua; Hang, Bo; Wang, Shoulin; Zhou, Zuomin; Sha, Jiahao; Wang, Xinru
Varicocele is a prevalent pathology among infertile men. The mechanisms linking this condition to infertility, however, are poorly understood. Our previous work showed a relationship between sperm functional quality and the ability of spermatozoa to respond to capacitating conditions with increased membrane fluidity and protein tyrosine phosphorylation. Given the reported association between varicocele, oxidative stress, and sperm dysfunction, we hypothesized that spermatozoa from infertile patients with varicocele might have a combined defect at the level of membrane fluidity and protein tyrosine phosphorylation. Semen samples from infertile patients with and without grade II/III left varicocele were evaluated for motion parameters (computer-assisted semen analysis [CASA]), hyperactivation (CASA), incidence and intensity of protein tyrosine phosphorylation (phosphotyrosine immunofluorescence and western blotting), and membrane fluidity (Laurdan fluorometry), before and after a capacitating incubation (6 hr at 37 degrees C in Ham's F10/BSA, 5% CO(2)). Spermatozoa from varicocele samples presented a decreased response to the capacitating challenge, showing significantly lower motility, hyperactivation, incidence and intensity of tyrosine phosphorylation, and membrane fluidity. The findings reported in this article indicate that the sperm dysfunction associated to infertile varicocele coexists with decreased sperm plasma membrane fluidity and tyrosine phosphorylation. These deficiencies represent potential new pathophysiological mechanisms underlying varicocele-related infertility. PMID:16897700
Buffone, M G; Brugo-Olmedo, S; Calamera, J C; Verstraeten, S V; Urrutia, F; Grippo, L; Corbetta, J P; Doncel, G F
Estrogen receptor alpha has a central role in human fertility by regulating estrogen action in all human reproductive tissues. Leukemia inhibitory factor (LIF) expression, a cytokine critical for blastocyst implantation, is mediated by estrogen signaling, so we hypothesized that ESR1 gene polymorphisms might be candidate risk markers for endometriosis-related infertility and in vitro fertilization (IVF) failure. We included 98 infertile women with endometriosis, 115 infertile women with at least one IVF failure and also 134 fertile women as controls. TaqMan SNP assays were used for genotyping LIF (rs929271), MDM2 (rs2279744), MDM4 (rs1563828), USP7 (rs1529916), and ESR1 (rs9340799 and rs2234693) polymorphisms. The SNP ESR1 rs9340799 was associated with endometriosis-related infertility (P < 0.001) and also with IVF failure (P = 0.018). After controlling for age, infertile women with ESR1 rs9340799 GG genotype presented 4-fold increased risk of endometriosis (OR 4.67, 95% CI 1.84-11.83, P = 0.001) and 3-fold increased risk of IVF failure (OR 3.33, 95% CI 1.38-8.03, P = 0.007). Our results demonstrate an association between ESR1 rs9340799 polymorphism and infertile women with endometriosis and also with women who were submitted to IVF procedures and had no blastocyst implantation. PMID:24427778
Paskulin, Diego Davila; Cunha-Filho, João Sabino; Paskulin, Livia Davila; Souza, Carlos Augusto Bastos; Ashton-Prolla, Patricia
1745 patients at the Department of Urology of Tenon Hospital (Paris, France) from 1990 to 2006 and at the department of urology of Tbilisi State Medical University (Georgia) during last several months have been examined and counseled on male infertility. Leydig cell tumor was found in 4 patients, among them 3 by palpation and testicle echography, fourth patient (at the age of 33) with bilateral varicocele (III stage at the left, II stage at the right) was more interesting for us. Leydig cell tumor was found out at the scrotum exploration. Oligoteratozoospermia (OATS) has been distinguished from his spermogram. Microsurgical bilateral correction of varicocele and scrotum exploration, and double-sided double biopsy of testicle have been carried out. During examination of the left testis the hardly palpable node has been found out in the lower pole. We became compelled to make enlarged incision of tunica alba of the testicle lower pole. After that it was found out the solid, well encapsulated and yellow-brown node (8 mm in diameter). The node enucleation away from tumor by 0.5 cm has been carried out. Exact histological investigation confirmed the presence of Leydig cell tumor. In 6 years after surgical operation the tumor node 1.8 mm in diameter has been found out in right (contra lateral) testis. The patient was urgently operated, ex-tempo investigation confirmed the presence of Leydig cell tumor in right testicle--high orchidectomy at the right has been carried out. Now, patient has not any symptoms of disease during 3.5 years of observation. Given case shows that the enucleation of Leydig cell tumor proves to be equivalent alternative of orchidectomy, which is suggested by many authors. Taking into account the presence of encapsulation and tumor benignity it is important to have opportunity of the testicle preservation due to infertility problems. However, this tactics must be carried out under strong observation due to the opportunity of relapse even in several days after surgical operation. PMID:17404447
Chovelidze, Sh G; Kochiashvili, D K; Gogeshvili, G G; Getta, Tieri; Lababidi, Alim
The aim of this study is to present the authors' experience in the diagnosis and treatment of tubal proximal disease by means of hysteroscopy. The study includes 96 patients with tubal infertility to which hysteroscopy was performed in 1998-2003 in the 2nd Clinic of Obstetrics and Gynecology, Ia?i. The average age was 32.5 +/- 1.2 years. The indication was proximal tubal obstruction diagnosed by hysterosalpingography or sono-hysterosalpingography. The hysteroscopy revealed lesions affecting fertility that were treated in the same operative sequence. Proximal tubal obstruction was present in 50 cases (52%): unilateral--41 cases, bilateral--9 cases. Tubal permeabilization was performed by tubal catheterization or by removing polyps, adhesion and was verified by chromo-tubation at the end of hysteroscopy and by sono-hysterosalpingography, 2 months after the intervention. When proximal tubal obstruction is suspected, hysteroscopy offers a solution by confirming the diagnosis and by efficiently treating the lesions, leading to an increased average of pregnancies. PMID:19292093
Lupa?cu, Ivona; Veghe?, Simina; David, Cristina; Vi?an, Valeria; Vasiliu, Veronica
Women frequently present to their general practitioner (GP) stating they have been trying for some time to get pregnant and failed. All GPs must be able to deal with the range of initial presentations in terms of history taking, examination and routine investigation. Treatment may be initiated in primary care, although at present most GPs are likely to refer to secondary care. In the future more GPs will undertake treatment themselves or refer to a GP with a special interest at Primary Care Trust (PCT) level. Both clomiphene and metformin either separately or together can be used in appropriate cases in primary care and are likely to lead to a high success rate and the prevention of unnecessary referrals to secondary care. GPs need to provide ongoing care throughout investigation and treatment for infertility and deal with subsequent outcomes both positive and negative. GPs as well as women themselves must be involved in the development of local guidelines from the outset together with secondary care specialists and those working on behalf of the PCT. It has yet to be shown that any guideline reduces NHS costs or improves patient outcomes. PMID:12869770
Smith, Lindsay F P
Steroid 21-hydroxylase deficiency is the most common adrenal genetic disease and is also named congenital adrenal hyperplasia. Depending on the severity of CYP21A2 gene mutations, there are severe or "classical" forms and moderate or "nonclassical" forms of 21-hydroxylase deficiency. The enzyme deficiency causes a disruption of adrenal steroidogenesis, which induces hyperandrogenism and elevated plasma levels of progesterone and 17-hydroxyprogesterone, the two substrates of 21-hydroxylase. These endocrine abnormalities will disrupt gonadal axis, endometrial growth and maturation and finally secretion of cervical mucus. All these phenomena contribute to a female hypofertility. Infertility is more severe in classical forms. When to become pregnant, treatment with hydrocortisone or dexamethasone can limit the production of adrenal androgens and progesterone and improves spontaneous pregnancy rates while minimizing the risk of miscarriage, which is usually relatively high in this disease. When planning pregnancy in patients with a 21-hydroxylase deficiency, genotyping the partner is required to screen for heterozygozity (1/50) and to assess the risk of transmission of a classical form in the progeny. PMID:24852906
Robin, G; Decanter, C; Baffet, H; Catteau-Jonard, S; Dewailly, D
Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperitoneal surgery, diabetes, congenital spinal abnormalities, multiple sclerosis and spinal cord injury. Erectile dysfunction can be managed by an increasingly invasive range of treatments including medications, injection therapy and the surgical insertion of a penile implant. Retrograde ejaculation is managed by medications to reverse the condition in mild cases and in bladder harvest of semen after ejaculation in more severe cases. Anejaculation might also be managed by medication in mild cases while assisted ejaculatory techniques including penile vibratory stimulation and electroejaculation are used in more severe cases. If these measures fail, surgical sperm retrieval can be attempted. Ejaculation with penile vibratory stimulation can be done by some spinal cord injured men and their partners at home, followed by in-home insemination if circumstances and sperm quality are adequate. The other options always require assisted reproductive techniques including intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection. The method of choice depends largely on the number of motile sperm in the ejaculate.
Fode, Mikkel; Krogh-Jespersen, Sheila; Brackett, Nancy L; Ohl, Dana A; Lynne, Charles M; S?nksen, Jens
Summary Centrins are calmodulin-like Ca2+-binding proteins that can be found in all ciliated eukaryotic cells from yeast to mammals. Expressed in male germ cells and photoreceptors, centrin 1 (CETN1) resides in the photoreceptor transition zone and connecting cilium. To identify its function in mammals, we deleted Cetn1 by homologous recombination. Cetn1?/? mice were viable and showed no sign of retina degeneration suggesting that CETN1 is nonessential for photoreceptor ciliogenesis or structural maintenance. Phototransduction components localized normally to the Cetn1?/? photoreceptor outer segments, and loss of CETN1 had no effect on light-induced translocation of transducin to the inner segment. Although Cetn1?/? females and Cetn1+/? males had normal fertility, Cetn1?/? males were infertile. The Cetn1?/? testes size was normal, and spermatogonia as well as spermatocytes developed normally. However, spermatids lacked tails suggesting severe defects at the late maturation phase of spermiogenesis. Viable sperm cells were absent and the few surviving spermatozoa were malformed. Light and electron microscopy analyses of Cetn1?/? spermatids revealed failures in centriole rearrangement during basal body maturation and in the basal-body–nucleus connection. These results confirm an essential role for CETN1 in late steps of spermiogenesis and spermatid maturation.
