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Sample records for infertility

  1. Infertility

    MedlinePLUS

    Infertility means not being able to become pregnant after a year of trying. If a woman can ... keeps having miscarriages or stillbirths, that's also called infertility. Infertility is fairly common. After one year of ...

  2. Infertility - resources

    MedlinePLUS

    Resources - infertility ... The following organizations are good resources for information on infertility : Centers for Disease Control and Prevention -- www.cdc/gov/reproductivehealth/infertility March of Dimes -- www.marchofdimes.com/ ...

  3. Female Infertility

    MedlinePLUS

    ... might be infertile, see your doctor. There are tests that may tell if you have fertility problems. When it is possible to find the cause, treatments may include medicines, surgery, or assisted reproductive technologies. Happily, many couples treated for infertility are able ...

  4. Male Infertility

    MedlinePLUS

    ... you are infertile, see your doctor. There are tests that may tell if you have fertility problems. When it is possible to find the cause, treatments may include medicines, surgery, or assisted reproductive technology. Happily, many couples treated for infertility are able ...

  5. Infertility FAQ's

    MedlinePLUS

    ... infertility. Top of Page What is assisted reproductive technology (ART)? Assisted Reproductive Technology (ART) includes all fertility ... Top of Page How often is assisted reproductive technology (ART) successful? Success rates vary and depend on ...

  6. Treating Infertility

    MedlinePLUS

    ... A common problem that leads to male infertility, varicocele , sometimes can be treated with surgery. How are ... contains and nourishes the developing fetus during pregnancy. Varicocele: Varicose veins in the scrotum. If you have ...

  7. Male Infertility

    MedlinePLUS

    ... men who are older than 35). Sometimes the cause of male infertility cannot be identified. In these cases, there may be an underlying genetic problem. Diagnosis & Tests Should men be checked for ...

  8. Female infertility

    PubMed Central

    2010-01-01

    Introduction About 17% of couples in industrialised countries seek help for infertility, which may be caused by ovulatory failure, tubal damage or endometriosis, or a low sperm count. In developed countries, 80% to 90% of couples attempting to conceive are successful after 1 year and 95% after 2 years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for infertility caused by ovulation disorders? What are the effects of treatments for tubal infertility? What are the effects of treatments for infertility associated with endometriosis? What are the effects of treatments for unexplained infertility? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 55 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: clomifene; drug-induced ovarian suppression; gonadotrophin priming of oocytes before in vitro maturation; gonadotrophins; gonadotrophin-releasing hormone agonists plus gonadotrophins; gonadotrophin-releasing hormone antagonists; in vitro fertilisation; intrauterine insemination alone, or combined with gonadotrophins or clomifene; laparoscopic ablation of endometrial deposits; laparoscopic ovarian drilling; laparoscopic removal; metformin; ovarian wedge biopsy; pulsatile gonadotrophin-releasing hormone; selective salpingography plus tubal catheterisation; tamoxifen; tubal flushing; and tubal surgery before in vitro fertilisation. PMID:21406133

  9. Female infertility

    PubMed Central

    2005-01-01

    Introduction About 17% of couples in industrialised countries seek help for infertility, which may be caused by ovulatory failure, tubal damage or endometriosis, or a low sperm count. In resource-rich countries, 80-90% of couples attempting to conceive are successful after 1 year and 95% after 2 years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for infertility caused by ovulation disorders? What are the effects of treatments for tubal infertility? What are the effects of treatments for infertility associated with endometriosis? We searched: Medline, Embase, The Cochrane Library and other important databases up to April 2004 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 56 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: clomifene; cyclofenil; drug-induced ovarian suppression; gonadotrophin priming of oocytes before in vitro maturation; gonadotrophins; gonadotrophin-releasing hormone agonists plus gonadotrophins; gonadotrophin-releasing hormone antagonists; in vitro fertilisation; intrauterine insemination plus controlled ovarian stimulation; intrauterine insemination plus gonadotrophins; laparoscopic ablation of endometrial deposits; laparoscopic ovarian drilling; metformin; ovarian wedge biopsy; pulsatile gonadotrophin-releasing hormone; selective salpingography plus tubal catheterisation; tamoxifen; tubal flushing with oil-soluble media or with water-soluble media; tubal surgery before in vitro fertilisation.

  10. Infertility and Fertility

    MedlinePLUS

    ... NICHD Research Information Clinical Trials Resources and Publications Infertility and Fertility: Condition Information Skip sharing on social media links Share this: Page Content What is infertility? "Infertility" is a term that describes when a ...

  11. Psychological Component of Infertility

    MedlinePLUS

    ... 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 ...

  12. Causes of Male Infertility

    MedlinePLUS

    ... Professional Societies and Organizations Home › Causes of Male Infertility Dr. Roger Lobo of the American Society for Reproductive Medicine covers causes of male infertility. "Understanding Infertility - The Basics" is a series of ...

  13. Sexual Dysfunction and Infertility

    MedlinePLUS

    ... American Society for Reproductive Medicine Sexual dysfunction and infertility What is sexual dysfunction and how common is ... and 40% of women. For couples dealing with infertility, it is even more common. Often, people ignore ...

  14. Primary infertility (image)

    MedlinePLUS

    Primary infertility is a term used to describe a couple that has never been able to conceive a pregnancy ... to do so through unprotected intercourse. Causes of infertility include a wide range of physical as well ...

  15. Understanding Infertility - The Basics

    MedlinePLUS

    ... Links to Professional Societies and Organizations Home › Understanding Infertility - The Basics A series of patient education videos ... out more of ASRM's Educational Videos here . Basic Infertility Evaluation 450 x 274 | Running Time: 3 min ...

  16. Stress and Infertility

    MedlinePLUS

    ... infertility It is not clear how exactly stress impacts fertility. It is not known whether high levels ... a “fight or flight” response. How can stress impact a fertility patient? Sometimes, infertility patients respond to ...

  17. Psychosocial Consequences of Infertility on Infertile Women.

    PubMed

    Fatima, P; Rahman, D; Hossain, H B; Hossain, H N; Mughi, C R

    2015-10-01

    This study explores to find out the qualitative and quantitative psychosocial consequences of infertility in women coming for infertility treatment in tertiary infertility center. A total of 400 infertile couples who agreed to participate in the study were asked to fill up the questionnaires and later interviewed to access the psychosocial consequences of infertility on their personal life in a tertiary infertility clinic in Dhaka at Center for Assisted Reproduction (CARe Hospital), Dhaka from June 2011 to December 2011 and agreed to participate in the study were included in the study. The data was analyzed and the quantitative and qualitative psychosocial factors were evaluated. Four hundred infertile couple who filled the questionnaires was included in the study. Sixty three percent of the women belonged to age group >20 30 years at the time of interview. Regarding age at marriage 43.8% of the women were married by 20 years, 51.3% were married between 20 30 years. Mean±SD duration of present married life was 7.20±4.45 (range 1 to 28) years and 74.4% of the women were living with their husbands. Of them 75.5% women were housewife. When asked whether they knew what was the reason of infertility in the couple, 32.5% knew the cause was in the female partner, 14.5%, knew the cause was in the male partner, 10.3% knew the cause was in both partners, 21.5% knew cause of infertility was not in any of the partners, and 21.3% had no idea about the cause of infertility. The male partner's response about the issue of prognosis and outcome of couple's infertility revealed 37.3% believed their wives will conceive someday, 31.3% had no intention for a second marriage, 13% were indifferent, 11.3% blamed their wives for infertility and 4.8% threatened for a second marriage. Only 2.5% of the male partners were suggested on consulting and continuing treatment by specialist. The family pressure by in-laws and relatives towards their infertility was that 57.3% insisted on consulting a good gynaecologist, 29.8% had no family pressure, 11.3% insisted the male partners to remarry, and 1.8% insisted the husbands to divorce their wives. In evaluating the social response it showed that 55.8% was suggested to consult a good gynaecologist, 31% asks embarrassing questions, 13% taunted and 0.3% insisted the husband to divorce the wife. In developing countries, despite overpopulation, unwanted childlessness is also an important psychosocial burden that needs attention. The consequences of infertility have greater impact on woman's life and can be a life time crisis. There is no direct intervention regarding infertility from government or NGO's. National services is lacking because policy makers and donor NGOs are not interested to invest on it and also women want to hide their infertility as long as they can. PMID:26620007

  18. [Therapy for infertile couples].

    PubMed

    Sperling, H; Eisenhardt, A; Becker, M; Rbben, H

    2005-10-01

    Therapy for infertile couples comprises gender-specific as well as couple-specific aspects. Diagnostic and therapeutic procedures focus on the causes of the infertility such as refertilization or epididymovasostomy on the one hand and assisted fertilization with extracted spermatozoa on the other. Using an interdisciplinary approach including urology, gynecology, reproductive medicine and human genetics, the treating physicians are able to fulfil the desire of infertile couples for a healthy child in many cases. PMID:16167125

  19. STDs and Infertility

    MedlinePLUS

    ... Literature: Programs to Promote Chlamydia Screening - a literature review to support an infertility prevention social marketing campaign Male Chlamydia Screening Consultation - Review and guidance ( ...

  20. Infertility with Testicular Cancer.

    PubMed

    Ostrowski, Kevin A; Walsh, Thomas J

    2015-08-01

    Testicular germ cell cancer is one of the most curable cancers. Most patients are treated during their reproductive years, making infertility a significant quality of life issue after successful treatment. This focused review evaluates the factors that contribute to infertility and specific fertility risks with the various testicular cancer treatments. Timing of patient discussions and current fertility treatments are reviewed. PMID:26216827

  1. Age-related infertility.

    PubMed

    Crawford, Natalie M; Steiner, Anne Z

    2015-03-01

    Oocyte number and quality decrease with advancing age. Thus, fecundity decreases as age increases, with a more rapid decline after the mid-30s. Patients more than 35 years old should receive prompt evaluation for causes of infertility after no more than 6 months of attempted conception. Patients with abnormal tests of ovarian reserve have a poorer prognosis and may need more expedited and aggressive treatment. Although oocyte donation is the best method to overcome age-related infertility, other treatment options may help women proceed quicker toward pregnancy. Patients at an advanced age should be counseled and evaluated before undergoing infertility treatments. PMID:25681837

  2. Female obesity and infertility.

    PubMed

    Talmor, Alon; Dunphy, Bruce

    2015-05-01

    Infertility affects one in seven couples, and its rate is on the increase. Ovulatory defects and unexplained causes account for >50% of infertile aetiologies. It is postulated that a significant proportion of these cases are either directly or indirectly related to obesity. The prevalence of overweight and obese men and women has topped 50% in some developed countries. Obesity is on the increase worldwide; in turn, the consequences in terms of the associated morbidity and mortality have also been increasing. Obesity is associated with various reproductive sequelae including anovulation, subfertility and infertility, increased risk of miscarriage and poor neonatal and maternal pregnancy outcomes. Thus, the combination of infertility and obesity poses some very real challenges in terms of both the short- and long-term management of these patients. The mechanism with which obesity impacts female reproductive function is summarised in this review. PMID:25619586

  3. Parenthood after Primary Infertility.

    ERIC Educational Resources Information Center

    Frances-Fischer, Jana E.; Lightsey, Owen Richard, Jr.

    2003-01-01

    Reviews the literature on the experience of parenting after primary infertility and describes construction and initial testing of an instrument for assessing characteristics of this understudied population. (Contains 52 references and 4 tables.) (GCP)

  4. Smoking and Infertility

    MedlinePLUS

    ... Website of the American Society for Reproductive Medicine Smoking and infertility Can smoking affect my ability to have a child? Most people understand that smoking increases the risk for heart, vascular, and lung ...

  5. Diagnostic imaging of infertility

    SciTech Connect

    Winfield, A.C.; Wentz, A.C.

    1987-01-01

    This text presents a review of all the imaging modalities available in the diagnosis of infertility. This book integrates the perspectives of experts in ob/gyn, radiology, reproductive endocrinology, and urology. It's a one-of-a-kind ''how to'' guide to hysterosalpinography and infertility evaluation, providing complete clinical information on the techniques, pitfalls, problems encountered and differential diagnosis. Detailed descriptions accompany numerous high-quality illustrations to help correlate findings and give meaning to the radiographic and ultrasound images.

  6. Psychiatric aspects of infertility and infertility treatments.

    PubMed

    Burns, Linda Hammer

    2007-12-01

    Infertility counseling, whether provided by a psychiatrist or another health care professional, involves the treatment and care of patients, not simply when they are undergoing fertility treatment but also with their long-term emotional well-being, and that of their children and the reproductive helpers who may assist them in achieving biologic or reproductive parenthood. They can educate patients about the side effects of infertility treatment medications and the impact of hormone shifts on psychologic well-being. They are also helpful with differential diagnoses among grief, depressions, and stress; in assessing psychologic preparedness; and in determining the acceptability and suitability of gamete donation, a gestational carrier, or surrogacy as a family-building alternative for individuals, couples, and reproductive collaborators. PMID:17938041

  7. Antiphospholipid antibodies and infertility.

    PubMed

    Chighizola, C B; de Jesus, G R

    2014-10-01

    Since the late 1980s some publications have proposed that antiphospholipid antibodies (aPL) may have some relationship with infertility, considering reported deleterious effects that aPL exert on trophoblast proliferation and growth. Although not included in current classification criteria for antiphospholipid syndrome, many physicians investigate for aPL in patients with a history of infertility, including antibodies not listed in classification criteria, and most of those patients will receive anticoagulant therapy if any of those antibodies have a result considered positive. A review of literature was conducted searching for studies that investigated the association of aPL and infertility and if aPL positivity alters in vitro fertilization (IVF) outcome. The definition of infertility, routine work-up to exclude other causes of infertility, definition of IVF failure as inclusion criteria and control populations were heterogeneous among studies. Most of them enrolled women over 40 years of age, and exclusion of other confounding factors was also inconsistent. Of 29 studies that assessed aPL positivity rates in infertile women, the majority had small sample sizes, implying a lack of power, and 13 (44.8%) reported higher frequency of aPL in infertile patients compared to controls, but most of them investigated a panel of non-criteria aPL tests, whose clinical significance is highly controversial. Only two studies investigated all three criteria tests, and medium-high titer of anticardiolipin cut-off conforming to international guidelines was used in one study. Considering IVF outcome, there was also disparity in this definition: few studies assessed the live birth rate, others the implantation rate. Of 14 publications that addressed the relationship between aPL and IVF outcome, only two described a detrimental effect of these autoantibodies. In conclusion, available data do not support an association between aPL and infertility, and aPL positivity does not seem to influence IVF outcome. Well-designed clinical studies recruiting women with a clear diagnosis of infertility and a high-risk aPL profile should be performed to test whether clinically relevant aPL do-or not-exert an effect on human fertility. PMID:25228713

  8. Endometriosis: Does It Cause Infertility?

    MedlinePLUS

    ... 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 ...

  9. Drug-induced infertility.

    PubMed

    Buchanan, J F; Davis, L J

    1984-02-01

    Primary infertility may result from the use of various drugs. This phenomenon may be the result of an effect on the hypothalamic-pituitary-gonadal axis or a direct toxic effect on the gonads. Some of the drugs considered in this article demonstrate sex-related differences in their ability to cause infertility; there also may be age-related differences. The drugs described in this review, in regard to their association with the development of infertility, include various individual antineoplastic agents (cyclophosphamide, chlorambucil, busulphan, and methotrexate) and combinations of these chemotherapeutic drugs, glucocorticosteroids, hormonal steroids (diethylstilbestrol, medroxyprogesterone acetate, estrogen, and the constituents of oral contraceptives), antibiotics (sulfasalazine and co-trimoxazole), thyroid supplements, spironolactone, cimetidine, colchicine, marihuana, opiates, and neuroleptic agents. PMID:6141923

  10. [Genetic male infertility].

    PubMed

    Van Steirteghem, A; Liebaers, I; Camus, M

    1999-06-15

    Several etiological factors in male infertility have been identified and it is now clear that a proportion of these factors have a genetic basis. This implies that using assisted reproductive technology procedures and especially intracytoplasmic sperm injection these genetic factors may be transmitted to the children. The following genetic factors involved in severe male infertility will be discussed: the presence of numerical and structural chromosomal anomalies, the occurrence of microdeletions on the long arm of the Y chromosome and the relation between cystic fibrosis and congenital bilateral absence of the vas deferens. PMID:10488663

  11. Male infertility microsurgical training

    PubMed Central

    Mehta, Akanksha; Li, Philip S

    2013-01-01

    Microsurgical training is imperative for urologists and clinical andrologists specializing in male infertility. Success in male infertility microsurgery is heavily dependent on the surgeon's microsurgical skills. Laboratory-based practice to enhance microsurgical skills improves the surgeon's confidence, and reduces stress and operating time, benefiting both the patient and the surgeon. This review provides guidelines for setting up a microsurgical laboratory to develop and enhance microsurgical skills using synthetic and animal models. The role of emerging techniques, such as robotic-assisted microsurgery, is also discussed. PMID:23160265

  12. Infertility: Medical and Social Choices.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Office of Technology Assessment.

    This report illustrates a range of options for Congressional action in nine principal areas of public policy related to infertility: (1) collecting data on reproductive health; (2) preventing infertility; (3) information to inform and protect consumers; (4) providing access to infertility services; (5) reproductive health of veterans; (6) transfer…

  13. Fertility and Infertility.

    ERIC Educational Resources Information Center

    Orgebin-Crist, Marie-Claire; And Others

    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

  14. Parenting after Infertility

    ERIC Educational Resources Information Center

    Olshansky, Ellen

    2009-01-01

    Becoming a parent after experiencing infertility can pose unique challenges to early parenthood. Parents may struggle with the normal anxiety and fatigue, as well as possible depression, that accompany new parenthood, but with added guilt or shame because of how much they wanted a child and how hard they worked to become parents. These feelings…

  15. Parenting after Infertility

    ERIC Educational Resources Information Center

    Olshansky, Ellen

    2009-01-01

    Becoming a parent after experiencing infertility can pose unique challenges to early parenthood. Parents may struggle with the normal anxiety and fatigue, as well as possible depression, that accompany new parenthood, but with added guilt or shame because of how much they wanted a child and how hard they worked to become parents. These feelings

  16. Fertility and Infertility.

    ERIC Educational Resources Information Center

    Orgebin-Crist, Marie-Claire; And Others

    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…

  17. Lycopene and male infertility.

    PubMed

    Durairajanayagam, Damayanthi; Agarwal, Ashok; Ong, Chloe; Prashast, Pallavi

    2014-01-01

    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

  18. ACR appropriateness Criteria infertility.

    PubMed

    Wall, Darci J; Javitt, Marcia C; Glanc, Phyllis; Bhosale, Priyadarshani R; Harisinghani, Mukesh G; Harris, Robert D; Khati, Nadia J; Mitchell, Donald G; Nyberg, David A; Pandharipande, Pari V; Pannu, Harpreet K; Shipp, Thomas D; Siegel, Cary Lynn; Simpson, Lynn; Wong-You-Cheong, Jade J; Zelop, Carolyn M

    2015-03-01

    Appropriate imaging for women undergoing infertility workup depends upon the clinician's suspicion for potential causes of infertility. Transvaginal US is the preferred modality to assess the ovaries for features of polycystic ovary syndrome (PCOS), the leading cause of anovulatory infertility. For women who have a history or clinical suspicion of endometriosis, which affects at least one third of women with infertility, both MRI and pelvic US can provide valuable information. If tubal occlusion is suspected, whether due to endometriosis, previous pelvic inflammatory disease, or other cause, hysterosalpingogram (HSG) is the preferred method of evaluation. To assess for anatomic causes of recurrent pregnancy loss (RPL) such as Mllerian anomalies, synechiae, and leiomyomas, saline infusion sonohysterography, MRI and 3-D US are most appropriate. Up to 10% of women suffering recurrent pregnancy loss have a congenital Mllerian anomaly. When assessment of the pituitary gland is indicated, MRI is the imaging exam of choice.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:25706363

  19. Lycopene and male infertility

    PubMed Central

    Durairajanayagam, Damayanthi; Agarwal, Ashok; Ong, Chloe; Prashast, Pallavi

    2014-01-01

    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 infertilitylipid 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 48 mg of lycopene daily for 312 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

  20. Preconception interventions in infertile couples

    PubMed Central

    Nekuei, Nafisehsadat; Kazemi, Ashraf; Hasanzadeh, Akbar

    2014-01-01

    Background: Preconception interventions in infertile couples can increase the chance of pregnancy and lower its complications. The success in infertility treatment and achieving a successful pregnancy is of great importance among infertile couples compared to others. This study has tried to investigate necessary preconception interventions before beginning of infertility treatment cycle among infertile couples. Materials and Methods: This is a cross-sectional study of 268 individuals presenting to fertility clinics (Moshtagh and Shahid beheshty) across the city of Isfahan, Iran. Simple sampling method was used. Questionnaire and patients medical records were used to collect data. Descriptive and analytic statistical methods and SPSS software were used for analysis. Results: The results showed that the interventions related to diseases treatment and prescription of folic acid before the beginning of infertility treatment were complete for most of the subject (47.06% and 79.9% respectively), but referral for genetics counseling had not been conducted in most of the cases (98.9%). Specific interventions in relation with the infertility treatment before beginning the treatment cycle had been conducted in 50% of the subjects. Conclusion: The results of this study showed a weakness concerning necessary preconception interventions before beginning of infertility treatment cycle in most of the studied subjects. With regard to the effect of preconception interventions on outcome of infertility treatment, and with consideration of high importance of pregnancy success in infertile couples, paying more attention to conduct this manner is necessary. PMID:25250367

  1. Treatment of male infertility.

    PubMed

    Palermo, Gianpiero D; Kocent, Justin; Monahan, Devin; Neri, Queenie V; Rosenwaks, Zev

    2014-01-01

    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

  2. Male infertility microsurgical training

    PubMed Central

    Li, Philip S.; Goldstein, Marc

    2014-01-01

    A strong foundation in microsurgical techniques is imperative for urologists and clinical andrologists specializing in male infertility. Laboratory-based microsurgical training enhances surgical skills, improves surgeon confidence, and reduces stress and operating time, thereby benefiting both the patient and the surgeon. The laboratory environment additionally allows for the development of novel and innovative techniques. This review provides guidelines for setting up a microsurgical laboratory to develop and enhance microsurgical skills using synthetic and animal models. PMID:26816761

  3. Tarlov Cyst and Infertility

    PubMed Central

    Singh, Pankaj Kumar; Singh, Vinay Kumar; Azam, Amir; Gupta, Sanjeev

    2009-01-01

    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. PMID:19569467

  4. Lived experience of infertile men with male infertility cause

    PubMed Central

    Fahami, Fariba; Quchani, Samaneh Hosseini; Ehsanpour, Soheila; Boroujeni, Ali Zargham

    2010-01-01

    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. PMID:22069398

  5. Adolescent Varicoceles and Infertility.

    PubMed

    Casey, Jessica T; Misseri, Rosalia

    2015-12-01

    Varicoceles are associated with testicular atrophy and abnormal spermatogenesis. Varicocele-related testicular damage is thought to be progressive in nature. Adult varicoceles are common in men with infertility, and varicocele repair in this population has demonstrated improved semen parameters and paternity outcomes. However, without solid objective endpoints (reproducible semen analyses, paternity), the indications for adolescent varicocele repair remain controversial. Given the controversy surrounding adolescent varicocele management, it is not surprising that surveys of pediatric urologists have revealed a lack of consensus on diagnostic approaches, treatment decisions, and operative approaches. PMID:26568496

  6. A Biopsychosocial Theory of Infertility.

    ERIC Educational Resources Information Center

    Gerrity, Deborah A.

    2001-01-01

    Briefly reviews the literature on infertility and its emotional, physical, existential, and relational effects on individuals, couples, and families. Life crisis and biopsychosocial theories are discussed as they apply to persons struggling with infertility issues. In addition, stage models derived from a biopsychosocial perspective are presented.…

  7. Strategies for Counseling Infertile Couples.

    ERIC Educational Resources Information Center

    Daniluk, Judith C.

    1991-01-01

    Presents specific intervention strategies that may serve to reinforce infertility experience as opportunity for personal and marital growth. Concludes through counseling clients may complete much of the emotional work required to reach a point of resolution and acceptance of their infertility. (Author/ABL)

  8. The male infertility office visit.

    PubMed

    Dadhich, P; Ramasamy, R; Lipshultz, L I

    2015-06-01

    One in six couples are infertile, and in 50% of these couples, a male factor plays a role. Therefore, it is imperative that physicians become comfortable in the basic evaluation of the infertile male. By performing a thorough history and physical examination, physicians can usually establish a differential diagnosis and proceed to laboratory testing that will help to establish an etiology for infertility. The purpose of this review is to provide general guidelines for a physician seeking to evaluate a man's fertility status and to suggest the most common pathologies that might be found through a directed work-up. PMID:25604696

  9. Medical treatment of male infertility

    PubMed Central

    Dabaja, Ali A.

    2014-01-01

    The majority of male infertility is idiopathic. However, there are multiple known causes of male infertility, and some of these causes can be treated medically with high success rates. In cases of idiopathic or genetic causes of male infertility, medical management is typically empirical; in most instances medical therapy represents off-label use that is not specifically approved by the FDA. Understanding the hypothalamic-pituitary-gonadal (HPG) axis and the effect of estrogen excess is critical for the assessment and treatment of male infertility. The use of certain medical treatment has been associated with an increase in sperm production or motility, and primarily focuses on optimizing testosterone (T) production from the Leydig cells, increasing follicle-stimulating hormone (FSH) levels to stimulate Sertoli cells and spermatogenesis, and normalizing the T to estrogen ratio. PMID:26816749

  10. Infertility Research at the NICHD

    MedlinePLUS

    ... infertile women with PCOS. This study is nearing completion. For details, visit Clinical Trials.gov ID: NCT00719186 . ... fellowships, with a strong emphasis on research. Upon completion of the curriculum, fellows may apply to the ...

  11. Diagnostic Testing for Male Factor Infertility

    MedlinePLUS

    ... PATIENT FACT SHEET Diagnostic Testing for Male Factor Infertility When a couple has trouble having a baby, ... to find out what may be causing your infertility. Semen analysis Semen analysis is probably the first ...

  12. Infertility: A Crisis with No Resolution.

    ERIC Educational Resources Information Center

    Butler, Robert R.; Koraleski, Stephanie

    1990-01-01

    Discusses helpful ways for mental health counselors to work with infertile clients, explaining nature of infertility, psychological crisis it provokes, common reactions of infertile clients, and strategies to help clients cope. Discusses specific strategies for assessing clients' potential for suicide or self-destructive acts and improving their…

  13. Childlessness: Strategies for Coping with Infertility.

    ERIC Educational Resources Information Center

    Woollett, Anne

    1985-01-01

    Examines the coping strategies adopted by 50 infertile men and women. All interviewed had sought medical help, and many became knowledgeable about reproduction and infertility. Redefining the problem and managing negative concepts about infertility were other coping strategies. Seeking social support, positive identities, and other ways of meeting…

  14. Infertility and Life Satisfaction among Women

    ERIC Educational Resources Information Center

    McQuillan, Julia; Stone, Rosalie A. Torres; Greil, Arthur L.

    2007-01-01

    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…

  15. Infertility: An Unanticipated and Prolonged Life Crisis.

    ERIC Educational Resources Information Center

    Forrest, Linda; Gilbert, Mary S.

    1992-01-01

    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.…

  16. Sex and Intimacy among Infertile Couples.

    ERIC Educational Resources Information Center

    Greil, Arthur; And Others

    Infertility is a widespread health problem in the United States, affecting anywhere from 10 to 15 percent and perhaps even a greater percentage of U.S. couples. Infertility can have far-reaching effects on life satisfaction, well-being, and psychological adjustment. This paper presents an analysis of sex and intimacy among infertile couples based…

  17. Infertility: An Unanticipated and Prolonged Life Crisis.

    ERIC Educational Resources Information Center

    Forrest, Linda; Gilbert, Mary S.

    1992-01-01

    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.

  18. Infertility and Life Satisfaction among Women

    ERIC Educational Resources Information Center

    McQuillan, Julia; Stone, Rosalie A. Torres; Greil, Arthur L.

    2007-01-01

    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

  19. Childlessness: Strategies for Coping with Infertility.

    ERIC Educational Resources Information Center

    Woollett, Anne

    1985-01-01

    Examines the coping strategies adopted by 50 infertile men and women. All interviewed had sought medical help, and many became knowledgeable about reproduction and infertility. Redefining the problem and managing negative concepts about infertility were other coping strategies. Seeking social support, positive identities, and other ways of meeting

  20. [Circulating nucleic acids and infertility].

    PubMed

    Scalici, E; Mullet, T; Ferrires Hoa, A; Gala, A; Loup, V; Anahory, T; Belloc, S; Hamamah, S

    2015-09-01

    Circulating nucleic acids (cell-free DNA and microRNAs) have for particularity to be easily detectable in the biological fluids of the body. Therefore, they constitute biomarkers of interest in female and male infertility care. Indeed, in female, they can be used to detect ovarian reserve disorders (polycystic ovary syndrome and low functional ovarian reserve) as well as to assess follicular microenvironment quality. Moreover, in men, their expression levels can vary in case of spermatogenesis abnormalities. Finally, circulating nucleic acids have also the ability to predict successfully the quality of in vitro embryo development. Their multiple contributions during assisted reproductive technology (ART) make of them biomarkers of interest, for the development of new diagnostic and/or prognostic tests, applied to our specialty. Circulating nucleic acids would so offer the possibility of personalized medical care for infertile couples in ART. PMID:26298813

  1. The Infertility Experience: Biopsychosocial Effects and Suggestions for Counselors

    ERIC Educational Resources Information Center

    Watkins, Kathryn J.; Baldo, Tracy D.

    2004-01-01

    Infertility affects many individuals and couples. This article begins with a case study of a couple who have experienced infertility yet do not identify infertility as their presenting problem. Clients and counselors alike often overlook infertility. This article offers an overview of the biology of infertility and its psychological and…

  2. Male factor infertility and ART

    PubMed Central

    Tournaye, Herman

    2012-01-01

    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 1106 progressively motile spermatozoa are recovered after sperm preparation. If no pregnancy is achieved after 36 cycles of IUI, optimized in vitro fertilization (IVF) can be proposed. When less than 0.5106 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. PMID:22179511

  3. Male Infertility and Its Causes in Human

    PubMed Central

    Miyamoto, Toshinobu; Tsujimura, Akira; Miyagawa, Yasushi; Koh, Eitetsu; Namiki, Mikio; Sengoku, Kazuo

    2012-01-01

    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. PMID:22046184

  4. The conventional management of male infertility.

    PubMed

    Nieschlag, Eberhard; Lenzi, Andrea

    2013-12-01

    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

  5. Eastern medicine approaches to male infertility.

    PubMed

    Hu, Min; Zhang, Yuehui; Ma, Hongli; Ng, Ernest H Y; Wu, Xiao-Ke

    2013-07-01

    Male factor is a common cause of infertility and the male partner must be systematically evaluated in the workup of every infertile couple. Various Eastern medical strategies have been tried with variable success. This article describes the clinical effects of Eastern medicine approaches including acupuncture, Chinese herbal medicine, massage, yoga, tai chi, and qi gong, which could improve the sperm parameters and motility, genital inflammatory conditions, as well as immune system disorders, sexual dysfunction, and varicocele. Acupuncture reduces inflammation, increases sperm motility, improves semen parameters, modulates the immune system, and improves sexual and ejaculatory dysfunction in male infertility. The clinical effects may be mediated via activation of somatic afferent nerves innervating the skin and muscle. Chinese herbal medicines may also exert helpful effects in male infertility, and it is worth noting that some herbal drugs may result in male infertility. Massage also exerts positive effects in male infertility. Nevertheless, the mechanisms of clinical effects are unclear. Tai chi, qi gong, and yoga have not been investigated in male infertility, but it has been reported to regulate endocrine and central or autonomic nervous systems. In conclusion, Eastern medical approaches have beneficial on reproductive effects in male infertility. However, future well-designed, randomized, clinical control trials are needed to evaluate the safety, efficacy, and mechanisms of Eastern medical approaches for male infertility. PMID:23775386

  6. Beyond the Mechanics of Infertility: Perspectives on the Social Psychology of Infertility and Involuntary Childlessness.

    ERIC Educational Resources Information Center

    Matthews, Anne Martin; Matthews, Ralph

    1986-01-01

    Examines the social and social psychological implications of infertility and involuntary childlessness. Examines the clinical and popular literature on the correlates and causes of infertility and the social psychological consequences of infertility. Suggests ways that family practitioners and researchers might overcome some of the limitations.…

  7. Genetics Home Reference: Sensorineural deafness and male infertility

    MedlinePLUS

    ... Genetic disorder catalog Conditions > Sensorineural deafness and male infertility On this page: Description Genetic changes Inheritance Diagnosis ... April 2010 What is sensorineural deafness and male infertility? Sensorineural deafness and male infertility is a condition ...

  8. Genetics Home Reference: CATSPER1-related nonsyndromic male infertility

    MedlinePLUS

    ... 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 ...

  9. Domestic violence in Iranian infertile women

    PubMed Central

    Sheikhan, Zohre; Ozgoli, Giti; Azar, Mahyar; Alavimajd, Hamid

    2014-01-01

    Background: Millions of men and women suffer from infertility worldwide. In many cultures, infertile women are at risk of social and emotional problems. Infertility may affect the public health in many countries. Domestic violence is the intentional use of physical force, power or threat against oneself, another person or another group or community which leads to injury, death, mental harm, lack of development or deprivation. This study aimed to assess the prevalence of domestic violence against infertile women who referred to the infertility centres of Tehran, Iran in 2011. Methods: This was cross- sectional descriptive study conducted on 400 infertile women who were selected through convenient sampling method. The questionnaire used in this study included two sections: a demographic section with questions about demographic characteristics of the infertile women and their husbands; and the domestic violence questionnaire with questions about physical, emotional and sexual violence. Data were analysed by SPSS16; descriptive statistics, Spearman’s test, t- test, one-way analysis of variance (ANOVA) and logistic regression were used for data analysis. Results: Four hundred women with the average age of 30.50 ± 6.16 years participated in the study; of whom, 34.7% experienced domestic violence physical violence (5.3%), emotional violence (74.3%) and sexual violence (47.3%). Domestic violence was significantly associated with unwanted marriage, number of IVFs, drug abuse, emotional status of the women, smoking and addiction or drug abuse of the spouse, mental and physical diseases of the husband (p< 0.05). Conclusion: Many of the current problems in this society, particularly in families are due to the transition of the society from a traditional model to a modern one. The majority of the infertile women experience violence in Iran. Domestic violence against infertile women is a problem that should not be ignored. Clinicians should identify abused women. Providing counseling services to women in infertility treatment centers is suggested to prevent domestic violence against infertile women. PMID:25695010

  10. [Androgen receptor and male infertility].

    PubMed

    Eldar-Geva, Talia; Milatiner, David; Halle, David

    2004-06-01

    The androgen receptor (AR) mediates androgen action determining male sexual phenotypes and promotion of spermatogenesis. Mutations in the AR cause various degrees of androgen resistance resulting in a range of androgen insensitivity syndromes. A single copy gene in the X chromosome encodes the AR. The gene contains a polymorphic triple repeat sequence [(CAG)n] with 9-36 repeats in the normal population, and displays ethnic dependence. In vitro, there is an inverse correlation between CAG repeat length and AR function. Associations exist between short alleles and prostate cancer in men or clinical hyperandrogenism in women. Expansion of the CAG tract > 40 repeats leads to spinal bulbar muscular atrophy (SBMA, Kennedy disease), an adult onset neurodegenerative disease that also presents with low virilization and spermatogenetic defects. The disease may show evidence of anticipation (increasing severity with succeeding generations accompanying further expansion of repeat length). Twelve studies involving Singaporean, Australian, North American and Japanese men reported a relationship between AR CAG repeat length and male infertility, whereas 10 studies, most of them European, found no association. Differences in hereditary or acquired factors in these populations may explain the equivocality. However, statistical methods, sample sizes, study definition and control populations, in addition to laboratory methods vary widely within the published papers, and could affect the results and conclusions. Current data is insufficient to conclude whether IVF patients who display AR CAG expansion may transfer infertility or premutation of neurodegenerative disease to their descendants. We recommend screening of AR CAG repeat length, at least in those populations where an association between repeat length and infertility could be found. PMID:15524101

  11. Epigenetics, spermatogenesis and male infertility.

    PubMed

    Rajender, Singh; Avery, Kelsey; Agarwal, Ashok

    2011-01-01

    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

  12. Investigation of the Infertile Couple

    PubMed Central

    Daya, Salim

    1989-01-01

    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. PMID:21248976

  13. Trends of male factor infertility, an important cause of infertility: A review of literature

    PubMed Central

    Kumar, Naina; Singh, Amit Kant

    2015-01-01

    Infertility and problems of impaired fecundity have been a concern through ages and is also a significant clinical problem today, which affects 812% of couples worldwide. Of all infertility cases, approximately 4050% is due to male factor infertility and as many as 2% of all men will exhibit suboptimal sperm parameters. It may be one or a combination of low sperm concentration, poor sperm motility, or abnormal morphology. The rates of infertility in less industrialized nations are markedly higher and infectious diseases are responsible for a greater proportion of infertility. The present literature will help in knowing the trends of male factor infertility in developing nations like India and to find out in future, various factors that may be responsible for male infertility. PMID:26752853

  14. Is Infertility Associated with Childhood Autism?

    ERIC Educational Resources Information Center

    Grether, Judith K.; Qian, Yinge; Croughan, Mary S.; Wu, Yvonne W.; Schembri, Michael; Camarano, Loretta; Croen, Lisa A.

    2013-01-01

    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…

  15. Pastoral Care to the Infertile Couple.

    ERIC Educational Resources Information Center

    Louw, D. J.

    This paper examines the crisis of infertility in the context of the biological or instinctual, cultural, and religious root of parenting. A therapeutic approach to the problem of infertility suggests that pastoral care should make a thorough diagnosis of the correlation between the motivation for parenting, role expectations in the social and…

  16. Choices and Motivations of Infertile Couples.

    ERIC Educational Resources Information Center

    van Balen, Frank; Verdurmen, Jacqueline; Ketting, Evert

    1997-01-01

    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.