Avasthi, Prachee; Scheel, Jan Frederik; Ying, Guoxin; Frederick, Jeanne M.; Baehr, Wolfgang; Wolfrum, Uwe
Mating of a babirusa (Babyrousa babyrussa) boar and a domestic sow (Sus scrofa) resulted in the birth of 5 live domestic pig-babirusa hybrid piglets. Chromosome analysis of one of the surviving males confirmed that they were domestic pig-babirusa hybrids by revealing the presence of a complete haploid set of 19 porcine chromosomes as well as a complete haploid set of 19 babirusa chromosomes in the karyotype. None of the surviving piglets, two males and one female, had shown signs of sexual maturity at age 27 months. Histological examination of gonadal biopsies from the 2 males revealed that both were azoospermatic. Immunostaining revealed SCP3-positive axial elements in the nuclei of primary spermatocytes, indicating that they were progressing through leptotene and zygotene of meiotic prophase. However, the presence of multiple short stretches of axial elements in pachytene nuclei indicated that this phase was blocked, probably due to aberrant chromosome pairing. Histological examination of the ovaries revealed follicular structures, but oocytes within them were generally degenerated. We conclude that both male and female pig-babirusa hybrids were infertile, most likely due to germ cell death resulting from abnormalities of chromosome pairing during meiotic prophase. PMID:20924163
Thomsen, P D; Schauser, K; Bertelsen, M F; Vejlsted, M; Grøndahl, C; Christensen, K
Centrins are calmodulin-like Ca(2+)-binding proteins that can be found in all ciliated eukaryotic cells from yeast to mammals. Expressed in male germ cells and photoreceptors, centrin 1 (CETN1) resides in the photoreceptor transition zone and connecting cilium. To identify its function in mammals, we deleted Cetn1 by homologous recombination. Cetn1(-/-) mice were viable and showed no sign of retina degeneration suggesting that CETN1 is nonessential for photoreceptor ciliogenesis or structural maintenance. Phototransduction components localized normally to the Cetn1(-/-) photoreceptor outer segments, and loss of CETN1 had no effect on light-induced translocation of transducin to the inner segment. Although Cetn1(-/-) females and Cetn1(+/-) males had normal fertility, Cetn1(-/-) males were infertile. The Cetn1(-/-) testes size was normal, and spermatogonia as well as spermatocytes developed normally. However, spermatids lacked tails suggesting severe defects at the late maturation phase of spermiogenesis. Viable sperm cells were absent and the few surviving spermatozoa were malformed. Light and electron microscopy analyses of Cetn1(-/-) spermatids revealed failures in centriole rearrangement during basal body maturation and in the basal-body-nucleus connection. These results confirm an essential role for CETN1 in late steps of spermiogenesis and spermatid maturation. PMID:23641067
Avasthi, Prachee; Scheel, Jan Frederik; Ying, Guoxin; Frederick, Jeanne M; Baehr, Wolfgang; Wolfrum, Uwe
Cystic fibrosis (CF) is an autosomal recessive disease caused by mutations in the CFTR gene. Among males with CF, 95% are infertile due to congenital absence of the vas deferens. We investigated the role of family\\u000a history of infertility among CF subjects and characterized mutations in them. Among 50 CF subjects, four had a family history\\u000a of infertility. A homozygous
Neeraj Sharma; Meenu Singh; Naveen Acharya; Shrawan K. Singh; Babu R. Thapa; Gurjeet Kaur; Rajendra Prasad
Infertility is a problem of global proportions, affecting on average 8-12 percent of couples worldwide. In some societies, however-particularly those in the "infertility belt" of sub-Saharan Africa-as many as one-third of all couples are unable to conceive. Factors causing high rates of tubal infertility in parts of the developing world include sexually transmitted, postpartum, and postabortion infections; however, male infertility, which is rarely acknowledged, contributes to more than half of all cases. Unfortunately, the new reproductive technologies (NRTs) such as in vitro fertilization (IVF), which are prohibitively expensive and difficult to implement in many parts of the developing world, represent the only solution to most cases of tubal and male infertility. Not surprisingly, these technologies are rapidly globalizing to pronatalist developing societies, where children are highly desired, parenthood is culturally mandatory, and childlessness socially unacceptable. Using Egypt as an illustrative case study, this paper examines five of the major forces fueling the global demand for NRTs; these include demographic and epidemiological factors, the fertility-infertility dialectic, problems in health care seeking, gendered suffering, and adoption restrictions. Following this overview, a detailed examination of the implications of the rapid global spread of NRTs to the developing world will be offered. By focusing on Egypt, where nearly 40 IVF centers are in operation, this article will demonstrate the considerable constraints on the practice and utilization of NRTs in a developing country on the "receiving end" of global reproductive technology transfer. The article concludes by stressing the need for primary prevention of infections leading to infertility, thereby reducing global reliance on NRTs. PMID:12650724
Inhorn, Marcia C
The mechanism of infertility in women with endometriosis is unknown, but it is independent of mechanical factors that affect fallopian tube function. Increased numbers of peritoneal macrophages are present in women with endometriosis and have access to the female reproductive tract via the oviducts. To determine whether peritoneal macrophages might phagocytize sperm and thereby contribute to infertility in women with endometriosis, we examined peritoneal macrophages from 32 fertile and infertile women; the infertile group was separated into those with and those without visible endometriosis. Peritoneal macrophages from infertile patients with endometriosis phagocytized more normal sperm in vitro (84% +/- 4%) than did those from fertile women (43% +/- 4%) or infertile women without endometriosis (46% +/- 8%) (p less than 0.002). The sperm phagocytosis occurred rapidly and reached a peak by approximately 6 hours. Incubation at 0 degrees C, lysing the macrophages by freezing and thawing, or fixing the macrophages with glutaraldehyde inhibited the sperm uptake by macrophages. The process occurred in cultures with or without serum, thereby indicating that the sperm phagocytosis was not dependent on sperm opsonization with a serum factor. Electron microscopy showed internalization of the spermatozoa into phagosomes with subsequent intravacuolar degradation. These data demonstrate that: (1) peritoneal macrophages phagocytize and degrade sperm in vitro and (2) peritoneal macrophages isolated from women with endometriosis exhibit greater phagocytosis in vitro than do macrophages from fertile women or infertile women without endometriosis. These results suggest that, if peritoneal macrophages from women with endometriosis enter the reproductive tract via the oviducts, they might adversely influence fertilization by phagocytizing sperm. PMID:6753586
Muscato, J J; Haney, A F; Weinberg, J B
AIM: This study aimed to evaluate the efficacy of ketotifen on sperm motility of asthenospermic infertile men. SETTING AND DESIGN: It is a prospective study designed in vivo. MATERIALS AND METHODS: In this interventional experimental study, a total of 40 infertile couples with asthenospermic infertility factor undergoing assisted reproductive technology (ART) cycles were enrolled. The couples were randomly assigned to one of two groups at the starting of the cycle. In control group (n = 20), the men did not receive Ketotifen, while in experiment group (n = 20), the men received oraly ketotifen (1 mg Bid) for 2 months. Semen analysis, under optimal circumferences, was obtained prior to initiation of treatment. The second semen analysis was done 2-3 weeks after stopped ketotifen treatment and sperm motility was defined. Clinical pregnancy was identified as the presence of a fetal sac by vaginal ultrasound examination. STATISTICAL ANALYSIS USED: All data are expressed as the mean ± standard error of mean (SEM). t test was used for comparing the data of the control and treated groups. RESULTS: The mean sperm motility increased significantly (from 16.7% to 21.4%) after ketotifen treatment (P < 0.001). This sperm motility improvement was more pronounced in the primary infertility cases (P < 0.003). The rate of pregnancy was 12.5% in infertile couples that their men receiving 1 mg/twice a day ketotifen. In 52% of infertile men's semen, the percentage of sperm motility was increased from 5% to 35% and this sperm motility improvement was also observed in 33% of necrospermia (0% motility) cases. CONCLUSION: These results suggest that ketotifen may represent as a novel therapeutic approach to improve sperm motility in the infertile men with cause of asthenospermia or necrospermia.
Saharkhiz, Nasrin; Nikbakht, Roshan; Hemadi, Masoud
Background Several studies have been conducted in Iran in order to investigate the prevalence of depression among infertile couples. However, there is a remarkable diversity among the results. This meta-analysis was conducted to estimate an overall prevalence rate of depression among infertile couples in Iran. Methods: International and national electronic databases were searched up to June 2011 including MEDLINE, Science Citation Index Expanded, Scopus, SID, MagIran, and IranMedex as well as conference databases. Furthermore, reference lists of articles were screened and the studies’ authors were contacted for additional references. Cross-sectional studies addressing the prevalence of depression among infertile couples were included in this meta-analysis. We assessed 12 separate studies involving overall 2818 participants of which 1251 had depression. Results: Overall prevalence rate of depression among infertile couples was 0.47 (95% CI: 0.40, 0.55). The prevalence rate of depression was 0.44 (95% CI: 0.32, 0.56) during 2000 to 2005 and 0.50 (95% CI: 0.43, 0.57 during 2006 to 2011. The prevalence rate of depression was 0.46 (95% CI: 0.39, 0.53) among women and 0.47 (95% CI: 0.40, 0.54) among men. Conclusion: Not only the prevalence of depression in infertile couples was high but also had increasing growth in recent years. Furthermore, despite many studies conducted addressing the prevalence of depression in infertile couples, there is however a remarkable diversity between the results. Thus, one can hardly give a precise estimation of the prevalence rate of depression among infertile couples in Iran now.
MASOUMI, Seyyedeh Zahra; POOROLAJAL, Jalal; KERAMAT, Afsaneh; MOOSAVI, Seyyed Abbas
Objectives Infertility is an important medical and social problem that has an impact on well-being. A significant development in the last 10 years in the study of human infertility has been the discovery that oxidative sperm DNA damage has a critical role in the etiology of poor semen quality and male infertility. Selenium (Se) is an essential element for normal testicular development, spermatogenesis, and spermatozoa motility and function. The predominant biochemical action of Se in both humans and animals is to serve as an antioxidant via the Se-dependent enzyme glutathione peroxidase and thus protect cellular membranes and organelles from peroxidative damage. We explored the efficacy of Se in combination with vitamin E for improving semen parameters and pregnancy rates in infertile men. Materials and methods The study included 690 infertile men with idiopathic asthenoteratospermia who received supplemental daily Se (200 ?g) in combination with vitamin E (400 units) for at least 100 days. The mean age of cases was 28.5 years (range 20–45), and the median age was 30 years. These cases had presented with male factor infertility (primary or secondary) for at least 1 year. The longest and shortest duration of infertility was 10 years and 1 year, respectively. The median time of diagnosis of infertility was 1 year with a mean of 2.5 years. Results We observed 52.6% (362 cases) total improvement in sperm motility, morphology, or both, and 10.8% (75 cases) spontaneous pregnancy in comparison with no treatment (95% confidence interval: 3.08 to 5.52). No response to treatment occurred in 253 cases (36.6%) after 14 weeks of combination therapy. Mean difference between semen analyses of cases before and after treatment was 4.3% with a standard deviation of 4.29. On the basis of paired t-test results, combination therapy with oral Se and vitamin E was effective for treatment of asthenospermia or asthenoteratospermia or induction of spontaneous pregnancy (P ? 0.001). Conclusions Supplemental Se and vitamin E may improve semen quality and have beneficial and protective effects, especially on sperm motility. We advocate their use for the treatment of idiopathic male infertility diagnosed with asthenoteratospermia or asthenospermia in semen analysis.
Moslemi, Mohammad K; Tavanbakhsh, Samaneh
Background Methylenetetrahydrofolate reductase (MTHFR) converts 5,10-methylene tetrahydrofolate to 5-methyl tetrahydrofolate and affects the activity of cellular cycles participating in nucleotide synthesis, DNA repair, genome stability, maintenance of methyl pool, and gene regulation. Genetically compromised MTHFR activity has been suggested to affect male fertility. The objective of the present study was to find the impact on infertility risk of c.203G>A, c.1298A>C, and c.1793G>A polymorphisms in the MTHFR gene. Methods PCR-RFLP and DNA sequencing were used to genotype the common SNPs in the MTHFR gene in 630 infertile and 250 fertile males. Chi-square test was applied for statistical comparison of genotype data. Linkage disequilibrium between the SNPs and the frequency of common haplotypes were assessed using Haploview software. Biochemical levels of total homocysteine (tHcy) and folic acid were measured. Meta-analysis on c.1298A>C polymorphism was performed using data from ten studies, comprising 2734 cases and 2737 controls. Results c.203G>A and c.1298A>C were found to be unrelated to infertility risk. c.1793G>A was protective against infertility (P?=?0.0008). c.677C>T and c.1793G>A were in significant LD (D’?=?0.9). Folic acid and tHcy level did not correlate with male infertility. Pooled estimate on c.1298A>C data from all published studies including our data showed no association of this polymorphism with male infertility (Odds ratio?=?1.035, P?=?0.56), azoospermia (Odds ratio?=?0.97, P?=?0.74), or oligoasthenoteratozoospermia (Odds ratio?=?0.92, p?=?0.29). Eight haplotypes with more than 1% frequency were detected, of which CCGA was protective against infertility (p?=?0.02), but the significance of the latter was not seen after applying Bonferroni correction. Conclusion Among MTHFR polymorphisms, c.203G>A and c.1298A>C do not affect infertility risk and c.1793G>A is protective against infertility. Haplotype analysis suggested that risk factors on the MTHFR locus do not extend too long on the DNA string.
Gupta, Nishi; Sarkar, Saumya; David, Archana; Gangwar, Pravin Kumar; Gupta, Richa; Khanna, Gita; Sankhwar, Satya Narayan; Khanna, Anil; Rajender, Singh
Background: Infertility has been described as creating a form of stress leading to a variety of psychological problems. Both psychotherapy and pharmacotherapy are effective treatments for infertility stress. The aim of this study was to evaluate the effectiveness of cognitive behavioral therapy along with fluoxetine for improvement infertility stress in infertile women. Materials and Methods: In a randomized controlled clinical trial, 89 infertile women with mild to moderate depression (Beck scores 10-47) were recruited into the following three groups: i. cognitive behavior therapy (CBT), ii. antidepressant therapy, and iii. control group. Twenty-nine participants in the CBT method received gradual relaxation training, restructuring, and eliminating of negative automatic thoughts and dysfunctional attitudes to infertility for 10 sessions. Thirty participants in the pharmacotherapy group took 20 mg fluoxetine daily for 90 days. Thirty individuals in control group did not receive any intervention. All participants completed fertility problem inventory (FPI) and the Beck Depression Inventory (BDI) at the beginning and end of the study. We applied Chi-square paired t test, ANOVA and Turkey’s test to analyze the data. Results: The mean of the infertility stress scores in CBT, fluoxetine, and control groups at the beginning and end of the study were as follows, respectively: 3.5 ± 0.62 vs.2.7 ± 0.62 (p<0.05), 3.5 ± 0.53 vs.3.2 ± 4.4 (p<0.05), and 3.4 ± 0.55 vs. 3.5 ± 0.48. In CBT group, the mean scores of social concern, sexual concern, marital concern, rejection of child-free lifestyle, and need for parenthood decreased meaningfully compared to those before starting the therapy. But in fluoxetine group, mean score of women sexual concern out of those five main problems of infertility reduced significantly. Also, fluoxetine and CBT reduced depression compared to the control group. Conclusion: CBT improved the social concerns, sexual concerns, marital concerns, rejection of child-free lifestyle, and need for parenthood more than floxitine group. Thus, CBT was not only a reliable alternative to pharmacotherapy, but also superior to fluoxetine in resolving and reducing of infertility stress (Registration Number: IRCT2012061710048N1).
Faramarzi, Mahbobeh; Pasha, Hajar; Esmailzadeh, Seddigheh; Kheirkhah, Farzan; Heidary, Shima; Afshar, Zohreh
Background This article analyzes several key issues in the debate: the acceptability of in vitro fertilization; regulation of assisted reproduction and the possibilities of reimbursement for assisted reproduction treatment in Lithuania. Method Two groups of respondents participated in the survey: fertile women and women with fertility disorders. 93 completed questionnaires from women with fertility problems and 146 from women with no fertility problems were analysed. Results Fertile respondents more frequently perceived the embryo as a human being (Fertile Individuals – 68.5%; Infertile Individuals – 35.5%; p < 0.05) and more frequently maintained that assisted reproduction treatment should be only partly reimbursed (Fertile Individuals – 71.3%; Infertile Individuals – 39.8%; p < 0.05). Respondents with fertility disorders more frequently thought that artificial insemination procedure could also be applied to unmarried couples (Fertile Individuals – 51.4%; Infertile Individuals – 76.3%; p < 0.05), and more frequently agreed that there should be no age limit for artificial insemination procedures (Fertile Individuals – 36.3%; Infertile Individuals – 67.7%; p < 0.05). The majority of respondents in both groups (Fertile Individuals – 77.4%; Infertile Individuals – 82.8%; p < 0.05) believed that donation of reproductive cells should be regulated by law. Fertile respondents more frequently considered that strict legal regulation was necessary in case of the number of transferred embryos (Fertile Individuals – 69.2%; Infertile Individuals – 39.8%; p < 0.05) and freezing of embryos (Fertile Individuals – 69.9%; Infertile Individuals – 57.0%; p < 0.05). Conclusion Fertile respondents were statistically more likely to believe that the IVF procedure should be applied only to married couples or women who had a regular partner, the age limit should be defined and the psychological assessment of the couple’s relationship and their readiness for the IVF procedure was necessary. In contrast, infertile couples were statistically more likely than fertile respondents to maintain that the IVF procedure should be fully reimbursed by the state. Fertile respondents were statistically more likely to be categorical with respect to the number of embryos and the freezing of embryos. Meanwhile there is a statistically significant difference in opinions of infertile respondents who were in favour of stricter regulation on donation of reproductive cells.
Background The experience of infertility can be extremely stressful. Some of the risk factors for depression in infertility are being female, repeated unsuccessful treatment cycles or a 2 to 3 year history of infertility, low socioeconomic status, foreign nationality, lack of partner support, life events and previous depression. In this study, we analyzed the Beck Depression Inventory score at the beginning and the end of infertility treatment, to determine which factors may influence the BDI score after treatment of infertility. Methods In a before-after study, in a university-affiliated teaching hospital, 251 women who had been visited for assisted reproductive technology infertility treatment participated in the study. BDI score was assessed before and after treatment of infertility. Results The mean BDI score rose after unsuccessful treatment and dropped after successful treatment. Those with lower education levels had a higher BDI score before treatment. BDI score after treatment was positively correlated with pretreatment BDI scoreand duration of infertility. Conclusion BDI score after treatment was strongly connected to the BDI score before treatment, the result of therapy and to the duration of infertility. The influence of duration of infertility on BDI score after treatment of infertility is weak. So a simple method to screen patients at risk of depression after infertility treatment is determining pretreatment BDI score and predicting the result of infertility treatment by other risk factors.
Khademi, Afsaneh; Alleyassin, Ashraf; Aghahosseini, Marzieh; Ramezanzadeh, Fatemeh; Abhari, Ali Ahmadi
In vitro fertilization (IVF) is a risk factor for pregnancy, but there have been few studies on the effect of infertility's aetiology. Thus, we have assessed the role of aetiology on IVF pregnancy outcomes in a retrospective cohort study comparing the outcomes of IVF singleton pregnancies with those of spontaneous pregnancies in the general Finnish population. The study group consisted of 255 women with births resulting from singleton IVF pregnancies. Six subgroups were formed according to the following causes of infertility: anovulation (27%), endometriosis (19%), male factor (17%), tubal factor (15%), polycystic ovary syndrome (11%), and unexplained infertility (12%). The reference group consisted of 26,870 naturally conceived women. Adjusted odds ratios (AORs), for confounding factors such as age and parity, were estimated using logistic regression analysis. Women with endometriosis and anovulation had increased risks of preterm birth (AOR 3.25, 95% CI 1.5-7.1 and AOR 2.1, and 95% CI 1.0-4.2, resp.), while women in couples with male factor infertility had a twofold risk of admission to neonatal intensive care (AOR 2.5, 95% CI 1.2-5.3). The findings show that the aetiology of infertility influenced the obstetrics outcome, and that pooling results may obscure some increased risks among subgroups. PMID:22570795
Kuivasaari-Pirinen, Paula; Raatikainen, Kaisa; Hippeläinen, Maritta; Heinonen, Seppo
BACKGROUND: Cases of endometriosis with no tubal damage are associated with infertility, suggesting an immunological rather than mechanical barrier to reproduction. Laparoscopy and falloposcopy results of clinically asymptomatic women undergoing investigation of infertility were correlated with the outcomes of microbiological screening for Chlamydia trachomatis, Mycoplasma pneumoniae, Mycoplasma hominis, ureaplasma species, Neisseria gonorrhoeae, Neisseria meningitidis and Chlamydia pneumoniae. METHODS: A total of 44 women presenting to a hospital IVF service for laparoscopic or laparoscopic/falloposcopic investigation of infertility provided endocervical swabs, fallopian tube washings, and peripheral whole blood for analysis. RESULTS: Of these 44 women, 15.9% (7) showed evidence of C. trachomatis infection as detected by either PCR or EIA serology. Of these 7 women, 5 (71%) had no or mild endometriosis and 2 (29%) had moderate or severe endometriosis. Of the remaining 37 women who showed no evidence of chlamydial infection, 15 (40.5%) had no or mild endometriosis. CONCLUSION: Women with infertility, but without severe endometriosis at laparoscopy, showed a trend towards tubal damage and a higher rate of previous C. trachomatis infection. Although not statistically significant, this trend would suggest that, where moderate to severe tubal damage is found to be the primary cause of infertility, C. trachomatis infection could be a likely cause for such tubal damage.
Debattista, Joseph; Gazzard, Caroline M.; Wood, Robyn N.; Allan, John A.; Allan, Janet M.; Scarman, Anthony; Mortlock, Miranda; Timms, Peter; Knox, Christine L.
Defects in early meiotic events are thought to play a critical role in male infertility; however, little is known regarding the relationship between early meiotic events and the chromosomal constitution of human sperm. Thus, we analyzed testicular tissue from 26 men (9 fertile and 17 infertile men), using immunofluorescent techniques to examine meiotic chromosomes, and fluorescent in situ hybridization to assess sperm aneuploidy. Based on a relatively small sample size, we observed that 42% (5/12) of men with impaired spermatogenesis displayed reduced genome-wide recombination when compared to the fertile men. Analysis of individual chromosomes showed chromosome-specific defects in recombination: chromosome 13 and 18 bivalents with only a single crossover and chromosome 21 bivalents lacking a crossover were more frequent among the infertile men. We identified two infertile men who displayed a novel meiotic defect in which the sex chromosomes failed to recombine: one man had an absence of sperm in the testes, while the other displayed increased sex chromosome aneuploidy in the sperm, resulting in a 45,X abortus after intracytoplasmic sperm injection. When all men were pooled, we observed an inverse correlation between the frequency of sex chromosome recombination and XY disomy in the sperm. Recombination between the sex chromosomes may be a useful indicator for identifying men at risk of producing chromosomally abnormal sperm. An understanding of the molecular mechanisms that contribute to sperm aneuploidy in infertile men could aid in risk assessment for couples undergoing assisted reproduction. PMID:17728321
Ferguson, Kyle A; Wong, Edgar Chan; Chow, Victor; Nigro, Mark; Ma, Sai
Objectives. To evaluate the prevalence of infertility in women with Graves' disease (GD) or Hashimoto's thyroiditis (HT) and associated factors. Material and Methods. This cross-sectional study was conducted at the Endocrinology Clinic for Thyroid Autoimmune Diseases, with 193 women aged 18-50 years with GD and 66 women aged 18-60 years with HT. The women were interviewed to obtain data on their gynecological and obstetric history and family history of autoimmune diseases. Their medical records were reviewed to determine the characteristics of the disease and to confirm association with other autoimmune diseases. Infertility was defined as 12 months of unprotected sexual intercourse without conception. Results. The prevalence of infertility was 52.3% in GD and 47.0% in HT. Mean age at diagnosis was 36.5 years and 39.2 years, in GD and HT, respectively. The mean number of pregnancies was lower in women who were 35 years old or younger at diagnosis and was always lower following diagnosis of the disease, irrespective of age. The only variable associated with infertility was a shorter time of the disease in HT. Conclusions. The prevalence of infertility was high in women with GD and HT and affected the number of pregnancies in young women. PMID:24678319
Quintino-Moro, Alessandra; Zantut-Wittmann, Denise E; Tambascia, Marcos; Machado, Helymar da Costa; Fernandes, Arlete
In vitro fertilization (IVF) is a risk factor for pregnancy, but there have been few studies on the effect of infertility's aetiology. Thus, we have assessed the role of aetiology on IVF pregnancy outcomes in a retrospective cohort study comparing the outcomes of IVF singleton pregnancies with those of spontaneous pregnancies in the general Finnish population. The study group consisted of 255 women with births resulting from singleton IVF pregnancies. Six subgroups were formed according to the following causes of infertility: anovulation (27%), endometriosis (19%), male factor (17%), tubal factor (15%), polycystic ovary syndrome (11%), and unexplained infertility (12%). The reference group consisted of 26,870 naturally conceived women. Adjusted odds ratios (AORs), for confounding factors such as age and parity, were estimated using logistic regression analysis. Women with endometriosis and anovulation had increased risks of preterm birth (AOR 3.25, 95% CI 1.5–7.1 and AOR 2.1, and 95% CI 1.0–4.2, resp.), while women in couples with male factor infertility had a twofold risk of admission to neonatal intensive care (AOR 2.5, 95% CI 1.2–5.3). The findings show that the aetiology of infertility influenced the obstetrics outcome, and that pooling results may obscure some increased risks among subgroups.
Kuivasaari-Pirinen, Paula; Raatikainen, Kaisa; Hippelainen, Maritta; Heinonen, Seppo
Twenty-two buffalo bulls suffering from three different types of infertility were slaughtered and used for this study. Except for the reproductive system, no signs of localised or generalised disease were observed. Microbiological investigations were negative for brucellosis, vibriosis, mycoplasma and other non-specific microorganisms. Nine bulls with type 1 infertility had low bodyweights and underdevelopment of testes, accessory sex glands and endocrine glands. This picture suggests a total dysfunction of the pituitary-growth-gonadal axis. One bull of this type also showed bilateral epididymitis. Four out of 11 bulls with type 2 infertility had low bodyweights and most suffered from underdevelopment of testes, accessory sex glands and endocrine glands. Six bulls of this type had lesions of either epididymitis or orchitis or both. Two of these animals showed adhesions of periorchitis. One also showed seminal vesiculitis. In two bulls with type 3 infertility, bodyweights, reproductive organs and endocrine glands were normal. In later life, they yielded poor quality semen. Semen samples collected a few months before slaughter from nine bulls with type 2 and type 3 infertility were of poor quality and had higher percentages of abnormal spermatozoa in most cases. PMID:4049694
Ahmad, M; Latif, M; Ahmad, M; Khan, I H; Ahmad, N; Anzar, M
This paper reports an aspect of a poststructural feminist study in which I explored the discursive formations within which women for whom in vitro fertilisation (IVF) was unsuccessful constitute themselves. In my exploration I draw on data from interviews with women who discontinued infertility treatment, print media material and infertility self-help books. Specifically, I highlight a metaphor of lottery in discourses of infertility, arguing that it is hegemonic and showing how when women are situated as gamblers, the metaphor is instrumental in polarising them into 'winners' or 'losers' in relation to the subjectivity of motherhood. I further deconstruct these subjectivities, showing how 'winners' are valorised and 'losers' are pathologised. But importantly, I show how infertile women who are not mothers resisted locating themselves as 'losers' in a metaphor of lottery and instead situated themselves in a contesting metaphor of investment as diligent 'workers' and as active agents in choosing the best employment of their bodily and monetary resources. This paper therefore amplifies the marginalised perspective of infertile women who are not mothers. PMID:12164714
de Lacey, Sheryl
The present investigation was undertaken to assess the role of Mucuna pruriens in infertile men who were under psychological stress. Study included 60 subjects who were undergoing infertility screening and were found to be suffering from psychological stress, assessed on the basis of a questionnaire and elevated serum cortisol levels. Age-matched 60 healthy men having normal semen parameters and who had previously initiated at least one pregnancy were included as controls. Infertile subjects were administered with M. pruriens seed powder (5 g day?1) orally. For carrying out morphological and biochemical analysis, semen samples were collected twice, first before starting treatment and second after 3 months of treatment. The results demonstrated decreased sperm count and motility in subjects who were under psychological stress. Moreover, serum cortisol and seminal plasma lipid peroxide levels were also found elevated along with decreased seminal plasma glutathione (GSH) and ascorbic acid contents and reduced superoxide dismutase (SOD) and catalase activity. Treatment with M. pruriens significantly ameliorated psychological stress and seminal plasma lipid peroxide levels along with improved sperm count and motility. Treatment also restored the levels of SOD, catalase, GSH and ascorbic acid in seminal plasma of infertile men. On the basis of results of the present study, it may be concluded that M. pruriens not only reactivates the anti-oxidant defense system of infertile men but it also helps in the management of stress and improves semen quality.