  17. Male infertility: role of genetic background.

    PubMed

    Ferlin, Alberto; Raicu, Florina; Gatta, Valentina; Zuccarello, Daniela; Palka, Giandomenico; Foresta, Carlo

    2007-06-01

    Male infertility represents one of the clearest examples of a complex disease with a substantial genetic basis. Numerous male mouse models, mutation screening and association studies reported over the last few years reveal the high prevalence of genetic causes of spermatogenic impairment, accounting for 10-15% of severe male infertility, including chromosomal aberrations and single gene mutations. Natural selection prevents the transmission of mutations causing infertility, but this protective mechanism may be overcome by assisted reproduction techniques. Consequently, the identification of genetic factors is important for appropriate management of the infertile couple. However, a large proportion of infertile males are diagnosed as idiopathic, reflecting poor understanding of the basic mechanisms regulating spermatogenesis and sperm function. Furthermore, the molecular mechanisms underlying spermatogenic damage in cases of genetic infertility (for example Yq microdeletions) are not known. These problems can be addressed only by large scale association studies and testicular or spermatozoal expression studies in well-defined alterations of spermatogenesis. It is conceivable that these studies will have important diagnostic and therapeutic implications in the future. This review discusses the genetic causes of male infertility known to date, the genetic polymorphisms possibly associated with male infertility, and reports novel results of global gene expression profiling of normal human testis by microarray technology. PMID:17579990

  18. Is Infertility Associated with Childhood Autism?

    ERIC Educational Resources Information Center

    Grether, Judith K.; Qian, Yinge; Croughan, Mary S.; Wu, Yvonne W.; Schembri, Michael; Camarano, Loretta; Croen, Lisa A.

    2013-01-01

    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

  19. Choices and Motivations of Infertile Couples.

    ERIC Educational Resources Information Center

    van Balen, Frank; Verdurmen, Jacqueline; Ketting, Evert

    1997-01-01

    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.…

  20. Is infertility associated with childhood autism?

    PubMed

    Grether, Judith K; Qian, Yinge; Croughan, Mary S; Wu, Yvonne W; Schembri, Michael; Camarano, Loretta; Croen, Lisa A

    2013-03-01

    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 Permanente Northern California. Among singletons (349 cases, 1,847 controls), we found no evidence to support an increase in risk of ASD associated with infertility. Among multiple births (21 cases, 54 controls), we found an increased risk associated with infertility history and with infertility evaluations and treatment around the time of index pregnancy conception; however, small sample size and lack of detailed data on treatments preclude firm interpretation of results for multiple births. PMID:22777105

  1. Genetic evaluation of male infertility

    PubMed Central

    2014-01-01

    Men with severe oligospermia (<5 million sperm/mL ejaculate fluid) or azoospermia should receive genetic testing to clarify etiology of male infertility prior to treatment. Categorization by obstructive azoospermia (OA) or non-obstructive azoospermia (NOA) is critical since genetic testing differs for the former with normal testicular function, testicular volume (~20 mL), and follicle-stimulating hormone (FSH) (1-8 IU/mL) when compared to the latter with small, soft testes and increased FSH. History and physician examination along with laboratory testing (following appropriate genetic counseling) is critical to accurate selection of genetic testing appropriate for azoospermia due to primary testicular failure as compared with congenital hypogonadotropic hypogonadism (HH). Genetic testing options include cystic fibrosis transmembrane conductance regulator (CFTR) testing for men with congenital absence of the vas, while karyotype, Y chromosome microdeletions (YCMD), and other specific genetic tests may be warranted depending on the clinical context of severe oligospermia or NOA. The results of genetic testing guide management options. The most recent techniques for genetic analysis, including sperm microRNA (miRNA) and epigenetics, are forming the foundation for future genetic diagnosis and therapeutic targets in male infertility. PMID:26813518

  2. Infertility

    MedlinePLUS

    ... such as intrauterine insemination (IUI) and in vitro fertilization (IVF) Medicines to treat infections and clotting disorders ... not include advanced techniques such as in vitro fertilization (IVF).

  3. Small Supernumerary Marker Chromosomes in Human Infertility.

    PubMed

    Armanet, Narjes; Tosca, Lucie; Brisset, Sophie; Liehr, Thomas; Tachdjian, Grard

    2015-01-01

    Small supernumerary marker chromosomes (sSMC) are structurally abnormal chromosomes that cannot be unambiguously identified by banding cytogenetics. The objective of this study was to provide an overview of sSMC frequency and characterization in a context of infertility and to review the literature describing sSMC in relation with male and female infertility. Therefore, a systematic literature review on sSMC associated with infertility was conducted by means of a PubMed literature and a sSMC database (http://ssmc-tl.com/sSMC.html) search. A total of 234 patients with infertility were identified as carriers of sSMC. All chromosomes, except chromosomes 10, 19 and the X, were involved in sSMC, and in 72% the sSMC originated from acrocentric chromosomes. Euchromatic imbalances were caused by the presence of sSMC in 30% of the cases. Putative genes have been identified in only 1.2% of sSMC associated with infertility. The implication of sSMC in infertility could be due to a partial trisomy of some genes but also to mechanical effects perturbing meiosis. Further precise molecular and interphase-architecture studies on sSMC are needed in the future to characterize the relationship between this chromosomal anomaly and human infertility. PMID:26398339

  4. Variations in Antioxidant Genes and Male Infertility

    PubMed Central

    Yu, Bolan; Huang, Zhaofeng

    2015-01-01

    Oxidative stress and reactive oxygen species (ROS) are generated from both endogenous and environmental resources, which in turn may cause defective spermatogenesis and male infertility. Antioxidant genes, which include catalase (CAT), glutathione peroxidase (GPX), glutathione S-transferase (GST), nitric oxide synthase (NOS), nuclear factor erythroid 2-related factor 2 (NRF2), and superoxide dismutase (SOD), play important roles in spermatogenesis and normal sperm function. In this review, we discuss the association between variations in major antioxidant genes and male infertility. Numerous studies have suggested that genetic disruption or functional polymorphisms in these antioxidant genes are associated with a higher risk for male infertility, which include low sperm quality, oligoasthenoteratozoospermia, oligozoospermia, and subfertility. The synergistic effects of environmental ROS and functional polymorphisms on antioxidant genes that result in male infertility have also been reported. Therefore, variants in antioxidant genes, which independently or synergistically occur with environmental ROS, affect spermatogenesis and contribute to the occurrence of male infertility. Large cohort and multiple center-based population studies to identify new antioxidant genetic variants that increase susceptibility to male infertility as well as validate its potential as genetic markers for diagnosis and risk assessment for male infertility for precise clinical approaches are warranted. PMID:26618172

  5. Social and Cultural Aspects of Infertility in Mozambique.

    ERIC Educational Resources Information Center

    Gerrits, Trudie

    1997-01-01

    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

  6. Social and Cultural Aspects of Infertility in Mozambique.

    ERIC Educational Resources Information Center

    Gerrits, Trudie

    1997-01-01

    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…

  7. [Male infertility in delay of sexual development].

    PubMed

    Kirpatovski?, I D; Kir'ianov, A V

    2007-01-01

    The examination of 260 infertile males revealed that delay of sexual development (DSD) predisposes to male infertility. DSD is often characterized by autoimmune reactions pointing to DSD as one of the causes of autoimmune infertility. Spermatozoa in DSD have low viability. Hormonal changes in DSD in adult males did not significantly change from the group with normal sexual development. LH/testosterone and testosteron/estradiol differed significantly in DSD and hypogonadism. Calculation of these proportions may serve differential criteria of DSD and secondary hypogonadism. PMID:17915450

  8. Selecting barrenness: the use of preimplantation genetic diagnosis by congenitally infertile women to select for infertility.

    PubMed

    Shah, Kavita R

    2010-01-01

    Congenitally infertile women such as those with Turner syndrome or Mayer Rokitansky-Kuster-Hauser syndrome have available the technologies of oocyte harvesting, cryropreservation, in-vitro fertilization, and gestational surrogacy in order to have genetically related offspring. Since congenital infertility results in a variety of experiences that impacts on nearly every aspect of a person's life, in the future it is possible that these women might desire a congenitally infertile child through the use of preimplantation genetic diagnosis so as to share this common bond. While infertility results in a relatively normal quality of life, it is morally wrong to necessitate the future use of infertility services with its variable success rate on a child. Also, whereas the woman has fundamental reproductive autonomy, she lacks the substantive autonomy regarding the specific characteristics of her child. Finally, the infertile community does exhibit a strong presence, but it lacks characteristics that define it as a culture. PMID:21644427

  9. Genetics Home Reference: Y chromosome infertility

    MedlinePLUS

    ... chromosome infertility is usually caused by deletions of genetic material in regions of the Y chromosome called azoospermia ... AZF regions may affect several genes. The missing genetic material likely prevents production of a number of proteins ...

  10. Endometriosis and Infertility: Can Surgery Help?

    MedlinePLUS

    ... Website of the American Society for Reproductive Medicine Endometriosis and Infertility: Can Surgery Help? This fact sheet ... with The Society of Reproductive Surgeons What is endometriosis? When tissue like the tissue that that normally ...

  11. Perspective in infertility: the ovarian stem cells.

    PubMed

    Silvestris, Erica; D'Oronzo, Stella; Cafforio, Paola; D'Amato, Giuseppe; Loverro, Giuseppe

    2015-01-01

    Infertility is a medical and social condition that affects millions of women worldwide and is today considered so far as a new disease. A considerable progress has been recently pursued in the field of the reproductive medicine and the infertility treatment may account for novel and modern procedures such as in vitro oocyte fertilization, egg donation, pregnancy surrogacy and preimplantation diagnosis. However, great interest has lately been reserved to the ovarian stem cells (OSCs) whose existence in woman ovaries has been proven. OSCs are thus suitable for developmental studies in infertility and in other clinical applications as endocrine derangements due to premature ovarian failure, or for infertility treatment after cancer chemotherapies, as well as in restoring the hormonal balance in postmenopausal age. PMID:26250560

  12. Society for Reproductive Endocrinology and Infertility

    MedlinePLUS

    ... Might Be Infertile From: Headlines in Reproductive Medicine In Vitro Fertilization Bill Would Define Embryos as Human Life From: Headlines in Reproductive Medicine View All News & Research » Fact Sheets ...

  13. Surgical management of male infertility: an update

    PubMed Central

    Velasquez, Monica

    2014-01-01

    Male factor infertility is common, affecting 7% of the total population and up to half of couples who are trying to conceive. Various surgical and reconstructive options allow biological paternity depending on the etiology of the male factor issues. This article describes historical treatments and newer approaches, discussing the role for traditional open surgery, microsurgery and robotic surgery, as well as interventional radiologic procedures in the management of male infertility. PMID:26816754

  14. Hysteroscopy for infertile women: a review.

    PubMed

    Cholkeri-Singh, Aarathi; Sasaki, Kirsten J

    2015-01-01

    Hysteroscopy is widely performed in infertile women. A review of peer-reviewed, published literature from the PubMed database on uterine intracavitary pathology, proximal tubal occlusion, failed in vitro fertilization procedures, and first trimester miscarriages of infertile women was performed to examine the importance, feasibility, and success rates of diagnostic and operative hysteroscopy when evaluating and treating these conditions. PMID:25553895

  15. Gestational surrogacy: Viewpoint of Iranian infertile women

    PubMed Central

    Rahmani, Azad; Sattarzadeh, Nilofar; Gholizadeh, Leila; Sheikhalipour, Zahra; Allahbakhshian, Atefeh; Hassankhani, Hadi

    2011-01-01

    BACKGROUND: Surrogacy is a popular form of assisted reproductive technology of which only gestational form is approved by most of the religious scholars in Iran. Little evidence exists about the Iranian infertile women's viewpoint regarding gestational surrogacy. AIM: To assess the viewpoint of Iranian infertile women toward gestational surrogacy. SETTING AND DESIGN: This descriptive study was conducted at the infertility clinic of Tabriz University of Medical Sciences, Iran. MATERIALS AND METHODS: The study sample consisted of 238 infertile women who were selected using the eligible sampling method. Data were collected by using a researcher developed questionnaire that included 25 items based on a five-point Likert scale. STATISTICAL ANALYSIS: Data analysis was conducted by SPSS statistical software using descriptive statistics. RESULTS: Viewpoint of 214 women (89.9%) was positive. 36 (15.1%) women considered gestational surrogacy against their religious beliefs; 170 women (71.4%) did not assume the commissioning couple as owners of the baby; 160 women (67.2%) said that children who were born through surrogacy would better not know about it; and 174 women (73.1%) believed that children born through surrogacy will face mental problems. CONCLUSION: Iranian infertile women have positive viewpoint regarding the surrogacy. However, to increase the acceptability of surrogacy among infertile women, further efforts are needed. PMID:22346081

  16. [Sport, infertility and erectile dysfunction].

    PubMed

    Gulino, G; Sasso, F; D'Onofrio, A; Palermo, G; Di Luigi, F; Sacco, E; Pinto, F; Bassi, P F

    2010-01-01

    In the last decades a growing interest has been dedicated to prevention, diagnosis and therapy of male genital pathologies, such as varicocele, infertility and erectile dysfunction in the population involved in sport activities. High incidence (up to 30%) of varicocele has been reported in a population of athletes and up to 60-80% in the subgroup of body-builders. The incidence of varicocele specifically increases with hours of training, in a linear model. Controversial data come from literature about the effects of physical activity on fertility, with prevalence of trials demonstrating worsening of seminal parameters. Furthermore, it has been demonstrated that physical stress in healthy male athletes can interfere with LH levels. Bicycling is one of the major risk factors for erectile dysfunction, with incidence of 13-24%. This is due to the prolonged compression of perineal arteries leading to reduced chronic penile perfusion. Bioengineering studies have been the basis for industry to produce specifically shaped saddles that significantly reduce and minimize compressive effects. Finally, high frequency of lower urinary tract symptoms (LUTS) in cyclists has been related to increased incidence of erectile dysfunction in comparison with normal population. PMID:20890868

  17. [Protamine gene polymorphisms and male infertility].

    PubMed

    Jiang, Wei-jun; Zhang, Jing; Xia, Xin-yi; Xu, Hao-qin

    2015-12-01

    Protamine (PRM) is one of the most abundant arginine-rich nucleoproteins in sperm and plays an important role in spermatogenesis. In the late stage of spermatogenesis, the replacement of PRM by histone prompts the closer combination between the nuclear matrix of sperm and nucleoprotein in order for high enrichment and condensation of nuclear chromatin in addition to preventing the sperm genome from mutation induced by internal and external factors. With the development of DNA sequencing techniques, researches on the association between PRM polymorphisms and male fertility are surfacing as a hot field. Many studies show that rs2301365 polymorphism is a risk factor for male infertility and increases the risk of male infertility by 27 - 66%, that rs737008 polymorphism of PRM1 and rs1646022 polymorphism of PRM2 are protective factors against Asian infertility, and that the ratio of PRM1 to PRM2 is intensively associated with male infertility. This review presents an update on the association between PRM gene polymorphisms and male infertility. PMID:26817310

  18. Secondary infertility and the aging male, overview

    PubMed Central

    Al–Hawsawi, Khalid; Motair, Wael; Bawa, Abdallah Makhloof

    2014-01-01

    Introduction Old men preparing themselves for marriage late in their lives might face infertility. Infertility in this group of men should be considered from a wider perspective, as they face any age–related health troubles that include, but are not limited to, androgen deficiency and psychological disorders that impede early conception. This review aims to shed light on the proper approach to this minority of secondarily infertile men. Material and methods A comprehensive electronic English literature search was conducted, using various medical websites and books, for the factors that cause infertility in senior fathers. The physiology of geriatric males, together with their common comorbidities, were discussed. Results Old men presenting with secondary infertility should be approached differently. Aging, itself, has a significant impact on male sexual function, sperm parameters, and fertility; all of which contribute to poor fecundability, decreased fertilizing capacity, increased time to pregnancy, increased rate of DNA damage, high abortion rates and increased prevalence of fetal developmental failures. The complexity and the unknowns of the aging male physiology, together with the interaction of obstinate diseases the patient might have, make the issue very difficult to tackle. Conclusions Management should include the conventional way of treating young sufferers and further target the underlying causes, if known, along with the provision of geriatric, psychologic, and andrologic support. PMID:25140235

  19. British South Asian communities and infertility services.

    PubMed

    Culley, Lorraine A; Hudson, Nicky; Rapport, Frances L; Katbamna, Savita; Johnson, Mark R D

    2006-03-01

    This paper presents key findings from the first major study of the provision of infertility services to South Asian communities in the UK. The research aimed to explore the social meanings of infertility and to examine the experiences of couples receiving fertility treatment. Focus groups with people from Pakistani, Bangladeshi and Indian communities (n = 93) revealed a strongly pro-natalist ideology and a relatively limited knowledge of infertility and treatments. Interviews with 50 participants from the same communities revealed a general satisfaction with secondary level infertility services. However, a minority felt inadequately informed about their condition, tests undertaken and treatment options; only one-third were given any written information about treatment; many were concerned about delays and waiting times; a minority felt that staff could be more sympathetic in their response to 'failed' treatment and several couples suggested that additional emotional support would be helpful. No information or resources were available in any South Asian language and the arrangements for communication support for non-English speakers were generally less than adequate. There was little evidence of the use of data on ethnic or religious background in infertility clinics. Recommendations for policy and practice are proposed. PMID:16581720

  20. Attitudes of Iranian infertile couples toward surrogacy

    PubMed Central

    Kian, Ensiyeh Mohebbi; Riazi, Hedieh; Bashirian, Saeid

    2014-01-01

    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. PMID:24829531

  1. Infertile Men May Have Higher Risk of Heart Disease, Diabetes

    MedlinePLUS

    ... nih.gov/medlineplus/news/fullstory_156083.html Infertile Men May Have Higher Risk of Heart Disease, Diabetes ... 2015 MONDAY, Dec. 7, 2015 (HealthDay News) -- Infertile men may have a higher risk of developing other ...

  2. Roles and Role Conflict of Women in Infertile Couples.

    ERIC Educational Resources Information Center

    Allison, Janet R.

    1979-01-01

    Explores the experience of role conflict for women in infertile couples. Findings lead to an understanding of infertility as part of an interactional system for dealing with potentially intolerable sources of role conflict. (Author)

  3. How Common is Male Infertility, and What Are Its Causes?

    MedlinePLUS

    ... 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 ...

  4. Genetics Home Reference: Sensorineural deafness and male infertility

    MedlinePLUS

    ... 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 ...

  5. Impact of obesity on infertility in women

    PubMed Central

    Dağ, Zeynep Özcan; Dilbaz, Berna

    2015-01-01

    The prevalence of obesity and overweight are increasing and have become an epidemic worldwide. Obesity has detrimental influences on all systems, including reproductive health. The prevalence of obesity in infertile women is high, and it is well known that there is an association between obesity and infertility. The relationship between obesity and reproductive functions is still being explored. Overweight women have a higher incidence of menstrual dysfunction and anovulation. Overweight and obese women are at a high risk for reproductive health. The risk of subfecundity and infertility, conception rates, miscarriage rates, and pregnancy complications are increased in these women. They have poor reproductive outcomes in natural as well as assisted conception. These poor reproductive outcomes include assisted reproduction such as ovulation induction, in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), and ovum donation cycles. Weight loss has beneficial effects on the reproductive outcomes in these patients. PMID:26097395

  6. Impact of obesity on infertility in women.

    PubMed

    Da?, Zeynep zcan; Dilbaz, Berna

    2015-01-01

    The prevalence of obesity and overweight are increasing and have become an epidemic worldwide. Obesity has detrimental influences on all systems, including reproductive health. The prevalence of obesity in infertile women is high, and it is well known that there is an association between obesity and infertility. The relationship between obesity and reproductive functions is still being explored. Overweight women have a higher incidence of menstrual dysfunction and anovulation. Overweight and obese women are at a high risk for reproductive health. The risk of subfecundity and infertility, conception rates, miscarriage rates, and pregnancy complications are increased in these women. They have poor reproductive outcomes in natural as well as assisted conception. These poor reproductive outcomes include assisted reproduction such as ovulation induction, in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), and ovum donation cycles. Weight loss has beneficial effects on the reproductive outcomes in these patients. PMID:26097395

  7. Infertility and the provision of infertility medical services in developing countries

    PubMed Central

    Ombelet, Willem; Cooke, Ian; Dyer, Silke; Serour, Gamal; Devroey, Paul

    2008-01-01

    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. PMID:18820005

  8. Exploration of Infertile Couples’ Support Requirements: A Qualitative Study

    PubMed Central

    Jafarzadeh-Kenarsari, Fatemeh; Ghahiri, Ataollah; Habibi, Mojtaba; Zargham-Boroujeni, Ali

    2015-01-01

    Background Due to high prevalence of infertility, increasing demand for infertility treatment, and provision of high quality of fertility care, it is necessary for healthcare professionals to explore infertile couples’ expectations and needs. Identification of these needs can be a prerequisite to plan the effective supportive interventions. The current study was, therefore, conducted in an attempt to explore and to understand infertile couples’ experiences and needs. Materials and Methods This is a qualitative study based on a content analysis ap- proach. The participants included 26 infertile couples (17 men and 26 women) and 7 members of medical personnel (3 gynecologists and 4 midwives) as the key informants. The infertile couples were selected from patients attending public and private infertility treatment centers and private offices of infertility specialists in Isfahan and Rasht, Iran, during 2012-2013. They were selected through purposive sampling method with maximum variation. In-depth unstructured interviews and field notes were used for data gathering among infertile couples. The data from medical personnel was collected through semi-structured interviews. The interview data were analyzed using conventional content analysis method. Results Data analysis revealed four main categories of infertile couples’ needs, including: i. Infertility and social support, ii. Infertility and financial support, iii. Infertility and spiritual support and iv. Infertility and informational support. The main theme of all these categories was assistance and support. Conclusion The study showed that in addition to treatment and medical needs, infertile couples encounter various challenges in different emotional, psychosocial, communicative, cognitive, spiritual, and economic aspects that can affect various areas of their life and lead to new concerns, problems, and demands. Thus, addressing infertile couples’ needs and expectations alongside their medical treatments as well as provision of psychosocial services by development of patient-centered approaches and couple-based interventions can improve their quality of life and treatment results and also relieve their negative psychosocial consequences. PMID:25918596

  9. Metabolic syndrome and infertility in men.

    PubMed

    Morrison, Christopher D; Brannigan, Robert E

    2015-05-01

    Metabolic syndrome is a compilation of symptoms including central obesity, insulin resistance, dyslipidemia, and hypertension. Initially used to predict cardiovascular disease, it is now clear that the molecular and physiologic abnormalities seen in metabolic syndrome extend well beyond the cardiovascular system. Growing evidence has linked metabolic syndrome and its individual symptoms to the increasing prevalence of male infertility. This manuscript reviews the recent evidence connecting metabolic syndrome to male infertility as well as the underlying pathophysiology. Currently, there are limited prospective studies examining the effects of treating metabolic syndrome on male reproduction and these relationships will need to be a focus of further investigation. PMID:25487258

  10. Frustrated Fertility: Infertility and Psychological Distress among Women.

    ERIC Educational Resources Information Center

    McQuillan, Julia; Greil, Arthur L.; White, Lynn; Jacob, Mary Casey

    2003-01-01

    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…

  11. Using Acceptance and Commitment Therapy to Treat Infertility Stress

    ERIC Educational Resources Information Center

    Peterson, Brennan D.; Eifert, Georg H.

    2011-01-01

    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…

  12. Frustrated Fertility: Infertility and Psychological Distress among Women.

    ERIC Educational Resources Information Center

    McQuillan, Julia; Greil, Arthur L.; White, Lynn; Jacob, Mary Casey

    2003-01-01

    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

  13. Using Acceptance and Commitment Therapy to Treat Infertility Stress

    ERIC Educational Resources Information Center

    Peterson, Brennan D.; Eifert, Georg H.

    2011-01-01

    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

  14. Sexual behavior of infertile women: a qualitative study

    PubMed Central

    Bokaie, Mahshid; Simbar, Masoumeh; Yassini Ardekani, Seyed Mojtaba

    2015-01-01

    Background: Infertility makes an essential challenge to the sexual life of couples, especially infertile women. When pregnancy does not happen, infertile women think that sexual intercourse is not fruitful and sexual desire became reduce gradually. Infertile women progressively forget that their sexual relationship is also a response to their natural need. Objective: This qualitative study was conducted to explore the infertility consequences in the sexual behavior of infertile women. Materials and Methods: This was a qualitative content analysis study; and it was part of a widespread study, used a sequential mixed-method and conducted from August 2014 until February 2015. A purposeful sampling was used to recruit infertile women who had referred to Yazd Research and Clinical Center for Infertility. Data gathering techniques employed in this research included in-depth semi structured open face-to-face interviews and field notes. Credibility, transferability, confirm ability, and dependability were assessed for the rigor of the data collection. Results: Totally, 15 infertile women and 8 key informants were interviewed. Data analysis showed four themes about impact of infertility on female sexual behavior: 1/ Impact of infertility drugs on couple sexual behavior, 2/ Impact of assisted reproductive technologies on female sexual behavior, 3/ Timed intercourse during infertility and 4/ The psychological impact of infertility on sexual behavior. Conclusion: Some of Iranian infertile women could cope with their problems, but some of them were very affected by infertility drugs and assisted reproductive technologies procedures. Psychosexual counseling before medical treatment could help them to have a better sexual life. PMID:26644793

  15. Genetics Home Reference: Y chromosome infertility

    MedlinePLUS

    ... Y chromosome and occurs in men with no history of the disorder in their family. When men with Y chromosome infertility do father children, either naturally or with the aid of assisted reproductive technologies, they pass on the genetic changes on the ...

  16. Guidelines for counselling in infertility: outline version.

    PubMed

    Boivin, J; Appleton, T C; Baetens, P; Baron, J; Bitzer, J; Corrigan, E; Daniels, K R; Darwish, J; Guerra-Diaz, D; Hammar, M; McWhinnie, A; Strauss, B; Thorn, P; Wischmann, T; Kentenich, H

    2001-06-01

    The Guidelines for Counselling in Infertility describe the purpose, objectives, typical issues and communication skills involved in providing psychosocial care to individuals using fertility services. The Guidelines are presented in six sections. The first section describes how infertility consultations differ from other medical consultations in obstetrics and gynaecology, whereas the second section addresses fundamental issues in counselling, such as what is counselling in infertility, who should counsel and who is likely to need counselling. Section 3 focuses on how to integrate patient-centred care and counselling into routine medical treatment and section 4 highlights some of the special situations which can provoke the need for counselling (e.g. facing the end of treatment, sexual problems). Section 5 deals exclusively with third party reproduction and the psychosocial implications of gamete donation, surrogacy and adoption for heterosexual and gay couples and single women without partners. The final section of the Guidelines is concerned with psychosocial services that can be used to supplement counselling services in fertility clinics: written psychosocial information, telephone counselling, self-help groups and professionally facilitated group work. This paper summarizes the different sections of the Guidelines and describes how to obtain the complete text of the Guidelines for Counselling in Infertility. PMID:11387309

  17. Mechanisms linking obesity to male infertility

    PubMed Central

    2015-01-01

    Introduction Obesity in men is associated with infertility in numerous studies. The current trend for decline in semen parameters parallels the increasing prevalence of obesity worldwide. In addition to impaired semen quality, fertility among obese men may be affected by sexual dysfunction, endocrinopathy, aromatization activity, psychological and thermal effects, sleep apnea, leptin and minor toxins, and possibly the inflammatory and obstructive elements of epididymitis pathology. The variable degrees of certainty associated with these causes parallel the levels of supporting evidence. This search aims to shed lights on different conditions that obese men suffer from; as that makes the treatment of infertility more categorized. Material and methods A PubMed search was conducted to identify clinical and pathological mechanisms linking obesity to male infertility. Results Among the myriad of publications reviewed in this paper, impaired spermatogenesis and sexual dysfunction have been shown to drive other variables towards poor fertility potentials. The paper presented a new, detailed flow chart showing more factors and further interactions among conditions leading to infertility. Conclusions The prime hormonal defect in obese men is hypotestosteronaemia, which results in impaired spermatogenesis leading to poor fecundability. Studies have shown that most mechanisms accounting for reduced fertility potentials in overweight men are reversible. PMID:25914843

  18. Characteristics of the Biopsychosocial Crisis of Infertility.

    ERIC Educational Resources Information Center

    Cook, Ellen Piel

    1987-01-01

    Presents a framework for understanding the crisis of infertility which is characterized by extensive anxiety, damaged self-esteem, grief, uncertainty about the future, and estranged relationships with each other and with family and friends. Proposes some interventions appropriate to helpers from a variety of disciplines. (ABB)

  19. Coping Processes of Couples Experiencing Infertility

    ERIC Educational Resources Information Center

    Peterson, Brennan D.; Newton, Christopher R.; Rosen, Karen H.; Schulman, Robert S.

    2006-01-01

    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…

  20. Preparing for Pregnancy and Infertility Treatment

    MedlinePLUS

    ... Infertility Treatment " When you go through something like In-Vitro Fertilization, you want to make sure you have the best chance possible. " ~ April This information is for women who are considering ... 400 mcg of folic acid daily, in the form of a vitamin supplement or enriched ...

  1. Coping Processes of Couples Experiencing Infertility

    ERIC Educational Resources Information Center

    Peterson, Brennan D.; Newton, Christopher R.; Rosen, Karen H.; Schulman, Robert S.

    2006-01-01

    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

  2. Lost in transition: women experiencing infertility.

    PubMed

    Cunningham, Nicola

    2014-09-01

    This paper illustrates key findings from a qualitative doctoral research project exploring women's experience of infertility. Six women maintained treatment diaries, reflecting on their experiences prior to, during and beyond infertility treatment. The following key themes are identified: hopefulness, adaptation, transitioning and shifting focus. The data suggest that treatment, clinic experience and living a life 'on hold' act as turning points within the individual life course. It is at the intersection between treatment and outcome that difficulties negotiating the expected and anticipated life course become illuminated, revealing limited connectivity and transitioning through and beyond the treatment process. This is a critical focus area and one that sets the scene for effective future adaptation. The data suggest that the accessibility of supportive care moving through and beyond treatment is limited. This paper argues that the infertility clinic is a critical space and place and one where effective supportive care may enable effective transitioning beyond the experience of infertility as an unanticipated life course disruption. PMID:25019683

  3. Melatonin hormone profile in infertile males.

    PubMed

    Awad, Hosni; Halawa, Fawzy; Mostafa, Taymour; Atta, Hazem

    2006-06-01

    Melatonin is a hormone produced by the pineal gland. There is much controversy about its relationship to the male reproductive process. In this study, seminal plasma as well as the serum melatonin levels were studied in different infertile male groups and were correlated with their semen parameters and hormonal levels. One hundred twenty male cases subdivided into six equal groups were consecutively included; fertile normozoospermic men, oligoasthenozoospermia (OA), OA with leucocytospermia, OA with varicocele, non-obstructive azoospermia (NOA) with high serum follicle stimulating hormone (FSH) and NOA with normal FSH. Semen analysis, estimation of melatonin, FSH, testosterone (T) and prolactin (PRL) hormone was carried out. Mean level of serum melatonin was higher than its corresponding seminal concentrations in all investigated groups with a positive correlation between their levels (r = 0.532, p = 0.01). Serum and seminal plasma melatonin levels in all infertile groups were reduced significantly compared with their levels in the fertile group. The lowest concentrations were in OA with leucocytospermia group. Melatonin in both serum and semen demonstrated significant correlation with sperm motility (r = 607, 0.623 respectively, p = 0.01). Serum melatonin correlated positively with serum PRL (r = 0.611, p = 0.01). It may be concluded that melatonin may be involved in the modulation of reproductive neuroendocrine axis in male infertility. Also, low levels of melatonin in semen were observed in infertile groups having reduced sperm motility, leucocytospermia, varicocele and NOA. PMID:16371109

  4. Masculinity, infertility, stigma and media reports.

    PubMed

    Gannon, Kenneth; Glover, Lesley; Abel, Paul

    2004-09-01

    There is growing concern about the health of men in the developed West. Compared with women they have higher rates of morbidity and mortality and are less likely to seek out and employ medical services. Several authors have drawn on social constructionist models, such as the concept of hegemonic masculinity, to account for these gender differences in risk and behaviour. One might anticipate that certain conditions, such as male infertility, would be perceived as posing a particular threat to conventional views of masculinity. There is some support for this, although there is little research into the social construction of male infertility. In this study Discourse Analysis was employed to analyse newspaper accounts of a reported decline in sperm counts in order to study the way in which infertility and masculinity were represented and constructed in the media. The results indicate a construction of fertility as being in crisis and of male infertility as conflated with impotence. Men were positioned as vulnerable and threatened by forces outside their control. The accounts drew on a range of stereotypically masculine reference points, such as warfare and mechanical analogies. These results are consistent with concepts of hegemonic masculinity and suggest that men are offered a highly restricted set of options in terms of perceiving and representing their bodies and their health. PMID:15210089

  5. Sperm chromatin heterogeneity as an infertility factor.

    PubMed

    Ibrahim, M E; Moussa, M A; Pedersen, H

    1988-01-01

    Semen samples from husbands with a history of unexplained infertility (n = 33), of women with habitual abortion (n = 36), or normal fertile donors (n = 20) were subjected to conventional semen analysis (SA), Acridine orange test (AOT), and zona-free hamster egg penetration test (HEPT). The three tests operate independently. The most discriminatory test was AOT (p = 0.0001) followed by HEPT (p = 0.019). The frequency of sperm chromatin heterogeneity as detected by AOT red fluorescence was highest in habitual abortion (39.4%), followed by unexplained infertility (16.4%), and, last, donors (9.4%). However the percentage of penetration was highest in habitual abortion (50.7%), followed by donors (43.1%), and least in unexplained infertility (33.9%). Conventional semen parameters (sperm density, motility, abnormality, and vitality) were the least to discriminate between the three groups. The presence of abnormal sperm chromatin may lead to infertility as a result of early pregnancy loss. PMID:3223787

  6. Infertility and childlessness: a qualitative study of the experiences of infertile couples in Northern Ghana

    PubMed Central

    2013-01-01

    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. PMID:23517021

  7. New insights into the genetic basis of infertility

    PubMed Central

    Venkatesh, Thejaswini; Suresh, Padmanaban S; Tsutsumi, Rie

    2014-01-01

    Infertility is a disease of the reproductive system characterized by inability to achieve pregnancy after 12 or more months of regular unprotected sexual intercourse. A variety of factors, including ovulation defects, spermatogenic failure, parental age, obesity, and infections have been linked with infertility, in addition to specific karyotypes and genotypes. The study of genes associated with infertility in rodent models has expanded the field of translational genetics in identifying the underlying cause of human infertility problems. Many intriguing aspects of the molecular basis of infertility in humans remain poorly understood; however, application of genetic knowledge in this field looks promising. The growing literature on the genetics of human infertility disorders deserves attention and a critical concise summary is required. This paper provides information obtained from a systematic analysis of the literature related to current research into the genetics of infertility affecting both sexes. PMID:25506236

  8. Prevention of multiple pregnancies in infertility treatment.

    PubMed

    Tiitinen, Aila

    2012-12-01

    The most important outcome of infertility treatment is a birth of a healthy baby. In many countries, in-vitro fertilisation treatments carry a high risk of twin pregnancy, which brings a higher risk to the mother and child than singleton pregnancies. Preterm delivery and low birth weight are the main factors accounting for the excess in neonatal morbidity. The use of elective single embryo transfer combined with cryopreservation can minimise the twin rate. Recent studies have shown that repeat single-embryo transfer can produce more live births per oocyte retrieval than double-embryo transfer. Ovulation-induction treatment protocols can also be improved and optimised. Correct counselling is important, as many infertile couples may desire twin pregnancies. Good counselling should include realistic information on the risks of twin gestation and also on later burdens with a multiple birth. PMID:22795237

  9. Frequency and epidemiologic aspects of male infertility.

    PubMed

    Sohrabvand, Farnaz; Jafari, Mohammad; Shariat, Mamak; Haghollahi, Fedyeh; Lotfi, Mandana

    2015-01-01

    According to different geographical conditions, human health in different sub-regions of the world and cultural differences, the male factor infertility has heterogeneous causes in the world. This study was performed in an attempt to clarify the associated factors which might play a role in this respect in a group of Iranian infertile men. This study was a cross - sectional, descriptive and retrospective study. The information was obtained from the men who had attended the clinic from March 2004-2006. The factors which were studied in this research are the demographic characteristics, smoking, addiction, alcohol drinking, and exposure to lead, cimetidine and history of surgery. In 23.7 % of couples the cause of infertility was pure male factor and in 19.3 % of them the problem was related to male and female factor both. The most important associated factors for male factor included smoking (29%) and history of varicocele operation (22%). Since the quality of individual and social life is related to fertility state, it seems that more comprehensive studies on factors affecting male fertility at the community level are justified and recommended. PMID:25871021

  10. Genital infection in males with idiopathic infertility.

    PubMed

    Mosli, H A; Gazzaz, F S; Farsi, H M; Abduljabar, H S

    1996-01-01

    We investigated a group of male patients with idiopathic infertility to determine the presence of genital infection and to identify the pattern of this infection using a specially designed protocol. A prospective study was carried out on 63 patients and 23 controls. We cultured the first voided urine, semen and swabs taken from the anterior urethra of these patients and controls for bacteria, chlamydia. Ureaplasma urealyticum and Mycoplasma hominis. Two techniques were used for chlamydial isolation and identification. These involved the use of chlamydial culture on McCoy cells with culture confirmation test and the direct fluorescent identification of Chlamydiatrachomatis. The all-liquid media (MYCOFAST ALL-IN) kits were used for the identification of mycoplasma. Our results indicate that there is a significantly higher incidence of genital infection among male patients with idiopathic infertility than in normal fertile controls (P=0.0004). Extensive microbial investigations are indicated when genital infection is suspected to be the cause of the fertile state or cannot be ruled out as a possible cause in case of idiopathic infertility. PMID:17372403

  11. [Genetic male infertility and medically assisted reproduction].