Shukla, Kamla Kant; Ahmad, Mohammad Kaleem; Jaiswar, Shyam Pyari; Shankwar, Satya Narain; Tiwari, Sarvada Chandra
Testicular microlithiasis (TM) is a pathological event characterised by the presence of microliths within the testicular entities, and such calcium deposition is thought to have deleterious impacts on the structure of blood-testis barrier (BTB). Breaches in the BTB appear to be a risk factor for antisperm antibody (ASA) production, which is reported to have negative influence on human fertility. Thus, the theories are provocative that ASA formation is elicited in TM men, and the resultant ASA will accordingly affect the fecundity in these men. To illustrate these hypotheses, this study enrolled 22 infertile men incidentally diagnosed with TM by testicular ultrasound evaluation. Sperm samples were collected, and direct immunobead test was used to determine the ASA levels. None of the infertile men with TM were found to display significant levels of ASA, whilst relatively abnormal sperm parameters in these cases were revealed by semen analysis. These observations suggest that TM exposure does not increase the risk of ASA production in infertile men, and therefore, ASA is discarded as an active participant in the development of infertility in TM men. Nevertheless, disrupted spermatogenesis resulting from TM may, at least in part, have certain implications for the pathogenesis of TM-associated infertility. PMID:22928752
Jiang, H; Zhu, W-J
The aim of this study was to compare the reproductive parameters and the health-related, lifestyle and educational factors in middle-aged healthy men and male partners of infertile couples. Our patient group included 164 male partners of infertile couples with a preceding period of infertility of at least 12 months and 61 men attending a prostate health screening and considering themselves healthy. Significant differences between the groups were found in testicular volume, total sperm output, density and morphology as well as oestradiol levels in serum. The analysis showed significant positive correlations between testicular volume and semen quality, while negative correlations were observed between gonadotrophin levels and sperm parameters in both groups. Physical activity and sexual capability were higher in healthy men, while coital frequency and a history of sexually transmitted diseases were higher in male partners of infertile couples. The impact of physical activity and sexual capability on semen quality for all subjects was revealed. We can conclude that impaired reproductive function, that is, semen quality, in men >45 years is related not only with general male ageing but obvious differences between subjects of infertile couples and healthy middle-aged men can be seen. Their relations with lifestyle, environmental or physiological factors need further study. PMID:23278341
Ausmees, K; Mändar, R; Korrovits, P; Zarkovski, M; Timberg, G; Punab, M
Unexplained infertility (UI) is a difficult diagnosis in the field of obstetrics and gynaecology. This report describes TENS treatment as an adjunct therapy for a 30-year-old woman with long-standing UI who was scheduled to undergo ovarian stimulation for in vitro fertilization (IVF) and embryo transfer. She had three unsuccessful intrauterine insemination treatments. Her last IVF treatment also failed. The treatment consisted of burst-TENS for seven sessions, which was applied daily from the second day of induction of ovulation (IO) to hCG administration. The transvaginal ultrasonography with pulsed Doppler curves was performed to measure the uterine artery impedance indices of Pulsatility Index (PI) and Resistance Index (RI). Before TENS application, on the first day of IO, the PI and RI for right side uterine artery were 3.96 and 0.96, respectively. For left uterine artery, the PI and RI were 6.92 and 1, respectively. After treatment with TENS, on the day of hCG administration, the PI and RI for right side uterine artery were 3.39 and 0.90, respectively. On the left side, they were PI=2.62 and RI=0.86. IVF was performed and on the day of oocytes collection, 22 oocytes were collected and inseminated. Fertilization was confirmed 16 hours after insemination by visualization of 2 pronuclei. A singleton pregnancy was achieved by the presence of a fetal sac during an ultrasound examination. It is concluded that the addition of TENS resulted in remarkable reduction of uterine artery PI and RI and a successful pregnancy after IVF for this woman with UI. PMID:20690870
Salsabili, Nasser; Ansari, Noureddin Nakhostin; Berjis, Katayoon; Sedighi, Asefeh; Salsabili, Hoda
We present the case of two brothers who were referred to a male infertility clinic for infertility workup. Conventional chromosome analysis and Y chromosome microdeletions did not reveal any genetic alterations. We utilized the chromosome microarray analysis (CMA) to identify novel and common variations associated with this severely impaired spermatogenesis cases. CMA specific results showed a common deletion in the 15q15.3 region that harbors genes like CATSPER2, STRC and PPIP5K1 in both cases (M18 and M19). In addition we identified small duplication in X and 11 chromosomes of M19. This is the first familial case report from India on occurrence of CATSPER gene deletion in human male infertility. PMID:24690399
Jaiswal, Deepika; Singh, Vertika; Dwivedi, U S; Trivedi, Sameer; Singh, Kiran
The staff and services of the endocrine biochemistry laboratory are essential to the efficient investigation of infertility. Each centre should adopt a detailed strategy for the investigation of the infertile couple which specifies the hormone analyses required at each stage. Appropriate first-line hormone tests should be selected after a thorough clinical history and physical examination of both partners. Second-line hormone testing should be determined from the results of the initial investigation and should be restricted to requests that either confirm or clarify an endocrine basis to infertility or monitor the response to treatment. The clinical biochemist should advise on specimen timing and collection, have responsibility for guaranteeing time and valid hormone results, and be part of the team that audits the overall strategy and the outcome for individual patients.
Beastall, G H
Ovarian pregnancy is a rare form of extra uterine pregnancy. Serous cyst adenoma is a benign variant of epithelial cell tumors of ovary. The coexistence of a cyst adenoma with an ovarian pregnancy in the same ovary is extremely rare. Some studies suggested that infertility or ovulation-inducing drugs can be involved in increased risk of ovarian tumors and ovarian pregnancies. A 28-year-old infertile woman presented with a ruptured ovarian pregnancy following ovulation induction with metformin. She had a concurrent benign serous cyst adenoma in the same ovary. Resection of both ovarian pregnancy and tumoral mass were performed. The ovary was preserved. Removal of gestational tissue and preservation of the involved ovary are the best options for management of ovarian pregnancy in young patient. Although there is an association between infertility/ovulation inducting medications and ovarian gestation, their connections with serous cyst adenoma are undetermined. PMID:24696771
Ebrahimi, Mahbod; Akbari Asbagh, Firoozeh
The specific radioimmunoassay system was developed for the titration of the antibodies to porcine zona pellucida (ZP) in human sera by using /sup 125/I-labeled purified porcine ZP as antigen, which is known to have cross-reactivity with human ZP. The antibodies in human sera were detected in 3 of 11 (27%) women with unexplained infertility, in 16 of 48 (33%) amenorrheic patients, in 4 of 12 (33%) fertile women, and in 3 of 10 (30%) men. Moreover, antibody titers in infertile women were no higher than those in fertile women and in men. These results seem to suggest that the antibodies in human sera that cross-react with porcine ZP may not be an important factor in causing infertility in women.
Kurachi, H.; Wakimoto, H.; Sakumoto, T.; Aono, T.; Kurachi, K.
We examined male partners’ influence on the decision to seek medical help for infertility using from the National Survey of Fertility Barriers. Building upon an existing help-seeking framework, we incorporated characteristics of both partners from 219 heterosexual couples who had ever perceived a fertility problem. In logistic regression analyses, we found an association between couple-level attitudes and medical help-seeking even when other predisposing and enabling conditions existed. Overall, the findings highlight that both partners contribute to the infertility help-seeking process, and that different factors may play a role in different stages of help-seeking. Studies of infertility help-seeking need to be more inclusive of the context that these decisions are embedded within to better understand service use.
Johnson, Katherine M.; Johnson, David R.
Oxidative stress and trace elements in the oocytes environment is explored in endometriosis and impact on in vitro fertilization (IVF) outcome assessed. Follicular fluid was aspirated at the time of oocyte retrieval from endometriosis (n=200) and tubal infertility (n=140) and the analytes measured using spectroscopy and HPLC. Increased concentration of reactive oxygen species (ROS), nitric oxide (NO), lipid peroxidation (LPO), iron, lead, cadmium and reduced levels of total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx), glutathione reductase (GR), vitamins A, C, E, copper, zinc and selenium was observed compared to tubal infertility. Increased ROS and NO in endometriosis and tubal infertility associated with poor oocytes and embryo quality. Increased levels of ROS, NO, LPO, cadmium and lead were observed in women who did not become pregnant compared to women who did. Intrafollicular zinc levels were higher in women with endometriosis who subsequently became pregnant following IVF. PMID:23994512
Singh, Abhay K; Chattopadhyay, Ratna; Chakravarty, Baidyanath; Chaudhury, Koel
Aim: The purpose of the present study is to evaluate the relationship between endometrial concentrations of estrogen and progesterone receptors throughout the menstrual cycle in women with unexplained infertility. Material and methods: In forty four infertile women with unexplained infertility, biopsy of the endometrium was performed during simultaneous laparoscopy and hysteroscopy. Material was prepared for immunohistochemical staining. Forty four endometrial samples obtained from women with normal menstrual cycles were divided into four categories: early proliferative, late proliferative, early secretory and late secretory. Immunohistochemical localization of estrogen receptors (ER) and progesterone receptors (PR) was scored according to intensity of staining and proportion of cells specifically stained in glandular epithelium and stroma and results were analyzed. Conclusion: The early secretory phase appeared to be period of transition from the strong and ubiquitous staining for receptor characteristic of proliferative phase of endometrium to the weak, focal pattern of estrogen receptors. Progesterone receptors in early secretory phase were of strong staining and sufficient number of stained cells.
Godinjak, Zulfo; Bilalovic, Nurija
This study evaluated the rate and factors influencing male uptake of infertility investigations. Infertility constituted 11.2% of all new gynaecological consultations in the centre during the study period. A total of 61 (70.1%) males consented to seminal fluid studies without much hesitation, 12.4% after much persuasion, while the remainder (17.5%) refused. Obliging doctor's recommendation was the primary motivation for those who willingly had seminal fluid studies while the claim to be healthy and not being responsible for infertility were the commonest barriers for reluctance or refusal to be investigated. Fears of exposure of semen so obtained to witchcraft and rituals were also contributory. Gynaecologists working in rural South-east Nigeria should through systematic public enlightenment dispel misconceptions of necessary medical intervention. PMID:18569479
Umeora, O U J; Ejikeme, B N; Sunday-Adeoye, I; Umeora, M C
Background: The aim of this study was to detect Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyti- cum from semen samples of infertile men by Multiplex PCR and investigation of influence of bacteriospermia on semen parameters. Methods: Semen samples of 200 infertile men were evaluated by Multiplex PCR. In addition, analysis of semen parameters was performed according to the WHO guidelines.
M Golshani; G Eslami; Sh Mohhammadzadeh Ghobadloo; F Fallah; H Goudarzi; AA Soleimani Rahbar; F Fayaz
Previous findings on relationships between infertility, infertility therapies, and autism spectrum disorders (ASD) have been inconsistent. The goals of this study are first, to briefly review this evidence and second, to examine infertility and its treatments in association with having a child with ASD in newly analyzed data. In review, we identified 14 studies published as of May 2013 investigating infertility and/or its treatments and ASD. Overall, prior results showed little support for a strong association, though some increases in risk with specific treatments were found; many limitations were noted. In new analyses of the CHildhood Autism Risk from Genetics and the Environment (CHARGE) population-based study, cases with autism spectrum disorder (ASD, n = 513) and controls confirmed to have typical development (n = 388) were compared with regard to frequencies of infertility diagnoses and treatments overall and by type. Infertility diagnoses and treatments were also grouped to explore potential underlying pathways. Logistic regression was used to obtain crude and adjusted odds ratios overall and, in secondary analyses, stratified by maternal age (?35 years) and diagnostic subgroups. No differences in infertility, infertility treatments, or hypothesized underlying pathways were found between cases and controls in crude or adjusted analyses. Numbers were small for rarer therapies and in subgroup analyses; thus the potential for modest associations in specific subsets cannot be ruled out. However, converging evidence from this and other studies suggests that assisted reproductive technology is not a strong independent risk factor for ASD. Recommendations for future studies of this topic are provided.
Lyall, Kristen; Baker, Alice; Hertz-Picciotto, Irva; Walker, Cheryl K.
The goal of this study was to examine the effect of palmitoylethanolamide (PEA) on the capacitation process and hy- peractivated motility (HA) in idiopathic infertile men. Our data show the effect of PEA on the kinematic parameters of sperm cells from idiopathic infertile men during the capacitation of spermatozoa in vitro, both in the presence and absence of 2.5 nM
ANNARINA AMBROSINI; GIOVANNA ZOLESE; SIMONA AMBROSI; ENRICO BERTOLI; FRANCO MANTERO; MARCO BOSCARO; GIANCARLO BALERCIA
In infertile women suffering from polycystic ovary syndrome (PCOS), anti-thyroid peroxidase antibodies values exceeding the upper level of normal were found in significantly more clomiphene citrate resistant patients compared clomiphene citrate responders and metformin responders. Thus, elevated antiTPO levels are associated with poor treatment response in infertile women who suffer from PCOS. PMID:20638057
Ott, Johannes; Aust, Stefanie; Kurz, Christine; Nouri, Kazem; Wirth, Stefan; Huber, Johannes C; Mayerhofer, Klaus
The experience of marital infertility is a major biosocial life crisis that also represents a serious threat to the development of psychosocial generativity. Psychological studies of the consequences of involuntary infertility, however, are rare. A study was undertaken to identify variations in the coping patterns used by men who have experienced…
Snarey, John; And Others
BACKGROUND: Evidence about the effects of infertility and assisted reproduction technique (ART) on marital relationships is discrepant. Here, we examined the impact of ART on marital relationships. The roles of life stressors, infertility and treatment characteristics in predicting marital relations were also evaluated. METHODS: Subjects: 367 couples with singleton IVF\\/ICSI pregnancies. Controls: 379 couples with spontaneous singleton pregnancies. Women and
L. Repokari; R.-L. Punamaki; L. Unkila-Kallio; S. Vilska; P. Poikkeus; J. Sinkkonen; F. Almqvist; A. Tiitinen; M. Tulppala
Background: Endometriosis is one of the most challenging diseases that constitute 20% - 40% of women searching for their infertility diagnosis. Objective: This study was undertaken in order to compare the outcome of in vitro fertilization\\/intracytoplasmic sperm injection (IVF\\/ICSI) in women with endometriosis, and tubal factor infertility as controls. Materials and Methods: From 2005 to 2006 a retrospective study was
Ensieh Shahrokh; Tehrani Nejad; Batool Hosein Rashidi; Atefeh Larti
A qualitative diagnosis of infertility requires attention to male and female physical abnormalities including endocrine anomalies and genetic conditions that interfere with reproduction. Many genes are likely to be involved in the complex process of reproduction. Congenital bilateral absence of the vas deferens (CBAVD) is a genital form of cystic fibrosis (CF) that is responsible for 2%-6% of male infertility.
RAMIN RADPOUR; HAMID GOURABI; AHMAD VOSOUGH DIZAJ; WOLFGANG HOLZGREVE; XIAO YAN ZHONG
An aromatase encoded by the CYP19 gene catalyzes the final step in the biosynthesis of estrogens, which is related to endometriosis development. To assess the association of CYP19 gene polymorphisms with the risks of endometriosis, chocolate cysts and endometriosis-related infertility, a case-control study was conducted in Chinese Han women by recruiting 225 healthy control females, 146 patients with endometriosis, 94 endometriosis women with chocolate cyst and 65 women with infertility resulting from endometriosis, as diagnosed by both pathological and laparoscopic findings. Individual genotypes at rs2236722:T>C, rs700518:A>G, rs10046:T>C and [TTTA]n polymorphisms were identified. Allelic and genotypic frequencies were compared between the control group and case groups by chi-square analysis. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were determined by logistic regression analysis to predict the association of CYP19 gene polymorphisms with the risk of endometriosis, the related chocolate cysts and infertility. The genotype distributions of the tested CYP19 gene polymorphisms were not significantly different between the healthy control group and the endometriosis/endometriosis with the chocolate cyst group. However, the CYP19 rs700518AA genotype was significantly associated with an increased risk of endometriosis-related infertility (55.4% in the infertility group vs 25.3% in the control group, P<0.001; OR (95% CI): 3.66 (2.06-6.50)) under the recessive form of the A allele. Therefore, we concluded that in Chinese Han females CYP19 gene polymorphisms are not associated with susceptibility to endometriosis or chocolate cysts, whereas CYP19 rs700518AA genotype confers genetic susceptibility to endometriosis-related infertility. PMID:24968701
Wang, Ledan; Lu, Xiaosheng; Wang, Danhan; Qu, Wanglei; Li, Wenju; Xu, Xiaowen; Huang, Qiusui; Han, Xueying; Lv, Jieqiang
Background: Unexplained infertility is still a challenging issue as to its causes, appropriate management and treatment. Evidence implicates early embryopathy or implantation failure as likely causes. Objective: This study aims to investigate the effect of local endometrial injury on pregnancy rate in selected unexplained infertile patients. Materials and Methods: This was a randomized clinical trial conducted in Shiraz University Infertility Clinic of Ghadir Hospital. A total of 217 women with unexplained infertility aged 23-35 years old were randomly divided into two study groups through block randomization. After superovulation by clomiphene-citrate and gonadotropins and when the dominant follicles reached 18-20 mm, patients were randomly assigned to undergo endometrial local injury at posterior uterine wall by piplle endometrial sampling (n=114) or mock pipette biopsy (n=103) during pre-ovulatory days (when spontaneous urinary LH surge was detected). Then all the patients were instructed to follow a regularly timed intercourse. Results: The pregnancy rate was significantly higher in the endometrial injury group compared to the control group [17/114 (14.9%) vs. 6/103 (5.8%) (OR: 2.83 95% CI: 1.07-7.49, p=0.03]. The abortion rate was comparable between two groups (17.64% vs. 14.28%; p=0.701). Conclusion: Local mechanical injury of the endometrium can enhance the uterine receptivity and facilitates the embryo implantation. This simple, easy, and cost effective procedure is worth considering in selective unexplained infertility patients who implantation failure is the likely causes of infertility before complex treatments. This procedure may help reduce psychological tensions and high expenses imposed through such interventions. Registration ID in IRCT: IRCT2012082510657N1. PMID:24639710
Parsanezhad, Mohammad Ebrahim; Dadras, Nasrin; Maharlouei, Najmeh; Neghahban, Leila; Keramati, Peghah; Amini, Madihe
Background: Some studies propose that changes in leptin concentrations (above or under the normal range) result in infertility. Therefore, we investigated serum and follicular fluid leptin concentrations in infertile women with polycystic ovary syndrome (PCOS). Objective: To study serum and follicular fluid leptin concentrations in infertile women with PCOS. Materials and Methods: We conducted a case-control study. The case group consisted of 30 infertile women with PCOS who were admitted to the Infertility Department of Imam Khomainy Hospital in Ahvaz, Iran. The control group consisted of 30 healthy fertile women adjusted for age and body mass index (BMI) with the case group. On day 14 of the menstrual cycle, 5 ml of blood was obtained from subjects in both groups. Serum and follicular fluid leptin concentrations were determined by the enzyme linked immunosorbent assay (ELISA). A Biovendor kit was used for the measurement of leptin concentrations. All data were analyzed using statistical package for the social sciences (SPSS) software (version 17.0, Nie, Bent & Hull, USA). Results: There was a significant correlation between BMI and serum leptin concentrations in both the control (p=0.005, r=0.516) and case groups (p=0.006, r=0.547). In the case group, serum leptin concentrations were consistent with follicular fluid leptin concentrations (p<0.001, r=0.839). Comparison of serum leptin concentrations between the case and control groups revealed no significant difference (p=0.56). Conclusion: Infertility among women with PCOS was not a consequence of changes in leptin concentrations.
Dayer, Dian; Nikbakht, Roshan; Kadkhodai Elyaderani, Manijeh
Antibodies reactive with the ovarian glycoprotein zona pellucida (ZP) have been linked with human female infertility. Anti-fertility vaccines that target ZP antigens have been utilized to restrict pest animal populations and their efficacy is associated with ovary-specific antibody induction. However, the necessity for zona pellucida-specific antibody in mediating infertility has not been examined in vivo. A recombinant mouse cytomegalovirus vaccine encoding murine zona pellucida 3 that induces rapid and complete infertility in BALB/c mice has been produced. The onset of infertility is temporally related to the presence of antibody sequestered into ovarian follicles and binding to the ZP of infected mice and the loss of mature follicles. When this vaccine was inoculated into immunoglobulin-deficient BALB/c mice with a null mutation in the immunoglobulin mu chain gene Igh-6, fertility was unaffected. Passive transfer of serum containing ZP3 antibodies also elicited transient infertility. Electron microscopy of ovarian tissue collected from ZP3-immunized immunocompetent mice demonstrated significant focal thinning of the zona pellucida (ZP) with reduced length and concentration of transzonal processes and many oocytes displayed evidence of injury. None of these changes were found in vaccinated immunoglobulin-deficient mice. These data confirm that ZP3-reactive antibody is necessary and sufficient to induce autoimmune-mediated follicular depletion and fertility suppression following the inoculation of this vaccine, and suggest that this is due to impaired zona pellucida formation. These findings have relevance in understanding the etiology of autoimmune ovarian disease in woman where anti-ZP antibodies are likely to have a causal role in infertility. PMID:20382503
Lloyd, Megan L; Papadimitriou, John M; O'Leary, Sean; Robertson, Sarah A; Shellam, Geoffrey R
Background: Some studies propose that changes in leptin concentrations (above or under the normal range) result in infertility. Therefore, we investigated serum and follicular fluid leptin concentrations in infertile women with polycystic ovary syndrome (PCOS). Objective: To study serum and follicular fluid leptin concentrations in infertile women with PCOS. Materials and Methods: We conducted a case-control study. The case group consisted of 30 infertile women with PCOS who were admitted to the Infertility Department of Imam Khomainy Hospital in Ahvaz, Iran. The control group consisted of 30 healthy fertile women adjusted for age and body mass index (BMI) with the case group. On day 14 of the menstrual cycle, 5 ml of blood was obtained from subjects in both groups. Serum and follicular fluid leptin concentrations were determined by the enzyme linked immunosorbent assay (ELISA). A Biovendor kit was used for the measurement of leptin concentrations. All data were analyzed using statistical package for the social sciences (SPSS) software (version 17.0, Nie, Bent & Hull, USA). Results: There was a significant correlation between BMI and serum leptin concentrations in both the control (p=0.005, r=0.516) and case groups (p=0.006, r=0.547). In the case group, serum leptin concentrations were consistent with follicular fluid leptin concentrations (p<0.001, r=0.839). Comparison of serum leptin concentrations between the case and control groups revealed no significant difference (p=0.56). Conclusion: Infertility among women with PCOS was not a consequence of changes in leptin concentrations. PMID:24639732
Dayer, Dian; Nikbakht, Roshan; Kadkhodai Elyaderani, Manijeh
An aromatase encoded by the CYP19 gene catalyzes the final step in the biosynthesis of estrogens, which is related to endometriosis development. To assess the association of CYP19 gene polymorphisms with the risks of endometriosis, chocolate cysts and endometriosis-related infertility, a case–control study was conducted in Chinese Han women by recruiting 225 healthy control females, 146 patients with endometriosis, 94 endometriosis women with chocolate cyst and 65 women with infertility resulting from endometriosis, as diagnosed by both pathological and laparoscopic findings. Individual genotypes at rs2236722:T>C, rs700518:A>G, rs10046:T>C and [TTTA]n polymorphisms were identified. Allelic and genotypic frequencies were compared between the control group and case groups by chi-square analysis. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were determined by logistic regression analysis to predict the association of CYP19 gene polymorphisms with the risk of endometriosis, the related chocolate cysts and infertility. The genotype distributions of the tested CYP19 gene polymorphisms were not significantly different between the healthy control group and the endometriosis/endometriosis with the chocolate cyst group. However, the CYP19 rs700518AA genotype was significantly associated with an increased risk of endometriosis-related infertility (55.4% in the infertility group vs 25.3% in the control group, P<0.001; OR (95% CI): 3.66 (2.06–6.50)) under the recessive form of the A allele. Therefore, we concluded that in Chinese Han females CYP19 gene polymorphisms are not associated with susceptibility to endometriosis or chocolate cysts, whereas CYP19 rs700518AA genotype confers genetic susceptibility to endometriosis-related infertility.