    PubMed

    May-Panloup, P; Malinge, M C; Larget-Piet, L; Chrtien, M F

    2001-09-01

    About half the cases of infertility have their origin in the male partner. Infertility due to males has several possible aetiologies. In about 30% of cases, genetic disorders are suspected of being the main cause. They could interfere with the development of the male gonads, the urogenital tract or the hypothalamo-hypophyseal axes. Such disorders could also stop germ cell generation and maturation or lead to the production of non-functional spermatozoa. Genetic disorders of chromosomal origin could give rise to abnormal karyotypes or germinal mosic figure. They could involve gene abnormalities affecting numerous genes localized on several chromosomes, in particular the Y chromosome. The physiopathologic identification of male infertility is interesting because of the risk of the genetic factors involved being transmitted to the offspring. The subject is of importance, specially because of the increasing use of intracytoplasmic sperm injections. Couples should therefore be precisely counselled to enable them to make a well-informed choice among various solutions, e.g. ART, with or without sperm donation, or adoption. PMID:11680946

  12. Human infertility: are endocrine disruptors to blame?

    PubMed Central

    Marques-Pinto, André; Carvalho, Davide

    2013-01-01

    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. PMID:23985363

  13. Anabolic steroids abuse and male infertility.

    PubMed

    El Osta, Rabih; Almont, Thierry; Diligent, Catherine; Hubert, Nicolas; Eschwège, Pascal; Hubert, Jacques

    2016-01-01

    For several decades, testosterone and its synthetic derivatives have been used with anabolic and androgenic purposes. These substances were first restricted to professional bodybuilders, but become more and more popular among recreational athletes. Up to date, 3,000,000 anabolic-androgenic steroids (AAS) users have been reported in the United States with an increasing prevalence, making AAS consumption a major public health growing concern. Infertility is defined by the WHO as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse and a male factor is present in up to 50 % of all infertile couples. Several conditions may be related to male infertility. Substance abuse, including AAS, is commonly associated to transient or persistent impairment on male reproductive function, through different pathways. Herein, a brief overview on AAS is offered. Steroids biochemistry, patterns of use, physiological and clinical issues are enlightened. A further review about fertility outcomes among male AAS abusers is also presented, including the classic reports on transient anabolic steroid-induced hypogonadism (ASIH), and the more recent experimental reports on structural and genetic sperm damage. PMID:26855782

  14. An epidemiologic survey on the causes of infertility in patients referred to infertility center in Fatemieh Hospital in Hamadan

    PubMed Central

    Masoumi, Seyedeh Zahra; Parsa, Parisa; Darvish, Nooshin; Mokhtari, Sahar; Yavangi, Mahnaz; Roshanaei, Ghodratollah

    2015-01-01

    Background: Infertility is considered as a major health care problem of different communities. The high prevalence of this issue doubled its importance. A significant proportion of infertility have been related to environmental conditions and also acquired risk factors. Different environmental conditions emphasized the need to study the different causes of infertility in each area. Objective: The aim of this study was to determine the frequency causes of infertility in infertile couples. Materials and Methods: In this cross sectional descriptive study 1200 infertile men and women that were referred to infertility clinic of Fatemieh Hospital during 2010 to 2011, were examined. This center is the only governmental center for infertility in Hamadan. Sampling was based on census method. Information about the patients was obtained from medical examinations and laboratory findings. To analyze the data, descriptive statistics such as frequencies and the mean were used. Results: The prevalence of primary and secondary infertility was 69.5% and 30.5% respectively. Among the various causes of infertility women factors (88.6%) had the highest regard. In the causes of female infertility, menstrual disorders, diseases (obesity, thyroid diseases, and diabetes), ovulation dysfunction, uterine factor, fallopian tubes and cervical factor had the highest prevalence respectively. The causes of male infertility based on their frequency included semen fluid abnormalities, genetic factors, vascular abnormalities, and anti-spermatogenesis factors, respectively. Conclusion: Etiology pattern of infertility in our study is similar with the many other patterns that have been reported by the World Health Organization. However, frequency of menstrual disorders is much higher than other studies that require further consideration. PMID:26568755

  15. The status of depression and anxiety in infertile Turkish couples

    PubMed Central

    Kazandi, Mert; Gunday, Ozlem; Mermer, Timucin Kurtulus; Erturk, Nuray; Ozkınay, Erdinc

    2011-01-01

    Background: Infertility is a major psychosocial crisis as well as being a medical problem. The factors that predict psychosocial consequences of infertility may vary in different gender and different infertile populations. Objective: The primary purpose of this study was to investigate whether Turkish infertile couples had higher levels of depression and anxiety when compared to non-infertile couples. Our secondary aim was to evaluate the relationship between sociodemographic characteristics and levels of depression and anxiety in Turkish infertile couples. Materials and Methods: We designed a descriptive cross sectional study of 248 infertile women and 96 infertile men with no psychiatric disturbance and 51 women and 40 men who have children to evaluate the depression and anxiety levels between infertile couples and fertile couples. A gynecologist evaluated participants for demographic data and then they were visited by a psychologist to perform questionnaire scales which were The Beck Depression Inventory and the State-Trait Anxiety Inventory for the evaluation of the degree of psychopathology. The data were statistically analyzed, with p<0.05 as the level of statistical significance. Results: We observed significant differences between the infertile couples and fertile couples with respect to state and trait anxiety (p<0.0001) while no difference was regarding with depression, both of women and men. Anxiety and depression were observed as independent from gender when infertile women and men were compared (p=0.213). Conclusion: We believed that the psychological management at infertile couples must be individualized with cultural, religious, and class related aspects. PMID:25587255

  16. CHLAMYDIAL INFECTION, PLASMA PEROXIDATION AND OBESITY IN TUBAL INFERTILITY

    PubMed Central

    Nsonwu-Anyanwu, A.C.; Charles-Davies, M.A.; Oni, A.A.; Taiwo, V.O.; Bello, F.A.

    2011-01-01

    Background: Genital tract infections and obesity are both sources of oxidative stress. Alterations in immune and antioxidant parameters may arise from this or from an indeterminate autoimmune mechanism. Objective: This study aimed to investigate the association of Chlamydial infection, obesity and oxidative response with tubal infertility in Nigerian women. Methods: It was a case-control study of 40 women with tubal infertility and 32 fertile women, respectively, recruited from the Infertility and Family Planning Clinics respectively, of the University College Hospital, Ibadan, Nigeria. Anthropometric indices were measured in each subject and endocervical swabs were taken to screen for current genital tract infection. Antioxidant, hormonal and immunologic analysis were performed on serum. Results: None of the subjects had current genital tract infections. Chlamydia trachomatis IgG positivity was significantly higher in infertile than in fertile subjects [OR 4.33; 95%CI (0.078-0.681)]. No significant variations were observed in the anthropometric indices, antioxidant parameters and hormones between infertile and the fertile women. Body mass index correlated positively with oxidative stress in infertile subjects. Waist and hip circumferences correlated negatively with oestradiol in women with tubal infertility. Conclusion: Chlamydial infection is associated with tubal factor infertility, however, obesity seems to increase oxidative stress and reduce fertility potential in women with tubal factor infertility. PMID:25161489

  17. [Relationship of MTHFR gene polymorphisms with infertility].

    PubMed

    Guo, Kai-min; Tian, Run-hui; Wang, Hong-liang

    2016-02-01

    The folate metabolic pathway plays important roles in cellular physiology by participating in nucleotide synthesis, DNA repair and methylation, and maintenance and stability of the genome. Methylenetetrahydrofolate reductase (MTHFR) is a key regulatory enzyme involved in folate metabolism. Polymorphisms of MTHFR may change the level of homocysteine and affect DNA synthesis and methylation, leading to an increased oxidative stress and disturbed methylation reactions and consequently affecting reproductive function. This article presents an overview on MTHFR gene polymorphisms, proposing that multicentered, large-sample and long-term prospective studies are needed to reveal the relationship between MTHFR gene polymorphisms and infertility. PMID:26939404

  18. A Comparative Study of Serum and Follicular Fluid Leptin Concentrations among Explained Infertile, Unexplained Infertile and Fertile Women

    PubMed Central

    Kamyabi, Zahra; Gholamalizade, Tayebe

    2015-01-01

    Background The relationship between metabolism and reproduction has been always considered as an important topic in female endocrinology. It seems that leptin is one of the involved factors in infertility. Leptin, in addition to regulating body weight plays an important role in regulation of endocrine, reproductive and immune systems. The aim of this stduy is to compare serum and follicular fluid leptin concentrations in order to find the role of leptin level in infertility. Materials and Methods This case-control study was performed from September 2010 to March 2013. A total of 90 women referred to the Infertility Center of Afzalipour Hos- pital, Kerman, Iran, and divided into three equal groups (n=30/per group) of explained infertile (including 4 subgroups), unexplained infertile and normal fertile (control group). The three groups were matched in regard to demographic features [age: 20-40 years and body mass index (BMI): 20-25]. In order to determine leptin level, blood sample and fol- licular fluid were taken one hour prior and at the time of follicular puncture, respectively. Serum and follicular fluid leptin levels were measured using enzyme-linked immune sorbent assay (ELISA). Data were analyzed using descriptive-analytic tests, like Mann- Whitney and Kruskal Wallis tests, through Statistical Package for the Social Sciences (SPSS) version 16. Results In explained infertile and fertile groups, as opposed to unexplained infertile group, mean leptin level was lower in follicular fluid than in serum. Mean follicular fluid leptin concentration in women with unexplained infertility was higher com- pared to the other two groups. Women with unexplained infertility had lower level of serum leptin in comparison to the other two groups. Follicular fluid leptin level in all subgroups of explained infertile group was lower as compared to unexplained and fertile women. Conclusion The results suggested that high leptin level of follicular fluid is one of the main factors involved in infertility. PMID:26246872

  19. Psychotherapy for Infertility: A Cognitive-Behavioral Approach for Couples.

    ERIC Educational Resources Information Center

    Myers, Lisa B.; Wark, Linda

    1996-01-01

    Describes a cognitive-behavioral model for treating couples' negative reactions to infertility. After a discussion of why the cognitive-behavioral approach can competently address the goals of couples coping with infertility, three phases of treatment are outlined: assessment, therapy, and closure. Areas for assessment include spouses, marital…

  20. Associations of Psychosocial Factors with the Stress of Infertility Treatment

    ERIC Educational Resources Information Center

    Schneider, Myra G.; Forthofer, Melinda S.

    2005-01-01

    This study investigated psychosocial factors thought to be associated with perceived stress over the course of infertility treatment. The research was based on secondary analysis of data from the Study of Marriage, Family, and Life Quality with a sample of 128 people who completed an infertility-related stress instrument at all three measurement…

  1. Predictors of Psychological Distress among Infertility Clinic Patients.

    ERIC Educational Resources Information Center

    Morrow, Kelly A.; And Others

    1995-01-01

    Investigated predictors of psychological distress among infertility clinic patients. Analyses indicated that infertile men and women reported greater psychological distress than the general population. Self-blame and avoidance coping significantly predicted psychological distress among men and women. Increased age and childlessness added to…

  2. Themes of Hope and Healing: Infertile Couples' Experiences of Adoption.

    ERIC Educational Resources Information Center

    Daniluk, Judith C.; Hurtig-Mitchell, Joss

    2003-01-01

    Using qualitative approach, authors explored the experiences of becoming parents through adoption after unsuccessful infertility treatments. Analysis of data revealed three overarching themes. Findings are discussed in terms of their implications for counselors who work with infertile couples considering adoption, clients engaged in adoption…

  3. Psychosocial response of Chinese infertile husbands and wives.

    PubMed

    Lee, T Y; Sun, G H

    2000-01-01

    Some 15% or 1 in 6 American couples in the childbearing years have infertility problems. Numerous studies have demonstrated that both infertile men and women have negative emotional responses, such as stress, anxiety and depression. In Europe, Canada, and the United States the response of infertile husbands was different from that of their wives in self-image, marital adjustment, and sexual relations. The differences in psychological distress, marital satisfaction, and sexual satisfaction between Chinese infertile husbands and wives were evaluated. Fifty-nine infertile couples participated in this study. The subjects completed an Infertility Questionnaire, Marital Satisfaction Questionnaire, and Sexual Satisfaction Questionnaire as measures of gender differences in facing infertility problems. Paired t tests revealed that husbands expressed significantly less distress than that of the wives. The husbands' self-esteem was higher than that of the wives. The husbands' marital and sexual satisfaction was also higher than that of the wives. These results propose that although differences exist in cultural, ethnic, and religious norms between Chinese society and Western society, the Chinese couples' response to infertility is similar to that of Western couples. The major difference is that the in-laws play an important role in Chinese society, especially in marital satisfaction. PMID:11111862

  4. Infertility in the Gambia: Traditional and Modern Health Care.

    ERIC Educational Resources Information Center

    Sundby, Johanne

    1997-01-01

    A population survey was undertaken to study infertility in Gambia. All infertile women in 24 randomly selected enumeration areas were assessed. Problems faced, coping mechanisms employed, and types of health care available were examined. Patterns of consultation with traditional versus formal health care and rural/urban differences were uncovered

  5. Predictors of Psychological Distress among Infertility Clinic Patients.

    ERIC Educational Resources Information Center

    Morrow, Kelly A.; And Others

    1995-01-01

    Investigated predictors of psychological distress among infertility clinic patients. Analyses indicated that infertile men and women reported greater psychological distress than the general population. Self-blame and avoidance coping significantly predicted psychological distress among men and women. Increased age and childlessness added to

  6. [Feelings and emotions in women treated for infertility].

    PubMed

    Jedrzejczak, Piotr; Luczak-Wawrzyniak, Jadwiga; Szyfter, Joanna; Przewo?na, Joanna; Taszarek-Hauke, Grazyna; Pawelczyk, Leszek

    2004-01-01

    The aim of this study was an assessment of women's moods and emotions during infertil-ity treatment. Sixty married women diagnosed and treated for primary infertility at Division of Infertility and Reproductive Endocrinology Department of Gynecology and Obstetrics University of Poznan Medical Sciences from January to April 2003 were included in this study. The average age of women was 28.5 years. Control group consisted of 30 female students at similar age, single, not planning pregnancy in the nearest future. Depression was assessed using Beck scale. The special questionnaire was made to evaluate women's different psychological features connected with infertility. The interviews had a personal character and every question was filled in the questionnaire by the investigator. The first reaction most patients experienced when they found out about infertility was: 1) astonishment 2) sadness 3) anger, and similar was the opinion from the control group. Both the patients and the control group consider that having a baby is: 1) goal of their lives 2) sense of marriage 3) providing a woman with a sense of fulfillment. More than 25% of both groups of women think that infertility is the most important problem for their couples. Economic difficulties seem to be the biggest problem for patients during their treatment of infertility. What is very interesting patients average Beck scale depression score was significantly higher that of control respondents (8,6 points for patients and 4,4 for control group). PMID:15850324

  7. Associations of Psychosocial Factors with the Stress of Infertility Treatment

    ERIC Educational Resources Information Center

    Schneider, Myra G.; Forthofer, Melinda S.

    2005-01-01

    This study investigated psychosocial factors thought to be associated with perceived stress over the course of infertility treatment. The research was based on secondary analysis of data from the Study of Marriage, Family, and Life Quality with a sample of 128 people who completed an infertility-related stress instrument at all three measurement

  8. Infertility in the Gambia: Traditional and Modern Health Care.

    ERIC Educational Resources Information Center

    Sundby, Johanne

    1997-01-01

    A population survey was undertaken to study infertility in Gambia. All infertile women in 24 randomly selected enumeration areas were assessed. Problems faced, coping mechanisms employed, and types of health care available were examined. Patterns of consultation with traditional versus formal health care and rural/urban differences were uncovered…

  9. Infertility: A Review of Physical and Emotional Aspects

    PubMed Central

    Kredentser, Jeremy V.

    1986-01-01

    Infertility affects 15% of couples. The primary causes are poor sperm production, ovulation defects, and fallopian tube obstruction, which can be detected by a simple, logical investigation. Infertility and its investigation precipitate characteristic emotional responses that require care by an informed, sensitive physician. PMID:21267117

  10. An update on the clinical assessment of the infertile male

    PubMed Central

    Esteves, Sandro C; Miyaoka, Ricardo; Agarwal, Ashok

    2011-01-01

    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. PMID:21655766

  11. Effect of fertility and infertility on longevity.

    PubMed

    Ehrlich, Shelley

    2015-05-01

    Changing demographic trends and projections of the survival and fertility rates of each generation have been a topic of great interest to not only demographers and epidemiologists but also to evolutionary biologists and reproductive endocrinologists. Compelling evolutionary theories suggest that there is an inverse association between fertility and longevity. Multiple historic, demographic, and current studies have since been conducted to test this theory, but the results have been inconclusive. The average number of children born to each woman has been declining progressively in developed countries during recent decades. This is in part due to changes in the behavior of couples but also to environmental factors. While improved accessibility to assisted reproductive technology can relieve some of the burden of infertility on these couples and lessen the problem of low total fertility rates in many developed countries, it is not enough to overcome the overall decrease in total fertility rates that we have witnessed in recent decades. This article critically reviews some important studies and provides an overview of this ongoing debate, while highlighting the relevance of trying to understand the possible mechanisms that may link fertility and infertility to longevity. PMID:25934598

  12. Possible fetal determinants of male infertility.

    PubMed

    Juul, Anders; Almstrup, Kristian; Andersson, Anna-Maria; Jensen, Tina K; Jørgensen, Niels; Main, Katharina M; Rajpert-De Meyts, Ewa; Toppari, Jorma; Skakkebæk, Niels E

    2014-09-01

    Although common reproductive problems, such as male infertility and testicular cancer, present in adult life, strong evidence exists that these reproductive disorders might have a fetal origin. The evidence is derived not only from large epidemiological studies that show birth-cohort effects with regard to testicular cancer, levels of testosterone and semen quality, but also from histopathological observations. Many infertile men have histological signs of testicular dysgenesis, including Sertoli-cell-only tubules, immature undifferentiated Sertoli cells, microliths and Leydig cell nodules. The most severe gonadal symptoms occur in patients with disorders of sexual development (DSDs) who have genetic mutations, in whom even sex reversal of individuals with a 46,XY DSD can occur. However, patients with severe DSDs might represent only a small proportion of DSD cases, with milder forms of testicular dysgenesis potentially induced by exposure to environmental and lifestyle factors. Interestingly, maternal smoking during pregnancy has a stronger effect on spermatogenesis than a man's own smoking. Other lifestyle factors such as alcohol consumption and obesity might also have a role. However, increasing indirect evidence exists that exposure to ubiquitous endocrine disrupting chemicals, present at measurable concentrations in individuals, might affect development of human fetal testis. If confirmed, health policies to prevent male reproductive problems should not only target adult men, but also pregnant women and their children. PMID:24935122

  13. Evolution of psychology and counseling in infertility.

    PubMed

    Boivin, Jacky; Gameiro, Sofia

    2015-08-01

    Five key paradigm shifts are described to illustrate the evolution of psychology and counseling in infertility. The first paradigm shift was in the 1930s when psychosomatic concepts were introduced in obstetrics and gynecology as causal factors to explain why some couples could not conceive despite the absence of organic pathology. In the second shift, the nurse advocacy movement of the 1970s stimulated the investigation of the psychosocial consequences of infertility and promoted counseling to help couples grieve childlessness when medical treatments often could not help them conceive. The third shift occurred with the advent of IVF, which created a demand for mental health professionals in fertility clinics. Mental health professionals assessed the ability of couples to withstand the demands of this new high technology treatment as well as their suitability as potential parents. The fourth shift, in the 1990s, saw reproductive medicine embrace the principles of evidence-based medicine, which introduced a much more rigorous approach to medical practice (effectiveness and safety) that extended to psychosocial interventions. The most recent paradigm shift, in the new millennium, occurred with the realization that compliance with protracted fertility treatment depended on the adoption of an integrated approach to fertility care. An integrated approach could reduce treatment burden arising from multiple sources (i.e., patient, clinic, and treatment). This review describes these paradigm shifts and reflects on future clinical and research directions for mental health professionals. PMID:26092131

  14. Infertility Evaluation and Treatment among Women in the United States

    PubMed Central

    Kessler, Lawrence M.; Craig, Benjamin M.; Plosker, Shayne M.; Reed, Damon R.; Quinn, Gwendolyn P.

    2013-01-01

    Objective To examine the characteristics of women seeking infertility evaluation and treatment. Design Cross-sectional survey based on in-person interviews, followed by two-step hurdle analysis. Participants 4,558 married or cohabitating women ages 2544 Setting U.S. household population of women based on the 20062010 National Survey of Family Growth Intervention None Main Outcome Measure(s) Likelihood of seeking preliminary infertility evaluation. Likelihood of seeking infertility treatment once evaluated. Treatment type provided. Results 623 women (13.7%) reported seeking infertility evaluation, of which 328 reported undergoing subsequent infertility treatment. Age at marriage, marital status, education, health insurance status, race/ethnicity, and religion were associated with the likelihood of seeking infertility evaluation. For example, the predicted probability that a non-White woman who married at 25 will seek evaluation was 12%. This probability increased to 34% for White women with a graduate degree who married at age 30. Among women who are evaluated, income, employment status, and ethnicity correlated strongly with the likelihood of seeking infertility treatment. Infertility drug therapy was the most frequent treatment used. Reproductive surgery and in vitro fertilization (IVF) were used the least. Conclusions The use of infertility services is not random and understanding the socio-demographic factors correlated with use may assist new couples with family planning. Roughly 50% of the women evaluated for infertility progressed to treatment, and only a small proportion were treated with more advanced assisted reproductive technologies (ARTs) such as IVF therapy. Future research aimed at improving access to effective healthcare treatments within the boundaries of affordability is warranted. PMID:23849845

  15. Cytokines in the blood and semen of infertile patients

    PubMed Central

    Havrylyuk, Anna; Chopyak, Valentyna; Boyko, Yaryna; Kril, Iryna

    2015-01-01

    Cytokines have been important mediators of the immunity and can be involved in numerous processes in the male genital tract including acting as immunomodulatory elements within the male gonad. The aims of this study were: 1) to detect pro- and anti-inflammatory cytokine levels in the control group and subgroups of infertile men; and 2) to set up the practical recommendations concerning determination of cytokine levels for the male infertility diagnosis. Observations were performed in a group of 82 men: healthy controls (n = 27) and infertile patients (n = 55). The male infertility group was further subdivided into patients with: varicocele (n = 22), idiopathic infertility (n = 13) and partners of couples with recurrent spontaneous abortion (RSA; n = 20). Semen analysis was determined following WHO criteria. The cytokine interleukin 1? (IL-1?), IL-6, IL-10, IL-18; tumor necrosis factor ? (TNF-?), interferon g (IFN-g) and transforming growth factor ?1 (TGF-?1) contents in serum and seminal plasma were determined by quantitative ELISA. An interesting marker of male infertility appears to be TGF-?1 (blood) significantly elevated in idiopathically infertile males and in the RSA group. Besides elevated TGF-?1 in a group of idiopathic infertility significantly elevated IL-10, IL-18, IFN-g (blood) and statistically decreased IL-1? while increased IFN-g were revealed in seminal plasma compared to healthy controls. We may postulate novel cytokine micropatterns for patients with different background of infertility. Therefore, circulating cytokines: IL-1?, IL-10, IL-18, TGF-?1, IFN-g and IL-1?, IFN-g and TGF-?1 in seminal plasma should be extended in evaluation of specific types of male infertility. PMID:26648778

  16. Complementary and alternative medicine utilization by a sample of infertile couples in Jordan for infertility treatment: clinics-based survey

    PubMed Central

    2013-01-01

    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. PMID:23414246

  17. The experience of infertility: a review of recent literature.

    PubMed

    Greil, Arthur L; Slauson-Blevins, Kathleen; McQuillan, Julia

    2010-01-01

    About 10 years ago Greil published a review and critique of the literature on the socio-psychological impact of infertility. He found at the time that most scholars treated infertility as a medical condition with psychological consequences rather than as a socially constructed reality. This article examines research published since the last review. More studies now place infertility within larger social contexts and social scientific frameworks although clinical emphases persist. Methodological problems remain but important improvements are also evident. We identify two vigorous research traditions in the social scientific study of infertility. One tradition uses primarily quantitative techniques to study clinic patients in order to improve service delivery and to assess the need for psychological counselling. The other tradition uses primarily qualitative research to capture the experiences of infertile people in a sociocultural context. We conclude that more attention is now being paid to the ways in which the experience of infertility is shaped by social context. We call for continued progress in the development of a distinctly sociological approach to infertility and for the continued integration of the two research traditions identified here. PMID:20003036

  18. Investigation of male infertility using quantitative comparative proteomics.

    PubMed

    Lgar, Christine; Droit, Arnaud; Fournier, Frdric; Bourassa, Sylvie; Force, Andr; Cloutier, Francine; Tremblay, Roland; Sullivan, Robert

    2014-12-01

    Male factors account for 40% of infertility cases. The identification of differentially expressed proteins on spermatozoa from fertile and infertile men can help in the elucidation of the molecular basis of male infertility. The aim of this study was to compare sperm proteomes from 3 different groups: fertile men, normozoospermic men consulting for infertility, and normozoospermic men with an impaired capacity for fertilization (IVF-failure). We used differential proteomics with isobaric tags for relative and absolute quantitation (iTRAQ) labeling, and LC-MS analysis to identify proteins that are differentially expressed. A total of 348 unique proteins were identified and quantified. The analysis identified 33 proteins that were differentially expressed in the IVF-failure group vs the fertile group. Comparison of the infertile and fertile groups revealed that 18 proteins appeared to be differentially expressed. Four proteins were similarly altered in the IVF-failure and infertile groups: semenogelin 1 (SEMG1), prolactin-induced protein (PIP), glyceraldehyde-3-phosphate dehydrogenase (GAPDHS), and phosphoglycerate kinase 2 (PGK2). These protein markers were selected for validation using multiple reactions monitoring mass spectrometry (MRM-MS) and further confirmed by Western blot analysis. Overall, these results suggest that a panel of proteins may be used as biomarkers for future studies of infertility. PMID:25355644

  19. Exploring infertile women's experiences about sexual life: A qualitative study

    PubMed Central

    Kohan, Shahnaz; Ghasemi, Zahra; Beigi, Marjan

    2015-01-01

    Background: Infertility is a serious problem in a couple's life that affects their marriage relationships. So, dissatisfaction with sexual function resulting from interpersonal problems is common among these couples. This qualitative study aimed to explore the experiences of infertile women in their sexual life. Materials and Methods: This is a qualitative study with a phenomenological approach. The participants were 20 infertile women referring to the health care centers and infertility clinics of Isfahan and were selected through purposive sampling. Data were collected by tape recording of deep interviews and analyzed by Colaizzi's method. Results: Analysis of the participants experiences led to five main concepts: Disturbed in femininity-body image, discouragement of sexual relations, sacrifice of sexual pleasure for the sake of getting pregnant, confusion in sexual relation during infertility treatment, and striving to protect their marriage. Conclusions: Findings revealed that infertility affects women's different aspects of sexual life, especially disturbance in femininity-body image and sexual reluctance. With regard to women's willingness to protect their matrimonial life and prevent sexual trauma as a destroying factor for their family's mental health, it seems sexual counseling is necessary for infertile couples. PMID:25709688

  20. Infertility and Parenthood: Does Becoming a Parent Increase Well-Being?

    ERIC Educational Resources Information Center

    Abbey, Antonia; And Others

    1994-01-01

    Examined parenthood among 174 infertile couples and 74 presumed fertile couples. Infertile women who became parents experienced greater global well-being but diminished marital well-being, compared with infertile women who had not become parents. Infertile men who became parents experienced same negative effects that wives reported but did not

  1. Psychosocial Predictors of Life Quality: How Are They Affected by Infertility, Gender, and Parenthood?

    ERIC Educational Resources Information Center

    Abbey, Antonia; And Others

    1994-01-01

    Longitudinally examined effects of infertility on marital and global life quality with 174 infertile couples and 74 fertile couples. By third interview, 42% of infertile couples and 36% of fertile couples were parents. Psychosocial predictors of life quality were highly similar for members of infertile and fertile couples and for couples with and…

  2. Infertility and Parenthood: Does Becoming a Parent Increase Well-Being?

    ERIC Educational Resources Information Center

    Abbey, Antonia; And Others

    1994-01-01

    Examined parenthood among 174 infertile couples and 74 presumed fertile couples. Infertile women who became parents experienced greater global well-being but diminished marital well-being, compared with infertile women who had not become parents. Infertile men who became parents experienced same negative effects that wives reported but did not…

  3. TGFβ3 (TGFB3) polymorphism is associated with male infertility

    PubMed Central

    Droździk, Marek; Kaczmarek, Maciej; Malinowski, Damian; Broś, Urszula; Kazienko, Anna; Kurzawa, Rafał; Kurzawski, Mateusz

    2015-01-01

    Factors affecting the blood-testis barrier function may be involved in testicular damage and male infertility. Two cytokines play an important role in the barrier regulation, namely transforming growth factor beta 3 (TGF-β3) and tumor necrosis factor (TNF-α). The aim of this study was to investigate the potential association between TGF-β3 (TGFB3) and TNF-α (TNF) gene polymorphisms and male infertility. A total of 846 subjects, 423 diagnosed with male infertility and 423 fertile men were enrolled. TGFB3 (rs2268626:T > C, rs3917158:C > T, rs2284792:A > G, rs2268625:T > C, rs3917187:C > T) and TNF (rs1800629:-308G > A) gene polymorphisms were genotyped. No association between TNF genotype and infertility was observed. As for TGFB3, the genotypes distribution was similar in infertile and fertile men. However, rs2284792 minor allele frequency was significantly higher among infertile subjects. Heterozygous rs2284792 AG genotype was associated with increased odds for infertility [OR = 1.40 (95% CI 1.05–1.86), p = 0.021] and similar results were observed for G allele carrier status [OR = 1.40 (95% CI 1.06–1.84), p = 0.017]. Heterozygosity in TGFB3 rs3917158 was also associated with the infertility [OR = 1.37 (95% CI 1.01–1.87), p = 0.041]. The TGFB3 variant genotypes were associated with lower spermatozoa motility parameters in fertile men. The results indicate that variants in TGFB3 gene may be associated with male infertility. However, the findings require further replication and validation. PMID:26612435

  4. Cystic fibrosis as a cause of infertility.

    PubMed

    Jarzabek, Katarzyna; Zbucka, Monika; Pepi?ski, Witold; Szamatowicz, Jacek; Domitrz, Jan; Janica, Jerzy; Wo?czy?ski, S?awomir; Szamatowicz, Marian

    2004-07-01

    Cystic fibrosis (CF) is one of the autosomal recessive diseases, caused by mutations in a gene known as cystic fibrosis transmembrane regulator (CFTR). The majority of adult males with CF (99%) is characterized by congenital bilateral absence of vas deferens (CBAVD). CBAVD is encountered in 1-2% of infertile males without CF. Females with CF are found to be less fertile than normal healthy women. In females with CF, delayed puberty and amenorrhoea are common due to malnutrition. CFTR mutations are also associated with congenital absence of the uterus and vagina (CAUV). The National Institutes of Health recommend genetic counseling for any couple seeking assisted reproductive techniques with a CF male or obstructive azoospermia which is positive for a CF mutation. PMID:15297887

  5. Management of infertility in women over 40.

    PubMed

    Cabry, Rosalie; Merviel, Philippe; Hazout, Andre; Belloc, Stephanie; Dalleac, Alain; Copin, Henri; Benkhalifa, Moncef

    2014-05-01

    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

  6. Endometrial osseous metaplasia: an unusual cause of infertility.

    PubMed

    Garg, Deepika; Bekker, Genia; Akselrod, Faina; Narasimhulu, Deepa Maheswari

    2015-01-01

    Osseous metaplasia of the endometrium is a rare disorder associated with the presence of bone in the uterine endometrium. Most patients with this condition presenting with infertility do so owing to the presence of a foreign body in the endometrium. We report a case of a 38-year-old woman who presented with secondary infertility due to osseous metaplasia in the endometrial cavity. She conceived spontaneously after hysteroscopic removal of the bony fragments from the uterus. Uterine osseous metaplasia is a rare cause of infertility that can be easily managed by hysteroscopic removal of the bony fragments, which results in return of fertility. PMID:25837325

  7. Increasing and decreasing factors of hope in infertile women with failure in infertility treatment: A phenomenology study

    PubMed Central

    Mosalanejad, Leili; Parandavar, Nehle; Gholami, Morteza; Abdollahifard, Sareh

    2014-01-01

    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

  8. Occupational risk for male infertility: a case-control study of 218 infertile and 227 fertile men.

    PubMed

    Chia, S E; Tay, S K

    2001-11-01

    The aim of the study was to determine if certain occupations pose an increased risk for infertility (of no known cause) among a group of infertile men compared with a group of fertile men. A total of 640 consecutive men whose spouses were unable to conceive were recruited from an infertility clinic. Of these, 218 men (cases) were found to have no known cause for their infertility. A total of 227 men whose spouses were pregnant at the time of the study were recruited as controls. The Singapore Standard Occupational Classification was used to code the subjects' occupations. Semen parameters (density, total sperm counts, motility, viability, and normal morphology) in all of the cases were significantly poorer than those in the controls. The risk for infertility is associated with smoking adjusted odds ratio (OR) 2.85 and 95% confidence interval (CI) 1.91 to 4.24. Work, independently, is not a risk factor for infertility. Engineering technicians (adjusted OR, 2.75; 95% CI, 1.36 to 5.54), finance analysts (adjusted OR, 4.66; 95% CI, 1.90 to 11.40), corporate and computing managers (adjusted OR, 2.49; 95% CI, 1.04 to 5.98), and teachers (adjusted OR, 7.72; 95% CI, 1.86 to 32.10) were at a greater risk of infertility compared with "services and clerical workers." Using services and clerical workers as a reference group, certain occupations are at a higher risk for infertility. Higher work demands and possible electromagnetic field exposure could be contributory factors for infertility. PMID:11725334

  9. The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study

    PubMed Central

    Hasanpoor-Azghdy, Seyede Batool; Simbar, Masoumeh; Vedadhir, Abouali

    2014-01-01

    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) PMID:24799871

  10. Nonsurgical treatment of male infertility: specific and empiric therapy

    PubMed Central

    Cocuzza, Marcello; Agarwal, Ashok

    2007-01-01

    Management of male infertility is always a difficult task, and the pathologic process is often poorly understood. Even though modern assisted reproduction techniques (ART) can help overcome severe male factor infertility, the application of these methods in all infertile couples would definitely represent over-treatment. Several conditions can interfere with spermatogenesis and reduce sperm quality and production. A careful diagnostic work-up is necessary before any andrological treatment can be initiated so that adequate treatment options can be selected for individual patients. Most hormonal imbalances can be readily identified and successfully treated nonsurgically. However, the treatment of men with unexplained idiopathic infertility remains a challenge. In the absence of a correctable etiology, patients are managed with either empirical medical therapy or ART. Empiric medical therapy continues as a viable option. However, physicians and patients must understand that the success rates with any of the pharmacological therapies remain suboptimal. PMID:19707335

  11. Infertility Counseling and Support: When and Where to Find It

    MedlinePLUS

    ... and support families during struggles with infertility and adoption, TheAFA.org Choice Moms: An organization to help ... to become the best mother they can, through adoption or conception, choicemoms.org Fertile Hope: A national ...

  12. Active, Passive Smoking Tied to Infertility, Early Menopause: Study

    MedlinePLUS

    ... gov/medlineplus/news/fullstory_156230.html Active, Passive Smoking Tied to Infertility, Early Menopause: Study Researchers found ... 16, 2015 TUESDAY, Dec. 15, 2015 (HealthDay News) -- Smoking and being exposed to secondhand smoke may trigger ...

  13. Analysis of PAEs in semen of infertile men

    PubMed Central

    Wang, Sheng-Yuan; Wang, Yu; Xie, Fang-Qin; Li, Yan-Xing; Wan, Xue-Lian; Ma, Wei-Wei; Wang, De-Cai; Wu, Yong-Hui

    2015-01-01

    Objectives: Phthalates are environmental chemicals with reproductive toxicity and estrogenic effects in animals. They are of increasing concern to human health. Aim: To determine whether phthalate levels in semen were associated with infertility. Methods: Using semen samples from 107 infertile and 94 fertile men, the presence and quantity of five phthalate esters were measured using high-performance liquid chromatography (HPLC). Using data collected from questionnaires and clinical examinations, the correlation between phthalate exposure and semen quality was analyzed. Results: The cumulative levels of the measured phthalate esters were significantly higher in the infertility group compared to the control group (P<0·05). Concentrations of the five phthalate esters in men varied by age with older men showing higher cumulative levels. Conclusions: The presence of phthalates may contribute to male infertility in our study population. PMID:25384258

  14. Male infertility: recent advances and a look towards the future.

    PubMed

    Lamb, D J; Lipshultz, L I

    2000-07-01

    The past decade has witnessed clinical and basic scientific advances that have revolutionized the diagnosis and treatment of the infertile male. Advances in the clinic and laboratory have resulted in men who were previously thought to be hopelessly infertile, but who are now able to conceive their own biologic offspring. In the future, we believe that the laboratory will continue to play a key role in advancing our ability both to diagnose and to treat the infertile male. We summarize here some of the major advances of the past decade that have influenced our treatment and our understanding of the etiology of male infertility. When possible, clinical innovations and advances in basic science are discussed in combination in order to emphasize the translational importance of reproductive research. PMID:10918975

  15. Male Infertility Might Signal Higher Odds of Testicular Cancer

    MedlinePLUS

    ... nlm.nih.gov/medlineplus/news/fullstory_155748.html Male Infertility Might Signal Higher Odds of Testicular Cancer ... 16, 2015 MONDAY, Nov. 16, 2015 (HealthDay News) -- Men with reduced fertility could be at increased risk ...

  16. Prevalence of chromosomal abnormalities in infertile couples in romania

    PubMed Central

    Mierla, D; Malageanu, M; Tulin, R; Albu, D

    2015-01-01

    The purpose of this study was to establish a correlation between the presence of chromosomal abnormalities in one of the partners and infertility. This retrospective study was performed at the Department of Reproductive Medicine, Life Memorial Hospital, Bucharest, Romania, between August 2007 to December 2011. Two thousand, one hundred and ninety-five patients with reproductive problems were investigated, and the frequency of chromosomal abnormalities was calculated. The control group consisting of 87 fertile persons who had two or more children, was investigated in this retrospective study. All the patients of this study were investigated by cytogenetic techniques and the results of the two groups were compared by a two-tailed Fisher’s exact test. In this study, 94.99% patients had a normal karyotype and 5.01% had chromosomal abnormalities (numerical and structural chromosomal abnormalities). In the study group, numerical chromosomal abnormalities were detected in 1.14% of infertile men and 0.62% of infertile women, and structural chromosomal abnormalities were detected in 1.38% of infertile men and 1.87% of infertile women, respectively. The correlation between the incidence of chromosomal anomalies in the two sexes in couple with reproductive problems was not statistically significant. Recently, a possible association between infertility and chromosomal abnormalities with a significant statistical association has been reported. Our study shows that there is no association between chromosomal abnormalities and infertility, but this study needs to be confirmed with further investigations and a larger control group to establish the role of chromosomal abnormalities in the etiology of infertility. PMID:26929902

  17. Current Chlamydia trachomatis Infection, A Major Cause of Infertility

    PubMed Central

    Mania-Pramanik, Jayanti; Kerkar, Shilpa; Sonawane, Shobha; Mehta, Pratibha; Salvi, Vinita

    2012-01-01

    Background In India, the impact of current Chlamydia trachomatis (C. trachomatis) in reproductive health remains a neglected area of investigation. The present study evaluates if current Chlamydia infection is associated with any clinical complication that needs the attention of clinical investigators. Methods In this cross-sectional study, we enrolled 896 women attending the Gynecology Out Patient for the detection of C. trachomatis infection. Polymerase chain reaction was used to diagnose current C. trachomatis infection and ELISA for past infections. Bacterial vaginosis, Candida and Trichomonas were screened. The results of symptomatic and asymptomatic groups were compared. The data was analyzed using Epi Info version 6 and “Z” test. A probability value of p≤0.05 was considered as significant.. Results Statistical analysis revealed significant association between current C. trachomatis infection with infertility when comparing infected fertile (18.6% vs. 9.4%, odds ratio: 2.19, p<0.0005) and uninfected infertile women (45.6% vs. 27.3%, odds ratio: 2.24, p<0.0001). Average infection rate was 12.1%, highest in women with infertility (18.6%) or with ectopic pregnancy (25%). Significant proportions of infected women with infertility (p<0.01) or with recent pregnancy (p<0.001) were asymptomatic. Follow up of infected women who became negative after treatment [28 women from infertility group and 9 women with recurrent spontaneous abortion (RSA)] revealed live birth in 8 (21.6%) women within one year, 4 with infertility and 4 with RSA. Conclusion Study findings suggest association between current C. trachomatis infection and infertility. Absence of signs and symptoms associated with this infection highlights its diagnosis in women with a history of infertility and RSA for their better management, as revealed by live births with one year of follow up. PMID:23926547

  18. Isolation of Arcanobacterium haemolyticum in semen of an infertile patient.

    PubMed

    Penna-Videau, Salvador; Cermeño, Julman; Padrón-Medina, Aracelis

    2006-09-01

    This is the report of a genital tract infection caused by Arcanobacterium haemolyticum in an infertile man from Venezuela. This 29 year-old patient was evaluated for primary infertility, without symptoms of seminal infection. Laboratory analysis showed leukocytospermia, low sperm count, motility and vitality, without abnormalities in hormonal profile. Sperm culture was positive for A. haemolyticum. After erythromycin therapy an improvement in some sperm parameters was observed. A. haemolyticum could be considered as a cause for silent seminal infection. PMID:17672288

  19. Recommended foods for male infertility in Iranian traditional medicine

    PubMed Central

    Nejatbakhsh, Fatemeh; Nazem, Esmaeil; Goushegir, Ashrafeddin; Isfahani, Mohammad Mahdi; Nikbakht Nasrabadi, Alireza; Baygom Siahpoosh, Marzieh

    2012-01-01

    Background: Male infertility accounts for 30-50% of all infertilities among couples. Iranian traditional medicine (ITM) stressed the importance of nutrition in the prevention and treatment of male infertility. Many Iranian traditional physicians have described the traits of specific foods for prevention and treatment of male infertility. Objective: To explore the principles and roles of foods recommended by ITM scientists in prevention and treatment of male infertility as well as enlisting all the recommended foods for treating this problem addressed through the ITM original resources written between 815 and 1901. Materials and Methods: In this review study specific data related to the subject among all referral ITM texts was extracted firstly, and then the collected data were analyzed using inductive content analysis. Results: The analysis of data revealed that foods that enhance sexual performance must have 3 properties; they should be warm in nature, very nutritious, and flatulent. Foods that are warm in nature and nutritious affect the quality and quantity of semen. A food having the third trait of being flatulent is required to complete sexual performance by creating an erection. Foods with only one of these traits must be consumed with another food that has the other trait. This study also provided a list of foods that can enhance the quality and increase the quantity of semen. Conclusion: Foods that can enhance sexual performance and the quality and quantity of semen can be recommended to male patients who suffer from infertility in medical centers. PMID:25246919

  20. Ethical Problems with Infertility Treatments: Attitudes and Explanations*

    PubMed Central

    Shreffler, Karina M.; Johnson, David R.; Scheuble, Laurie K.

    2014-01-01

    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, gestational carriers) and about the factors that shape them. Two representative telephone survey samples (930 adults in a Midwestern state, and 580 adult women aged 25 to 50 in the North Central region) are analyzed to gauge public views on the ethics of infertility treatments and estimate the effects of social structure and exposure on these views. Ethical concerns were viewed as more serious for techniques that could result in a child who may not be biologically related to the woman or her partner than for those yielding a child biologically related to both parents. Social structural factors such as age and education were the strongest predictors of attitudes towards the ethics of infertility treatments. Neither parenthood nor experiencing infertility was related to ethical concerns, although women reporting the use of infertility services had fewer ethical concerns than their counterparts. PMID:25210214

  1. Counselling, care in infertility: the ethic of care.

    PubMed

    Appleton, T

    1990-07-01

    Infertility is a health-care problem which has very definite physiological, psychological and social implications. Infertile couples are continually reminded of their plight--the structure of society is based on the family unit; simple activities such as shopping are a constant reminder, the shops being geared to the family; the neighbours fill their cars with all the paraphernalia which accompanies children--the stigma of infertility often leads to mental disharmony, marital difficulties, divorce, and in some cultures to ostracism. The suffering experienced by infertile people is very real. We need to remind ourselves that we are treating 'people who are infertile' rather than 'infertility'. Our care goes beyond their physical treatment--their stresses and strains are our concern and we must be careful not to add additional stress to their existing problems. Successful treatment can transform their lives: 'They are bright, healthy, beautiful children--a dream come true. Our lives are transformed and complete. Thank you a million times.' Failure after years of trying is all the more painful. The availability of effective, informed, independent and involved counselling is essential. PMID:2207611

  2. The Genetics of Infertility: Current Status of the Field

    PubMed Central

    Zorrilla, Michelle; Yatsenko, Alexander N

    2013-01-01

    Infertility is a relatively common health condition, affecting nearly 7% of all couples. Clinically, it is a highly heterogeneous pathology with a complex etiology that includes environmental and genetic factors. It has been estimated that nearly 50% of infertility cases are due to genetic defects. Hundreds of studies with animal knockout models convincingly showed infertility to be caused by gene defects, single or multiple. However, despite enormous efforts, progress in translating basic research findings into clinical studies has been challenging. The genetic causes remain unexplained for the vast majority of male or female infertility patients. A particular difficulty is the huge number of candidate genes to be studied; there are more than 2,300 genes expressed in the testis alone, and hundreds of those genes influence reproductive function in humans and could contribute to male infertility. At present, there are only a handful of genes or genetic defects that have been shown to cause, or to be strongly associated with, primary infertility. Yet, with completion of the human genome and progress in personalized medicine, the situation is rapidly changing. Indeed, there are 10-15 new gene tests, on average, being added to the clinical genetic testing list annually. PMID:24416713

  3. [THE VARICOCELE ENIGMA: "BACKGROUND NOISE" OR COMMON MALE INFERTILITY ETIOLOGY?].

    PubMed

    Gat, Itai; Madgar, Igael

    2015-05-01

    Infertility derived from mate etiology is a health problem which has increased over the last decades. Varicocele is a common cause for mate infertility with incidence of 35% and 75% among males with primary and secondary infertility, respectively, compared to 10%-15% among the general population. VaricoceLe is defined as dilated and entangled pampiniform plexus and internal spermatic veins located in the spermatic cord. The effect of varicocele on male infertility was controversial due to lack of published data uniformity and high standard studies. During recent years several published researches supplied reliable evidence regarding the influence of varicocele on mate infertility, treatment options and appropriate indications. Adequate patient selection significantly improves the chances for spontaneous pregnancy. Treatment varies between surgical veins ligation by various means and embolization by the endovascular approlch of the dilated veins. The current article summarizes updated treatment indications, advantages and drawbacks of the optional approaches and describes the considerations for choosing the optimal treatment for the infertile couple due to varicocele. PMID:26168642

  4. [Association study of telomere length with idiopathic male infertility].

    PubMed

    Shuyuan, Liu; Changjun, Zhang; Haiying, Peng; Xiaoqin, Huang; Hao, Sun; Keqin, Lin; Kai, Huang; Jiayou, Chu; Zhaoqing, Yang

    2015-11-01

    Telomeres are evolutionary conserved, multifunctional DNA-protein complexes located at the ends of eukaryotic chromosomes. Telomeres maintain chromosome stability and genome integrity and also play an important role in meiosis which aid in synapsis, homologous recombination, and segregation. Sperm telomere has been reported to play an important role in fertilization and embryo development. Nowadays, the association between telomere and reproduction is one of the major areas of interest, however whether sperm telomere associated with male infertility is not clear. In this study, in order to find out the association between Chinese idiopathic infertility and sperm telomere length, we analyzed the difference of sperm telomere length between idiopathic infertile men and normal fertile men, as well as the correlations between sperm telomere length and human semen characteristics. We analyzed 126 Chinese idiopathic infertile men and 138 normal fertile men for sperm telomere length by using quantitative PCR. We found that the relative sperm mean telomere length of infertile men was significantly shorter than that of fertile men (2.894 0.115 vs. 4.016 0.603, P=5.097 x 10??). Both sperm count and semen progressive motility are related with telomere length. Our results suggest that sperm telomere length is associated with idiopathic male infertility of China and we proposed the possibility that shorter telomeres in sperm chromosome will reduce spermatogenesis and sperm functions, which finally affected the fertility of male. PMID:26582527

  5. Saline sonohysterosalpingographic findings in infertile Nigerian women.

    PubMed

    Onah, H E; Ezike, H A; Mgbor, S O

    2006-11-01

    This paper describes the findings in the first 100 women who underwent saline sonohysterosalpingography (SHG) at two privately owned health facilities in Enugu, South East Nigeria. This was a prospective study of the first 100 consecutive women presenting with infertility to the authors at Mbanefo Hospital and Hansa Clinics, both in Enugu, South-East geopolitical zone of Nigeria from 1 May 2005 to 20 January 2006. Saline sonohysterosalpingography was carried out in the standard way in these women. The findings were analysed using simple percentages and means +/- SD. The procedure was completed in 98 women, while in two others it was not possible to cannulate the uterine cavity. A total of 61 of the women had normal uterine musculature, 37 had interstitial fibroids and two had sonographic features of adenomyosis. Regarding the endometrial cavity, 93 women had a normal endometrium, four had a submucosal fibroid, one had intrauterine adhesions, while the endometrial cavity could not be assessed in two women who could not be cannulated. No case of submucosal polyp or uterine septa or other congenital uterine anomalies was seen. As assessed sonologically, 77 of the study subjects had bilateral patent tubes, while five had unilateral tubal patency. In one woman, there was uncertainty about tubal patency or blockage; in two women, the tubes could not be assessed because of non-cannulation of the uterine cavity and in 15 women, both tubes were blocked. A total of 74 women had normal ovaries; 15 had polycystic ovaries; five had atrophic ovaries consistent with ovarian failure and six women had ovarian cysts. In 18 women, the findings at sonosalpingography (SSG) were confirmed at laparoscopy in 11 women or laparotomy (two women) or by the fact that the patients became pregnant (five women). In 15 (83.3%) of these 18 women, the findings at SSG and laparotomy/laparoscopy or of the woman becoming pregnant were compatible. SSG is a useful screening test for assessing endometrial, tubal and ovarian factors in infertile Nigerian women, thereby obviating the need for laparoscopy and hysteroscopy in the majority of cases. PMID:17130032

  6. New studies link IUDs, infertility; say copper devices safer.

    PubMed

    1985-06-01

    2 studies sponsored by the National Institute of Child Health and Human Development (NICHD) report direct evidence of a link between IUDs and infertility. Both studies indicate that copper-bearing IUDs are less likely than inert IUDs to lead to infertility, but increased risk was evident for both types of IUDs. 2 of the studies' authors said the findings confirm the current practice of many clinicians to discourage women who have no children from using IUDs as their contraceptive method. 1 study involved about 90% of the infertility specialists in Seattle. Janet R. Daling, Ph.D., University of Washington School of Public Health and Community Medicine, and colleagues compared rates of IUD use in 159 childless women who had tubal infertility with an equal number of new mothers. They reached the following conclusions: using any IUD more than doubled (2.6 times) the risk of tubal infertility compared with not using an IUD; the type of IUD affected risk with Dalkon Shield users having 6.8 times the risk of tubal infertility compared with women who never used IUDs, Lippes Loop or Saf-Toil users having 3.2 times the risk, and Copper-7 or Copper-T users having 1.9 times the risk if a copper device was used at 1 time and a plastic device at another time but 1.3 times the risk if only a copper device was used; and the risk of tubal infertility for IUD users increased among women who did not have symptoms of infection as well as those who did. A 2nd larger study involved 7 infertility centers and collaborating hospitals. Dr. Daniel W. Cramer, Brigham and Women's Hospital in Boston, headed the investigation, which evaluated IUD use in 283 childless women with tubal infertility, 69 women with tubal infertility after 1 child, and 3833 new mothers. The Boston-based study found the following: overall the cumulative experience with all IUD use doubled (2.0 relative risk) the risk of tubal infertility; the type of IUD affected the risk of tubal infertility; no increased risk of infertility was apparent for women with a single sex partner; a high risk was apparent for women with a history of infection, pain, or bleeding with IUD use; and noncopper IUD users with 1 child had about 3 times the risk (2.8 relative risk) of never users of developing "secondary" tubal infertility or infertility associated with using an IUD after a 1st live birth. George Rubin, chief of the epidemiological studies branch of the Centers for Disease Control Division of Reproductive Health states that the new data confirm what has been good clinical practice for a number of years. PMID:12313655

  7. Assessment of Correlation between Androgen Receptor CAG Repeat Length and Infertility in Infertile Men Living in Khuzestan, Iran

    PubMed Central

    Khatami, Saeid Reza; Galehdari, Hamid; Rasekh, Abdorrahman; Mombeini, Hayat; Konar, Elham

    2015-01-01

    Background The androgen receptor (AR) gene contains a polymorphic trinucleotide repeat that encodes a polyglutamine tract in its N-terminal transactivation domain (N- TAD). We aimed to find a correlation between the length of this polymorphic tract and azoospermia or oligozoospermia in infertile men living in Khuzestan, Iran. Materials and Methods In this case-control study during two years till 2010, we searched for microdeletions in the Y chromosome in 84 infertile male patients with normal karyotype who lived in Khuzestan Province, Southwest of Iran. All cases (n=12) of azoospermia or oligozoospermia resulting from Y chromosome microdele- tions were excluded from our study. The number of CAG repeats in exon 1 of the AR gene was determined in 72 patients with azoospermia or oligozoospermia and in 72 fertile controls, using the polymerase chain reaction (PCR) and polyacrylamide gel electrophoresis. Results Microdeletions were detected in 14.3% (n=12) patients suffering severe oligozoospermia. The mean CAG repeat length was 18.99 0.35 (range, 11-26) and 19.96 0.54 (range, 12-25) in infertile males and controls, respectively. Also in the infertile group, the most common allele was 19 (26.38%), while in controls, it was 25 (22.22%). Conclusion Y chromosome microdeletions could be one of the main reasons of male infertility living in Khuzestan Province, while there was no correlation between CAG length in AR gene with azoospermia or oligozoospermia in infertile men living in Khuzestan, Iran. PMID:26246877

  8. Varicocele-Induced Infertility in Animal Models

    PubMed Central

    Razi, Mazdak; Malekinejad, Hassan

    2015-01-01

    Varicocele is characterized by abnormal tortuosity and dilation of the veins of the pampiniform plexus within the spermatic cord. Although several reports show the mechanisms by which the varicocele exerts its infertility impact, the exact pathophysiology for varicocele-induced inflammation and its relationship with testicular endocrine disruption remain largely unknown. This review article will update previous findings by discussing the pathophysiology of long term-induced varicocele in rats. Testicular endocrine disruption in experimentally-induced varicocele, new findings related to biochemical alterations in germinal epithelium, and sperm cells apoptosis are highlighted. Recent observations show that varicocele down-regulates first and second maturation divisions, results in Leydig and Sertoli cell inflammation, and increases immune cell infiltration in the testes of the rat as an animal model. Ultimately, previous findings of our laboratory have revealed that varicocele decreased sperm motility, viability and severe DNA damage. Damage in sperm significantly lowers the animal’s fertility potential. Varicocele not only exerts its pathologic impact by lowering the testicular antioxidant capacity but it also down-regulates first and second maturation divisions by exerting biochemical alterations such as reducing the intracytoplasmic carbohydrate ratio in germinal epithelium. PMID:26246871

  9. Management of male neurologic patients with infertility.

    PubMed

    Fode, Mikkel; Snksen, Jens

    2015-01-01

    Many aspects of fertility rely on intact neurologic function and thus neurologic diseases can result in infertility. While research into general female fertility and alterations in male semen quality is limited, we have an abundance of knowledge regarding ejaculatory dysfunction following nerve injury. Normal ejaculation is the result of coordinated reflex activity involving both the sympathetic and somatic nervous systems. Nerve injury can result in retrograde ejaculation, and anejaculation. With retrograde ejaculation, the ejaculate is propelled into the bladder instead of out through the urethra. In mild cases this condition can be reversed by sympathomimetic medications and, in more severe cases, sperm cells can be extracted from the bladder following ejaculation. With anejaculation, the ejaculatory reflex is not activated by normal sexual stimulation. In such cases, the first choice of treatment is assisted ejaculation, preferably by penile vibratory stimulation. If vibratory stimulation is unsuccessful, then ejaculation can almost always be induced by electroejaculation. In cases where assisted ejaculation fails, sperm can be retrieved surgically from either the epididymis or from the testis. Once viable sperm cells have been obtained, these are used in assisted reproductive techniques, including intravaginal insemination, intrauterine insemination, and in vitro fertilization/intracytoplasmic sperm injection. PMID:26003259

  10. Semen quality, infertility and mortality in the USA

    PubMed Central

    Eisenberg, Michael L.; Li, Shufeng; Behr, Barry; Cullen, Mark R.; Galusha, Deron; Lamb, Dolores J.; Lipshultz, Larry I.

    2014-01-01

    STUDY QUESTION What is the relationship between semen parameters and mortality in men evaluated for infertility? SUMMARY ANSWER Among men undergoing an infertility evaluation, those with abnormal semen parameters have a higher risk of death, suggesting a possible common etiology between infertility and mortality. WHAT IS KNOWN ALREADY Conflicting data exist that suggest either an inverse relationship or no relationship between semen quality and mortality. STUDY DESIGN, SIZE, DURATION A study cohort was identified from two centers, each specializing in infertility care. In California, we identified men with data from 1994 to 2011 in the Stanford Reproductive Endocrinology and Infertility semen database. In Texas, we identified men with data from 1989 to 2009 contained in the andrology database at the Baylor College of Medicine Special Procedures Laboratory who were evaluated for infertility. Mortality was determined by data linkage to the National Death Index or Social Security Death Index. Comorbidity was estimated based on calculation of the Charlson Comorbidity Index or Centers for Medicare & Medicaid Services-Hierarchical Condition Categories Model. PARTICIPANTS/MATERIALS, SETTING, METHODS In all, 11 935 men were evaluated for infertility from 1989 to 2011. During 92 104 person years of follow-up, 69 of 11 935 men died (0.58%). The mean age at infertility evaluation was 36.6 years with a mean follow-up of 7.7 years. MAIN RESULTS AND THE ROLE OF CHANCE Compared with the general population, men evaluated for infertility had a lower risk of death with 69 deaths observed compared with 176.7 expected (Standardized mortality rate 0.39, 95% CI 0.300.49). When stratified by semen parameters, however, men with impaired semen parameters (i.e. male factor infertility) had significantly higher mortality rates compared with men with normal parameters (i.e. no male factor infertility). Low semen volume, sperm concentration, sperm motility, total sperm count and total motile sperm count were all associated with higher risk of death. In contrast, abnormal sperm morphology was not associated with mortality. While adjusting for current health status attenuated the association between semen parameters and mortality, men with two or more abnormal semen parameters still had a 2.3-fold higher risk of death compared with men with normal semen (95% CI 1.124.65). LIMITATIONS, REASONS FOR CAUTION Our cohort represents infertile men, which may limit generalizability. As comorbidity relied on administrative data, granular information on each man regarding infertility diagnosis and lifestyle factors was unavailable. WIDER IMPLICATIONS OF THE FINDINGS Men with impaired semen parameters have an increased mortality rate in the years following an infertility evaluation suggesting semen quality may provide a marker of health. STUDY FUNDING/COMPETING INTEREST(S) This study is supported in part by P01HD36289 from the Eunice Kennedy Shriver National Institute for Child Health and Human Development, National Institutes of Health (to D.J.L. and L.I.L.). The project was also partially supported by an NIH CTSA award number UL1 RR025744. None of the authors has any conflict of interest to declare. PMID:24838701

  11. Folate and vitamin B12 in idiopathic male infertility.

    PubMed

    Murphy, Laurel E; Mills, James L; Molloy, Anne M; Qian, Cong; Carter, Tonia C; Strevens, Helena; Wide-Swensson, Dag; Giwercman, Aleksander; Levine, Richard J

    2011-11-01

    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 B(12) (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 infertility and 184 fertile male controls recruited at the Fertility Center and Antenatal Care Center, University Hospital, Malm and Lund, Sweden. Serum folate, red cell folate (RCF), serum B12, plasma tHcy and semen quality were measured. Subjects were genotyped for 20 common variants in 12 genes related to folate/B12/homocysteine metabolism. Metabolite concentrations and genotype distributions were compared between cases and controls using linear and logistic regression with adjustment for covariates. The phosphatidylethanolamine N-methyltransferase (PEMT) M175V and TCblR rs173665 polymorphisms were significantly associated with infertility (P=0.01 and P=0.009, respectively), but not with semen quality. Among non-users of supplements, infertile men had lower serum folate concentrations than fertile men (12.89 vs. 14.73 nmol l(-1); P=0.02), but there were no significant differences in RCF, B12 or tHcy. Folate, B12 and tHcy concentrations were not correlated with any semen parameters. This study provides little support for low folate or B12 status in the pathogenesis of idiopathic male infertility. Although additional data are needed to confirm these initial findings, our results suggest that PEMT and TCblR, genes involved in choline and B12 metabolism, merit further investigation in idiopathic male infertility. PMID:21857689

  12. Cost-effective treatment for the couple with infertility.

    PubMed

    Van Voorhis, B J; Syrop, C H

    2000-12-01

    Although the evaluation of cost-effective approaches to infertility treatment remains in its infancy, several important principles have emerged from the initial studies in this field. Currently, in treating couples with infertility without tubal disease or severe male-factor infertility, the most cost-effective approach is to start with IUI or superovulation-IUI treatments before resorting to IVF procedures. The woman's age and number of sperm present for insemination are significant factors influencing cost-effectiveness. The influence of certain diagnoses on the cost-effectiveness of infertility treatments requires further study. Even when accounting for the costs associated with multiple gestations and premature deliveries, the cost of IVF decreases within the range of other cost-effective medical procedures and decreases to less than the willingness to pay for these procedures. Indeed, for patients with severe tubal disease, IVF has been found to be more cost-effective than surgical repair. The cost-effectiveness of IVF will likely improve as success rates show continued improvements over the course of time. In addition, usefulness of embryo selection and practices to reduce the likelihood of high-order multiple pregnancies, without reductions in pregnancy rates, will significantly impact cost-effectiveness. The exclusion of infertility treatments from insurance plans is unfortunate and accentuates the importance of physicians understanding the economics of infertility treatment with costs that are often passed directly to the patient. The erroneous economic policies and judgments that have led to inequities in access to infertility health care should not be tolerated. PMID:11100309

  13. Human parasitic protozoan infection to infertility: a systematic review.

    PubMed

    Nourollahpour Shiadeh, Malihe; Niyyati, Maryam; Fallahi, Shirzad; Rostami, Ali

    2016-02-01

    Protozoan parasitic diseases are endemic in many countries worldwide, especially in developing countries, where infertility is a major burden. It has been reported that such infections may cause infertility through impairment in male and female reproductive systems. We searched Medline, PubMed, and Scopus databases and Google scholar to identify the potentially relevant studies on protozoan parasitic infections and their implications in human and animal model infertility. Literature described that some of the protozoan parasites such as Trichomonas vaginalis may cause deformities of the genital tract, cervical neoplasia, and tubal and atypical pelvic inflammations in women and also non-gonoccocal urethritis, asthenozoospermia, and teratozoospermia in men. Toxopalasma gondii could cause endometritis, impaired folliculogenesis, ovarian and uterine atrophy, adrenal hypertrophy, vasculitis, and cessation of estrus cycling in female and also decrease in semen quality, concentration, and motility in male. Trypanosoma cruzi inhibits cell division in embryos and impairs normal implantation and development of placenta. Decrease in gestation rate, infection of hormone-producing glands, parasite invasion of the placenta, and overproduction of inflammatory cytokines in the oviducts and uterine horns are other possible mechanisms induced by Trypanosoma cruzi to infertility. Plasmodium spp. and Trypanosoma brucei spp. cause damage in pituitary gland, hormonal disorders, and decreased semen quality. Entamoeba histolytica infection leads to pelvic pain, salpingitis, tubo-ovarian abscess, and genital ulcers. Cutaneous and visceral leishmaniasis can induce genital lesion, testicular amyloidosis, inflammation of epididymis, prostatitis, and sperm abnormality in human and animals. In addition, some epidemiological studies have reported that rates of protozoan infections in infertile patients are higher than healthy controls. The current review indicates that protozoan parasitic infections may be an important cause of infertility. Given the widespread prevalence of parasitic protozoa diseases worldwide, we suggest further studies to better understanding of relationship between such infections and infertility. PMID:26573517

  14. Nanobacteria may be linked to testicular microlithiasis in infertility.

    PubMed

    Zhang, Qing-Hua; Lu, Gen-Sheng; Shen, Xue-Cheng; Zhou, Zhan-Song; Fang, Qiang; Zhang, Xin; Li, Long-Kun; Jin, Xi-Yu; Song, Bo

    2010-01-01

    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

  15. Quality and quantity of infertility care in Bangladesh.

    PubMed

    Fatima, P; Ishrat, S; Rahman, D; Banu, J; Deeba, F; Begum, N; Anwary, S A; Hossain, H B

    2015-01-01

    Infertility is an important health issue which has been neglected in the developing countries. First test-tube babies (triplet) in Bangladesh were born on 30th May, 2001. Although there is no tertiary level infertility center in the public sector, several private centers have come up with the facilities. The objective of the study was to find i) the quality and quantity of infertility care in Bangladesh and ii) the cause of infertility in the attending patients iii) the treatment seeking behaviors iv) and the reasons for not taking treatment among the attending patients. There are now 10 tertiary level Infertility centers in Bangladesh. The information was collected in a preformed datasheet about the facilities and the profile of the patients and the treatment seeking behavior of the attending patients. Out of the ten centers two centers refused to respond and did not disclose their data. Around 16700 new patients are enrolled in a year in the responsive clinics. Five percent (5%) of the patients underwent ART, 7% of the patients gave only one visit, 84% of the patients completed their evaluation, 76% of the patients took treatment. Causes of infertility in the patients taking treatment were male factor in 36.4%, bilateral tubal block in 20.2%, PCOS and anovulation in 31.7%, endometriosis in 19.6%, unexplained in 10.95, combined in 3.5%, ovarian failure in 1.4%, testicular failure in 0.33%, congenital anomaly in 0.3%. The main reason for not taking treatment was financial constrainment. The quality and quantity of infertility care is dependent on the available resources and on the use of the resources by the patients. In developing countries the resources are merging and confined to specified areas which cannot meet the demand of their population. The study gives us the idea of the need and the demand of the services in the country. PMID:25725670

  16. SUFFERING INFERTILITY: THE IMPACT OF INFERTILITY ON WOMEN’S LIFE EXPERIENCES IN TWO NIGERIAN COMMUNITIES

    PubMed Central

    LARSEN, ULLA; HOLLOS, MARIDA; OBONO, OKA; WHITEHOUSE, BRUCE

    2013-01-01

    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. PMID:20561392

  17. [Surgery of male infertility: an update].

    PubMed

    Franco, Giorgio; Misuraca, Leonardo; Ciletti, Mario; Leonardo, Costantino; De Nunzio, Cosimo; Palminteri, Enzo; De Dominicis, Carlo

    2014-01-01

    Surgery for male infertility includes three main areas: varicocele surgery, recanalization of seminal tract, sperm retrieval.Varicocele treatment in infertily is still controversial. Recent scientific evidence appears to demonstrate that in selected cases varicocele treatment is beneficial in improving semen parameters and pregnancy rate. The key for the success of treatment seems to be a correct indication. It is our opinion that varicocele should be treated in presence of abnormal semen parameters, when clinically significant, and in adolescents with atrophy of the affected testis. So far, no specific technique, either surgical, microsurgical or sclerotherapic, can be considered the gold standard. Good results in our hands have been obtained with the microsurgical lymphatic sparing high ligation of internal spermatic vein.Innovations in surgery for seminal tract obstructions include the new tubular invagination techniques for epididimovasostomy, which showed excellent results with a simplified and time-saving microsurgical approach. In distal obstructions, a new transperineal ultrasound-guided approach has been proposed for the diagnostic work-up and treatment. Advantages of this technique and of the TURED must be balanced with those of immediate sperm retrieval for ART.In sperm retrieval, microTESE represents the most important surgical evolution in non-obstructive azoospermia. We have recently proposed a new stepwise approach starting with a minimal equatorial incision for conventional testicular biopsy which is extended to perform microTESE only when no sperm is retrieved. In this way microTESE is offered only to patients who really need it. Another field of innovation is sperm retrieval for ICSI in patients with Klinefelter Syndrome. PMID:25214369

  18. Power of Proteomics in Linking Oxidative Stress and Female Infertility

    PubMed Central

    Gupta, Sajal; Sharma, Rakesh; Agarwal, Ashok

    2014-01-01

    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. PMID:24900998

  19. Empirical medical therapy in idiopathic male infertility: Promise or panacea?

    PubMed Central

    Jung, Jae Hung

    2014-01-01

    Male factors account for 20%-50% of cases of infertility and in 25% of cases, the etiology of male infertility is unknown. Effective treatments are well-established for hypogonadotropic hypogonadism, male accessory gland infection, retrograde ejaculation, and positive antisperm antibody. However, the appropriate treatment for idiopathic male infertility is unclear. Empirical medical treatment (EMT) has been used in men with idiopathic infertility and can be divided into two categories based on the mode of action: hormonal treatment and antioxidant supplementation. Hormonal medications consist of gonadotropins, androgens, estrogen receptor blockers, and aromatase inhibitors. Antioxidants such as vitamins, zinc, and carnitines have also been widely used to reduce oxidative stress-induced spermatozoa damage. Although scientifically acceptable evidence of EMT is limited because of the lack of large, randomized, controlled studies, recent systematic reviews with meta-analyses have shown that the administration of gonadotropins, anti-estrogens, and oral antioxidants results in a significant increase in the live birth rate compared with control treatments. Therefore, all physicians who treat infertility should bear in mind that EMT can improve semen parameters and subsequent fertility potential through natural intercourse. PMID:25309854

  20. Microbiota of the seminal fluid from healthy and infertile men

    PubMed Central

    Hou, Dongsheng; Zhou, Xia; Zhong, Xue; Settles, Matt; Herring, Jessica; Wang, Li; Abdo, Zaid; Forney, Larry J.; Xu, Chen

    2013-01-01

    Objective: To explore potential causes of male infertility by determining the composition and structure of commensal bacterial communities in seminal fluids. Design: Microscopy of gram stained semen samples and classification of 16S rRNA gene sequences to determine the species composition of semen bacterial communities. Setting(s): Clinical andrology laboratory and academic research laboratories. Patient(s): 19 sperm donors and 58 infertility patients. Intervention(s): None. Main Outcome Measure(s): Classification of 16S rRNA gene sequences, clustering of seminal microbial communities, and multiple statistical tests. Result(s): High numbers of diverse kinds of bacteria were present in most samples of both sperm donors and infertility patients. The bacterial communities varied widely between subjects, but they could be clustered into six groups based on similarities in composition and the rank abundances of taxa. Overall there were no significant differences between sperm donors and infertility patients. However, multiple statistical tests showed a significant negative association between sperm quality and the presence of Anaerococcus. The results also indicated that many of the bacterial taxa identified in semen also occur in the vaginal communities of some women, especially those with bacterial vaginosis, which suggests heterosexual sex partners may share bacteria. Conclusion(s): Diverse kinds of bacteria were present in the human semen, there were no significant differences between sperm donors and infertility patients, The presence of Anaerococcus might be a biomarker for low sperm quality. PMID:23993888

  1. Association between endometriosis and hyperprolactinemia in infertile women

    PubMed Central

    Esmaeilzadeh, Seddigheh; Mirabi, Parvaneh; Basirat, Zahra; Zeinalzadeh, Mahtab; Khafri, Soraya

    2015-01-01

    Background: The association of endometriosis with hyperprolactinemia is controversial. Objective: The present study aimed to determine the frequency of endometriosis and association of prolactin with endometriosis in infertile women. Materials and Methods: 256 infertile women who underwent diagnostic laparoscopy for the evaluation of infertility, referred to Fatemezahra Infertility and Reproductive Health Research Center were included in a cross-sectional study. The presence of endometriosis was evaluated. To investigate the association of endometriosis with hyperprolactinemia, the patients whose infertility was not caused by endometriosis were included as control group. Serum prolactin (PRL) level was measured in both groups. The comparison of basal serum PRL levels between the two groups was performed, using independent t-test. One way ANOVA was used to determine PRL association with endometriosis stages. Results: The frequency of endometriosis was found to be 29%. PRL levels were significantly higher in endometriosis group compared to control group (23.021.25 vs. 17.221.22 respectively, p=0.004). Statistically significant associations were found between staging of endometriosis and prolactin levels (p=0.01). Conclusion: Hyperprolactinemia may be associated with endometriosis and its progression. PMID:26000006

  2. [Infertility over forty: Pros and cons of IVF].

    PubMed

    Belaisch-Allart, J; Maget, V; Mayenga, J-M; Grefenstette, I; Chouraqui, A; Belaid, Y; Kulski, O

    2015-09-01

    The population attempting pregnancy and having babies is ageing. The declining fertility potential and the late age of motherhood are increasing significantly the number of patients over forty consulting infertility specialists. Assisted reproductive technologies (ART) cannot compensate the natural decline in fertility with age. In France, in public hospital, ART is free of charge for women until 43 years, over 43, social insurance does not reimburse ART. Hence, 43years is the usual limit, but between 40 and 42 is ART useful? The answer varies according to physicians, couples or society. On medical level, the etiology of the infertility must be taken into account. If there is an explanation to infertility (male or tubal infertility) ART is better than abstention. If the infertility is only due to age the question is raised. In France, the reimbursement by the society of a technique with very low results is discussed. However efficacy is not absolutely compulsory in Medicine. On the opposite to give false hopes may be discussed too. To obtain a reasonable consensus is rather difficult. PMID:26297163

  3. Empirical medical therapy in idiopathic male infertility: Promise or panacea?

    PubMed

    Jung, Jae Hung; Seo, Ju Tae

    2014-09-01

    Male factors account for 20%-50% of cases of infertility and in 25% of cases, the etiology of male infertility is unknown. Effective treatments are well-established for hypogonadotropic hypogonadism, male accessory gland infection, retrograde ejaculation, and positive antisperm antibody. However, the appropriate treatment for idiopathic male infertility is unclear. Empirical medical treatment (EMT) has been used in men with idiopathic infertility and can be divided into two categories based on the mode of action: hormonal treatment and antioxidant supplementation. Hormonal medications consist of gonadotropins, androgens, estrogen receptor blockers, and aromatase inhibitors. Antioxidants such as vitamins, zinc, and carnitines have also been widely used to reduce oxidative stress-induced spermatozoa damage. Although scientifically acceptable evidence of EMT is limited because of the lack of large, randomized, controlled studies, recent systematic reviews with meta-analyses have shown that the administration of gonadotropins, anti-estrogens, and oral antioxidants results in a significant increase in the live birth rate compared with control treatments. Therefore, all physicians who treat infertility should bear in mind that EMT can improve semen parameters and subsequent fertility potential through natural intercourse. PMID:25309854

  4. The biology of infertility: research advances and clinical challenges

    PubMed Central

    Matzuk, Martin M; Lamb, Dolores J

    2013-01-01

    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 descriptive diagnoses that do not provide a cause for their defect. For other individuals with a known etiology, effective cures are lacking, although their infertility is often bypassed with assisted reproductive technologies (ART), some accompanied by safety or ethical concerns. Certainly, progress in the field of reproduction has been realized in the twenty-first century with advances in the understanding of the regulation of fertility, with the production of over 400 mutant mouse models with a reproductive phenotype and with the promise of regenerative gonadal stem cells. Indeed, the past six years have witnessed a virtual explosion in the identification of gene mutations or polymorphisms that cause or are linked to human infertility. Translation of these findings to the clinic remains slow, however, as do new methods to diagnose and treat infertile couples. Additionally, new approaches to contraception remain elusive. Nevertheless, the basic and clinical advances in the understanding of the molecular controls of reproduction are impressive and will ultimately improve patient care. PMID:18989307

  5. Varicocele as a source of male infertility current treatment techniques

    PubMed Central

    Dobro?ski, Piotr Artur; Radziszewski, Piotr

    2015-01-01

    To establish the extent of varicocele as the cause of infertility in men and compare the various techniques of treatment. We searched PubMed and the Cochrane Library database using varicocele, male infertility, varicocelectomy as keywords. Varicocele seems to be a growing problem considered to be one of the most common causes of male infertility in recent times. Nevertheless, its role remains unclear. The best treatment option seems to be microscopic surgery the most effective and linked to rare surgical complications. But the greatest clinical problem remains the selection of patients to treat recently it is believed that varicocelectomy is a possibly advisable option in patients with clinical varicocele and seminal parameter impairment [1]. More high-quality, multicenter, long-term randomized controlled trials (RCT's) are required to verify the findings. PMID:26568883

  6. Environmentally Induced Epigenetic Transgenerational Inheritance of Male Infertility

    PubMed Central

    Guerrero-Bosagna, Carlos; Skinner, Michael K.