Wang, Ledan; Lu, Xiaosheng; Wang, Danhan; Qu, Wanglei; Li, Wenju; Xu, Xiaowen; Huang, Qiusui; Han, Xueying; Lv, Jieqiang
Background A routine semen analysis is a first step in the laboratory evaluation of the infertile male. In addition, other tests such as measurement of reactive oxygen species can provide additional information regarding the etiology of male infertility. The objective of this study was to investigate the association of semen parameters with reactive oxygen species (ROS) in two groups: healthy donors of unproven and proven fertility and infertile men. In addition, we sought to establish an ROS cutoff value in seminal plasma at which a patient may be predicted to be infertile. Methods Seminal ejaculates from 318 infertile patients and 56 donors, including those with proven fertility were examined for semen parameters and ROS levels. Correlations were determined between traditional semen parameters and levels of ROS among the study participants. ROS levels were measured using chemiluminescence assay. Receiver operating characteristic curves were obtained to calculate a cutoff value for these tests. Results Proven Donors (n?=?28) and Proven Donors within the past 2 years (n?=?16) showed significantly better semen parameters than All Patients group (n?=?318). Significantly lower ROS levels were seen in the two Proven Donor groups compared with All Patients. The cutoff value of ROS in Proven Donors was determined to be 91.9 RLU/s with a specificity of 68.8% and a sensitivity of 93.8%. Conclusions Infertile men, irrespective of their clinical diagnoses, have reduced semen parameters and elevated ROS levels compared to proven fertile men who have established a pregnancy recently or in the past. Reactive oxygen species are negatively correlated with traditional semen parameters such as concentration, motility and morphology. Measuring ROS levels in the seminal ejaculates provides clinically-relevant information to clinicians.
Male infertility is a major cause of problems for many couples in conceiving a child. Recently, lifestyle pastimes such as alcohol, tobacco and marijuana have been shown to have further negative effects on male reproduction. The endocannabinoid system (ECS), mainly through the action of anandamide (AEA) and 2-arachidonoylglycerol (2-AG) at cannabinoid (CB1, CB2) and vanilloid (TRPV1) receptors, plays a crucial role in controlling functionality of sperm, with a clear impact on male reproductive potential. Here, sperm from fertile and infertile men were used to investigate content (through LC-ESI-MS), mRNA (through quantitative RT-PCR), protein (through Western Blotting and ELISA) expression, and functionality (through activity and binding assays) of the main metabolic enzymes of AEA and 2-AG (NAPE-PLD and FAAH, for AEA; DAGL and MAGL for 2-AG), as well as of their binding receptors CB1, CB2 and TRPV1. Our findings show a marked reduction of AEA and 2-AG content in infertile seminal plasma, paralleled by increased degradation: biosynthesis ratios of both substances in sperm from infertile versus fertile men. In addition, TRPV1 binding was detected in fertile sperm but was undetectable in infertile sperm, whereas that of CB1 and CB2 receptors was not statistically different in the two groups. In conclusion, this study identified unprecedented alterations of the ECS in infertile sperm, that might impact on capacitation and acrosome reaction, and hence fertilization outcomes. These alterations might also point to new biomarkers to determine male reproductive defects, and identify distinct ECS elements as novel targets for therapeutic exploitation of ECS-oriented drugs to treat male fertility problems.
Di Tommaso, Monia; Pucci, Mariangela; Battista, Natalia; Paro, Rita; Simon, Luke; Lutton, Deborah; Maccarrone, Mauro
Background Infertility is a public health problem associated with devastating psychosocial consequences. In countries where infertility care is difficult to access, women turn to herbal medicines to achieve parenthood. The aim of this study was to determine the prevalence and factors associated with herbal medicine use by women attending the infertility clinic. Methods This was a cross-sectional study of 260 women attending the infertility clinic at Mulago hospital. The interviewer administered questionnaire comprised socio-demographic characteristics, infertility-related aspects and information on herbal medicine use. The main outcome measure was herbal medicines use for infertility treatment. Determinants of herbal medicine use were assessed using multivariable logistic regression. Results The majority (76.2%) of respondents had used herbal medicines for infertility treatment. The mean age of the participants was 28.3 years?±?5.5. Over 80% were married, 59.6% had secondary infertility and 2/3 of the married participants were in monogamous unions. In a multivariable model, the variables that were independently associated with increased use of herbal medicine among infertile patients were being married (OR 2.55, CI 1.24-5.24), never conceived (OR 4.08 CI 1.86-8.96) and infertility for less than 3 years (OR 3.52 CI 1.51-8.821). Factors that were associated with less use of herbal medicine among infertile women were being aged 30 years or less (OR 0.18 CI 0.07-0.46), primary and no education (OR 0.12 CI 0.05-0.46) and living with partner for less than three years (OR 0.39 CI 0.16-0.93). Conclusions The prevalence of herbal medicine use among women attending the infertility clinic was 76.2%. Herbal medicine use was associated with the participants’ age, level of education, marital status, infertility duration, nulliparity, and duration of marriage. Medical care was often delayed and the majority of the participants did not disclose use of herbal medicines to the attending physician. Health professionals should enquire about use of herbal medicines. This may help in educating the patients about the health risks of using herbal medicine and may reduce delays in seeking appropriate care. Collaboration of health professionals with herbal medicine practitioners would help identify the common herbal medicines used for infertility treatment, their potential benefits and harm.
Herlyn-Werner-Wunderlich syndrome (HWWS), characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis, is an uncommon combined Mullerian and mesonephric duct anomaly, and its presentation in adulthood is even rarer. We report here a 22-year-old female presenting with primary infertility where magnetic resonance imaging (MRI) suggested the diagnosis of HWWS with endometriosis. In a patient of infertility with endometriosis and unilateral renal agenesis, diagnosis of HWWS should be suspected and MRI is the investigation of choice for such anomalies.
Ahmad, Zohra; Goyal, Ankur; Das, Chandan J; Deka, Dipika; Sharma, Raju
Abstract,INTRODUCTION:Heavy metals can negatively influence the reproduction,due to the fact that they are able to impair the immune,reactions,including,autoantibody,pro- duction,in susceptible individuals. In such a way the infertility could,be also caused by altered pathologic,immune,reaction. AIM OF THE STUDY: To investigate the in vitrolymphocyte,reaction,after stimula- tion with metals,and production,of gamma,interferon,and antisperm,antibodies in supernatants,after lymphocyte,stimulation,in patients with infertility and with proven,antisperm,antibodies,in their,serum. The
Stepan Podzimek; Jarmila Prochazkova; Lenka Bultasova; Jirina Bartova; Zdena Ulcova-gallova; Lubor Mrklas; V Era Dm Stejskal
Background: Human pathogens that can cause infertility may also affect sperm count and quality. Viral infections can be considered as direct and/or indirect cause of male factor infertility. Objective: Our goal was to investigate the prevalence of herpes simplex virus in the semen of infertile men attending the Avicenna Infertility Clinic, and to compare it with the herpes virus serology results. Materials and Methods: This cross sectional study was conducted during 2009-2010. Infertile men participating without any clinical signs of infection with herpes simplex virus, and no obvious cause for their infertility were included. Semen and blood samples were used for Polymerase Chain Reaction (PCR) and serologic testing for these people. Two samples were collected: one ml semen sample to verify the existence of genital herpes simplex virus in infertile men, and blood samples of 217 individuals tested for antibodies to herpes simplex virus. Data were analyzed by SPSS 16. Results: According to the PCR results of semen samples the prevalence of herpes simplex in semen was 12% and serologic test showed 3.2% prevalence within blood. Nine to 10% of IgM negative were PCR positive and only 2-3% of IgM positive were PCR positive. Between herpes serologic studies with positive controls and negative controls by using both tests, there was a significant positive relationship (r=0.718 and p<0.001). The relationship between semen PCR test results and serological survey of herpes patients with a negative control in both Pearson and Spearman tests was positive and significant (r=0.229 and p=0.001). Correlation between the PCR results of semen samples with two positive control subjects and a positive IgM test was statistically confirmed (r=0.235 and p<0.001). Conclusion: We recommend that if there is suspicion to herpes simplex as a microorganism that theoretically could impact semen parameters and cause infertility it is prudent to use PCR technique on semen sample rather than ELISA on serum.
Amirjannati, Nasser; Yaghmaei, Farhad; Akhondi, Mohammad Mehdi; Nasiri, Mahboubeh; Heidari-Vala, Hamed; Sehhat, Zahra
Resume\\u000a Objectifs L’exploration de l’homme azoospermique est aujourd’hui d’un intérêt capital compte tenu des progrès récents des techniques\\u000a d’Assistance Médicale à la Procréation, essentiellement l’injection intra-cytoplasmique de spermatozoïde, qui permet désormais\\u000a à des hommes considérés définitivement infertiles, de devenir pères avec leurs propres gamètes. Nous rapportons ici les résultats\\u000a d’une étude rétrospective, effectuée sur 54 patients infertiles tunisiens, suivis pour exploration
Leila Ammar-Keskes; Nozha Chakroun; Afifa Sellami Ben Hamida; Lobna Hadj-Kacem; Nouha Bouayed-Abdelmoula; Hammadi Ayadi; Mohamed Nabil Mhiri; Tarek Rebai; Ali Bahloul
Objective Osseous metaplasia is a rare pathological entity that affects the uterus and usually appears following abortion, chronic endometritis,\\u000a metabolic disorders or following LEEP excision of the cervix.\\u000a \\u000a \\u000a \\u000a Case Herein, we present the occurrence of osseous metaplasia in a 27-year-old patient with a history of an abortion 2 years ago\\u000a and suffering infertility.\\u000a \\u000a \\u000a \\u000a Conclusion We suggest that the infertility in this patient may be
Metin Akbulut; Çi?dem Berna Ege; Esra Canan Kelten; Mehmet Emin Soysal
Background: Primary and secondary infertility are the most common presenting symptom in patients with pelvic tuberculosis (PT). Endometriosis is commonly associated with an increased risk of infertility. Case: Here, we report a rare case of coexisting PT and endometriosis in a 30-year- old woman, and the effects of controlled ovarian stimulation on reactivation of pathogen. Conclusion: Coexisting endometriosis and tuberculosis of fallopian tube and ovary, as in present case, may alter clinical and radiological features, leading to difficulty in diagnosis. Early diagnosis with surgical exploration and adequate treatment can improve the chances of conception and also minimize morbidity.