    2014-01-01

    Decreasing male fertility has been observed for the past fifty years. Examples of affected reproductive parameters include decreases in sperm count and sperm quality and increases in testicular cancer, cryptorchidism and hypospadias. Exposures to environmental toxicants during fetal development and early postnatal life have been shown to promote infertility. Environmental exposures inducing epigenetic changes related to male infertility range from life style, occupational exposures, environmental toxicants and nutrition. Exposures during fetal gonadal sex determination have been shown to alter the epigenetic programming of the germline that then can transmit this altered epigenetic information to subsequent generations in the absence of any exposures. This environmentally induced epigenetic transgenerational inheritance of disease will be a component of the etiology of male infertility. PMID:25104619

  7. Male infertility: the role of imaging in diagnosis and management

    PubMed Central

    Ammar, T; Sidhu, P S; Wilkins, C J

    2012-01-01

    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. PMID:22763036

  8. Infertility in public health: the case of Norway

    PubMed Central

    Sundby, J.

    2010-01-01

    Infertility is a health issue that demonstrates how unequal access to health care is at a global level. In the poorer segments of the world, and in poor parts of wealthy societies, access is often minimal or non-existent. Public and lay attitudes to modern infertility treatment have been heavily debated alongside development of methods. I have looked at the changes in the public discourse in modern media, legislation, politics, and among professionals. The paper seeks to present and discuss some of these changes as they have evolved in one of the countries that have had one of the more strict laws regulating access to treatment, namely Norway. It is a country that nevertheless offers treatment in the public health system. The paper also tries to connect this discussion to the difficulties faced in every attempt to expand infertility services to the developing world. PMID:25013709

  9. Females become infertile as the stored sperm's oxygen radicals increase

    PubMed Central

    Reinhardt, Klaus; Ribou, Anne-Cecile

    2013-01-01

    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.

  10. Analysis of partial AZFc deletions in Malaysian infertile male subjects.

    PubMed

    Almeamar, Hussein Ali; Ramachandran, Vasudevan; Ismail, Patimah; Nadkarni, Prashan; Fawzi, Nora

    2013-04-01

    Complete deletions in the AZF (a, b, and c) sub-regions of the Y-chromosome have been shown to contribute to unexplained male infertility. However, the role of partial AZFc deletions in male infertility remains to be verified. Three types of partial AZFc deletions have been identified. They are gr/gr, b1/b3, and b2/b3 deletions. A recent meta-analysis showed that ethnic and geographical factors might contribute to the association of partial AZFc deletions with male infertility. This study analyzed the association of partial AZFc deletions in Malaysian infertile males. Fifty two oligozoospermic infertile males and 63 fertile controls were recruited to this study. Screening for partial AZFc deletions was done using the two sequence-tagged sites approach (SY1291 and SY1191) which were analyzed using both the conventional PCR gel-electrophoresis and the high resolution melt, HRM method. Gr/gr deletions were found in 11.53% of the cases and 9.52% of the controls (p = 0.725). A B2/b3 deletion was found in one of the cases (p = 0.269). No B1/b3 deletions were identified in this study. The results of HRM analysis were consistent with those obtained using the conventional PCR gel-electrophoresis method. The HRM analysis was highly repeatable (95% limit of agreement was -0.0879 to 0.0871 for SY1191 melting temperature readings). In conclusion, our study showed that partial AZFc deletions were not associated with male infertility in Malaysian subjects. HRM analysis was a reliable, repeatable, fast, cost-effective, and semi-automated method which can be used for screening of partial AZFc deletions. PMID:23231020

  11. Psychiatric Morbidity in Infertility Patients in a Tertiary Care Setup

    PubMed Central

    Verma, Pankaj; Rastogi, Rajesh; Gandhi, Raghu; Kapoor, Rohit; Sachdeva, Sarthak

    2015-01-01

    Context Infertility is regarded as a trigger for psychological morbidity. Infertile couples often suffer from anxiety, depression and lack of self confidence. Aims To study the demographic factors associated with infertility in a tertiary care setup and to determine the level of anxiety and depression associated with it by using standardized scales. The study protocol also included studying the various coping strategies employed by these patient groups. Settings and Design Case control study. Materials and Methods A prestructured questionnaire based study conducted for a span of 6 months. The study population included the patients attending the infertility and the family planning outpatient department. We applied the Hospital Anxiety and Depression scale (HADS) and the Becks Depression Inventory (BDI). Brief COPE Inventory was applied to look for the various coping measures that are employed by the anxious and depressed patients. Statistical Analysis Data analysis was done using SPSS ver20. Results A total of 280 study subjects were included in the study; which included 140 women from the infertility clinic and 140 from the family planning OPD. A total of 56.4% (79/140) of the females were found to be suffering from depression and 68.9% (96/140) of the females were found to be suffering from anxiety and depression both. Seven risk factors were found to be significant for depression based on the Beck Depression Inventory (BDI) scale and 6 risk factors were found to be significant based on the Hospital Anxiety and Depression Scale (HADS). The most common coping method employed by depressed women was venting 72.2% (57/79) followed by behavioural disengagement 70.9% (56/79); whereas the most important coping method employed by the anxious and depressed women was behavioural disengagement 71.9% (69/96). Conclusion Anxiety and depression is common among patients suffering from infertility and measures should be taken to alleviate it. PMID:26500988

  12. Utilization of Infertility Services: How Much Does Money Matter?

    PubMed Central

    Farley Ordovensky Staniec, J; Webb, Natalie J

    2007-01-01

    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. PMID:17489899

  13. Associated Factors with Male Infertility: A Case Control Study

    PubMed Central

    Ahmadi, Mohammad Reza Hafezi; Yasemi, Masood; Peyman, Hadi; Khajavikhan, Javaher; Yaghoubi, Monireh; Bimanand, Lida

    2014-01-01

    Objective: Sperm analysis is an important step to evaluate and diagnose males infertility. The present study aimed to determine associated factors with males infertility by using semen analysis. Materials and Methods: In this study 96 men were evaluated who attended to the infertility clinics of Ilam province, western Iran between May 2010 to May 2011. Semen analysis was done using the Weili Dynamic Sperm Analysis software adapted to the WHO classification. Based on movement and speed characters, sperms were classified to either A, B, C or D classes. Participants were stratified into two groups that called Oligospermia (OS) with sperm counts of less than 20 million in mL (n=48) and Non-Oligospermia (NOS) with values more than determined cutoff point (n=48). Results: The Mean age SD for OS and NOS group were 29.9 5.1 y and 31.17 5.24 y, respectively (p>0.05). Overall, 62.5% of OS and 31.2% of NOS were clinically infertile (OR=3.6, CI, 1.5-8.5, p=0.01). A significant difference was found between job and live ratio(A+B+C) in NOS group (F=2.8, p<0.05). Conclusion: Prevalence of infertility was higher in the OS men compared to the NOS group. The main risk factors in the OS group were History of Varicocele surgery and residence site of patients that are totally similar to the NOS men. Further case-control studies and clinical trials are recommended to recognize infertility causes in men. PMID:25386439

  14. In vitro fertilization/intracytoplasmic sperm injection for male infertility

    PubMed Central

    Merchant, Rubina; Gandhi, Goral; Allahbadia, Gautam N.

    2011-01-01

    Progress in the field of assisted reproduction, and particularly micromanipulation, now heralds a new era in the management of severe male factor infertility, not amenable to medical or surgical correction. By overcoming natural barriers to conception, in vitro fertilization and embryo transfer (IVF-ET), subzonal sperm insemination, partial zona dissection, and intracytoplasmatic injection of sperm (ICSI) now offer couples considered irreversibly infertile, the option of parenting a genetically related child. However, unlike IVF, which necessitates an optimal sperm number and function to successfully complete the sequence of events leading to fertilization, micromanipulation techniques, such as ICSI, involving the direct injection of a spermatozoon into the oocyte, obviate all these requirements and may be used to alleviate severe male factor infertility due to the lack of sperm in the ejaculate due to severely impaired spermatogenesis (non-obstructive azoospermia) or non-reconstructable reproductive tract obstruction (obstructive azoospermia). ICSI may be performed with fresh or cryopreserved ejaculate sperm where available, microsurgically extracted epididymal or testicular sperm with satisfactory fertilization, clinical pregnancy, and ongoing pregnancy rates. However, despite a lack of consensus regarding the genetic implications of ICSI or the application and efficacy of preimplantation genetic diagnosis prior to assisted reproductive technology (ART), the widespread use of ICSI, increasing evidence of the involvement of genetic factors in male infertility and the potential risk of transmission of genetic disorders to the offspring, generate major concerns with regard to the safety of the technique, necessitating a thorough genetic evaluation of the couple, classification of infertility and adequate counseling of the implications and associated risks prior to embarking on the procedure. The objective of this review is to highlight the indications, advantages, limitations, outcomes, implications and safety of using IVF/ICSI for male factor infertility to enable a more judicious use of these techniques and maximize their potential benefits while minimizing foreseen complications. PMID:21716935

  15. Medical management of male infertility in the absence of a specific etiology.

    PubMed

    Gudeloglu, Ahmet; Brahmbhatt, Jamin V; Parekattil, Sijo J

    2014-07-01

    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

  16. Influence of polymorphism of glutathione S-transferase T1 on Chinese infertile patients with varicocele.

    PubMed

    Wu, Qifei; Xing, Junping; Xue, Wei; Sun, Jianhua; Wang, Xinyang; Jin, Xiaojuan

    2009-03-01

    To investigate the influence of glutathione S-transferase T1 (GSTT1) gene polymorphism on Chinese infertile patients with varicocele, 63 infertile patients with varicocele and 54 healthy fertile controls were recruited in this case-control study. Our results show that oxidative damage may be the cause of infertility in patients with varicocele, and GSTT1 null genotype predisposes to over oxidative damage to spermatocytes of infertile patients with varicocele. PMID:18163994

  17. [Surgical laparoscopy in the management of women infertility].

    PubMed

    Rachdi, Radhouane; Messaoudi, Fethi; Yazidi, M; Ben Temime, Riadh; Basly, Mohamed; Chlayh, Mounir; Zayene, H; Messaoudi, Lotfi; Chibani, Mounir

    2004-09-01

    The authors report their experience about surgical laparoscopy in the management of women infertility. Based on a series of 87 patients (median age: 31 years), 61% have primary infertility. The surgical procedures were distal tuboplasty in 26 cases, endometriosis cure in 19 cases, ovarian driling for polycystic ovarian syndrome in 18 cases and adhesiolysis in 24 cases. The rate of intra uterine pregnancy of the 81 followed patients is 40.7% with 23 newborn (28.39%), 5 abortions (6.17%) and 5 current pregnancies (6.17%). The rate of ectopic pregnancies is 3.7%. PMID:15693477

  18. Inadequate cervical mucus--a cause of "idiopathic" infertility.

    PubMed

    Sher, G; Katz, M

    1976-08-01

    The purpose of this study was to investigate and treat a group of patients referred for "idiopathic" infertility in whom no apparent cause for infertility, apart from inadequate cervical mucus, was found. Hormone investigations revealed that these patients could be divided into two groups: those with low sex steroid profiles despite apparent ovulation, and a second group with normal sex steroid profiles. All patients were treated with ovulation-inducing agents in an attempt to produce "controlled" ovarian hyperstimulation and an improved cervical mucus. Four of six patients conceived. The rationale behind the use of ovulation-inducing agents in this situation is discussed. PMID:955130

  19. Robot-assisted microsurgery in male infertility and andrology.

    PubMed

    Gudeloglu, Ahmet; Brahmbhatt, Jamin V; Parekattil, Sijo J

    2014-11-01

    Use of the operative microscope marked a new era for microsurgery in male infertility and andrology in the 1970s. More than a decade has passed since the initial description of the first robotic-assisted microsurgical vasovasostomy. Large single-center series have recently been published on robotic-assisted microsurgery for vasectomy reversal, especially in the past few years. Multicenter studies are also beginning to be reported, and the potential for this new platform for microsurgery is starting to become more apparent. This article describes the basic technical details of robotic-assisted microsurgery in male infertility and andrology, and reviews the latest literature. PMID:25306167

  20. Varicocele-induced infertility: Newer insights into its pathophysiology

    PubMed Central

    Eisenberg, Michael L.; Lipshultz, Larry I.

    2011-01-01

    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. PMID:21716891

  1. Infertility: from a personal to a public health problem.

    PubMed Central

    Fidler, A T; Bernstein, J

    1999-01-01

    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 PMID:10670617

  2. What Are the Issues Confronting Infertile Women? A Qualitative and Quantitative Approach

    ERIC Educational Resources Information Center

    Hammerli, Katja; Znoj, Hansjorg; Berger, Thomas

    2010-01-01

    Infertility is a stressful experience, yet little is known about the specific issues confronting infertile women. In the present study, researchers sought to identify themes important to infertile women and examine possible associations with mental health levels. Using qualitative content analysis, researchers analyzed the email messages of 57…

  3. The Effect of Social Coping Resources and Growth-Fostering Relationships on Infertility Stress in Women.

    ERIC Educational Resources Information Center

    Gibson, Donna M.; Myers, Jane E.

    2002-01-01

    The experience of infertility often results in multiple stresses and needs for coping in these women. Study examines the relationship between the uses of social coping resources, growth-fostering relationships, and infertility stress. Results support the use of social coping resources for coping with infertility stress. (Contains 62 references and…

  4. Infertility: Towards an Awareness of a Need among Family Life Practitioners.

    ERIC Educational Resources Information Center

    Porter, Nancy L.; Christopher, F. Scott

    1984-01-01

    Discusses emotional problems related to infertility investigation and treatment. Reviews causes and treatment of infertility, coping patterns, and the role of counselors and family life educators in easing the crises of infertility and facilitating successful resolution of associated emotional problems. (JAC)

  5. The Effect of Social Coping Resources and Growth-Fostering Relationships on Infertility Stress in Women.

    ERIC Educational Resources Information Center

    Gibson, Donna M.; Myers, Jane E.

    2002-01-01

    The experience of infertility often results in multiple stresses and needs for coping in these women. Study examines the relationship between the uses of social coping resources, growth-fostering relationships, and infertility stress. Results support the use of social coping resources for coping with infertility stress. (Contains 62 references and

  6. Stem cell therapy for male infertility takes a step forward.

    PubMed

    Firlej, Virginie; Barraud-Lange, Virginie; Fouchet, Pierre

    2012-11-01

    The feasibility of using spermatogonial stem cells (SSCs) for cell-based infertility treatment has suffered from a lack of evidence in a preclinical nonhuman primate model. In this issue, Hermann et al. (2012) demonstrate that autologous and allogeneic transplantation of SSCs in testes of rhesus macaques produced functional sperm. PMID:23122284

  7. Spermatozoa protein alterations in infertile men with bilateral varicocele.

    PubMed

    Agarwal, Ashok; Sharma, Rakesh; Durairajanayagam, Damayanthi; Cui, Zhihong; Ayaz, Ahmet; Gupta, Sajal; Willard, Belinda; Gopalan, Banu; Sabanegh, Edmund

    2016-01-01

    Among infertile men, a diagnosis of unilateral varicocele is made in 90% of varicocele cases and bilateral in the remaining varicocele cases. However, there are reports of under-diagnosis of bilateral varicocele among infertile men and that its prevalence is greater than 10%. In this prospective study, we aimed to examine the differentially expressed proteins (DEP) extracted from spermatozoa cells of patients with bilateral varicocele and fertile donors. Subjects consisted of 17 men diagnosed with bilateral varicocele and 10 proven fertile men as healthy controls. Using the LTQ-orbitrap elite hybrid mass spectrometry system, proteomic analysis was done on pooled samples from 3 patients with bilateral varicocele and 5 fertile men. From these samples, 73 DEP were identified of which 58 proteins were differentially expressed, with 7 proteins unique to the bilateral varicocele group and 8 proteins to the fertile control group. Majority of the DEPs were observed to be associated with metabolic processes, stress responses, oxidoreductase activity, enzyme regulation, and immune system processes. Seven DEP were involved in sperm function such as capacitation, motility, and sperm-zona binding. Proteins TEKT3 and TCP11 were validated by Western blot analysis and may serve as potential biomarkers for bilateral varicocele. In this study, we have demonstrated for the first time the presence of DEP and identified proteins with distinct reproductive functions which are altered in infertile men with bilateral varicocele. Functional proteomic profiling provides insight into the mechanistic implications of bilateral varicocele-associated male infertility. PMID:25999357

  8. Cultural Considerations in Counseling Couples Who Experience Infertility

    ERIC Educational Resources Information Center

    Burnett, Judith A.

    2009-01-01

    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

  9. Level of male infertility in the Ghanaian city of Tema.

    PubMed

    Martin-Odoom, A; Brown, C A; Adjei, D N

    2015-11-01

    Infertility among couples is a sensitive issue in Ghana; females are mostly blamed. Most male infertility cases are generally due to low sperm counts (oligozoospermia), poor sperm quality - characterised by poor sperm motility (asthenozoospermia) - or a combination of both (oligoasthenozoospermia). This is a retrospective study from January 1995 to December 2005 which determined the level and type of male infertility in and around the city of Tema. Seminal fluid analysis reports of male clients who visited the Adom Medical Laboratory in Tema were extracted from laboratory data and analysed. Our study involved 2795 males in the age range of 24-36 years. In 1995, 75% of the total samples analysed had sperm concentrations ranging from 21 to 350 million sperms/ml and showed a decreasing trend to 41% in 2005. Samples with sperm concentrations below 20 million sperms/ml in 1995 increased from 20.5% to 57.6% in 2005; those with active motility > 45% decreased from 27 (30.7%) in 1995 to zero (0%) in 2005, whilst samples with > 50% non-motile sperms increased from 47 (53.4%) in 1995 to 449 (87.7%) in 2005. Male infertility in the samples analysed was due to a combination of oligozoospermia and asthenozoospermia. PMID:25774722

  10. Male infertility risk factors in a French military population.

    PubMed

    Velez de la Calle, J F; Rachou, E; le Martelot, M T; Ducot, B; Multigner, L; Thonneau, P F

    2001-03-01

    We investigated infertility risk factors by conducting a population-based case-control study in the military population of the French town of Brest. Sixty couples who had sought medical advice for infertility of more than 12 months duration (cases) were compared with 165 couples who had had a child (controls). All the men in these couples had been employed by the military. The infertility risk factors studied were male and female medical factors, occupational and environmental exposures. We obtained age-adjusted odds ratios of 7.4 [95% confidence interval (CI): 1.4--39.5] for testis surgery, and 13.0 for varicocele (95% CI: 1.4--120.3) in men. In logistic regression, the age-adjusted odds ratio for men who had worked in a nuclear submarine was found to be 2.0 (95% CI: 1.0--3.7), and that for heat exposure was 4.5 (95% CI: 1.9--10.6). One limitation of this study is the lack of exposure measurements, especially for potential exposure to nuclear radiation (type of reactor used in nuclear-powered submarines, inability to obtain personal dosimeters worn by military personnel working in nuclear submarines). In conclusion, this study suggests that in this military population, having worked as a submariner in a nuclear-powered submarine, and having worked in very hot conditions, should be considered as risk factors for infertility. PMID:11228215

  11. Gender and Infertility: A Relational Approach To Counseling Women.

    ERIC Educational Resources Information Center

    Gibson, Donna M.; Myers, Jane E.

    2000-01-01

    The Relational Model (J. V. Jordan, 1995) of women's development is a theory that explains women's development in a context of relationships, specifically relationships that promote growth for self and others. This model is applied to counseling women who are experiencing infertility, and a case presentation is provided to illustrate the approach.…

  12. Incorporating Ideological Context in Counseling Couples Experiencing Infertility

    ERIC Educational Resources Information Center

    Burnett, Judith A.; Panchal, Krishna

    2008-01-01

    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,…

  13. Five Medical Treatment Stages of Infertility: Implications for Counselors.

    ERIC Educational Resources Information Center

    Gerrity, Deborah A.

    2001-01-01

    Explores the marital happiness, state/trait anxiety, coping techniques, and types of support received for a national sample of men and women experiencing the infertility medical process. Suggests that counselors should be aware that medical treatment affects the distress level of the individual and couple and the types of coping used. Further…

  14. Cultural Considerations in Counseling Couples Who Experience Infertility

    ERIC Educational Resources Information Center

    Burnett, Judith A.

    2009-01-01

    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…

  15. Epigenetic alterations in sperm associated with male infertility.

    PubMed

    Kitamura, Akane; Miyauchi, Naoko; Hamada, Hirotaka; Hiura, Hitoshi; Chiba, Hatsune; Okae, Hiroaki; Sato, Akiko; John, Rosalind M; Arima, Takahiro

    2015-08-01

    The most common form of male infertility is a low sperm count, known as oligozoospermia. Studies suggest that oligozoospermia is associated with epigenetic alterations. Epigenetic alterations in sperm, which may arise due to the exposure of gametes to environmental factors or those that pre-exist in the sperm of infertile individuals, may contribute to the increased incidence of normally rare imprinting disorders in babies conceived after assisted reproductive technology using the sperm of infertile men. Genomic imprinting is an important developmental process whereby the allelic activity of certain genes is regulated by DNA methylation established during gametogenesis. The aberrant expression of several imprinted genes has been linked to various diseases, malignant tumors, lifestyle and mental disorders in humans. Understanding how infertility and environmental factors such as reproductive toxicants, certain foods, and drug exposures during gametogenesis contribute to the origins of these disorders via defects in sperm is of paramount importance. In this review, we discuss the association of epigenetic alterations with abnormal spermatogenesis and the evidence that epigenetic processes, including those required for genomic imprinting, may be sensitive to environmental exposures during gametogenesis, fertilization and early embryonic development. In addition, we review imprinting diseases and their relationships with environmental factors. While the plasticity of epigenetic marks may make these more susceptible to modification by the environment, this also suggests that aberrant epigenetic marks may be reversible. A greater understanding of this process and the function of epidrugs may lead to the development of new treatment methods for many adult diseases in the future. PMID:26212350

  16. Chromosomal Abnormalities in Infertile Men from Southern India

    PubMed Central

    Suganya, Jaganathan; Kujur, Smita B; Selvaraj, Kamala; Suruli, Muthiah S.; Haripriya, Geetha

    2015-01-01

    Background and Objective Male infertility has been associated with aneuploidies and structural chromosomal abnormalities, Yq microdeletions and specific gene mutations and/or polymorphisms. Besides genetic factors, any block in sperm delivery, endocrine disorders, testicular tumours, infectious diseases, medications, lifestyle factors and environmental toxins can also play a causative role. This study aimed to determine the constitutional karyotype in infertile males having normal female partners in a south Indian population. Materials and Methods A total of 180 men with a complaint of primary infertility ranging from 1 to 25 years were screened for chromosomal abnormalities through conventional analysis of GTG-banded metaphases from cultured lymphocytes. Results Four individuals were diagnosed to have Klinefelter syndrome. Two cases exhibited reciprocal translocations and one showed a maternally inherited insertion. Polymorphisms were seen in sixty-seven patients (37.2%). Conclusion The occurrence of chromosomal abnormalities in 4.6% and variants involving the heterochromatic regions of Y, chromosome 9 and the acrocentric chromosomes in 38.2% of the infertile men with an abnormal seminogram strongly reiterates the inclusion of routine cytogenetic testing and counselling in the diagnostic work-up prior to the use of assisted reproduction technologies. PMID:26393143

  17. Five Medical Treatment Stages of Infertility: Implications for Counselors.

    ERIC Educational Resources Information Center

    Gerrity, Deborah A.

    2001-01-01

    Explores the marital happiness, state/trait anxiety, coping techniques, and types of support received for a national sample of men and women experiencing the infertility medical process. Suggests that counselors should be aware that medical treatment affects the distress level of the individual and couple and the types of coping used. Further

  18. Gender and Infertility: A Relational Approach To Counseling Women.

    ERIC Educational Resources Information Center

    Gibson, Donna M.; Myers, Jane E.

    2000-01-01

    The Relational Model (J. V. Jordan, 1995) of women's development is a theory that explains women's development in a context of relationships, specifically relationships that promote growth for self and others. This model is applied to counseling women who are experiencing infertility, and a case presentation is provided to illustrate the approach.

  19. Spermatozoa protein alterations in infertile men with bilateral varicocele

    PubMed Central

    Agarwal, Ashok; Sharma, Rakesh; Durairajanayagam, Damayanthi; Cui, Zhihong; Ayaz, Ahmet; Gupta, Sajal; Willard, Belinda; Gopalan, Banu; Sabanegh, Edmund

    2016-01-01

    Among infertile men, a diagnosis of unilateral varicocele is made in 90% of varicocele cases and bilateral in the remaining varicocele cases. However, there are reports of under-diagnosis of bilateral varicocele among infertile men and that its prevalence is greater than 10%. In this prospective study, we aimed to examine the differentially expressed proteins (DEP) extracted from spermatozoa cells of patients with bilateral varicocele and fertile donors. Subjects consisted of 17 men diagnosed with bilateral varicocele and 10 proven fertile men as healthy controls. Using the LTQ-orbitrap elite hybrid mass spectrometry system, proteomic analysis was done on pooled samples from 3 patients with bilateral varicocele and 5 fertile men. From these samples, 73 DEP were identified of which 58 proteins were differentially expressed, with 7 proteins unique to the bilateral varicocele group and 8 proteins to the fertile control group. Majority of the DEPs were observed to be associated with metabolic processes, stress responses, oxidoreductase activity, enzyme regulation, and immune system processes. Seven DEP were involved in sperm function such as capacitation, motility, and sperm-zona binding. Proteins TEKT3 and TCP11 were validated by Western blot analysis and may serve as potential biomarkers for bilateral varicocele. In this study, we have demonstrated for the first time the presence of DEP and identified proteins with distinct reproductive functions which are altered in infertile men with bilateral varicocele. Functional proteomic profiling provides insight into the mechanistic implications of bilateral varicocele-associated male infertility. PMID:25999357

  20. The autoimmune bases of infertility and pregnancy loss.

    PubMed

    Carp, Howard J A; Selmi, Carlo; Shoenfeld, Yehuda

    2012-05-01

    Several lines of evidence suggest that autoimmune mechanisms may influence the reproductive life and fertility of both sexes, commonly manifesting as infertility or pregnancy loss. Part of the controversy that characterizes this assumption derives from the overlooked suspect of autoimmune conditions in the absence of symptoms or the limited physician awareness in a gynecological setting. Numerous autoimmune diseases, including but not limited to systemic lupus erythematosus and anti-phospholipid syndrome, may be associated with infertility and pregnancy loss through different putative mechanisms. First, serum autoantibodies such as anti-phospholipid, anti-thyroid, or antinuclear antibodies may be directly associated with infertility, regardless of the presence of a clinically overt autoimmune disease. Second, autoimmunity may affect all stages of fertility, via ovarian failure, testicular failure, implantation failure, and pregnancy loss. Third, infertility may also be secondary to vasculitis associated with other conditions such as systemic lupus erythematosus and diabetes mellitus. This review article will illustrate and critically discuss the available data on the link between the breakdown of tolerance that characterizes autoimmune diseases and the changes in reproductive life that affect patients in real clinical setting and that often constitute the iatrotropic stimulus. PMID:22284905

  1. Is the wrong question being asked in infertility research?

    PubMed

    Luke, Barbara; Stern, Judy E; Hornstein, Mark D; Kotelchuck, Milton; Diop, Hafsatou; Cabral, Howard; Declercq, Eugene R

    2016-01-01

    A persistent finding is that assisted reproductive technology (ART) is associated with compromised birth outcomes, including higher risks for prematurity, low birthweight, and congenital malformations, even among singletons. Over the past decade, our research group, the Massachusetts Outcome Study of Assisted Reproductive Technology (MOSART), has evaluated pregnancy and birth outcomes among three groups of women, those women treated with ART, those with indicators of subfertility but without ART treatment, and fertile women. We have also explored the influence of infertility-related diagnoses on outcomes for women and infants. Over the course of our research, we have changed our perspective from an original focus on ART treatment parameters as the primary cause of excess morbidity to one centered instead on the underlying infertility-related diagnoses. This paper summarizes the research findings from our group that support this change in focus for infertility-based research from a primary emphasis on ART treatment to greater attention to the contribution of preexisting pathology underlying the infertility and suggests directions for future analyses. PMID:26634257

  2. Age-related infertility: a tale of two technologies.

    PubMed

    Szewczuk, Elizabeth

    2012-03-01

    The reproductive body has become the site of intensive medical intervention, yet, paradoxically, women have never been more at risk of suffering the distress of infertility. Drawing on in-depth interviews with 22 infertile women, this article explores their reproductive experience from fertility postponement to assisted conception. All had used both modern contraception and in vitro fertilisation, yet none achieved the fertility they desired, when they desired it. All had structured their use of these technologies around the social practice of postponement. Modern contraception, however, while removing the sexual costs of postponement, did not resolve its reproductive dilemmas. Rather it appeared to collapse the experience of this traditionally difficult process, sustaining an illusion of reproductive control in which fertility decisions were 'put on the back burner', undiscussed and sometimes unimagined. For these women this delay then revealed the hidden cost of postponement--infertility--which, in turn, led to their pursuit of assisted conception after the age of 35, at precisely the point when its already limited efficacy begins to fail sharply. In these accounts age-related infertility emerged as a tale of two technologies: two technologies linked to each woman, and each other, through the social practice of postponement. PMID:21812793

  3. MOLECULAR ANALYSIS OF HUMAN SPERMATOZOA: POTENTIAL FOR INFERTILITY RESEARCH

    EPA Science Inventory

    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 ...

  4. Infertility Care Among OEF/OIF/OND Women Veterans in the Department of Veterans Affairs

    PubMed Central

    Mattocks, Kristin; Kroll-Desrosiers, Aimee; Zephyrin, Laurie; Katon, Jodie; Weitlauf, Julie; Bastian, Lori; Haskell, Sally; Brandt, Cynthia

    2015-01-01

    Background An increasing number of young women Veterans seek reproductive health care through the VA, yet little is known regarding the provision of infertility care for this population. The VA provides a range of infertility services for Veterans including artificial insemination, but does not provide in vitro fertilization. This study will be the first to characterize infertility care among OEF/OIF/OND women Veterans using VA care. Methods We analyzed data from the OEF/OIF/OND roster file from the Defense Manpower Data Center (DMDC)—Contingency Tracking System Deployment file of military discharges from October 1, 2001–December 30, 2010, which includes 68,442 women Veterans between the ages of 18 and 45 who utilized VA health care after separating from military service. We examined the receipt of infertility diagnoses and care using ICD-9 and CPT codes. Results Less than 2% (n = 1323) of OEF/OIF/OND women Veterans received an infertility diagnosis during the study period. Compared with women VA users without infertility diagnosis, those with infertility diagnosis were younger, obese, black, or Hispanic, have a service-connected disability rating, a positive screen for military sexual trauma, and a mental health diagnosis. Overall, 22% of women with an infertility diagnosis received an infertility assessment or treatment. Thirty-nine percent of women Veterans receiving infertility assessment or treatment received this care from non-VA providers. Conclusions Overall, a small proportion of OEF/OIF/OND women Veterans received infertility diagnoses from the VA during the study period, and an even smaller proportion received infertility treatment. Nearly 40% of those who received infertility treatments received these treatments from non-VA providers, indicating that the VA may need to examine the training and resources needed to provide this care within the VA. Understanding women’s use of VA infertility services is an important component of understanding VA’s commitment to comprehensive medical care for women Veterans. PMID:25767979

  5. Sexual, Marital, and Social Impact of a Mans Perceived Infertility Diagnosis

    PubMed Central

    Smith, James F.; Walsh, Thomas J.; Shindel, Alan W.; Turek, Paul J.; Wing, Holly; Pasch, Lauri; Katz, Patricia P.

    2010-01-01

    Introduction Male factor infertility is a relatively common problem. This diagnosis may increase sexual, marital, and relationship strain in male partners of infertile couples. Aim To measure the personal, social, sexual, and marital impacts of a male factor infertility diagnosis among men in couples evaluated for infertility. Methods Cross-sectional analysis of 357 men in infertile couples from eight academic and community-based fertility clinics. Participants completed written surveys and face-to-face and telephone interviews at study enrollment. This interview queried each participants perception of their infertility etiology to determine the primary study exposure (i.e., male factor only, male and female factors, female factor only, unknown). Main Outcome Measures Personal Impact, Social Impact, Marital Impact, and Sexual Impact scales. Results Among the 357 men, no male factor was reported in 47%, isolated male factor was present in 12%, combined male and female factors were present in 16%, and unexplained infertility was present in 25% of couples. Male factor infertility was independently associated with worse Sexual (mean 39 vs. 30, standard deviation [SD] 2.7, P = 0.004) and Personal (mean 37 vs. 29, SD 3.8, P = 0.04) Impact scores relative to men in couples without male factor infertility. These differences remained statistically significant after controlling for male age, partner age, race, religion, educational level, employment status, prior pregnancy, duration of infertility, and prior paternity. Conclusions Male partners in couples who perceive isolated male factor infertility have a lower sexual and personal quality of life compared with male partners of couples without perceived male factor infertility. Social strain is highest among couples without a clear etiology for infertility. These findings highlight the clinically significant negative sexual, personal, and social strains of a perceived infertility diagnosis for men. PMID:19619144

  6. Indonesian infertility patients’ health seeking behaviour and patterns of access to biomedical infertility care: an interviewer administered survey conducted in three clinics

    PubMed Central

    2012-01-01

    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. PMID:23020912

  7. A qualitative study of Ottawa university students’ awareness, knowledge and perceptions of infertility, infertility risk factors and assisted reproductive technologies (ART)

    PubMed Central

    2013-01-01

    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. PMID:23962162

  8. Smoking and Male Infertility: An Evidence-Based Review

    PubMed Central

    Harlev, Avi; Gunes, Sezgin Ozgur; Shetty, Amit; du Plessis, Stefan Simon

    2015-01-01

    Many studies have reported that the contents of cigarette smoke negatively affect sperm parameters, seminal plasma, and various other fertility factors. Nevertheless, the actual effect of smoking on male fertility is not clear. The effect of smoking on semen parameters is based on the well-established biological finding that smoking increases the presence of reactive oxygen species, thereby resulting in oxidative stress (OS). OS has devastating effects on sperm parameters, such as viability and morphology, and impairs sperm function, hence reducing male fertility. However, not all studies have come to the same conclusions. This review sheds light upon the arguable association between smoking and male fertility and also assesses the impact of non-smoking routes of tobacco consumption on male infertility. It also highlights the evidence that links smoking with male infertility, including newly emerging genetic and epigenetic data, and discusses the clinical implications thereof. PMID:26770934

  9. Infertility and miscarriage: common pathways in manifestation and management.

    PubMed

    Agenor, Angena; Bhattacharya, Sohinee

    2015-07-01

    The relationship between miscarriage and fertility is complex. While most healthcare settings treat miscarriage as a problem of subfertility in assisted reproduction units, others believe that miscarriage occurs in super-fertile women. Infertile women undergoing assisted reproduction are at a greater risk of having a miscarriage especially at an advanced age compared with women conceiving naturally. Aberrant expression of immunological factors and chromosomal abnormalities underlie both infertility and miscarriage. Common risk factors include increased maternal age, obesity, smoking, alcohol, pre-existing medical conditions and anatomical abnormalities of the reproductive system. Management pathways of both conditions may be similar with pre-implantation genetic testing and assisted reproductive technology used in both conditions. This paper discusses the synergies and differences between the two conditions in terms of their epidemiology, etiopathogenesis, risk factors and management strategies. The two conditions are related as degrees of severity of reproductive failure with common pathways in manifestation and management. PMID:26238301

  10. [New methods for the ambulatory evaluation of female infertility].

    PubMed

    Török, Péter; Major, Tamás

    2013-08-18

    Incidence of infertility increased in the past years and it affects 15% of couples. Female and male factors are responsible in 40% and 40% of the cases, respectively, while factors present in both females and males can be found in 20% of cases. Female factors can be further divided into organic and functional ones. Function of the female organs can be evaluated in an outpatient setting by well-developed laboratory techniques but evaluation of the uterine cavity and inspection of the tubal patency have been traditionally carried out in one-day surgery. However, the latter can be performed under ambulatory setting with the use of office hysteroscopy, so that the use of operating theatre and staff costs can be saved. Using selective pertubation for the evaluation of tubal patency via office hysteroscopy can reduce cost further. The new methods in infertility workup which can be performed in ambulatory setting have several advantages for the patients. PMID:23933606

  11. Obesity-associated infertility - the earliest known description.

    PubMed

    Ben-Shlomo, Izhar; Grinbaum, Eliezer; Levinger, Uriel

    2008-01-01

    Polycystic ovarian syndrome is a leading cause of anovulatory infertility. It was originally described as a syndrome by Stein and Leventhal in 1935. Its frequent association with obesity and the beneficial effects of weight loss are well established. In 1328, the French Rabbi Levi ben Gershom (1288-1344 AD), in a detailed commentary on the Bible, states that: '...it is recognized that excess fat and obesity are reasons for infertility'. He explains that Sarah and Rachel allowed Abraham and Jacob respectively to have children with their maids, expecting this to reduce their own appetite, lead to weight loss and consequent conception. Even if one doubts the historical accuracy of this explanation of the ancestors' situation, one cannot doubt that Rabbi Levi ben Gershom is describing a situation familiar to him, to explain the seemingly paradoxical behaviour of the two mothers. PMID:18644215

  12. Male Reproductive Cancers and Infertility: A Mutual Relationship

    PubMed Central

    Tvrda, Eva; Agarwal, Ashok; Alkuhaimi, Nawaf

    2015-01-01

    Reproductive dysfunction and malignancies related to the male gender represent a serious health concern, whose incidence has significantly risen over the past years. Prior to treatment, testicular or prostate cancer patients often display poor semen characteristics similar to subfertile or infertile patients. This fact is underscored by cases where the malignancy is often diagnosed in males who undergo a general fertility screening. This review aims to examine the associations between male infertility and reproductive cancers focusing on common etiologies and biological mechanisms underlining these pathologies. Furthermore, we discuss compelling epidemiological data hypothesizing that male reproductive failure may act as a precursor of future andrological malignancies, including testicular or prostate cancer, thus providing a stimulus for a more specific research in male reproductive health and emphasizing the importance of this relation for physicians taking care of male patients with a reproductive disease. PMID:25837470

  13. Unexplained Infertility Treated with Acupuncture and Herbal Medicine in Korea

    PubMed Central

    Kang, Myungja; Shin, Sangseop; Choi, Eunmi; Kwon, Sukyung; Wee, Hyosun; Nam, Bonghyun; Kaptchuk, Ted J.