Eftekhar, Maryam; Pourmasumi, Soheila; Motamed Zadeh, Leila
To determine the knowledge, attitude and practice of child adoption among infertile Nigerian women we undertook a questionnaire survey of 279 consecutive infertile women seen in three tertiary care centres in South Eastern Nigeria within a 9-month period. The data were analysed by means of simple percentages and descriptive and inferential statistics, using t-tests, chi-square tests and regression equations at the 95% confidence level. Two hundred and sixty-four questionnaires were analysed. Although 228 (86.4%) of the respondents were aware of child adoption, only 72 (27.3%) knew its correct meaning. Fifty-seven (21.6%) women knew how to adopt a baby while the rest did not; 183 (69.3%) respondents expressed their unwillingness to adopt a baby while the remaining 81 (30.7%) were willing. Twelve (14.8%) of these 81 respondents (or 4.5% of all respondents) had either adopted or made an effort to adopt a child at the time of the study. The major reasons given by the 183 respondents unwilling to adopt a child were: adoption not a solution to their infertility (84 respondents); adoption psychologically unacceptable (78 respondents); fear of unknown parental background (75 respondents) and abnormal behaviour in the child (75 respondents). Univariate analysis showed six factors significantly associated with a favourable attitude to child adoption: a correct knowledge of the meaning of adoption (P=0.00007), duration of infertility >5 years (P=0.0002), previous orthodox specialist treatment (P=0.0002), tubal infertility (P=0.002), no living child (P=0.02) and maternal age >35 years (P=0.03). In a multiple logistic regression involving these six factors, with attitude to adoption as the dependent variable, two factors were associated significantly with a favourable attitude to adoption: correct knowledge of the meaning of adoption (OR=1.9, P=0.04) and previous orthodox specialist treatment (OR=2.9, P=0.05). Although the majority of infertile Nigerian women have heard of child adoption, only a minority knew its real meaning, its legality and the process it entails. Approximately one-third of them were disposed favourably to adoption as a treatment option for their infertility. The Nigerian experience was compared and contrasted with the experiences of other countries. Factors associated with a favourable attitude to adoption were presented and discussed. In the presence of such factors, especially when the probability of cure of infertility is small, child adoption as a treatment option should be offered early so that willing couples can initiate the processes. PMID:12521712
Ezugwu, F O; Obi, S N; Onah, H E
Infertility is a condition loaded with meaning spanning across biomedical, psychological, social, economic, cultural and religious spheres. Given its disruptive power over women's lives, it provides a unique lens through which issues of kinship, gender, sexuality, cosmology and religion can be examined. The paper presents the results of an ethnographic study of infertility in Central Nigeria. Explanatory models of infertility were variegated, encompassing biomedical, folk and religious elements. Like other ethnographic studies of help seeking for infertility in Nigeria, among this group resort was made to biomedical treatments, traditional healers and religious healing with no one system being hegemonic. The findings of this study accord with studies of infertility in other cultural groups indicating the disruptive influence of missing motherhood. PMID:24069756
Dimka, Ritgak A; Dein, Simon L
The tendency to postpone childbearing in developed countries and the relatively high rate of infertility in older women contribute to an increase in the portion of women aged 40 years and older opting for infertility treatments. The main factor for infertility in this group is oocyte senescence, but since this process does not have a specific diagnosis many of those
Avi Tsafrir; Alex Simon; Ehud J Margalioth; Neri Laufer
Psychological morbidity concurrent with fertility problems has been the focus of substantial scientific inquiry. However, researchers have largely overlooked psychological resilience within this population. This study explored the associations between resilience, infertility-related and general distress, and coping behaviors in forty women from nine fertility clinics throughout the United States. Participants completed the Connor–Davidson Resilience Scale (CD-RISC), Symptom Checklist-90 (SCL-90), Beck-Depression
Minden B. Sexton; Michelle R. Byrd; Silvia von Kluge
The objective of the present study was to examine the relationships between infertility characteristics, cognitive coping strategies, and depressive symptoms in definitive involuntarily childless people. Both cross-sectional and prospective relationships were studied in a sample of 169 persons for whom an involuntarily childless future was definitive. The Cognitive Emotion Regulation Questionnaire (CERQ) and the Symptom Check List (SCL-90) were filled
Vivian Kraaij; Nadia Garnefski; Anne Vlietstra
Background The purpose of this study was to assess the accuracy of ovulation detection by the DuoFertility® monitor compared with transvaginal ultrasound in infertile women with regular menstrual cycles. Methods Eight infertile patients, aged 27–40 years, with a body mass index of 19–29, regular menses, normal ovaries on pelvic ultrasound scan, and normal early follicular luteinizing hormone (LH), follicle-stimulating hormone, and prolactin were recruited from infertility clinics in primary and secondary care for this pilot, prospective, observational study. The patients were asked to use the DuoFertility monitor for the whole cycle, with investigators and patients blind to DuoFertility data. Daily urine LH monitoring commenced on cycle day 8, with daily transvaginal ultrasound following the first positive LH until ovulation was observed. Ovulation was further confirmed by serum progesterone. The main outcome measure was detection of ovulation by the DuoFertility monitor, and correlation between day of ovulation assessed by DuoFertility and ultrasound. Results DuoFertility identified ovulation as having occurred within one day of that determined via ultrasound in all cycles. The sensitivity of ovulation detection was 100% (95% confidence interval 82–100). The specificity could not be concluded from the data. Conclusion In infertile women with regular cycles, the DuoFertility monitor appears to accurately identify ovulatory cycles and the day of ovulation.
Rollason, Jennie CB; Outtrim, Joanne G; Mathur, Raj S
Recent advances in assisted reproduction treatment have enabled some couples with severe infertility issues to conceive, but the methods are not successful in all cases. Notwithstanding the significant financial burden of assisted reproduction treatment, the emotional scars from an inability to conceive a child enacts a greater toll on affected couples. While methods have circumvented some root causes for male and female infertility, often the underlying causes cannot be treated, thus true cures for restoring a patient’s fertility are limited. Furthermore, the procedures are only available if the affected patients are able to produce gametes. Patients rendered sterile by medical interventions, exposure to toxicants or genetic causes are unable to utilize assisted reproduction to conceive a child – and often resort to donors, where permitted. Stem cells represent a future potential avenue for allowing these sterile patients to produce offspring. Advances in stem cell biology indicate that stem cell replacement therapies or in-vitro differentiation may be on the horizon to treat and could cure male and female infertility, although significant challenges need to be met before this technology can reach clinical practice. This article discusses these advances and describes the impact that these advances may have on treating infertility.
Easley, Charles A.; Simerly, Calvin R.; Schatten, Gerald
A total of 57 infertile women, who had been referred for in vitro fertilisation or for diagnostic laparoscopy, were tested for the presence of antibodies to Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma hominis. Four were excluded from the study. Of the remaining 53, 33 had laparoscopically obvious tubal disorders, such as adhesions, distal occlusions and strictures, and 20 did not.
K H Tjiam; G H Zeilmaker; A T Alberda; B Y van Heijst; J C de Roo; A A Polak-Vogelzang; T van Joost; E Stolz; M F Michel
Background Although the advantages of epidural anesthesia in open surgery have been established, its usefulness in the setting of laparoscopic surgery remains to be studied. Methods Patients undergoing laparoscopic surgery for infertility were randomly administered epidural anesthesia (group A, n = 11) or general anesthesia (group B, n = 9). The operation was performed under 4 mmHg pneumoperitoneum and in the
K. Kuramochi; Y. Osuga; T. Yano; M. Momoeda; T. Fujiwara; O. Tsutsumi; H. Tamai; K. Hanaoka; K. Koga; O. Yoshino; Y. Taketani
BACKGROUND: Previous research has highlighted a lack of fertility awareness in the general population especially in relation to the optimal fertile period during the menstrual cycle, incidence of infertility and duration of the repro- ductive life span. The current study assessed fertility knowledge more broadly in young people and investigated three areas of knowledge, namely risk factors associated with female
Laura Bunting; Jacky Boivin
Phospholipid hydroperoxide glutathione peroxidase (GPx4) is an intracellular antioxidant enzyme that directly reduces peroxidized phospholipids. GPx4 is strongly expressed in the mitochondria of testis and spermatozoa. We previously found a significant decrease in the expression of GPx4 in spermatozoa from 30% of infertile human males diagnosed with oligoasthenozoospermia (Imai, H., Suzuki, K., Ishizaka, K., Ichinose, S., Oshima, H., Okayasu, I., Emoto, K., Umeda, M., and Nakagawa, Y. (2001) Biol. Reprod. 64, 674–683). To clarify whether defective GPx4 in spermatocytes causes male infertility, we established spermatocyte-specific GPx4 knock-out mice using a Cre-loxP system. All the spermatocyte-specific GPx4 knock-out male mice were found to be infertile despite normal plug formation after mating and displayed a significant decrease in the number of spermatozoa. Isolated epididymal GPx4-null spermatozoa could not fertilize oocytes in vitro. These spermatozoa showed significant reductions of forward motility and the mitochondrial membrane potential. These impairments were accompanied by the structural abnormality, such as a hairpin-like flagella bend at the midpiece and swelling of mitochondria in the spermatozoa. These results demonstrate that the depletion of GPx4 in spermatocytes causes severe abnormalities in spermatozoa. This may be one of the causes of male infertility in mice and humans.
Imai, Hirotaka; Hakkaku, Nao; Iwamoto, Ryo; Suzuki, Jyunko; Suzuki, Toshiyuki; Tajima, Yoko; Konishi, Kumiko; Minami, Shintaro; Ichinose, Shizuko; Ishizaka, Kazuhiro; Shioda, Seiji; Arata, Satoru; Nishimura, Masuhiro; Naito, Shinsaku; Nakagawa, Yasuhito
Primary ovarian insufficiency (POI) and polycystic ovarian syndrome are ovarian diseases causing infertility. Although there is no effective treatment for POI, therapies for polycystic ovarian syndrome include ovarian wedge resection or laser drilling to induce follicle growth. Underlying mechanisms for these disruptive procedures are unclear. Here, we explored the role of the conserved Hippo signaling pathway that serves to maintain optimal size across organs and species. We found that fragmentation of murine ovaries promoted actin polymerization and disrupted ovarian Hippo signaling, leading to increased expression of downstream growth factors, promotion of follicle growth, and the generation of mature oocytes. In addition to elucidating mechanisms underlying follicle growth elicited by ovarian damage, we further demonstrated additive follicle growth when ovarian fragmentation was combined with Akt stimulator treatments. We then extended results to treatment of infertility in POI patients via disruption of Hippo signaling by fragmenting ovaries followed by Akt stimulator treatment and autografting. We successfully promoted follicle growth, retrieved mature oocytes, and performed in vitro fertilization. Following embryo transfer, a healthy baby was delivered. The ovarian fragmentation–in vitro activation approach is not only valuable for treating infertility of POI patients but could also be useful for middle-aged infertile women, cancer patients undergoing sterilizing treatments, and other conditions of diminished ovarian reserve.
Kawamura, Kazuhiro; Cheng, Yuan; Suzuki, Nao; Deguchi, Masashi; Sato, Yorino; Takae, Seido; Ho, Chi-hong; Kawamura, Nanami; Tamura, Midori; Hashimoto, Shu; Sugishita, Yodo; Morimoto, Yoshiharu; Hosoi, Yoshihiko; Yoshioka, Nobuhito; Ishizuka, Bunpei; Hsueh, Aaron J.
BACKGROUND: Uterine lymphoid cell repertoires are specialized in order to meet the twin demands of successful pregnancy and local immunosurveillance. The possibility that some of these populations might differentiate locally from progenitor cells has been proposed. METHODS: Endometrial tissue from women with a history of infertility as well as fertile controls was examined for haematopoietic stem cells (HSCs) and lymphoid
L. Lynch; L. Golden-Mason; M. Eogan; C. O'Herlihy; Cliona O'Farrelly
There are 10.000 new cases annually of spinal cord injury (SCI) in the United States. Eighty two percent of these cases are males and in their prime reproductive years (mean age, 26 years). Infertility is a significant and frustrating problem for men after spinal cord injury. The major causes are erectile and ejaculatory dysfunction and poor semen quality. Erectile dysfunction
Cristiano Utida; José Carlos Truzzi; Homero Bruschini; Rogério Simonetti; Agnaldo Cedenho; Miguel Srougi
Objectives To study the association between copper, magnesium and malondialdehyde levels in seminal plasma of oligozoospermic, azoospermic in relation to normozoospermic men. Methods The present study was conducted at the Chemistry and Biochemistry department, College of Medicine, Al-Nahrain University, Baghdad-Iraq during September 2007 to February 2008 after obtaining approval from the research and ethics committee and obtaining written consent, 78 infertile men (age range 33.01±4.20 years) were recruited at the institute of embryo research and infertility treatment, Al-Kadhimiya teaching hospital, Iraq and were categorized according to their seminal fluid parameters to oligozoospermia (n=43) and azoospermia (n=35). 41 fertile men (age range 30.29±2.30 years) were selected as controls. Seminal plasma copper and magnesium were measured by atomic absorption spectrophotometry. Malondialdehyde was measured calorimetrically using thiobarbituric acid assay which detects thiobarbituric acid reactive substances. Results Seminal plasma copper level was decreased significantly (p=0.000) in the azoospermic group compared to the control group. Whereas, the level decreased non-significantly in the oligozoospermic group. Seminal plasma magnesium levels were decreased significantly (p=0.000) in all the infertility groups studied. On the other hand, malondialdehyde levels which is an end product of lipid peroxidation were significantly elevated (p=0.000) in all the infertility groups studied. Conclusion Copper and magnesium work in different ways in order to maintain normal environment for spermatozoa for normal fertilization to occur.
Abdul-Rasheed, Omar F.