    2010-01-01

    Abstract Aim We aim to determine the safety and effectiveness of a standard therapeutic package of Korean medicine for the treatment of unexplained infertility in a cross-section of women who sought treatment at an integrative hospital in Seoul, Korea. Background Infertility affects more than 1.2 million women in the United States alone. Treatment options for infertility vary, yet the barriers of invasiveness, cost, and access inhibit treatment use for many women. Alternative medical approaches exist for this indication, and sustain certain popularity. Therefore, we systematically studied a standard therapeutic package of Korean medicine to treat unexplained infertility in women. Methods Female participants included in this observational study met inclusion criteria before receiving a set of treatments including herbal medicine, acupuncture, and moxibustion. A study physician screened each patient in accordance with inclusion criteria, provided study information, and after the patients consented, performed the baseline assessment. Assessments included age, the history of assisted reproductive technology, and duration of infertility. The key outcome measure included the number who achieved pregnancy and any neo-natal morbidity and mortality at follow-up stage for those who got pregnant. Any other adverse events including aggravation of existing symptoms, and the number of dropouts, were recorded. Treatments were supposed to be completed after 6 menstrual cycles between February 2005 and April 2006. Results One hundred and four (104) women with unexplained infertility were included in this observational study. Participant mean age was 32 years (SD: 2.7), with a range between 26 and 41 years. The median duration of infertility after diagnosis was 33.5 weeks (interquartile range: 20.850.3). In total, 41 participants (39.4%) had undergone a mean number of 1.4 (SD: 2.2) assisted reproductive technology treatments prior to joining the study. The number of patients remaining in or achieving pregnancy throughout the 6-month study period was 23 (14 pregnancies), 22.1%. Six (6) participants (4.8%) reported minor adverse events including rash in the face (n?=?1), diarrhea (n?=?2), dizziness (n?=?1), and heartburn (n?=?2). Of the 14 pregnancies, there were 10 normal births, and 4 miscarriages; otherwise, no neonatal morbidity/mortality occurred. According to per protocol analysis, 14 pregnancies out of 23 total were achieved by those who remained for the entire six menstruation cycle treatments, yielding a pregnancy rate of 60.9%. Conclusions The standard therapeutic package for unexplained infertility in women studied here is safe for infants and the treated women, when administered by licensed professionals. While it remains challenging to have the target population complete a 6-month treatment course, during which most patients have to pay out of pocket, the extent of successfully achieved pregnancy in those who received full treatment provides meaningful outcomes, warranting further attention. A future study that includes subsidized treatment costs, encouraging the appropriate compliance rate, is warranted. PMID:20180693

  14. The evolving role of saline infusion sonography (SIS) in infertility.

    PubMed

    Seshadri, S; Khalil, M; Osman, A; Clough, A; Jayaprakasan, K; Khalaf, Y

    2015-02-01

    Saline infusion sonography (SIS) has become a valuable diagnostic modality in gynaecology over the last three decades. SIS is now commonly employed for detailed evaluation of the uterine cavity as part of pre-treatment assessment in infertile women. The objective of this paper is review the scientific literature on SIS in infertility. Medline, Ovid and Cochrane databases were searched for relevant articles. The indications, technical aspects and the potential advantages of SIS are discussed. The efficacy and sensitivity of SIS are compared to hysteroscopy in the evaluation of uterine polyps, fibroids, intrauterine adhesions and uterine anomalies. Increasing evidence suggests the use of SIS prior to an in-vitro fertilization (IVF) cycle as it has increased sensitivity in the detection of intrauterine pathology. SIS is cost-effective and results in better patient satisfaction scores than hysteroscopy. PMID:25528732

  15. Treatment strategies for the infertile polycystic ovary syndrome patient.

    PubMed

    Tannus, Samer; Burke, Yechiel Z; Kol, Shahar

    2015-11-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Infertility is a prevalent presenting feature of PCOS, and approximately 75% of these women suffer infertility due to anovulation. Lifestyle modification is considered the first-line treatment and is associated with improved endocrine profile. Clomiphene citrate (CC) should be considered as the first line pharmacologic therapy for ovulation induction. In women who are CC resistant, second-line treatment should be considered, as adding metformin, laparoscopic ovarian drilling or treatment with gonadotropins. In CC treatment failure, Letrozole could be an alternative or treatment with gonadotropins. IVF is considered the third-line treatment; the 'short', antagonist-based protocol is the preferred option for PCOS patients, as it is associated with lower risk of developing ovarian hyperstimulation syndrome (specifically by using a gonadotropin--releasing hormone agonist as ovulation trigger), but with comparable outcomes as the long protocol. PMID:26626234

  16. Infertility evaluation and treatment according to Jewish law.

    PubMed

    Schenker, J G

    1997-02-01

    The Jewish attitude toward infertility can be learned from the fact that the first commandment of God to Adam was "be fruitful and multiply". When evaluating an infertile couple according to the Halakha (Hebrew law), one should first evaluate the female factor. If pathology is found, one may proceed to investigate the male factor, inadequate or abnormal production, ejaculation, or deposition of spermatozoa. The basic fact that allows in vitro fertilization (IVF) and embryo transfer (ET) to be considered in the rabbinical literature at all is that the oocyte and the sperm originate from the wife and the husband, respectively. For many centuries Jewish religious authorities have discussed the principle involved in artificial insemination from a donor. The discussions are based on ancient sources in the Talmud and the codes of Jewish law is prohibited for a variety of reasons e.g. incest, lack of genealogy, and the problem of inheritance. In the case of egg donation the problem that arises is who should be considered the mother, the donor of the oocyte or the one in whose uterus the embryo develops, the one who gives birth. Jewish law states that the child is related to the woman who finished its formation, the one who gave birth. The Jewish religion does not forbid the practice of surrogate motherhood in the case of full surrogacy. From the religious point of view, the child will belong to the father who gave the sperm and to the woman who gave birth. Creating and inducing a preimplantation in embryo in vitro for fertility research should be allowed if there is a real chance that the sperm owner may benefit and have a child as a result of this research. Nowadays, assisted reproductive technology is a common practice in the treatment of infertility. Nevertheless, different religious arguments of the world's religions impose limitations on the therapeutic approach to infertility. PMID:9138953

  17. Endometriosis and Infertility: How and When to Treat?

    PubMed Central

    Fadhlaoui, Anis; Bouquet de la Jolinière, Jean; Feki, Anis

    2014-01-01

    Endometriosis is defined as the presence of endometrial-like tissue (glands or stroma) outside the uterus, which induces a chronic inflammatory reaction. Although endometriosis impairs fertility, it does not usually completely prevent conception. The question of evidence based-medicine guidelines in endometriosis-associated infertility is weak in many situations. Therefore, we will highlight in this issue where the challenges are. PMID:25593948

  18. [48,XXYY men with azoospermia: how to manage infertility?].

    PubMed

    Roche, C; Sonigo, C; Benmiloud-Tandjaoui, N; Boujenah, J; Benzacken, B; Poncelet, C; Hugues, J-N

    2014-01-01

    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

  19. Chinese herbal medicine for infertility with anovulation: a systematic review.

    PubMed

    Tan, Li; Tong, Yao; Sze, Stephen Cho Wing; Xu, Mei; Shi, Yang; Song, Xin-yang; Zhang, Ting-ting

    2012-12-01

    The aim of this systematic review is to assess the effectiveness and safety of Chinese herbal medicine (CHM) in treatment of anovulation and infertility in women. Eight (8) databases were extensively retrieved. The Chinese electronic databases included VIP Information, CMCC, and CNKI. The English electronic databases included AMED, CINAHL, Cochrane Library, Embase, and MEDLINE(®). Randomized controlled trials using CHM as intervention were included in the study selection. The quality of studies was assessed by the Jadad scale and the criteria referred to Cochrane reviewers' handbook. The efficacy of CHM treatment for infertility with anovulation was evaluated by meta-analysis. There were 692 articles retrieved according to the search strategy, and 1659 participants were involved in the 15 studies that satisfied the selection criteria. All the included trials were done in China. Meta-analysis indicated that CHM significantly increased the pregnancy rate (odds ratio [OR] 3.12, 95% confidence interval [CI] 2.50-3.88) and reduced the miscarriage rate (OR 0.2, 95% CI 0.10-0.41) compared to clomiphene. In addition, CHM also increased the ovulation rate (OR 1.55, 95% CI 1.06-2.25) and improved the cervical mucus score (OR 3.82, 95% CI 1.78-8.21) compared to clomiphene, while there were no significant difference between CHM and clomiphene combined with other medicine. CHM is effective in treating infertility with anovulation. Also, no significant adverse effects were identified for the use of CHM from the studies included in this review. However, owing to the low quality of the studies investigated, more randomized controlled trials are needed before evidence-based recommendation regarding the effectiveness and safety of CHM in the management of infertility with anovulation can be provided. PMID:23198826

  20. Contemporary concepts in the evaluation and management of male infertility

    PubMed Central

    Hwang, Kathleen; Walters, R. Chanc; Lipshultz, Larry I.

    2013-01-01

    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 patients 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 empiricalusing medical therapy or assisted conception techniquesfor 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. PMID:21243017

  1. Hypothetical link between infertility and genetically modified food.

    PubMed

    Gao, Mingxia; Li, Bin; Yuan, Wenzhen; Zhao, Lihui; Zhang, Xuehong

    2014-01-01

    It is speculated that genetically modified food (GMF)/genetically modified organism (GMO) is responsible for infertility development. The risk linked with a wide use of GMFs/GMOs offers the basic elements for social criticism. However, to date, it has not been justified whether the bad effects are directly resulted from products of genetic modifications or trans-genesis process. Extensive experience with the risk assessment of whole foods has been applied recently on the safety and nutritional testing of GMFs/GMOs. Investigations have tested the safety of GMFs including sub-acute, chronic, reproductive, multi-generation and carcinogenicity studies. We extrapolated the potential risks associated with GMFs/GMOs on reproduction, and analyzed the multi-aspect linked between infertility and GMFs/GMOs. It could be conjectured that GMFs/GMOs could be potential hazard on reproduction, linking to the development of infertility through influencing the endocrine metabolism, endometriosis. However, little evidence shows the impaction on embryo or reproductive related tumor due to the limited literatures, and needs further research. The article presents some related patents on GMFs/GMOs, and some methods for tracking GMOs. PMID:25342149

  2. Seminal Corynebacterium strains in infertile men with and without leucocytospermia.

    PubMed

    Mashaly, M; Masallat, D T; Elkholy, A A; Abdel-Hamid, I A; Mostafa, T

    2016-04-01

    This study aimed to identify seminal Corynebacterium strains in infertile men with and without leucocytospermia. Semen samples from 60 infertile men were allocated into two equal groups: semen samples with leucocytospermia and semen samples without leucocytospermia. Semen culture for Corynebacterium species was carried out on Columbia agar medium confirmed by Gram-stained film and biochemical tests followed by analytical profile index biotyping and antibiotic susceptibility. Bacterial isolates were detected in 20/60 semen cultures (33.3%) as Corynebacteria, Staphylococci, Alpha haemolytic streptococci and E. coli. In all, 12/60 (20%) had Corynebacterium positive semen culture, whereas C. seminal was the major isolated species followed by C. amycolatum, C. jekium and C. urealyticum. There was nonsignificant difference between patients with/without Corynebacterium positive culture regarding sperm concentration and normal sperm morphology; however, in positive cultures sperm motility was significantly lower compared with negative cultures. Antimicrobial sensitivity among Corynebacteria strains was highest for vancomycin, rifampicin then imipenem, ampicillin + sulbactam, ciprofloxacin. It is concluded that positive semen cultures for different Corynebacteria species were demonstrated in infertile men, whereas Corynebacterium seminale was the most common isolated species. Vancomycin, rifampicin then imipenem and ampicillin + sulbactam are recommended as sensitive antibiotics. PMID:26228802

  3. Sensorineural deafness and male infertility: a contiguous gene deletion syndrome

    PubMed Central

    Zhang, Yuzhou; Malekpour, Mahdi; Al?Madani, Navid; Kahrizi, Kimia; Zanganeh, Marvam; Mohseni, Marzieh; Mojahedi, Faezeh; Daneshi, Ahmad; Najmabadi, Hossein; Smith, Richard J H

    2007-01-01

    Background Syndromic hearing loss that results from contiguous gene deletions is uncommon. Deafness?infertility syndrome (DIS) is caused by large contiguous gene deletions at 15q15.3. Methods Three families with a novel syndrome characterised by deafness and infertility are described. These three families do not share a common ancestor and do not share identical deletions. Linkage was established by completing a genome?wide scan and candidate genes in the linked region were screened by direct sequencing. Results The deleted region is about 100?kb long and involves four genes (KIAA0377, CKMT1B, STRC and CATSPER2), each of which has a telomeric duplicate. This genomic architecture underlies the mechanism by which these deletions occur. CATSPER2 and STRC are expressed in the sperm and inner ear, respectively, consistent with the phenotype in persons homozygous for this deletion. A deletion of this region has been reported in one other family segregating male infertility and sensorineural deafness, although congenital dyserythropoietic anaemia type I (CDAI) was also present, presumably due to a second deletion in another genomic region. Conclusion We have identified three families segregating an autosomal recessive contiguous gene deletion syndrome characterised by deafness and sperm dysmotility. This new syndrome is caused by the deletion of contiguous genes at 15q15.3. PMID:17098888

  4. [Contemporary methods of treating age-related infertility].

    PubMed

    Domitrz, Jan; Jagie??o, Ewa; Chrostowski, Bartosz; Szamatowicz, Jacek; Wo?czy?ski, S?awomir

    2005-09-01

    Age-related infertility that is caused by diminished reproductive potential is both medical and social problem of a great concern. Changes in modern ways of life make women postpone the decision of starting up a family, what may reduce their chances of having a healthy baby. It is also a problem of subfertile couples who after many years of insufficient treating approach the period where the age imposes on primary causes of infertility, what even more reduces the chance of pregnancy. The main reason of this is increased number of chromosomal abnormalities resulting in lower quality of oocytes. There is a lot of research being held on the reconstruction of gametes by transferring the nucleus or cytoplasm among the oocytes derived from young and older patients. However, it has not brought the expected results so far. The method of preimplantation genetic diagnosis--aneuploidy screening (PGD-AS) in patients older than 35 gives some hope for improving the efficiency of infertility treatment. Nevertheless, oocyte donation still remains the most effective and applied method of assisted reproduction in the group of older patients. PMID:16417089

  5. Infertility and Perinatal Loss: When the Bough Breaks.

    PubMed

    Bhat, Amritha; Byatt, Nancy

    2016-03-01

    Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders, and post-traumatic stress disorder. Young women, who lack social supports, have experienced recurrent pregnancy loss or a history of trauma and / or preexisting psychiatric illness are at a higher risk of experiencing psychiatric illnesses or symptoms after a perinatal loss or during infertility. It is especially important to detect, assess, and treat depression, anxiety, or other psychiatric symptoms because infertility or perinatal loss may be caused or perpetuated by such symptoms. Screening, psychoeducation, provision of resources and referrals, and an opportunity to discuss their loss and plan for future pregnancies can facilitate addressing mental health concerns that arise. Women at risk of or who are currently experiencing psychiatric symptoms should receive a comprehensive treatment plan that includes the following: (1) proactive clinical monitoring, (2) evidence-based approaches to psychotherapy, and (3) discussion of risks, benefits, and alternatives of medication treatment during preconception and pregnancy. PMID:26847216

  6. Laparoscopy--or not--for management of unexplained infertility.

    PubMed

    Badawy, A; Khiary, M; Ragab, A; Hassan, M; Sherif, L

    2010-01-01

    This study aimed at evaluating the role of laparoscopy in the management of unexplained infertility in a prospective randomised controlled trial. The study comprised of 255 patients as a study group and 257 patients as a control group. All women had unexplained infertility. Patients in the study group had laparoscopy followed by ovarian stimulation and timed intercourse for six cycles, while patients in the control group were treated directly with ovarian stimulation and timed intercourse for six cycles. Severe adhesions were found in one in each of the two groups, respectively. They were referred directly to the IVF/ICSI programme. Moderate pelvic endometriosis was demonstrated in three cases in the two groups. Again, severe endometriosis was found in two cases in the study groups and they were referred to the IVF/ICSI programme. After 6 months of follow-up, clinical pregnancy occurred in 114/255 (44.7%) in the study group and 107/257 (41.7%) in the control group and the difference was not statistically significant (p > 0.05). The miscarriage rate was similar in the two groups. We concluded that laparoscopy could be postponed when proceeding in the management of unexplained infertility, until ovarian stimulation and timed intercourse had been found to be unsuccessful in achieving pregnancy. PMID:20925617

  7. Treatment of infertility in men with spinal cord injury.

    PubMed

    Brackett, Nancy L; Lynne, Charles M; Ibrahim, Emad; Ohl, Dana A; Sønksen, Jens

    2010-03-01

    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 of treatment. Patients who fail penile vibratory stimulation can be referred for electroejaculation. If this approach is not possible, prostate massage is an alternative. Surgical sperm retrieval should be considered as a last resort when other methods fail. Most men with SCI have a unique semen profile characterized by normal sperm count but abnormally low sperm motility. Scientific investigations indicate that accessory gland dysfunction and abnormal semen constituents contribute to the problem. Despite abnormalities, sperm from men with SCI can successfully induce pregnancy. In selected couples, the simple method of intravaginal insemination is a viable option. Another option is intrauterine insemination. The efficacy of intrauterine insemination increases as the total motile sperm count inseminated increases. In vitro fertilization and intracytoplasmic sperm injection are options in cases of extremely low total motile sperm count. Reproductive outcomes for SCI male factor infertility are similar to outcomes for general male factor infertility. PMID:20157304

  8. A Nutrition Screening Form for Female Infertility Patients.

    PubMed

    Langley, Susie

    2014-12-01

    A Nutrition Screening Form (NSF) was designed to identify lifestyle risk factors that negatively impact fertility and to provide a descriptive profile of 300 female infertility patients in a private urban infertility clinic. The NSF was mailed to all new patients prior to the initial physician's visit and self-reported data were assessed using specific criteria to determine if a nutrition referral was warranted. This observational study revealed that 43% of the women had a body mass index (BMI) <20 or ?25 kg/m(2), known risks for infertility. Almost half reported a history of "dieting" and unrealistic weight goals potentially limiting energy and essential nutrients. A high number reported eating disorders, vegetarianism, low fat or low cholesterol diets, and dietary supplement use. Fourteen percent appeared not to supplement with folic acid, 13% rated exercise as "extremely" or "very active", and 28% reported a "high" perceived level of stress. This preliminary research demonstrated that a NSF can be a useful tool to identify nutrition-related lifestyle factors that may negatively impact fertility and identified weight, BMI, diet, exercise, and stress as modifiable risk factors deserving future research. NSF information can help increase awareness among health professionals and patients about the important link between nutrition, fertility, and successful reproductive outcomes. PMID:26067073

  9. Trace elements in seminal plasma of men from infertile couples

    PubMed Central

    Szynkowska, Ma?gorzata I.; Motak-Pochrz?st, Hanna; Pawlaczyk, Aleksandra; Sypniewski, Stanis?aw

    2015-01-01

    Introduction An analysis of lead, zinc, cadmium and other trace elements in semen of men from infertile couples was performed to determine the association between abnormal semen parameters and enviromental or occupational exposure to some trace metals. Material and methods Presence of manganese, cobalt, nickel, copper, zinc, molybdenum, cadmium, tin and lead was measured in seminal plasma of 34 men from infertile couples using spectrometry with time-of-flight analysis. Correlations among sperm parameters and trace metals were determined using cluster analysis and Pearson's correlation coefficient. Results Abnormally high concentrations of lead, cadmium, zinc and cobalt were found in 23 seminal plasma of men from infertile couples. The most consistent evidence was determined for an association between high cadmium concentration in seminal plasma and sperm count, motility and morphology below reference limits (p < 0.01). A correlation of significantly increased tin level and reduced sperm count in semen of men with limited fertility potential was observed (p = 0.04). Conclusions In our study we observed a correlation of tin level with sperm count in semen of men with limited fertility potential. PMID:26170853

  10. In vitro fertilization for male infertility: when and how?

    PubMed

    Hall, J; Fishel, S

    1997-12-01

    The first observation that in vitro fertilization (IVF) was useful for treating oligozoospermia and oligoasthenozoospermia was reported by Fishel and Edwards in 1982. This was followed by a series of cases indicating the value of IVF in such cases. Conventional IVF has been modified and refined to achieve increased rates of conception in cases of male factor infertility. Methods such as high insemination concentration IVF for the treatment of teratozoospermia and microscopic IVF for the treatment of oligozoospermia have had some impact on fertilization and pregnancy rates; however, reports of success are varied. The recent advent of micromanipulation and, in particular, intracytoplasmic sperm injection (ICSI) has overshadowed the use of these modified IVF procedures. Because of the high fertilization and pregnancy rates achieved with ICSI, other micromanipulation techniques (subzonal insemination and partial zona dissection) have been abandoned; there have also been suggestions that other more conventional techniques, i.e. IVF, should also be abandoned and that ICSI become the sole technique for the treatment of infertility. The rapid increase in the number of centres using ICSI has led to extreme pressure for individual units to achieve high fertilization and pregnancy rates and there is a temptation to assign all patients to ICSI treatment. It is important that, in this highly competitive environment, new techniques are not applied haphazardly and reduced to the mere injection of gametes and achievement of pregnancy regardless of the cause of infertility. In his 1986 IVF--Historical Perspective, Fishel quoted Auguste Comte: 'to understand science it is necessary to know its history'. IVF has much recent history in animal and also human work. Although ICSI is the most significant therapeutic advance in male infertility treatment, its application to human IVF is only 4 years old, with a paucity of animal studies on which to rely. For this reason IVF still plays a very important role in the treatment of male factor infertility and should only be ruled out when it has failed previously or the number of available sperm is limited. PMID:9692012

  11. Tubal factor infertility: diagnosis and management in the era of assisted reproductive technology.

    PubMed

    Dun, Erica C; Nezhat, Ceana H

    2012-12-01

    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

  12. Evaluation of the melatonin and oxidative stress markers level in serum of fertile and infertile women

    PubMed Central

    Soleimani Rad, Sara; Abbasalizadeh, Shamsi; Ghorbani Haghjo, Amir; Sadagheyani, Mehzad; Montaseri, Azadeh; Soleimani Rad, Jafar

    2015-01-01

    Background: Infertility is defined as the inability to achieve the pregnancy within a year of unprotected intercourse. Infertility is a complex issue and different factors such as stress oxidative can be involved in this problem. So, any attempt to neutralize oxidative stress would be helpful in the treatment of infertility. Melatonin is a known scavenger of free radicals. Objective: The aim of our study was to evaluate the level of melatonin and its correlation with oxidative biomarkers in fertile and infertile women. Materials and Methods: The participants including fertile and infertile women were divided into two groups of 30 people. Blood sampling was performed and sera were collected. The level of Malondialdehyde (MDA), total antioxidant capacity (TAC) and melatonin were detected. Data were analyzed using T-test and their correlation was assessed using Spearman test. Results: Serum melatonin from fertile women was higher than infertile women but the difference was not significant (p= 0.46). MDA level in fertile women was significantly lower than infertile women (p<0.001) and the level of TAC in fertile women was significantly higher than infertile women (p<0.001). Spearman test revealed a significant and direct correlation between melatonin and TAC in fertile and infertile women and a significant but reverse correlation between melatonin and MDA in infertile and fertile women. Conclusion: Differences in the level of oxidative stress biomarkers in fertile and infertile individuals have been reported. This study revealed a significant correlation between melatonin and oxidative stress biomarkers, concluding that melatonin level could be involved in infertility. PMID:26494992

  13. Chromosomal Aberrations and Polymorphic Evaluation in Males with Primary Infertility from Indian Population

    PubMed Central

    Pokale, Yamini S.; Jadhav, Ajinkya M.; Gangane, Suresh D.

    2014-01-01

    Background and objectives: The chromosomal abnormalities are one of the important causes of male infertility. In view of the genetic risks for the next generation, the importance of careful evaluation of karyotype is essential. The objective of this study was to determine the frequency of chromosomal abnormalities in infertile men with primary infertility from Indian population. Materials and Methods: The 78 infertile men with primary infertility, out of which 26 men were azoospermic, 19 men were oligospermic, 4 men were asthenospermic and 29 men were oligoasthenospermic were studied. Karyoptying was performed on peripheral blood lymphocytes by using the Giemsa trypsin banding (GTG) banding technique. Additional data was collected from published studies in Indian population leading to a total of 1814 cases. Results: Chromosome analysis of 78 infertile males showed major chromosome abnormalities in 10.2%, with 6.4% in autosomal chromosome abnormalities and 3.8% in sex chromosome abnormalities. The incidence of major chromosome abnormalities in oligospermic males were 21% and azoospermic males were 15.4 %. Chromosomal polymorphic variants were identified to be 16.7%. Combining the data from other published studies identified 153/ 1814 (8.4%) infertile men of chromosomal abnormalities; with 10.8% in azoospermia, 7.3% in oligospermia and 7.3% in oligoasthenoteratospermic from India. Interpretation and Conclusion: The overall high prevalence of chromosomal abnormalities in infertile males suggests that the conventional chromosomal analysis is an important investigative tool for male infertility, especially prior to use of any assisted reproductive techniques. PMID:25478430

  14. Exploration of the counseling needs of infertile couples: A qualitative study

    PubMed Central

    Jafarzadeh-Kenarsari, Fatemeh; Ghahiri, Ataollah; Zargham-Boroujeni, Ali; Habibi, Mojtaba

    2015-01-01

    Background: Identification of the main needs of infertile patients is essential to provision of appropriate supportive services and care based on their needs. Thus, the present study aims to explore infertile couples counseling needs. Materials and Methods: This study was carried out with an inductive qualitative content analysis approach during 20122013. The participants of this study included 26 Iranian infertile couples and 7 medical personnel (3 gynecologists and 4 midwives). The infertile couples were selected through purposive sampling and considering maximal variation from patients attending state-run and private infertility treatment centers as well as infertility specialists, offices in Isfahan and Rasht, Iran. Unstructured in-depth interviews and field notes were utilized for data gathering and replying to this research main question, What are the counseling needs of infertile couples? The data from medical personnel was collected through semi-structured interviews. Data analysis was carried out through conventional content analysis. Results: Data analysis revealed two main themes. The first theme was a need for psychological counseling, which included four subthemes: Emotional distress management, sexual counseling, marital counseling, and family counseling. The second theme was a need for guidance and information throughout treatment process, which included three subthemes: Treatment counseling, financial counseling, and legal counseling. Conclusions: The counseling needs of infertile couples are varied, and they require various psychosocial support and counseling interventions. The participants of this study identified clearly the significance of psychological counseling and information throughout the long and onerous journey of infertility and its treatment. PMID:26457091

  15. Infertility: Why can't we classify this inability as disability?

    PubMed Central

    Khetarpal, Abha; Singh, Satendra

    2012-01-01

    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. PMID:22848333

  16. Analysis of the serum reproductive system related autoantibodies of infertility patients in Tianjin region of China

    PubMed Central

    Huo, Yan; Xu, Yanying; Wang, Jianmei; Wang, Fang; Liu, Yu; Zhang, Yujuan; Zhang, Bumei

    2015-01-01

    Object: Reproductive system related autoantibodies have been proposed to be associated with natural infertility. However, large scale systematic analysis of these of antibodies has not been conducted. The aim of this study is to analyze the positive rate of antisperm antibody (ASAb), anti-endometrium antibody (EMAb), anti-ovary antibody (AOAb), anti-zona pellucida antibody (AZP) and anticardiolipin antibody (ACA) in infertility patients in Tianjin region of China. Methods: 1305 male and 1711 female primary infertility patients and 1100 female secondary infertility patients were included in this study, as well as 627 healthy female controls. The above autoantibodies were tested and the positive rates in each group were calculated. Results: the positive rate of ASAb were significantly higher in primary infertility female than that in male, further analysis revealed that primary infertility population all exhibit significant higher positive rate of EMAb, AOAb, AZP and ACA compared with control group. Furthermore, the positive rates of all the antibodies in primary infertility female were significantly higher than those in secondary infertility female. Conclusions: Our study thus indicates that these autoantibodies might be associated with immunological related primary infertility and may have clinical significance in its diagnosis and treatment. PMID:26550366

  17. Clinical management and therapeutic outcome of infertile couples in southeast Nigeria

    PubMed Central

    Menuba, Ifeanyi E; Ugwu, Emmanuel O; Obi, Samuel N; Lawani, Lucky O; Onwuka, Chidinma I

    2014-01-01

    Background Infertility is highly prevalent in Nigeria and most infertile couples in southeast Nigeria are offered conventional forms of treatment, which consist mainly of ovulation induction and tubal surgery, due to limited availability and high cost of endoscopic and assisted reproductive technologies like laparoscopy and in vitro fertilization. The aim of this study was to determine the prevalence of infertility, outcome of infertility investigation, and the treatment outcome of infertile couples following therapeutic interventions in southeast Nigeria over a 12-month period. Methods This was a prospective cross-sectional study of 218 consecutive infertile couples presenting for infertility management at the infertility clinics of two tertiary health institutions in Enugu, southeast Nigeria. Infertility investigations were carried out on these couples using the available conventional diagnostic facilities. Following the results of the investigations/diagnosis, conventional treatment was offered to the couples as appropriate. Data analysis was both descriptive and inferential at 95% confidence level. Results The mean age of the women was 33.54.62 (range: 1549) years. Most (58.3% [n=127]) were nulliparous. The prevalence of infertility was 12.1%. Infertility was primary in 28.4% (n=62) and secondary in 71.6% (n=156). Female etiologic factors were responsible in 32.1% (n=70), male factors in 26.1% (n=57), and a combination of male/female factors in 29.4% (n=64). The etiology was unknown in 12.4% (n=27). Tubal factors 23.8 % (n=52) and ovulation failures 26.1% (n=57) are common female factors implicated. Pregnancy rate following treatment was 16.7% (n=28). Multivariate regression analysis indicates that younger age of ?30 years, duration of infertility ?5 years, and female factor infertility were associated with higher pregnancy outcome following treatment. Conclusion The prevalence of infertility is high and pregnancy rate following conventional treatment is poor. There is a need to improve facilities for managing infertility as well as making artificial reproductive techniques readily available, accessible, and affordable. PMID:25328391

  18. Clinical genetic testing for male factor infertility: current applications and future directions.

    PubMed

    Hotaling, J; Carrell, D T

    2014-05-01

    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

  19. Measuring infertility in populations: constructing a standard definition for use with demographic and reproductive health surveys

    PubMed Central

    2012-01-01

    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. PMID:22938182

  20. Comparison of lifestyle in fertile and infertile couples in Kermanshah during 2013

    PubMed Central

    Khosrorad, Tahereh; Dolatian, Mahrokh; Riazi, Hedyeh; Mahmoodi, Zohreh; Alavimajd, Hamid; Shahsavari, Soodeh; Bakhtiari, Mitra

    2015-01-01

    Background: Infertility is a major reproductive health in gynecology. According to the world health organization, there are currently 50-80 million infertile couples in the world. Objective: Considering the critical effects of lifestyle on reproductive health, this study aimed to compare the lifestyle of fertile and infertile couples in Kermanshah during 2013. Materials and Methods: This research is a descriptive cross sectional study that was done on 216 fertile and infertile couples attending Infertility Center and six medical centers that were selected through the convenience sampling. Data were collected using a researcher-made questionnaire containing demographic and fertility-related information and also lifestyle items on nutrition, physical activity, perceived social support, responsibility for health, and inappropriate health behaviors. Descriptive statistics, logistic regression analysis, independent t, chi-square and Generalized Estimating equation were performed to analyze the data. Results: Fertile and infertile women (86.1% and 73. 1% respectively, p= 0. 03) as well as fertile and infertile men were significantly different in terms of physical activity (87% and 96.3% p<0.001, respectively) and perceived social support (p<0.001). Moreover, there was a significant difference between fertile and infertile women in nutrition (p<0.001). Similar differences were observed in responsibility for health and inappropriate health behaviors between fertile and infertile men. However, all of the dimensions of lifestyle, except nutrition, were significantly different between fertile and infertile couples. Conclusion: As lifestyle plays a crucial role in reproductive health, the inappropriate lifestyle of infertile couples has to be modified through effective measures such as awareness promotion, behavioral changes, and development of a healthy environment. PMID:26568759

  1. Genetic susceptibility to male infertility: news from genome-wide association studies.

    PubMed

    Aston, K I

    2014-05-01

    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

  2. AB61. Advances of surgical treatment in male infertility

    PubMed Central

    Seo, Ju Tae

    2014-01-01

    Approximately 15% of couples cannot conceive a child after 1 year of regular, unprotected intercourse. Male factor infertility is contributory in another 30% to 40%. Most causes of male infertility are treatable and the goal of many treatments is to restore the ability to conceive naturally. The dramatic recent improvements in the management of male infertility are largely contributable to improved surgical techniques and assisted reproductive technology (ART). Specifically in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) allow us to overcome even the most severe defects in spermatogenesis in which only a few are available. Varicocele repair may be considered as the primary treatment option when a man with a varicocele has suboptimal semen quality and the female partner is normal. varicocele repair can reverse a pathologic condition and halt further damage to testicular function, and improve spermatogenesis. Preferred approaches of most experts are microsurgical inguinal and subinguinal operations. Studies have shown that varicocele repair can improve semen parameters, testicular function and pregnancy rates in couples with male-factor infertility associated with varicocele. Also varicocele repair can result in sperm in the ejaculate of azoospermia men when severe hypospermatogenesis or maturation arrest spermatid stage is present. Obstructive azoospermia may result from epididymal, vasal or ejaculatory duct abnormalities. Microsurgical reconstruction remains the safest and most cost-effective treatment option for these patients (vasovasostomy, vasoepididymostomy). It is controversial that the technique of sperm retrieval (open or percutaneous) or the source of sperm (testicular, epididymal, vasal or seminal vesicular) affects pregnancy rate. Sperm extraction or aspiration for IVF via ICSI is needed in cure of surgically uncorrectable azoospermia or failed microsurgical reconstruction and the majority of patients with congenital bilateral absence of the vas deferens (CBAVD). Also sperm retrieval with IVF/ICSI is preferred to surgical treatment when the advanced female partner age, female infertility requiring IVF. Nonobstructive azoospermia (NOA) is the most challenging type, but no specific treatment was available previously. With advent of ICSI in conjunction with sperm retrieval via testicular sperm extraction (TESE), many of nonobstructive azoospermic patients are able to father own babies. However, 20-50% of NOA patients are not able to have sperm retrieved for ART. Microsurgical TESE is an advanced type of TESE that applies microsurgical techniques. This microsurgical TESE is an effective sperm retrieval from men with NOA for ICSI. The advantages of this technique are minimally invasive technique, removal of minimal amount of testicular tissue and minimalizing negative impact on testicular function. Microsurgical TESE is more effective in men with NOA than conventional TESE. Treatment strategies for male infertility have changed as dramatically over the past decade. These advances are largely contributable to microsurgical varicocele repair, microsurgical reconstructive techniques, and microsurgical techniques for surgical sperm retrieval and ART specifically ICSI.

  3. Associations between peripheral androgens and cortisol in infertile women.

    PubMed

    Gleicher, Norbert; Seier, Kenneth; Kushnir, Vitaly A; Weghofer, Andrea; Wu, Yan-Guang; Wang, Qi; Albertini, David F; Barad, David H

    2016-04-01

    Testosterone has in recent years been proven essential for normal growth and maturation of small growing follicles. Concomitantly, low functional ovarian reserve (LFOR), characterized by a small growing follicle pool, has been associated with low testosterone levels, which can be of ovarian and/or adrenal origin. In this study we, therefore, investigated whether peripheral sex steroid precursors and testosterone levels potentially reflect on adrenal function. In a retrospective cohort study of 355 consecutive infertile women, who presented to an academically affiliated fertility center in New York City, we investigated in a series of statistical models whether low peripheral sex steroid precursors and testosterone are associated with peripheral cortisol (C) levels, reflecting adrenal function. To determine potential correlations, we investigated the dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), androstenedione (AD), total testosterone (TT), free testosterone (FT); sex hormone binding globulin (SHBG), anti-Müllerian hormone (AMH), thyroid stimulating hormone (TSH) and C in a series of multivariate and logistic regression analyses, utilizing C either as a continuous variable or with cut off <5.0μg/dL, and TT only as a continuous variable. Practically all models demonstrated significant predictability of peripheral sex hormone precursors for C levels, with DHEA demonstrating the strongest and most consistent predictability as an individual parameter and as part of the DHEAS/DHEA ratio. We conclude that in infertile women peripheral sex hormone precursors, especially DHEA, reflect C levels and, therefore, adrenal function. In infertile women, at all ages low levels of sex hormone precursors, therefore, should be considered indications for further adrenal assessments. PMID:26804970

  4. Infertility in Jewish couples, biblical and rabbinic law.

    PubMed

    Hirsh, Anthony V.