Objectives: To review the outcomes of management of male infertility following spinal cord injury in a specialised fertility clinic. Study Design: Retrospective review of medical records. Setting: The Fertility Clinic of a 45-bed spinal cord injury service in New South Wales, Australia. Methods: The medical and fertility clinic records of 113 males who attended the clinic between 1987 and 1997
SB Rutkowski; TJ Geraghty; DL Hagen; DM Bowers; M Craven; JW Middleton
Summary. The Polycystic Ovary Syndrome (PSOS) is the commonest cause of anovulatory infertility. Matformin is effective in the treatment of PCOS- related anovulation. Metformin is an oral biguanide, well established for the treatment of hyperglycemia. Preliminary evidence indicates that metformin may also be effective in decreasing the risk of early spontaneous abortion in women with PCOS. The aim of the
BACKGROUND: The aetiology of human male fertility, with impairment of sperm number, motility and morphology (oligoasthenoteratozoospermia), has been difficult to understand, partly for lack of animal models. METHODS: An ethylnitrosourea (ENU) mutagenesis strategy has been successful in producing heritable gene mutations with phenotypes similar to human male infertility, and here, we describe three independent ENU-induced mutations that cause a phenotype
C. Lessard; H. Lothrop; J. C. Schimenti; M. A. Handel
Background: One of the main laboratory tests for evaluation of infertility is semen analysis (SA). However, additional tests may be suggested for further diagnosis of male fertility potentials. The seminal fluid contains sperms, non-sperm cells, and various types of lipids and glucose. Objective: The objective of this cross-sectional study was to correlate the sperm parameters with concentrations of cholesterol, triglyceride,
Mohammad Ali Khalili; Najmeh Zare-Zadeh; Hamideh Hashemi
Teratozoospermia is characterized by the presence of spermatozoa with abnormal morphology in sperm. This condition is frequently associated with infertility and intracytoplasmic sperm injection (ICSI) is frequently used as the treatment of choice. However, the use of ICSI has created consequential debate concerning the genetic risk for the offspring. Fluorescence in situ hybridization technique (FISH), allowing the specific identification of
N. Machev; P. Gosset; S. Viville
Interleukin-1 (IL-1) is a regulatory cytokine that plays an important role in the maintenance of the immune environment of the testis, regulation of junction dynamics and cell differentiation during spermatogenesis. Members of the IL-1 family are pleiotropic cytokines that are involved in inflammation, immunoregulation and other homeostatic functions in the body. IL-1?, IL-1?, and the IL-1 receptor antagonistic molecule (IL-1 Ra) are expressed in the testis under normal homeostasis and they further increase upon infection/inflammation. In the present study we have examined the association of Variable Number Tandem Repeats (VNTR) polymorphism of the Interleukin-1 receptor antagonist gene (IL1RN) with human male infertility. The case-control study comprised of two groups: 331 idiopathic infertile patients and 358 fertile healthy men. The study indicates risk of IL1RN2 variant with male infertility (OR: 1.43, CI: 1.1546 to 1.7804, P?=?0.001). To our best knowledge, this is the first report that links IL1RN VNTR polymorphism with human male infertility.
Jaiswal, Deepika; Trivedi, Sameer; Singh, Rajendra; Dada, Rima; Singh, Kiran
Women are turning to online health groups to deal with the stresses and complications of infertility. Online groups may provide a resource that is potentially absent in their face-to-face communities. This study examines how the sense of virtual community (SOVC) that develops in these groups serves as a buffer between perceived stress and physical health symptoms. A sample of 122
Jennifer L. Welbourne; Anita L. Blanchard; Marla D. Boughton
Ion radiation or radiotherapy is used to treat male patients with oligozoospermia, azoospermia, temporarily infertility, or even permanent infertility. The present study aims to investigate the potential infertility mechanism of sperm in mice after carbon ion radiation (CIR). The caudal epididymal sperm of male mice whole-body irradiated with carbon ion beam (0.5Gy and 4Gy) were used 7 days after irradiation. A two-dimensional gel electrophoresis approach was employed to investigate the changes in protein expression in the caudal edididymal sperm. Spot detection and matching were performed using the PDQuest 8.0 software. The criteria used to select spots for the analysis were more than a threefold difference in protein quantities (normalized spot volume), which allowed the detection of six differentially expressed proteins. Protein identification was performed using MALDI-TOF-TOF. Six specific proteins were identified by searching the NCBI protein sequence database. Among these proteins, HSP 70-2, PLC, GPX4, ?-tubulin, and GAPDHS were associated with sperm motility, which can affect fertility. ?-tubulin is important in axoneme migration flagellar movement and regulation, and GAPDHS is related to sperm energy supply. We analyzed their expressions using immunoblotting and immunofluorescence. The changes in sperm protein expression after CIR are mainly associated with motility. These proteins are potential markers for the mechanisms of infertility in space or radiotherapy. PMID:23435181
Li, Hong Yan; Zhang, Hong
Regarding the chemotaxis of sperms, new insights have been gained during the last 20 years. Olfactory receptors are expressed on the flagellar midpiece of human spermatogenic cells. One of them, OR1D2, is also expressed in the olfactory epithelium. This receptor has been suggested to play a role in sperm chemotaxis and thus in fertility. As OR1D2 is activated by bourgeonal, the aim of the study was to investigate whether patients with idiopathic infertility would exhibit a decreased olfactory sensitivity toward bourgeonal. Participants were 14 patients with idiopathic infertility and 23 controls (all young fathers). After having ascertained normosmia, odor thresholds and intensity ratings for the pleasant and flowery odors of bourgeonal, helional, and phenylethylalcohol were obtained. As a result, patients had specifically decreased intensity ratings for bourgeonal. It suggests that men with unexplained infertility tend to be less suprathreshold sensitive toward the odor of bourgeonal but not to that of other floral odors. It may be speculated that the decreased olfactory sensitivity relates to a decreased functionality of OR1D2, which in turn may be linked to idiopathic infertility. PMID:23535200
Sinding, Charlotte; Kemper, Eva; Spornraft-Ragaller, Petra; Hummel, Thomas
Background: Male are involved in near 50% of cases of infertility and reactive oxygen species (ROS) playing an important role in decreasing fertility potential. Accurate measurement of ROS seems to be important in evaluation of infertile male patients. Objective: To compare ROS measurement in neat and washed semen samples of infertile men and define the best method for evaluation of ROS in these patients. Materials and Methods: We measured the level of ROS in semen samples of thirty five non-azoospermic men with infertility. The semen samples were divided into two parts and the semen parameters and ROS levels in neat and washed samples were evaluated. We also evaluated the presence of pyospermia using peroxidase test. Results: The differences regarding sperm count and quick motility were significant in neat and washed semen samples. The mean ROS level was significantly higher in neat samples compared with washed spermatozoa (7.50 RLU vs. 1.20 RLU respectively). Difference in ROS levels was more significant in patients with pyospermia compared to whom with no pyospermia (378.67 RLU vs. 9.48 RLU respectively). Conclusion: Our study confirmed that neat or unprocessed samples are better index of normal oxidative status of semen samples. Because we do not artificially add or remove factors that may play an important role in oxidative equilibrium status.
Moein, Mohammad Reza; Vahidi, Serajedin; Ghasemzadeh, Jalal; Tabibnejad, Nasim
Background: Varicocele is associated with the failure of ipsilateral testicular growth and development, and the symptoms of pain and reduced fertility. The highly condensed structure of the sperm nuclear chromatin is provided by proper expression of Transition Nuclear Protein (TNP) genes, so any dysregulational expression of these genes results in abnormal spermatogenesis and infertility. Objective: The aim of present study was to assess the association between TNP1 mutations and varicocele in Iranian infertile men. Materials and Methods: Analysis of association between TNP1 gene mutation and varicocele phenotype was performed using PCR and Single-Stranded Conformational Polymorphism technique and DNA sequencing in 82 varicocele infertile men and 80 control subjects. Results: Sequence analysis was identified one variant in this gene that found in 15 infertile men and was absent in control group. This variant was a single nucleotide polymorphism that were identified in the intron region of this gene at position g.IVS1+75T>C. Conclusion: The effect of this nucleotide substitution in intronic region of the TNP1 gene and their role on expression remains to be determined.
Heidari, Mohammad Mehdi; Khatami, Mehri; Talebi, Ali Reza; Moezzi, Fahime
We examined male partners' influence on the decision to seek medical help for infertility using the National Study of Fertility Barriers. Building upon an existing help-seeking framework, we incorporated characteristics of both partners from 219 heterosexual couples who had ever perceived a fertility problem. In logistic regression analyses, we…
Johnson, Katherine M.; Johnson, David R.
Aims: Testicular apoptosis has been shown in human specimens, but its correlation with serum gonadotropins and testosterone levels has not been studied. The aim of this study was to evaluate the relationship of apoptosis with serum hormone levels and testicular histopathological findings in infertile men. Methods: Testis biopsy specimens were obtained for routine clinical purposes from 41 azoospermic men. The
Engin Kandirali; Selahittin Cayan; Abdullah Armagan; Bulent Erol; Ates Kadioglu
Fibroid management is surrounded by considerable controversy and uncertainty. This paper summarises the consensus developed by a group of Australasian subspecialists in reproductive endocrinology and infertility (the ACCEPT group) on the evidence concerning the impact and management of fibroids in infertility. The location of a fibroid within the uterus influences its effect on fertility. Subserosal fibroids do not appear to impact on fertility outcomes. Intramural (IM) fibroids may be associated with reduced fertility and an increased miscarriage rate (MR); however, there is insufficient evidence to inform whether myomectomy for IM fibroids improves fertility outcomes. Submucosal fibroids are associated with reduced fertility and an increased MR, and myomectomy for submucosal fibroids appears likely to improve fertility outcomes. The relative effect of multiple or different sized fibroids on fertility outcomes is uncertain, as is the relative usefulness of myomectomy in these situations. It is recommended that fibroids with suspected cavity involvement are defined by magnetic resonance imaging, sonohysterography or hysteroscopy because modalities such as transvaginal ultrasound and hysterosalpingography lack appropriate sensitivity and specificity. Medical management of fibroids delays efforts to conceive and is not recommended for the management of infertility associated with fibroids. Newer treatments such as uterine artery embolisation, radiofrequency ablation, bilateral uterine artery ligation, magnetic resonance-guided focussed ultrasound surgery and fibroid myolysis require further investigation prior to their establishment in the routine management of fibroid-associated infertility. PMID:21806566
Kroon, Ben; Johnson, Neil; Chapman, Michael; Yazdani, Anusch; Hart, Roger
It has been hypothesized that unexplained infertility may be related to specific personality and coping styles. We studied two groups of women with explained infertility (EIF, n?=?63) and unexplained infertility (UIF, n?=?42) undergoing an in vitro fertilization (IVF) cycle. Women completed personality and coping style questionnaires prior to the onset of the cycle, and state depression and anxiety scales before and at two additional time points during the cycle. Almost no in-between group differences were found at any of the measured time points in regards to the Minnesota Multiphasic Personality Inventory-2 validity and clinical scales, Illness Cognitions and Life Orientation Test, or for the situational measures. The few differences found suggest a more adaptive, better coping, and functioning defensive system in women with EIF. In conclusion, we did not find any clinically significant personality differences or differences in depression or anxiety levels between women with EIF and UIF during an IVF cycle. Minor differences found are probably a reaction to the ambiguous medical situation with its uncertain prognosis, amplifying certain traits which are not specific to one psychological structure but rather to the common experience shared by the group. The results of this study do not support the possibility that personality traits are involved in the pathophysiology of unexplained infertility. PMID:22847827
Aisenberg Romano, Gabi; Ravid, Hila; Zaig, Inbar; Schreiber, Shaul; Azem, Foad; Shachar, Izhak; Bloch, Miki
Recent changes in access to contraceptive and infertility treatments in the state of Illinois, and across the United States more generally, have heightened class cleavages in access to reproductive health care benefits in the United States. Using data gleaned from government testimonies, public documents, and telephone interviews, the authors found that poor women have broad access to contraceptive coverage but
LESLIE KING; MADONNA HARRINGTON MEYER
Objective The use of donor sperm or ova becomes an option for some infertile couples. We sought to determine the views towards donor sperm and eggs of both men and women. Design Prospective cohort of infertile couples Setting Eight California reproductive endocrinology practices Patients Infertile couples (n=377) were recruited after initial infertility clinic visit. Main Outcome Measures From questionnaires administered at recruitment, ratings concerning the impact of the use of donor gametes were assessed. Differences between men and women in attitudes toward donor gametes were compared with ANOVA. Linear regression was used to identify independent predictors of attitudes towards gametes. Results Female's attitudes towards donor sperm were significantly more negative than their attitudes towards donor eggs (5.1±1.4 vs 4.7±1.6*). Similarly, male donor gamete attitude scores were higher for donor sperm compared to donor eggs (4.9±1.6 vs 4.1±1.6*). Both men and women agreed that the use of donor sperm was more likely to have negative effects on their relationship and negative societal ramifications. Female donor gamete attitude scores were predicted by marital status, race, and education while men's scores were independent of all measured factors.* p<0.0001 Conclusions Both men and women view the use of donor sperm with more skepticism compared to the use of donor eggs suggesting a unique underlying perception regarding the use of male donor gametes.
Eisenberg, Michael L.; Smith, James F.; Millstein, Susan G.; Walsh, Thomas J.; Breyer, Benjamin N.; Katz, Patricia P.