    1998-01-01

    The Jewish religion is family orientated, and life is guided by 'Halacha', a code of conduct based on biblical and rabbinic law. There is a duty to have children, in view of the first biblical commandment 'be fruitful and multiply', which sanctions most treatments for infertility. Interpretations vary among Orthodox, Conservative and Progressive rabbis, but it is only rabbis who have authority to advise infertile couples on which procedures concur with Jewish law, and their appraisals tend towards leniency in the interests of domestic happiness. Prohibitions against 'wasting seed', and against marriage to a man with 'wounded testes or severed membrum', may be waived to allow semen collection for analysis and treatment for male infertility. All types of assisted conception are approved, including in vitro and micro-assisted fertilization, provided the gametes are from married couples. In short cycles, artificial insemination can be permitted in the post-menstrual week of 'niddah' when coitus is forbidden. Jewish descent from the mother is automatic but, for Orthodox couples, a technical violation of the law against adultery or incest can spoil the marriage prospects of a child or interrupt the paternal priestly line of Cohen or Levi. Donor gametes are largely unacceptable to Orthodox rabbis, since egg donation confuses the definition of the mother, and because sperm donation creates subterfuge in a child's genealogy and a risk of consanguinity. However, Progressive and Conservative rabbis place more emphasis on the social attributes of parents and frequently approve of gamete donation. The Jewish status of children resulting from surrogacy or adoption can be settled by religious conversion. Objections to treating unmarried couples, single or lesbian women, and to posthumous conception, arise because such households are not traditional families. PMID:11844302

  5. Genetics of male infertility: from research to clinic.

    PubMed

    Krausz, Csilla; Escamilla, Antoni Riera; Chianese, Chiara

    2015-11-01

    Male infertility is a multifactorial complex disease with highly heterogeneous phenotypic representation and in at least 15% of cases, this condition is related to known genetic disorders, including both chromosomal and single-gene alterations. In about 40% of primary testicular failure, the etiology remains unknown and a portion of them is likely to be caused by not yet identified genetic anomalies. During the last 10 years, the search for 'hidden' genetic factors was largely unsuccessful in identifying recurrent genetic factors with potential clinical application. The armamentarium of diagnostic tests has been implemented only by the screening for Y chromosome-linked gr/gr deletion in those populations for which consistent data with risk estimate are available. On the other hand, it is clearly demonstrated by both single nucleotide polymorphisms and comparative genomic hybridization arrays, that there is a rare variant burden (especially relevant concerning deletions) in men with impaired spermatogenesis. In the era of next generation sequencing (NGS), we expect to expand our diagnostic skills, since mutations in several hundred genes can potentially lead to infertility and each of them is likely responsible for only a small fraction of cases. In this regard, system biology, which allows revealing possible gene interactions and common biological pathways, will provide an informative tool for NGS data interpretation. Although these novel approaches will certainly help in discovering 'hidden' genetic factors, a more comprehensive picture of the etiopathogenesis of idiopathic male infertility will only be achieved by a parallel investigation of the complex world of gene environmental interaction and epigenetics. PMID:26447148

  6. Prospective Changes in Infertile Patients using Nonlinear Analysis

    NASA Astrophysics Data System (ADS)

    Takahashi, Yuko; Tomiyama, Tatsuhiro; Matsubayashi, Hidehiko; Tsukamoto, Asami; Oyama-Higa, Mayumi

    2011-06-01

    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.

  7. Adenomyosis reduces pregnancy rates in infertile women undergoing IVF.

    PubMed

    Salim, Rehan; Riris, Solon; Saab, Wael; Abramov, Benjamin; Khadum, Iffat; Serhal, Paul

    2012-09-01

    High-resolution transvaginal ultrasound has facilitated the diagnosis of adenomyosis. This study determined the prevalence of this finding in infertile women and its effect on the outcome of IVF/intracytoplasmic sperm injection (ICSI). This prospective study evaluated 275 consecutive women, commencing IVF/ICSI for the first time. Inclusion criteria were adequate ovarian reserve. Women with fibroids or a previous myomectomy were excluded. All women were screened for adenomyosis by transvaginal ultrasound on three separate occasions. The control group included 256 women and the adenomyosis group included 19 women. There was no significant difference in the ages of women, FSH, cause of infertility, body mass index, total dose of gonadotrophin used and number of oocytes collected between the two groups. However, women with adenomyosis had a higher mean antral follicle count (P=0.006). The clinical pregnancy rate (22.2% versus 47.2%) and ongoing pregnancy rate (11.1% versus 45.9%) were significantly lower in women with adenomyosis and the miscarriage rate (50.0% versus 2.8%) was significantly higher in women with adenomyosis (all P<0.001). Ultrasound evidence of adenomyosis is found in a significant number of women presenting with infertility and has a negative impact on the outcome of IVF/ICSI. This paper suggests that a common condition known as adenomyosis is associated with a reduced success following fertility treatment such as IVF. The diagnosis of adenomyosis has been greatly facilitated by the advent of high-resolution transvaginal ultrasound. This was a study including 275 consecutive women who were commencing IVF for the first time. Comparing women who did not have adenomyosis and those that did, the clinical and ongoing pregnancy rates were both lower in women with adenomyosis (22.2% versus 47.2% and 11.1% versus 45.9%, respectively). So, fewer women with adenomyosis became pregnant and had an ongoing pregnancy. The miscarriage rate was higher in women with adenomyosis compared with those without (50.0% versus 2.8%). We conclude that ultrasound evidence of adenomyosis is found in a significant number of women presenting with infertility and has a negative impact on the outcome of IVF. PMID:22832421

  8. [FSH and FSHR gene polymorphisms and male infertility: An update].

    PubMed

    Wu, Qiu-yue; Shui, Ying-chun; Xia, Xin-yi; Huang, Yu-feng

    2015-11-01

    Follicle-stimulating hormone (FSH) is synthesized and secreted by the anterior pituitary, which binds to its receptors expressed on the membrane of Sertoli cells in the testis to bring about spermatogenesis. With the development of DNA sequencing technology, FSH SNPs rs10835638 and FSHR SNPs rs6165, rs6166, and rs1394205 were detected, which might directly affect the expression of FSH and activity of FSHR, resulting in male spermatogenic dysfunction. This review focuses on the relationship of FSH and FSHR gene polymorphisms with male infertility. PMID:26738333

  9. Infertility treatment: lack of consensus plagues an unregulated field

    PubMed Central

    Easton, M

    1998-01-01

    Each year, in an attempt to stimulate journalism students' interest in medical writing, CMAJ sponsors the Amy Chouinard Memorial Essay Prize. The $750 award is in memory of Amy Chouinard, a longtime and valued contributor to CMAJ and the Canadian Journal of Surgery. Students from any recognized journalism program at a Canadian college or university are eligible to enter, and the deadline for 1998 entries is June 1. The 1997 winner, Megan Easton, presents a well-written and thorough account of the issues surrounding infertility treatment. Interest in the topic came naturally enough--her father, Dr. William Easton, is a urogynecologist in private practice in Scarborough, Ont. PMID:9614830

  10. Might uterus transplantation be an option for uterine factor infertility?

    PubMed Central

    Akar, Münire Erman

    2015-01-01

    Current data on uterus allotransplantation research has been reviewed and summarized. Over the past 15 years, progress in uterus transplantation research has increased dramatically. As a consequence, the first pregnancy and delivery following uterus allotransplantation in rats have been reported. The technique has been better defined. Although clinical pregnancy and delivery following uterus allotransplantation has been reported in humans, there are still many questions to be answered before clinical application. Gestational surrogacy still remains an important option for being a genetic parent in selected cases with uterine factor infertility. PMID:25788850

  11. Natural procreative technology for infertility and recurrent miscarriage

    PubMed Central

    Tham, Elizabeth; Schliep, Karen; Stanford, Joseph

    2012-01-01

    Abstract Objective To study the outcomes of women with infertility or miscarriage treated with natural procreative technology (NaProTechnology or NPT), a systematic medical approach to promoting conception in vivo; and to compare the outcomes with those previously published from a general practice in Ireland. Design Retrospective cohort study. Setting An urban Canadian primary care practice in which the physician had a part-time practice in NPT. Participants Couples with infertility or recurrent miscarriage who received treatment in the practice between August 2000 and July 2006. Intervention All couples were taught to identify the fertile time of their menstrual cycles using the Creighton Model FertilityCare System (CrMS) and completed a standard NPT evaluation. Many also received additional medical treatment to enhance conception in vivo. Main outcome measures Live birth was the primary outcome; secondary outcomes included conceptions, multiple births, low birth weight, and prematurity. Results A total of 108 couples received NPT and were included in the analysis, of which 19 (18%) reported having 2 or more previously unexplained miscarriages. The average female age was 35.4 years. Couples had been attempting to conceive for a mean of 3.2 years. Twenty-two participants (20%) had previously given birth; 24 (22%) had previous intrauterine insemination; and 9 (8%) had previous assisted reproductive technology. The cumulative adjusted proportion of first live births for those completing up to 24 months of NPT treatment was 66 per 100 couples, and the crude proportion was 38%. The cumulative adjusted proportion of first conceptions was 73 per 100 couples, and the crude proportion was 47%. Of the 51 couples who conceived, 12 couples (24%) conceived with CrMS instruction alone, 35 (69%) conceived with CrMS and NPT medical treatment, and 4 (8%) conceived after additional surgical treatment. All births were singleton births; 54% were born at 37 weeks gestation or later; and 78% had birth weights of 2500 g or greater. Conclusion Natural procreative technology in a family physicians office was effective in treating infertility and miscarriage with outcomes that were comparable to those in an NPT general practice in Ireland. Larger multicentre prospective studies to compare NPT directly to other forms of infertility treatment are warranted. PMID:22734170

  12. An overview of the development of infertility research and treatment.

    PubMed

    Philipp, E E

    1993-01-01

    Before the invention of the microscope, knowledge of the anatomic factors in human reproduction was limited to the approximations available to the naked eye. Van Leeuwenhoek developed the microscope and also discovered the spermatozoa. With the availability of microscopy, and later biochemistry, the corpus luteum was described and the endocrine functions of the ovaries were partially elucidated. In recent times, too, imaging--by x-ray, sonography, and MRI, and through the laparoscope--has been the key to advances in our understanding of reproduction and, thus, of infertility and its treatment. PMID:8348160

  13. A Holistic Approach to the Treatment of the Crisis of Infertility.

    ERIC Educational Resources Information Center

    Bresnick, Ellen R.

    1981-01-01

    Discusses the importance of assessing the impact infertility has on couples/individuals and understanding the relevance of this impact in the context of psychological treatment. Infertility's negative impact can be minimized by therapeutic intervention. Three psychological-behavioral categories for couples are posited, with case studies. (Author)

  14. An Exploratory Study of the Psychological Correlates of Infertility on Women.

    ERIC Educational Resources Information Center

    Fouad, Nadya A.; Fahje, Kristin Kons

    1989-01-01

    Investigated effect of various factors related to infertility on women's (N=31) self-esteem and concomitant incidence of depression. Results support positive relationship between infertile women's self-esteem and their internal locus of control, self-esteem and subjective satisfaction with their social support, and general satisfaction with social…

  15. Motherhood and Female Labor Supply in the Developing World: Evidence from Infertility Shocks

    ERIC Educational Resources Information Center

    Aguero, Jorge M.; Marks, Mindy S.

    2011-01-01

    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…

  16. Infertility in Women: Hysterosalpingographic Assessment of the Fallopian Tubes in Lagos, Nigeria

    ERIC Educational Resources Information Center

    Akinola, R. A.; Akinola, O. I.; Fabamwo, A. O.

    2009-01-01

    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…

  17. An Exploratory Study of the Psychological Correlates of Infertility on Women.

    ERIC Educational Resources Information Center

    Fouad, Nadya A.; Fahje, Kristin Kons

    1989-01-01

    Investigated effect of various factors related to infertility on women's (N=31) self-esteem and concomitant incidence of depression. Results support positive relationship between infertile women's self-esteem and their internal locus of control, self-esteem and subjective satisfaction with their social support, and general satisfaction with social

  18. Trends of Infertility and Childlessness in India: Findings from NFHS Data.

    PubMed

    Ganguly, S; Unisa, S

    2010-01-01

    Etiology of infertility varies from region to region and from one population to another and even from one locality to another within the same population. Childlessness has serious demographic, social and health implications. Hence an attempt has been made to get some approximation about levels and patterns of infertility and childlessness in India by using National Family Health Survey-2 (1998-1999) and National Family Health Survey-3 (2005-2006) data. The study population consists of women aged 20-49 years married for ??5 years. Age of women, age at first marriage, place of residence, standard of living, working status of women, and region are some of the variables related with the rate of infertility and childlessness. Infertility rate is high among women in urban areas. This may be due to lifestyle or a later age at first marriage. Considering religion, Muslims show the lowest infertility rate. Scheduled tribes have high infertility rate. With increasing levels of educational attainment among women, infertility rate increases. This can be related to the fact that with aspirations for attaining higher educational level, marriage is delayed as a result of which in confirmation with aforementioned causation factors (higher age at marriage, urban living style etc.), infertility rate is high among this sub group of population. PMID:25300753

  19. Economic aspects of infertility care: a challenge for researchers and clinicians.

    PubMed

    2015-10-01

    Infertility care has improved remarkably over the last few decades and has received growing attention from health care providers. Several treatments, including expensive options such as Assisted Reproductive Techniques, are now widely available for routine clinical use. In most cases, adoption of these treatments has occurred without robust cost-effective analyses. IVF for unexplained infertility and ICSI in the absence of semen abnormalities are two examples of this gradual technology creep. More in-depth economic analyses in the field of infertility are undoubtedly warranted. However, performing these analyses is challenging because infertility care poses a number of unique challenges. Studies of cost-effectiveness are open to criticism because there is a lack of consensus about the outcomes of choice and the appropriate perspective. The use of quality adjusted life years (QALYs) to allow comparisons with other clinical conditions is also controversial because the value associated with infertility care cannot be easily captured in QALYs. Moreover, their use triggers the crucial question of whose QALYs merit consideration-an individual's, a couple's or a child's. In conclusion, economic analysis in infertility represents a peculiar but crucial challenge. If management of infertility is to become an integral part of publicly or privately funded health care systems worldwide, better quality data and a shared vision about the costs and benefits of infertility treatments are needed. PMID:26141712

  20. Cognitive emotional consequences of male infertility in their female partners: a qualitative content analysis

    PubMed Central

    Karimi, Fatemeh Zahra; Taghipour, Ali; Roudsari, Robab Latifnejad; Kimiaei, Seyed Ali; Mazlom, Seyed Reza; Amirian, Maliheh

    2015-01-01

    Introduction Infertility, as a global phenomenon and one of the most important issues of reproductive health, affects women more often than men, even when the infertility is due to a male factor. The purpose of this study was to explore the cognitive emotional experiences of women faced with male infertility. Methods This qualitative study was conducted in 2014–2015 in Mashhad, Iran. The perceptions and experiences of healthy women whose husbands were diagnosed with primary male factor infertility were investigated using a qualitative content analysis approach. Participants were selected through purposeful sampling, and data collection was conducted using in-depth semistructured interviews. Data were analyzed using conventional content analysis with MAXqda software. Study rigor was verified via criteria proposed by Lincoln and Guba. Results One main theme emerged through analysis entitled “cognitive emotional reactions confronting infertility diagnosis” with sub-themes of cognitive emotional reactions when confronted with male infertility diagnosis with subthemes of disbelief and denial, fear and apprehension, suffering and emotional distress, disappointment, frustration, confusion, and joy. Conclusion The diagnosis of male infertility was associated with important emotional cognitive consequences for their female partners. Emotional support, providing new insights into how to treat the issue, and trying to shorten the process of diagnosis are necessary for these women. This kind of support could reduce the psychological effects of confrontation with the diagnosis of male infertility, including social insecurity for women. PMID:26767097

  1. Infertility in Women: Hysterosalpingographic Assessment of the Fallopian Tubes in Lagos, Nigeria

    ERIC Educational Resources Information Center

    Akinola, R. A.; Akinola, O. I.; Fabamwo, A. O.

    2009-01-01

    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

  2. Motherhood and Female Labor Supply in the Developing World: Evidence from Infertility Shocks

    ERIC Educational Resources Information Center

    Aguero, Jorge M.; Marks, Mindy S.

    2011-01-01

    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

  3. Study of cytomegalovirus infection in idiopathic infertility men referred to Shariati hospital, Tehran, Iran

    PubMed Central

    Habibi, Masoud; Bahrami, Alireza; Morteza, Afsaneh; Sadighi Gilani, Mohammad Ali; Hassanzadeh, Gholamreza; Ghadami, Mohsen; Choobineh, Hamid

    2014-01-01

    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. PMID:24799874

  4. Effect of Infertility on Sexual Function: A Cross-Sectional Study

    PubMed Central

    Direkvand-Moghadam, Ashraf; Direkvand-Moghadam, Azadeh

    2015-01-01

    Introduction Sexual dysfunction is an important psychological disorder that may increase in infertile couples. Aim To evaluate the effect of infertility on sexual function in women attending in private and public institutions in Ilam during 2013. Materials and Methods In a cross - sectional study evaluated the sexual function among 384 women attending in health care centers of Ilam western of Iran during 2013. Participants were divided in two groups, fertilities and infertilities women. Data was collected by trained research midwives using demographic and FSFI questionnaires. SPSS software Package 16 was used to analyse the data of this project. Differences were regarded statistically significant with an alpha error of 0.05. Results The mean age was 29.29 6.7 years in fertile and 31.74 8.07 in infertile women. Significant difference was reported in mean age between fertile and infertile women (p=0.014). The Mean SD of all demissions of female sexual function was difference between fertile and infertile women. Sexual function was lower in infertile women. Conclusion All dimensions of sexual function were lower in infertile women in compared with fertile women. Further research should be done on this subject and ways to address such problems should be found. PMID:26155520

  5. Adoption, infertility, and the new reproductive technologies: problems and prospects for social work and welfare policy.

    PubMed

    Holbrook, S M

    1990-07-01

    In this article, the author examines the social and psychological issues raised by infertility and addresses problems resulting from the increasing commercialization of children through adoption practices as well as through the proliferation of new reproductive technologies. The author begins with a discussion of infertility and considers some aspects of adoption, the traditional solution to infertility. Some historical, technical, ethical, psychological, and social aspects of artificial insemination, along with newer developments of surrogacy, such as in vitro fertilization and frozen embryos, also are discussed. Recommendations are suggested for meeting the service needs of people who have problems associated with infertility. Finally, the author stresses the importance of research along with the necessity for social workers to take a leadership role in helping society both to understand the ethical issues related to and to develop enlightened public policy on infertility, adoption, and the new reproductive technologies. PMID:2203152

  6. Studying The Effect of Infertility on Marital Violence in Turkish Women

    PubMed Central

    Akyuz, Aygul; Seven, Memnun; ?ahiner, Gonul; Bilal, Bak?r

    2013-01-01

    Background: The aim of this descriptive study was to evaluate the level of marital violence among Turkish women and to determine whether infertility was a risk factor for marital violence. Materials and Methods: This descriptive study was conducted during January-July 2009 at a training hospital. The study groups comprised 204 fertile and 228 infertile women. We administered the Descriptive Information Questionnaire and Scale for Marital Violence against Women (SDVW) to obtain data. Results: There was a statistically significant difference between infertile and fertile women for the total score of violence in marriage. The emotional, economic and sexual violence scores were higher in the infertile group. However, the verbal violence score was lower Conclusion: We performed a detailed study aimed at uncovering the presence of any violence from the data collection stage to the end of treatment in infertile couples with the intent to include questions to this effect in the care plan. PMID:24520453

  7. Experimental methods to preserve male fertility and treat male factor infertility.

    PubMed

    Gassei, Kathrin; Orwig, Kyle E

    2016-02-01

    Infertility is a prevalent condition that has insidious impacts on the infertile individuals, their families, and society, which extend far beyond the inability to have a biological child. Lifestyle changes, fertility treatments, and assisted reproductive technology (ART) are available to help many infertile couples achieve their reproductive goals. All of these technologies require that the infertile individual is able to produce at least a small number of functional gametes (eggs or sperm). It is not possible for a person who does not produce gametes to have a biological child. This review focuses on the infertile man and describes several stem cell-based methods and gene therapy approaches that are in the research pipeline and may lead to new fertility treatment options for men with azoospermia. PMID:26746133

  8. AB30. Effects of varicocele on male infertility

    PubMed Central

    Tan, Yan

    2014-01-01

    Varicoceles are an abnormal dilation of the pampiniform plexus of veins within the scrotum. Varicoceles are highly prevalent and can result in a myriad of deleterious effects on male reproduction. Numerous therapeutic options are available for correcting varicoceles, including surgical varicocelectomy radiographic venous embolization. The current literature is reviewed in an effort to answer the questions that varicocelectomy is really beneficial in the treatment of male factor infertility. Based upon the analysis, conclusions can be drawn that varicocele may cause any variation of severity in spermiogram including azoospermia. The treatment of varicocele may significantly improve spermatogenesis and renew sperm production. Adequate treatment may spare the need for TESE as preparation for ICSI in >30% of azoospermic patients. Since achievement of pregnancy in IVF units is higher when spermatogenesis is better, the treatment of varicocele is an effective medical adjunct for IVF units prior to the treatment. In men with spermatogenic failure, freshly ejaculated sperm are easier to use, and fertilization ability in ICSI is higher with normal semen than with sperm retrieved by TESE. For bilateral clinical varicoceles, microsurgical repair is a favourable option for treating couples with male factor infertility.

  9. Human Papillomavirus Infection, Infertility, and Assisted Reproductive Outcomes

    PubMed Central

    Pereira, Nigel; Kucharczyk, Katherine M.; Estes, Jaclyn L.; Gerber, Rachel S.; Lekovich, Jovana P.; Elias, Rony T.; Spandorfer, Steven D.

    2015-01-01

    The human papillomavirus (HPV) is a sexually transmitted infection common among men and women across all geographic and socioeconomic subgroups worldwide. Recent evidence suggests that HPV infection may affect fertility and alter the efficacy of assisted reproductive technologies. In men, HPV infection can affect sperm parameters, specifically motility. HPV-infected sperm can transmit viral DNA to oocytes, which may be expressed in the developing blastocyst. HPV can increase trophoblastic apoptosis and reduce the endometrial implantation of trophoblastic cells, thus increasing the theoretical risk of miscarriage. Vertical transmission of HPV during pregnancy may be involved in the pathophysiology of preterm rupture of membranes and spontaneous preterm birth. In patients undergoing intrauterine insemination for idiopathic infertility, HPV infection confers a lower pregnancy rate. In contrast, the evidence regarding any detrimental impact of HPV infection on IVF outcomes is inconclusive. It has been suggested that vaccination could potentially counter HPV-related sperm impairment, trophoblastic apoptosis, and spontaneous miscarriages; however, these conclusions are based on in vitro studies rather than large-scale epidemiological studies. Improvement in the understanding of HPV sperm infection mechanisms and HPV transmission into the oocyte and developing blastocyst may help explain idiopathic causes of infertility and miscarriage. PMID:26609434

  10. Serum oestradiol levels in male partners of infertile couples.

    PubMed

    Hagiuda, J; Ishikawa, H; Marumo, K

    2015-08-01

    A prospective clinical study was performed in the reproduction centre of Ichikawa General Hospital (Chiba, Japan) to investigate the relationship between sperm quality and serum oestradiol (E2) level in male partners of infertile couples. The semen parameters and blood samples were assessed in relation to several variables, including body mass index (BMI) and serum oestradiol (E2) levels. Four hundred and nine male partners of infertile couples aged 22-55 years (mean: 36.5 years) were referred to the reproduction centre. In total, 143 patients (35.0%) were included in the low E2 level group (18 pg ml(-1) ? E2). Serum E2 levels were slightly correlated with testosterone levels, BMI and serum FSH levels. Total motile sperm count and morphology were decreased in low E2 level group. In multivariate analysis, serum testosterone, E2 levels, existence of varicocele and age were risk factors for decreased semen quality. Serum E2 might be associated with BMI, serum testosterone level and spermatogenesis. PMID:25059733

  11. A potential tool for diagnosis of male infertility: Plasma metabolomics based on GC-MS.

    PubMed

    Zhou, Xinyi; Wang, Yang; Yun, Yonghuan; Xia, Zian; Lu, Hongmei; Luo, Jiekun; Liang, Yizeng

    2016-01-15

    Male infertility has become an important public health problem worldwide. Nowadays the diagnosis of male infertility frequently depends on the results of semen quality or requires more invasive surgical intervention. Therefore, it is necessary to develop a novel approach for early diagnosis of male infertility. According to the presence or absence of normal sexual function, the male infertility is classified into two phenotypes, erectile dysfunction (ED) and semen abnormalities (SA). The aim of this study was to investigate the GC-MS plasma profiles of infertile male having erectile dysfunction (ED) and having semen abnormalities (SA) and discover the potential biomarkers. The plasma samples from healthy controls (HC) (n=61) and infertility patients with ED (n=26) or with SA (n=44) were analyzed by gas chromatography-mass spectrometry (GC-MS) for discrimination and screening potential biomarkers. The partial least squares-discriminant analysis (PLS-DA) was performed on GC-MS dataset. The results showed that HC could be discriminated from infertile cases having SA (AUC=86.96%, sensitivity=78.69%, specificity=84.09%, accuracy=80.95%) and infertile cases having ED (AUC=94.33%, sensitivity=80.33%, specificity=100%, accuracy=87.36%). Some potential biomarkers were successfully discovered by two commonly used variable selection methods, variable importance on projection (VIP) and original coefficients of PLS-DA (?). 1,5-Anhydro-sorbitol and ?-hydroxyisovaleric acid were identified as the potential biomarkers for distinguishing HC from the male infertility patients. Meanwhile, lactate, glutamate and cholesterol were the found to be the important variables to distinguish between patients with erectile dysfunction from those with semen abnormalities. The plasma metabolomics may be developed as a novel approach for fast, noninvasive, and acceptable diagnosis and characterization of male infertility. PMID:26592580

  12. Proteomic signatures of infertile men with clinical varicocele and their validation studies reveal mitochondrial dysfunction leading to infertility.

    PubMed

    Agarwal, Ashok; Sharma, Rakesh; Samanta, Luna; Durairajanayagam, Damayanthi; Sabanegh, Edmund

    2016-01-01

    To study the major differences in the distribution of spermatozoa proteins in infertile men with varicocele by comparative proteomics and validation of their level of expression. The study-specific estimates for each varicocele outcome were combined to identify the proteins involved in varicocele-associated infertility in men irrespective of stage and laterality of their clinical varicocele. Expression levels of 5 key proteins (PKAR1A, AK7, CCT6B, HSPA2, and ODF2) involved in stress response and sperm function including molecular chaperones were validated by Western blotting. Ninety-nine proteins were differentially expressed in the varicocele group. Over 87% of the DEP involved in major energy metabolism and key sperm functions were underexpressed in the varicocele group. Key protein functions affected in the varicocele group were spermatogenesis, sperm motility, and mitochondrial dysfunction, which were further validated by Western blotting, corroborating the proteomics analysis. Varicocele is essentially a state of energy deprivation, hypoxia, and hyperthermia due to impaired blood supply, which is corroborated by down-regulation of lipid metabolism, mitochondrial electron transport chain, and Krebs cycle enzymes. To corroborate the proteomic analysis, expression of the 5 identified proteins of interest was validated by Western blotting. This study contributes toward establishing a biomarker "fingerprint" to assess sperm quality on the basis of molecular parameters. PMID:26732106

  13. Proteomic signatures of infertile men with clinical varicocele and their validation studies reveal mitochondrial dysfunction leading to infertility

    PubMed Central

    Agarwal, Ashok; Sharma, Rakesh; Samanta, Luna; Durairajanayagam, Damayanthi; Sabanegh, Edmund

    2016-01-01

    To study the major differences in the distribution of spermatozoa proteins in infertile men with varicocele by comparative proteomics and validation of their level of expression. The study-specific estimates for each varicocele outcome were combined to identify the proteins involved in varicocele-associated infertility in men irrespective of stage and laterality of their clinical varicocele. Expression levels of 5 key proteins (PKAR1A, AK7, CCT6B, HSPA2, and ODF2) involved in stress response and sperm function including molecular chaperones were validated by Western blotting. Ninety-nine proteins were differentially expressed in the varicocele group. Over 87% of the DEP involved in major energy metabolism and key sperm functions were underexpressed in the varicocele group. Key protein functions affected in the varicocele group were spermatogenesis, sperm motility, and mitochondrial dysfunction, which were further validated by Western blotting, corroborating the proteomics analysis. Varicocele is essentially a state of energy deprivation, hypoxia, and hyperthermia due to impaired blood supply, which is corroborated by down-regulation of lipid metabolism, mitochondrial electron transport chain, and Krebs cycle enzymes. To corroborate the proteomic analysis, expression of the 5 identified proteins of interest was validated by Western blotting. This study contributes toward establishing a biomarker “fingerprint” to assess sperm quality on the basis of molecular parameters. PMID:26732106

  14. Infertility etiologies are genetically and clinically linked with other diseases in single meta-diseases.

    PubMed

    Tarín, Juan J; García-Pérez, Miguel A; Hamatani, Toshio; Cano, Antonio

    2015-01-01

    The present review aims to ascertain whether different infertility etiologies share particular genes and/or molecular pathways with other pathologies and are associated with distinct and particular risks of later-life morbidity and mortality. In order to reach this aim, we use two different sources of information: (1) a public web server named DiseaseConnect ( http://disease-connect.org ) focused on the analysis of common genes and molecular mechanisms shared by diseases by integrating comprehensive omics and literature data; and (2) a literature search directed to find clinical comorbid relationships of infertility etiologies with only those diseases appearing after infertility is manifested. This literature search is performed because DiseaseConnect web server does not discriminate between pathologies emerging before, concomitantly or after infertility is manifested. Data show that different infertility etiologies not only share particular genes and/or molecular pathways with other pathologies but they have distinct clinical relationships with other diseases appearing after infertility is manifested. In particular, (1) testicular and high-grade prostate cancer in male infertility; (2) non-fatal stroke and endometrial cancer, and likely non-fatal coronary heart disease and ovarian cancer in polycystic ovary syndrome; (3) osteoporosis, psychosexual dysfunction, mood disorders and dementia in premature ovarian failure; (4) breast and ovarian cancer in carriers of BRCA1/2 mutations in diminished ovarian reserve; (5) clear cell and endometrioid histologic subtypes of invasive ovarian cancer, and likely low-grade serous invasive ovarian cancer, melanoma and non-Hodgkin lymphoma in endometriosis; and (6) endometrial and ovarian cancer in idiopathic infertility. The present data endorse the principle that the occurrence of a disease (in our case infertility) is non-random in the population and suggest that different infertility etiologies are genetically and clinically linked with other diseases in single meta-diseases. This finding opens new insights for clinicians and reproductive biologists to treat infertility problems using a phenomic approach instead of considering infertility as an isolated and exclusive disease of the reproductive system/hypothalamic-pituitary-gonadal axis. In agreement with a previous validation analysis of the utility of DiseaseConnect web server, the present study does not show a univocal correspondence between common gene expression and clinical comorbid relationship. Further work is needed to untangle the potential genetic, epigenetic and phenotypic relationships that may be present among different infertility etiologies, morbid conditions and physical/cognitive traits. PMID:25880215

  15. Rare chromosomal, genetic, and epigenetic-related risks associated with infertility treatment.

    PubMed

    Kurinczuk, Jennifer J; Bhattacharya, Siladitya

    2014-08-01

    This article reviews the rarer chromosomal, genetic, and epigenetic-related risks of adverse child outcomes associated with infertility and its treatment. Excess structural chromosomal anomalies have been found in both male and female partners undergoing infertility treatment, and these risk direct transmission to offspring. Microdeletions of the Y-chromosome associated with male infertility have been transmitted to sons following treatment with intracytoplasmic sperm injection. It is thus possible that male offspring of men with infertility could experience fertility problems in adulthood. Infertility treatment for men with cystic fibrosis, or with congenital bilateral absence of the vas deferens in the absence of cystic fibrosis, who have azoospermia is now possible using surgically retrieved sperm. Transmission of known cystic fibrosis mutations can be avoided by testing the female partner prior to treatment and offering pre-implantation genetic diagnosis if she is a carrier. The effect of infertility and its treatment on genomic imprinting is of increasing concern as our understanding of the mechanisms of imprinting in germ cell development and embryogenesis expands. At present, it is far from clear whether there are longstanding effects of infertility per se or of its treatment on the health of adults who were conceived following assisted reproductive technologies, but available data suggest that this should be of concern and long-term follow-up studies are required. PMID:24893827

  16. Joint effect of glutathione S-transferase genotypes and cigarette smoking on idiopathic male infertility.

    PubMed

    Yarosh, S L; Kokhtenko, E V; Churnosov, M I; Solodilova, M A; Polonikov, A V

    2015-11-01

    Inconsistent results of association studies investigated the role of glutathione S-transferase genes in idiopathic male infertility may be explained by ethnical differences in gene-gene and gene-environment interactions. In this study, we investigated a joint contribution of GSTM1, GSTT1 and GSTP1 gene polymorphisms and cigarette smoking to the risk of idiopathic infertility in Russian men. DNA samples from 203 infertile and 227 fertile men were genotyped by a multiplex polymerase chain reaction (GSTM1 and GSTT1 deletions) and PCR-restriction fragment length polymorphism (GSTP1 I105V) methods. The GSTP1 genotype 105IV was associated with increased risk of male infertility (OR = 1.50 95% CI 1.02-2.20 P = 0.04). Genotype combinations GSTP1 105II/GSTT1 del (G1), GSTM1 del/GSTT1 del (G2) and GSTM1 + /GSTT1 del (G3) were associated with decreased risk of male infertility (P ? 0.003), whereas a genotype combination GSTP1 105IV/GSTT1 + (G4) was associated with increased disease risk (P = 0.001). The genotype combinations G3 and G4 showed a significant association with infertility in smokers; however, nonsmokers carriers did show the disease risk. In conclusion, GSTM1, GSTT1 and GSTP1 genes are collectively involved in the development of idiopathic male infertility and their phenotypic effects on the disease risk are potentiated by cigarette smoking. PMID:25348056

  17. Role of genetic mutations in folate-related enzyme genes on Male Infertility

    PubMed Central

    Liu, Kang; Zhao, Ruizhe; Shen, Min; Ye, Jiaxin; Li, Xiao; Huang, Yuan; Hua, Lixin; Wang, Zengjun; Li, Jie

    2015-01-01

    Several studies showed that the genetic mutations in the folate-related enzyme genes might be associated with male infertility; however, the results were still inconsistent. We performed a meta-analysis with trial sequential analysis to investigate the associations between the MTHFR C677T, MTHFR A1298C, MTR A2756G, MTRR A66G mutations and the MTHFR haplotype with the risk of male infertility. Overall, a total of 37 studies were selected. Our meta-analysis showed that the MTHFR C677T mutation was a risk factor for male infertility in both azoospermia and oligoasthenoteratozoospermia patients, especially in Asian population. Men carrying the MTHFR TC haplotype were most liable to suffer infertility while those with CC haplotype had lowest risk. On the other hand, the MTHFR A1298C mutation was not related to male infertility. MTR A2756G and MTRR A66G were potential candidates in the pathogenesis of male infertility, but more case-control studies were required to avoid false-positive outcomes. All of these results were confirmed by the trial sequential analysis. Finally, our meta-analysis with trial sequential analysis proved that the genetic mutations in the folate-related enzyme genes played a significant role in male infertility. PMID:26549413

  18. Are superoxide dismutase 2 and nitric oxide synthase polymorphisms associated with idiopathic infertility?

    PubMed

    Faure, Celine; Leveille, Pauline; Dupont, Charlotte; Julia, Chantal; Chavatte-Palmer, Pascale; Sutton, Angela; Levy, Rachel

    2014-08-01

    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. PMID:24444339

  19. Genome-Wide Identification of Chlamydia trachomatis Antigens Associated with Tubal Factor Infertility

    PubMed Central

    Rodgers, Allison K.; Budrys, Nicole M.; Gong, Siqi; Wang, Jie; Holden, Alan; Schenken, Robert S.; Zhong, Guangming

    2011-01-01

    Objective To identify C. trachomatis antigens that can be used to differentially diagnose tubal factor infertility in comparison to previously reported Heat Shock Protein 60 (HSP60). Design In Vitro Study Patients Infertile women with and without tubal pathology diagnosed laparoscopically. Setting Academic medical center. Main Outcome Measures Antibody responses to C. trachomatis in infertile women with or without tubal pathologies using a C. trachomatis genome-wide proteome array. Results Comparison of the antibody profiles revealed 30 C. trachomatis antigens that were preferentially recognized by tubal factor infertility women with a detection sensitivity and specificity of 80.6% and 56.5%, respectively, 10 of which showed 100% specificity. A combination of CT443 and CT381 antigens yielded the highest detection sensitivity (67.7%) while maintaining 100% specificity. Conclusion These findings have demonstrated that antibodies to CT443 and CT381, when used in combination, have higher sensitivity and specificity in predicting tubal factor infertility than other indicators for tubal factor infertility such as HSP60 antibodies (35.5%, 100%) or hysterosalpingogram (65%, 83%). Using a panel of C. trachomatis antigens to serologically diagnose tubal factor infertility can save the patients from undertaking expensive and invasive procedures for determining tubal pathology and choosing treatment plans. PMID:21742324

  20. Chlamydia trachomatis Antigens Recognized by Women With Tubal Factor Infertility, Normal Fertility, and Acute Infection

    PubMed Central

    Budrys, Nicole M.; Gong, Siqi; Rodgers, Allison K.; Wang, Jie; Louden, Christopher; Shain, Rochelle; Schenken, Robert S.; Zhong, Guangming

    2015-01-01

    Objective To identify Chlamydia trachomatis antigens associated with tubal factor infertility and acute infection. Methods A C. trachomatis proteome array was used to compare antibody profiles among women with tubal factor infertility, normal fertility, and acute C. trachomatis infection. Results Thirteen immunodominant antigens reacted with 50% or more sera from all women (N=73). Six C. trachomatis antigens were uniquely recognized by women diagnosed with tubal factor infertility. Combining fragmentation of the six antigens with serum sample dilution, chlamydial antigens HSP60, CT376, CT557, and CT443 could discriminate between women with tubal factor infertility and women with normal fertility with a sensitivity of 63% (95% CI: 0.410.77) and specificity of 100% (95% CI: 0.911), respectively. These antigens were designated as tubal factor infertility-associated antigens. However, these tubal factor antigens were unable to distinguish tubal factor infertility patients from those with acute infection. A combination of CT875 and CT147 distinguished women with acute infection from all other C. trachomatis-exposed women with a detection sensitivity of 63% (95% CI: 0.410.77) and specificity of 100% (95% CI: 0.951), respectively. Thus, CT875 and CT147 were designated as acute infection-associated antigens. Conclusion A sequential screening of antibodies against panels of C. trachomatis antigens can be used to identify women with tubal factor infertility and acute C. trachomatis infection. PMID:22525912

  1. Role of genetic mutations in folate-related enzyme genes on Male Infertility.

    PubMed

    Liu, Kang; Zhao, Ruizhe; Shen, Min; Ye, Jiaxin; Li, Xiao; Huang, Yuan; Hua, Lixin; Wang, Zengjun; Li, Jie

    2015-01-01

    Several studies showed that the genetic mutations in the folate-related enzyme genes might be associated with male infertility; however, the results were still inconsistent. We performed a meta-analysis with trial sequential analysis to investigate the associations between the MTHFR C677T, MTHFR A1298C, MTR A2756G, MTRR A66G mutations and the MTHFR haplotype with the risk of male infertility. Overall, a total of 37 studies were selected. Our meta-analysis showed that the MTHFR C677T mutation was a risk factor for male infertility in both azoospermia and oligoasthenoteratozoospermia patients, especially in Asian population. Men carrying the MTHFR TC haplotype were most liable to suffer infertility while those with CC haplotype had lowest risk. On the other hand, the MTHFR A1298C mutation was not related to male infertility. MTR A2756G and MTRR A66G were potential candidates in the pathogenesis of male infertility, but more case-control studies were required to avoid false-positive outcomes. All of these results were confirmed by the trial sequential analysis. Finally, our meta-analysis with trial sequential analysis proved that the genetic mutations in the folate-related enzyme genes played a significant role in male infertility. PMID:26549413

  2. Genetic variants in TP53 and MDM2 associated with male infertility in Chinese population.

    PubMed

    Huang, Cong; Liu, Wei; Ji, Gui-Xiang; Gu, Ai-Hua; Qu, Jian-Hua; Song, Ling; Wang, Xin-Ru

    2012-09-01

    The TP53, a transcriptional regulator and tumor suppressor, is functionally important in spermatogenesis. MDM2 is a key regulator of the p53 pathway and modulates p53 activity. Both proteins have been functionally linked to germ cell apoptosis, which may affect human infertility, but very little is known on how common polymorphisms in these genes may influence germ cell apoptosis and the risk of male infertility. Thus, this study was designed to test whether three previously described polymorphisms 72Arg>Pro (rs1042522) and the Ex2+19C>T (rs2287498) in TP53, and the 5' untranslated region (5' UTR) 309T>G (rs937283) in MDM2, are associated with idiopathic male infertility in a Chinese population. The three polymorphisms were genotyped using OpenArray assay in a hospital-based case-control study, including 580 infertile patients and 580 fertile controls. Our analyses revealed that TP53 Ex2+19C>T and MDM2 309T>G polymorphisms are associated with male infertility. Furthermore, we detected a nearly statistically significant additive interaction between TP53 rs2287498 and MDM2 rs937283 for the development of male infertility (P(interaction)=0.055). In summary, this study found preliminary evidence, demonstrating that genetic variants in genes of the TP53 pathway are risk factors for male infertility. PMID:22773013

  3. Psychological Disturbances and Quality of Life in Obese and Infertile Women and Men

    PubMed Central

    Kocełak, Piotr; Chudek, Jerzy; Naworska, Beata; Bąk-Sosnowska, Monika; Kotlarz, Barbara; Mazurek, Monika; Madej, Paweł; Skrzypulec-Plinta, Violetta; Skałba, Piotr; Olszanecka-Glinianowicz, Magdalena

    2012-01-01

    Anovulatory cycles and endometriosis are the main causes of female infertility. The most frequently anovulatory cycles are related to polycystic ovary syndrome (PCOS) commonly associated with obesity and hormonal disturbances in the course of obesity. Recently published studies revealed that infertility affects about one in six couples during their lifetime and is more frequent in obese. Obesity is also associated with male infertility related to erectile dysfunction, hormonal disturbances and lower semen quality. Any of these above mentioned disorder is the important risk factor of psychological disturbances and poor quality of life among women and men in the reproductive age. On the other hand the mood disorders may exacerbate the hormonal disturbances and worsen the effectiveness of infertility management. Infertility, its therapy with accompanying psychological disturbances may also significantly affect the partners relationships. The review summarize the results described in the current literature on the association between obesity and infertility and psychological disturbances as well as their impact on quality of life and sexual functioning in women and men. Moreover, the impact of infertility and psychological disturbances on partners relationships is discussed. PMID:22844280

  4. The Effect of Marital Violence on Infertility Distress among A Sample of Turkish Women

    PubMed Central

    Akyz, Aygl; ?ahiner, Gnl; Seven, Memnun; Bak?r, Bilal

    2014-01-01

    Background: The aim of this study was to determine the relationship between marital violence and distress level among women with a diagnosis of infertility. Materials and Methods: This cross-sectional study consisted of 139 married women diagnosed as primary infertile who applied to an in vitro fertilization (IVF) center in Turkey, between September and December 2009. A descriptive information questionnaire developed by the researcher was used for data collection. In addition, an infertility distress scale (IDS) for determining the severity effect of infertility and the scale for marital violence against women (SDVW) for determining level of marital violence against the women were used. Results: The total IDS score of the study sample was 37.76 10.53. There was no significant relationship between the age and education level of the women and the total IDS score. The total IDS score was higher in women who did not work and those being treated for infertility for more than three years. The total SDVW score of the study sample was 67.0 8.26. The total SDVW score was higher in women who had been trying to have a child for more than six years and had received infertility treatment for longer than three years. The employment status of the women and physical, emotional, and sexual violence scores had a statistically significant relationship with the IDS scores. The emotional violence score was found to have the highest significance among the variables affecting total IDS score. Conclusion: Marital violence is a factor increasing the distress of infertile women. Healthcare staff serving infertile couples should consider the possibility of domestic violence against women as a factor affecting the psychological infertility distress level. PMID:24696770

  5. Prospective study of MTHFR genetic polymorphisms as a possible etiology of male infertility.

    PubMed

    Li, S-S; Li, J; Xiao, Z; Ren, A-G; Jin, L

    2014-01-01

    The aim of this study was to explore the relationship between 2 genetic polymorphisms of the methylenetetrahydrofolate reductase gene (MTHFR), C677T and A1298C, and determine the long-term reproductive outcome in infertile men. This was a prospective study conducted in an andrology clinic. Men with a 1-year history of infertility were assessed for the MTHFR polymorphisms at a 5-year follow-up. We compared the MTHFR C677T and A1298C polymorphisms by polymerase chain reaction-restriction fragment length polymorphism between men who did and did not bear children during follow-up. Of the 215 men who were infertile at 1 year, 82 (38.1%) remained infertile and 133 (61.9%) achieved natural conception during the 5-year follow-up, with the highest rate in the first year (32.6%). The MTHFR 677TT genotype (homozygote) was associated with a substantially increased risk of infertility during follow-up [odds ratio (OR) = 10.242; 95% confidence interval (CI) = 1.257-83.464] relative to the MTHFR 677CC genotype (wild-type). Risk of infertility was not increased by the MTHFR A1298C polymorphism alone, but was increased by the combination of polymorphisms MTHFR C677T and MTHFR A1298C (OR = 11.818; 95%CI = 1.415-98.674). The homozygous MTHFR C677T genotype was a risk factor for male infertility during 5-year follow-up, whereas a correlation between MTHFR A1298C and infertility was not observed. The MTHFR C677T and MTHFR A1298C polymorphisms had additive effects on male infertility. PMID:24737513

  6. Infertility caused by tubal blockage: An ayurvedic appraisal

    PubMed Central

    Shukla (Upadhyaya), Kamayani; Karunagoda, Kaumadi; Dei, L. P.

    2010-01-01

    Tubal blockage is one of the most important factors for female infertility. This condition is not described in Ayurvedic classics, as the fallopian tube itself is not mentioned directly there. The present study is an effort to understand the disease according to Ayurvedic principles. Correlating fallopian tubes with the Artavavaha (Artava-bija-vaha) Srotas, its block is compared with the Sanga Srotodushti of this Srotas. Charak's opinion that the diseases are innumerable and newly discovered ones should be understood in terms of Prakriti, Adhishthana, Linga, and Aayatana, is followed, to describe this disease. An effort has been made to evaluate the role of all the three Doshas in producing blockage, with classification of the disease done as per the Dasha Roganika. PMID:22131704

  7. Infertility today: the management of female medical causes.

    PubMed

    Tinneberg, Hans-Rudolf; Gasbarrini, Antonio

    2013-12-01

    It has to be suspected that some environmentally hazardous substances have genotoxic properties, revealing their reproductive toxicity at a later stage only. Cancer, including childhood cancer, is more common than usually expected. Undesirable side effects of surgery, chemotherapy, and/or radiation can be premature ovarian failure or even premature menopause. In cases of autoimmune disease, autoantibodies can directly affect maturation of oocytes in the follicle, fertilization, and implantation. Spontaneous abortions are more common in patients with autoimmune disease. Thrombophilia is known to display a higher rate of spontaneous abortions as well as pre-eclampsia and intrauterine growth retardation. Infections are a common threat to pregnancy. Metabolic syndrome is increasingly frequent in western countries and often associated with hyperandrogenemia and polycystic disease. Women with inflammatory bowel disease such as Crohn disease or ulcerative colitis usually have no problems conceiving. In conclusion, even though infertility is a multifactorial disease, various medical and non-medical conditions can be attributed to it. PMID:24140222

  8. Halachic infertility: rabbis, doctors, and the struggle over professional boundaries.

    PubMed

    Ivry, Tsipy

    2013-01-01

    This article analyzes a public controversy surrounding the hormonal treatment of infertility associated with observance of rabbinic law to illuminate the reach of rabbi-doctor relations in a local configuration of religion and biomedicine that I call "kosher medicine." I combine a historical perspective on the evolution of religious laws governing menstruation, and the rabbi-doctor relations with a contemporary ethnography of these relations and laws to illuminate the interplay of continuities, discontinuities, tradition, and modernity and their uses and abuses in the contemporary mode of interpenetration between observant Judaism and biomedicine. The controversy highlights asymmetric permeations into biomedical and rabbinic professional domains. Collaborations persist as long as doctors who declare their incompetence in rabbinic law accommodate to demands of rabbis who are expert in it and also claim competence to challenge medical decisions. Once a doctor demonstrates competence in rabbinic law to challenge rabbinic directives a crisis develops. PMID:23557006

  9. [Moving forward to overcome infertility after breast cancer treatment].

    PubMed

    Tamura, Nobuko; Shimizu, Chikako

    2015-03-01

    An increase in the number of young women with breast cancer together with improved outcomes after breast cancer treatments have lead healthcare providers and society in general to become more aware of fertility preservation. The potential for infertility caused by cancer treatment is one of the most important quality-of-life issues for young women with cancer, and guidelines and decision-aids to support those who wish to have children after cancer treatment have been developed. To move forward, a prospective database needs to be developed in order to overcome safety concerns, and to allow network building among breast oncologists and reproductive specialists. A multidisciplinary team is also urgently needed to address psychosocial and ethical issues. PMID:25812495

  10. The Invention of Infertility in the Classical Greek World:

    PubMed Central

    Flemming, Rebecca

    2013-01-01

    Summary The article examines the understandings of, and responses to, reproductive failure in the classical Greek world. It discusses explanations and treatments for non-procreation in a range of ancient Greek medical texts, focusing on the writings of the Hippocratic Corpus, which devote considerable energy to matters of fertility and generation, and places them alongside the availability of a divine approach to dealing with reproductive disruption, the possibility of asking various deities, including the specialist healing god Asclepius, for assistance in having children. Though the relations between these options are complex, they combine to produce a rich remedial array for those struggling with childlessness, the possibility that any impediment to procreation can be removed. Classical Greece, rather than the nineteenth century, or even 1978, is thus the time when “infertility,” understood as an essentially reversible somatic state, was invented. PMID:24362276

  11. Relationship amongst teratozoospermia, seminal oxidative stress and male infertility

    PubMed Central

    2014-01-01

    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?

  12. Novel methods of treating ovarian infertility in older and POF women, testicular infertility, and other human functional diseases.

    PubMed

    Bukovsky, Antonin

    2015-01-01

    In vitro maturation (IVM) and in vitro fertilization (IVF) technologies are facing with growing demands of older women to conceive. Although ovarian stem cells (OSCs) of older women are capable of producing in vitro fresh oocyte-like cells (OLCs), such cells cannot respond to IVM and IVF due to the lack of granulosa cells required for their maturation. Follicular renewal is also dependent on support of circulating blood mononuclear cells. They induce intermediary stages of meiosis (metaphase I chromosomal duplication and crossover, anaphase, telophase, and cytokinesis) in newly emerging ovarian germ cells, as for the first time demonstrated here, induce formation of granulosa cells, and stimulate follicular growth and development. A pretreatment of OSC culture with mononuclear cells collected from blood of a young healthy fertile woman may cause differentiation of bipotential OSCs into both developing germ and granulosa cells. A small blood volume replacement may enable treatment of ovarian infertility in vivo. The transferred mononuclear cells may temporarily rejuvenate virtually all tissues, including improvement of the function of endocrine tissues. Formation of new follicles and their development may be sufficient for IVM and IVF. The novel proposed in vitro approaches may be used as a second possibility. Infertility of human males affects almost a half of the infertility cases worldwide. Small blood volume replacement from young healthy fertile men may also be easy approach for the improvement of sperm quality in older or other affected men. In addition, body rejuvenation by small blood volume replacement from young healthy individuals of the same sex could represent a decline of in vitro methodology in favor of in vivo treatment for human functional diseases. Here we propose for the first time that blood mononuclear cells are essential for rejuvenation of those tissues, where immune system components participate in an appropriate division and differentiation of tissue stem cells. If needed, small blood volume replacement from distinct young healthy individuals could be utilized in six month intervals for repair of young altered or aged reproductive and other tissue functions. Systemic and local use of honey bee propolis tincture is an alternative option for functional rejuvenation of some tissues. PMID:25889983

  13. Mitochondrial DNA mutations may not be frequent in asthenospermic infertile men.

    PubMed

    Wang, Junkai; Chen, Jie; Cui, Xingang; Liu, Yushan; Yin, Lei; Li, Yao; Chen, Lu; Xu, Danfeng; Gao, Yi

    2016-03-01

    Mutations in mitochondrial DNA were implicated to be associated with male infertility. Due to its high mutation rate, mtDNA defects may occur at any nucleotide of its 16,569 bp sequence. In this study, we analyzed a recent paper concerning the role of mtDNA variations in asthenospermic infertile men, we found that mtDNA mutation was a frequent event in male infertility. However, some polymorphisms in gene encoding mt-tRNAs were mislabelled as "pathogenic mutations". We also discussed the potential pitfalls and mistakes in mitochondrial medicine studies. PMID:25103428

  14. Experiences of Infertility in British and Pakistani Women: A Cross-Cultural Qualitative Analysis.

    PubMed

    Batool, Syeda Shahida; de Visser, Richard Oliver

    2016-02-01

    The psychosocial impact of infertility is affected by cultural factors. In this cross-cultural qualitative study we explored the experience of infertility among six women living in Pakistan and eight living in the UK. Although infertile women in the UK and Pakistan had many shared experiences related to their own desires for motherhood and the hopes of others, they also faced unique psychosocial challenges shaped by cultural context. Based on our findings, we suggest a need for further resources and networks to support women, particularly women living in cultures that allow women few fulfilling social roles other than motherhood. PMID:25535774

  15. Health related quality of life among different PCOS phenotypes of infertile women

    PubMed Central

    Dilbaz, Berna; ?nar, Mehmet; zkaya, Enis; Tonyal?, Nazan Vanl?; Dilbaz, Serdar

    2012-01-01

    Objective: The aim of this study was to evaluate the clinical features and health quality profile differences between infertile women with polycystic ovary syndrome (PCOS) phenotypes and women with unexplained infertility. Material and Methods: The WHOQOL-BREF were administered in a cross-sectional survey to 132 women diagnosed with PCOS (study group) and 32 women diagnosed with unexplained infertility (control group). Body mass index (BMI), duration of infertility (DOI), type of infertility (TOI) and Ferriman Gallwey scores (FG scores), were compared between the study and control groups and between different phenotype groups of PCOS: Group 1-Hyperandrogenemia (HA)-anovulation (N=34), Group 2-HA-PCO (ovulatory PCOS, (N=34), Group 3-PCO-anovulation (N=32), and Group 4-HA-PCO-anovulation (N=32) and the associations of these parameters with the health quality profile were analyzed. Results: Physical, Spiritual and Environmental scores were significantly lower (p<0.05) in Group 1 patients (HA-AO) in comparison to the other three PCOS groups and the control group, while the same difference was observed in the social scores with a near significance (p=0.05). Linear regeression analyses revealed significant associations between type of infertility (beta coefficient: ?0.423, p=0.001), FG score (beta coefficient: ?0.177, p=0.016), phenotype 1 (beta coefficient: ?0.236, p=0.002) and physical scores. Psychological scores were associated with the type (beta coefficient: ?0.641, p=0.001) and duration (beta coefficient: ?0.149, p=0.009) of infertility. Scores in the social area were only associated with type of infertility (beta coefficient: ?0.443, p=0.001). Scores of environmental area were significantly associated again with the type of infertility (beta coefficient: ?0.499, p=0.001) and FG scores (beta coefficient: ?0.195, p=0.008). Primary infertility was a risk factor for low physical (odds ratio: 8.100, 95% CI: 3.82717.142), social (odds ratio: 9.183, 95% CI: 4.08420.648) and environmental (odds ratio: 9.966, 95% CI: 4.62321.468) scores determined according to the median level. Conclusion: FG scores, primary infertility and phenotype 1 PCOS were associated with lower health quality of life scores. Infertile women with Phenotype 1 (HA-AO) had the lowest scores. PMID:24592051

  16. Differential protein expression in seminal plasma from fertile and infertile males

    PubMed Central

    Cadavid J, Angela P.; Alvarez, Angela; Markert, Udo R.; Maya, Walter Cardona

    2014-01-01

    AIM: The aim of this study was to analyze human seminal plasma proteins in association with male fertility status using the proteomic mass spectrometry technology Surface-Enhanced Laser Desorption Ionization Time-of-Flight (SELDI-TOF-MS). MATERIALS AND METHODS: Semen analysis was performed using conventional methods. Protein profiles of the seminal plasma were obtained by SELDI-TOF mass spectrometry over a strong anion exchanger, ProteinChip Q10 array. RESULTS AND CONCLUSION: We found statistically significant differences in motility and sperm count between fertile and infertile men. In addition, we observed ten seminal proteins that are significantly up-regulated in the infertile group. In conclusion, comparison of seminal plasma proteome in fertile and infertile men provides new aspects in the physiology of male fertility and might help in identifying novel markers of male infertility. PMID:25395747

  17. Infertility Treatments Do Not Appear to Contribute to Developmental Delays in Children

    MedlinePLUS

    ... no risk by age 3 from in vitro fertilization, other widespread treatments. Children conceived via infertility treatments ... received: Assisted reproductive technology (ART), including: In vitro fertilization — fertilization in a laboratory dish, after eggs and ...

  18. "Spoiling the womb": definitions, aetiologies and responses to infertility in north west province, Cameroon.

    PubMed

    Richards, Sarah C

    2002-04-01

    Only one generation ago, the Cameroonian national population policy was pro-natalist, with great attention paid to the problem of sterility. Now, family planning is promoted nationwide to reduce population growth, and infertility is not addressed by public health policy or services. In contrast to the biomedical definition used by planners, at the local level infertility is defined as the inability to have a child when desired, and it has many causes including contraception, abortion and witchcraft. The young, less educated women especially are unlikely to use contraception as long as they feel susceptible to infertility, since their economic, social and psychological status hinge on their ability to have children. Drawing from epidemiological literature and qualitative data gathered in a market town in North West Province, I argue that a more balanced approach to reproductive health, one that recognises the importance of infertility, is critical for women's health and well-being. PMID:12476732

  19. Health-promoting Lifestyle and its Demographic Predictors in Infertile Couples Referred to Infertility Clinic of Tabriz Al-Zahra Hospital, 2013

    PubMed Central

    Mirghafourvand, Mojgan; Sehhati, Fahimeh; Rahimi, Mareieh

    2014-01-01

    Introduction: Improving the lifestyle of infertile couples led to the preservation of their performance, increase their quality of life, and reduce health cost. So, the aims of this study were to determine the health-promoting lifestyle and its predictors among infertile couples. Methods: In a cross-sectional, analytical study 322 infertile couples referred to an infertility clinic in Tabriz was participated with convenience sampling method. The demographic and the standard Health Promoting Lifestyle-II (HPLP II) questionnaires were completed by all couples individually. For determining the demographic predictors of health-promoting lifestyle, the multivariate linear regression was used. Results: The mean (standard deviation) score of health-promoting lifestyle in couples was 2.4 (0.4) of the achievable score ranged from 1 to 4. The highest mean score was for nutrition subscale 2.6 (0.5) in both men and women and the lowest mean score was for physical activity subscale in women 2.1(0.5) and men 2.3(0.5) and health responsibility subscale (2.3(0.5) in both men and women. Educational level, cause of infertility, adequacy of income for living expense, and living situation were predictors of health-promoting lifestyle. Conclusion: The results showed that participants do not carry out all health-promoting behaviors, especially physical activity and health responsibility, in an acceptable level. These behaviors have an important role in improving the quality of life, health maintenance, and fertility. Thus, the provision of strategies, including those in accordance with predictors of health-promoting behaviors, is important for improving the health status of infertile couples. PMID:25276761

  20. The risk of infertility and delayed conception associated with exposures in the Danish workplace

    SciTech Connect

    Rachootin, P.; Olsen, J.

    1983-05-01

    The association between infertility and a number of occupations and occupational exposures was examined in a case-control study utilizing data collected from medical records and mailed questionnaires. The results suggest that male exposure to heat and female exposure to noise, textile dyes and lead, mercury, and cadmium are associated with infertility. Further research is needed to examine the entire spectrum of abnormal reproductive and developmental outcomes of exposure to these agents and to identify their full effects.

  1. Improving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement

    PubMed Central

    Legro, Richard S.; Wu, Xiaoke; Barnhart, Kurt T.; Farquhar, Cynthia; Fauser, Bart C.J.M.; Mol, Ben

    2014-01-01

    Clinical trials testing infertility treatments often do not report on the major outcomes of interest to patients and clinicians and the public (such as live birth) nor on the harms, including maternal risks during pregnancy and fetal anomalies. This is complicated by the multiple participants in infertility trials which may include a woman (mother), a man (father), and result in a third individual if successful, their offspring (child), who is also the desired outcome of treatment. The primary outcome of interest and many adverse events occur after cessation of infertility treatment and during pregnancy and the puerperium, which create a unique burden of follow-up for clinical trial investigators and participants. In 2013, because of the inconsistencies in trial reporting and the unique aspects of infertility trials not adequately addressed by existing Consolidated Standards of Reporting Trials (CONSORT) statements, we convened a consensus conference in Harbin, China, with the aim of planning modifications to the CONSORT checklist to improve the quality of reporting of clinical trials testing infertility treatment. The consensus group recommended that the preferred primary outcome of all infertility trials is live birth (defined as any delivery of a live infant ?20 weeks gestations) or cumulative live birth, defined as the live birth per women over a defined time period (or number of treatment cycles). In addition, harms to all participants should be systematically collected and reported, including during the intervention, any resulting pregnancy, and during the neonatal period. Routine information should be collected and reported on both male and female participants in the trial. We propose to track the change in quality that these guidelines may produce in published trials testing infertility treatments. Our ultimate goal is to increase the transparency of benefits and risks of infertility treatments to provide better medical care to affected individuals and couples. PMID:25217611

  2. Birth characteristics in a clinical sample of women seeking infertility treatment: a casecontrol study

    PubMed Central

    Vikstrm, Josefin; Hammar, Mats; Josefsson, Ann; Bladh, Marie; Sydsj, Gunilla

    2014-01-01

    Objective To determine the distribution of low birth weight (LBW), preterm birth, small for gestational age (SGA) and large for gestational age (LGA) by main cause of infertility (female, combined, male, unexplained) in women seeking infertility treatment. Design A casecontrol study. Setting A Centre for Reproductive Medicine in Sweden. Participants All women (n=1293) born in Sweden in 1973 or later and who were part of heterosexual couples seeking infertility treatment at a Centre of Reproductive Medicine from 2005 to 2010 were asked to participate. Those who had not begun the diagnostic process and who declined participation in the study were excluded. In total, 1206 women (94.5%) participated in the study. Main outcome measures Main cause of infertility (female, combined, male, unexplained) collected from the patients medical charts. LBW (<2500?g), preterm birth (<37?weeks), SGA (+2SD of the mean weight for the gestational length), collected from the Swedish Medical Birth Register. Results The risk of being born with LBW was increased about 2.4 times (OR=2.40, CI 1.13 to 5.07, p=0.02) in women seeking treatment for infertility due to female causes rather than for male or unexplained causes. Women with a female infertility factor were 2.7 times more likely to be born SGA (OR=2.73, CI 1.02 to 7.34, p=0.047) compared with those in whom the cause of infertility was unexplained. Conclusions Women born with LBW or SGA seem to suffer an increased risk of infertility due to a female factor. Thus, infants born with birth characteristics that deviate from the norm may be at greater risk of difficulties in childbearing later on in life. Since this study is the first of its kind, more studies are needed to verify the associations found in this study and to determine their nature. PMID:24613821

  3. Clinical, epidemiological and socio-cultural aspects of infertility in resource-poor settings. Evidence from Rwanda

    PubMed Central

    Dhont, N.

    2011-01-01

    Infertility is a serious but entirely neglected public health problem in resource-poor countries. Most of the infertility is caused by infections and therefore potentially preventable. The problem of infertility in Rwanda has not been researched so far. We examined predictors for infertility and treatment-seeking behaviour in an unmatched case-control. We performed infertility investigations in all infertile couples and discussed consequences of infertility in focus group discussions. HSV-2 and HIV infection and sexual violence were the most important determinants of infertility. We found a higher HIV prevalence among couples in secondary and not primary infertile relationships with at least one HIV infected partner in 45% of these couples. Men in infertile relationships reported more frequently concurrent partners over the last year than fertile men. We found a high prevalence of tubal factor (70%) and male factor infertility (64%). Pregnancy rates (16%) were low after conventional therapy. Both men and women are unlikely to attribute infertility to the male partner. Participants reported a wide array of treatments they received in the past, often including ineffective or even harmful interventions. We demonstrated severe suffering as a consequence of infertility for both men and women but with women carrying the largest burden, similar to what is reported in other resource-poor countries. Overall, we can conclude that there is an urgent need for a more holistic approach towards reproductive health services in SSA, one that recognises the importance of reproductive failure. The link with HIV has important consequences for both HIV and reproductive health programs. PMID:24753853

  4. Efficacy of communication skills training workshop on sexual function in infertile women

    PubMed Central

    Fahami, Fariba; Pahlavanzadeh, Saeid; Asadi, Mahboobeh

    2015-01-01

    Background: Sexual function is reduced in an infertile woman. This study aimed to determine the effect of a communication skills training program on sexual function in infertile women referring to the medical centers in Isfahan in 2012. Materials and Methods: This study is a field trial study using control groups in which 32 infertile couples were selected by convenience sampling, and then, were randomly divided into control and training groups. Data were collected before (T1), 1 week after (T2), and 1 month after (T3) the training. In the intervention group, education was conducted in the form of five 3-h sessions, sequentially held with 1 week interval. Female Sexual Function Index (FISI) scale and Individual Fertility questionnaire were used to collect the data. Data were analyzed by descriptive statistical tests [t-test, analysis of variance (ANOVA), and least significant difference (LSD)]. Results: Communication skills training increased the sexual function in infertile women. ANOVA showed that women's sexual function was significantly greater in the intervention group compared to the control group, after training. LSD test showed no significant difference in sexual function in T2 and T3. Conclusions: Communication skills can have a significant impact on the sexual function of infertile couples, and communication skills training can improve the quality of marital life skills through the counseling sessions conducted with infertile couples. PMID:25878692

  5. X chromosome aneuploidy in infertile women: Analysis by interphase fluorescent in situ hybridization

    SciTech Connect

    Morris, M.A.; Moix, I.; Mermillod, B.

    1994-09-01

    Up to 1 in 3 couples have a problem of infertility at some time in their lives. Sex chromosome anomalies are found in 5-10% of couples, with mosaic aneuploidy being a common finding in primary infertility. Recurrent spontaneous abortion (RSA), in contrast, is frequently associated with autosomal structural anomalies. We hypothesized that low-level mosaic X chromosome aneuploidy was associated with primary infertility but not with RSA. Three groups were studied: women from couples with primary infertillity (n=26); women with three or more spontaneous abortions (n=22); and age-matched normally fertile women (at least two pregnancies; n=28). Interphase fluorescent in situ hybridization (FISH) was used to determine X chromosome ploidy in 100 nuclei per patient, using a contig of three cosmids from MAO locus (kindly donated by W. Berger, Nijmegen). A control probe (chr. 15 centromere) was simultaneously hybridized, and only nuclei containing two control signals were scored for the X chromosome. The mean numbers of nuclei with two X chromosome signals were the same in all groups (Welch equality of means test: p>0.97). However, there is a significant difference between the variances of the primary infertile and RSA groups (Levene`s test: p=0.025 after Bonferrone correction for multiple testing). This provides preliminary support for the hypothesis of an association between primary infertility and low-level mosaic X chromosome aneuploidy.

  6. The Social Consequences of Infertility among Iranian Women: A Qualitative Study

    PubMed Central

    Hasanpoor-Azghdy, Syedeh Batool; Simbar, Masoumeh; Vedadhir, Abouali

    2015-01-01

    Background Infertility may prevent couples to achieve the desired social roles and lead to some social and psychological problems. This study aimed to explain the social consequences of infertility in Iranian women seeking treatment. Materials and Methods A qualitative content analysis was conducted based on 32 semi-structured interviews with 25 women affected by primary and secondary infertility with no surviving children. The participants were purposefully selected with maximum variability from a fertility health research center in Tehran, Iran, from January to October 2012. Data were collected using semi-structured interviews and analyzed using the conventional content analysis method. Results Our findings indicate that the consequences of infertility are divided into five main categories: 1. violence including psychological violence and domestic physical violence, 2. marital instability or uncertainty, 3. social isolation including avoiding certain people or certain social events and self-imposed isolation from family and friends, 4. social exclusion and partial deprivation including being disregarded by family members and relatives and reducing social interactions with the infertile woman and 5. social alienation. Conclusion This study reveals that Iranian women with fertility issues seeking treatment face several social problems that could have devastating effects on the quality of their lives. It is, therefore, recommended that, in Iran, infertility is only considered as a biomedical issue of a couple and pay further attention to its sociocultural dimensions and consequences. PMID:25780523

  7. The genetics of human infertility by functional interrogation of SNPs in mice.

    PubMed

    Singh, Priti; Schimenti, John C

    2015-08-18

    Infertility is a prevalent health issue, affecting ?15% of couples of childbearing age. Nearly one-half of idiopathic infertility cases are thought to have a genetic basis, but the underlying causes are largely unknown. Traditional methods for studying inheritance, such as genome-wide association studies and linkage analyses, have been confounded by the genetic and phenotypic complexity of reproductive processes. Here we describe an association- and linkage-free approach to identify segregating infertility alleles, in which CRISPR/Cas9 genome editing is used to model putatively deleterious nonsynonymous SNPs (nsSNPs) in the mouse orthologs of fertility genes. Mice bearing "humanized" alleles of four essential meiosis genes, each predicted to be deleterious by most of the commonly used algorithms for analyzing functional SNP consequences, were examined for fertility and reproductive defects. Only a Cdk2 allele mimicking SNP rs3087335, which alters an inhibitory WEE1 protein kinase phosphorylation site, caused infertility and revealed a novel function in regulating spermatogonial stem cell maintenance. Our data indicate that segregating infertility alleles exist in human populations. Furthermore, whereas computational prediction of SNP effects is useful for identifying candidate causal mutations for diverse diseases, this study underscores the need for in vivo functional evaluation of physiological consequences. This approach can revolutionize personalized reproductive genetics by establishing a permanent reference of benign vs. infertile alleles. PMID:26240362

  8. Comparison of Sperm Parameters in Patients with Infertility Induced by Genital Infection versus Varicocele

    PubMed Central

    Pajovic, Bogdan; Dimitrovski, Antonio; Radojevic, Nemanja; Vukovic, Marko

    2015-01-01

    Background: Male infertility is a common and complex problem and, despite much research in this field, the major cause of infertility unfortunately remains unknown. Genital infection and varicocele are important causes of infertility. Aims: To compare the influence of genital infection and varicocele individually on male infertility based on semen analysis. Study Design: Cross-sectional study. Methods: The study included 120 infertile patients divided into two groups according to the presence of genital infection or varicocele. The first group included 60 examinees with proven genital infection, but without varicocele formation. The second included 60 patients with varicocele, regardless of the varicocele grade, but without genital infection. The fertile parameters were compared and an assessment was performed on the impact on quality of spermatogenesis due to infection and varicocele. Results: There is a statistically significant difference regarding abnormal forms of spermatozoids (45.949.79 vs. 25.276.54) and progressive motility (8.151.24 vs. 24.957.2), between two groups of patients. However, acidity of ejaculates, minimum sperm concentration, total spermatozoid motility and ejaculate volume showed no statistically significant difference. Conclusion: The study showed a stronger negative influence of genital infection on fertile parameters over varicocele. The significance of our study is the lack of contemporary researches comparing varicocele and genital infection influence on male infertility individually. PMID:26185712

  9. Antioxidants and infertility treatment, the role of Satureja Khuzestanica: A mini-systematic review

    PubMed Central

    Safarnavadeh, Tahereh; Rastegarpanah, Mansoor

    2011-01-01

    Background: The use of antioxidants in the treatment of infertility has been suggested and recent studies have indicated that oral administration of Satureja Khuzestanica essential oil (SKEO) to rats induces significant antioxidative effects. Objective: This systematic review was conducted to evaluate the effectiveness of antioxidants in infertility and also to assess the effectiveness of Satureja Khuzestanica in infertility management. Materials and Methods: Pubmed, Scopus, and Cochrane Library were searched for relevant trials published from respective database inception dates to August 2010. Study selection, and data extraction were performed by authors. Results: Fifteen trials on evaluation of antioxidants in infertility and seven studies on the effectiveness of Satureja Khuzestanica were identified. Only 4 of the 15 trials were with application of allocation concealment and three studies were done in in-vitro environment. Despite the methodological and clinical heterogeneity of the trials, 14 of the 15 (93.33%) trials showed an improvement in either sperm quality or pregnancy rate after antioxidant therapy. The human and animal studies of Satureja Khuzestanica showed a significant antioxidative potential of the plant and its effectiveness for infertility improvement. Conclusion: The use of oral antioxidants in infertility could improve sperm quality and pregnancy rates. Improved fertility observed by SKEO in rats might be due to its antioxidative effect. Further studies and clinical trials in humans are necessary to evaluate SKEO effectiveness in fertility disturbances. PMID:25587249

  10. The mediator role of emotion regulation processes on infertility-related stress.

    PubMed

    Galhardo, Ana; Cunha, M; Pinto-Gouveia, J; Matos, M

    2013-12-01

    The objective of this study is to investigate gender differences regarding the mediator role of self-compassion and self-judgment on the effects of external shame, internal shame, dyadic adjustment, on infertility-related stress. One hundred and sixty-two women and 147 men with a primary infertility diagnosis completed the following set of self-report measures: Others as Shamer, Experience of Shame Scale, Dyadic Adjustment Scale, Self-Compassion Scale, and Fertility Problem Inventory. Path analyses results revealed that in women self-compassion fully mediated the effect of internal shame on infertility-related stress and partially mediated the effect of dyadic adjustment on this variable, while external shame had only a direct effect. In men self-judgment fully mediated the effect of external and internal shame on infertility-related stress. Dyadic adjustment had only a direct effect on infertility-related stress. In conclusion, there is a distinct role of self-compassion and self-judgment on the relationship between shame and infertility-related stress in men and women. Such differences should be taken into account in psychological interventions with these patients. Future research is warranted to further support our results. PMID:23821009

  11. Seminal cyclooxygenase relationship with oxidative stress in infertile oligoasthenoteratozoospermic men with varicocele.

    PubMed

    Mostafa, T; Rashed, L; Taymour, M

    2016-03-01

    This study aimed to assess the relation of seminal cyclooxygenase COX-1, COX-2 with oxidative stress in infertile oligoasthenoteratozoospermic (OAT) men with varicocele (Vx). In all, 128 men were allocated into fertile men, fertile men with Vx, infertile OAT men without Vx and infertile OAT men with Vx. They were subjected to history taking, clinical examination and semen analysis. Also, seminal COX-1, COX-2, malondialdehyde (MDA) and glutathione peroxidase (GPx) were estimated. Mean levels of seminal COX-1, COX-2 were over-expressed, the mean level of seminal MDA was significantly increased, and the mean level of seminal GPx was significantly decreased in infertile OAT men with Vx compared with other groups. Seminal COX-1 and COX-2 were over-expressed in cases with Vx grade III compared with Vx grades I, II cases and in cases with bilateral Vx compared with unilateral Vx. There was significant negative correlation between seminal COX-1 and COX-2 with sperm concentration, sperm motility, sperm normal morphology, seminal GPx and significant positive correlation with seminal MDA. It is concluded that seminal COX-1 and COX-2 are over-expressed in infertile OAT men with Vx compared with fertile men with/without and infertile OAT men without Vx being associated with oxidative stress, Vx grade and Vx laterality. PMID:25906828

  12. Male sexual dysfunction and infertility associated with neurological disorders

    PubMed Central

    Fode, Mikkel; Krogh-Jespersen, Sheila; Brackett, Nancy L; Ohl, Dana A; Lynne, Charles M; Snksen, Jens

    2012-01-01

    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. PMID:22138899

  13. Clinical management of infertile men with nonobstructive azoospermia

    PubMed Central

    Esteves, Sandro C

    2015-01-01

    The clinical management of men with nonobstructive azoospermia (NOA) seeking fertility has been a challenge for andrologists, urologists, and reproductive medicine specialists alike. This review presents a personal perspective on the clinical management of NOA, including the lessons learned over 15 years dealing with this male infertility condition. A five-consecutive-step algorithm is proposed to manage such patients. First, a differential diagnosis of azoospermia is made to confirm/establish that NOA is due to spermatogenic failure. Second, genetic testing is carried out not only to detect the males in whom NOA is caused by microdeletions of the long arm of the Y chromosome, but also to counsel the affected patients about their chances of having success in sperm retrieval. Third, it is determined whether any intervention prior to a surgical retrieval attempt may be used to increase sperm production. Fourth, the most effective and efficient retrieval method is selected to search for testicular sperm. Lastly, state-of-art laboratory techniques are applied in the handling of retrieved gametes and cultivating the embryos resulting from sperm injections. A coordinated multidisciplinary effort is key to offer the best possible chance of achieving a biological offspring to males with NOA. PMID:25677138

  14. Infertility in reproductive-age female cancer survivors.

    PubMed

    Levine, Jennifer M; Kelvin, Joanne Frankel; Quinn, Gwendolyn P; Gracia, Clarisa R

    2015-05-15

    Improved survival rates among reproductive-age females diagnosed with cancer have increased the focus on long-term quality of life, including maintenance of the ability to conceive biological children. Cancer-directed therapies such as high-dose alkylating agents and radiation to the pelvis, which deplete ovarian reserve, radiation to the brain, which affects the hypothalamic-pituitary-gonadal axis, and surgical resection of reproductive structures can decrease the likelihood of having biological children. Standard fertility preservation strategies such as embryo and oocyte cryopreservation before the onset of therapy offer the opportunity to conserve fertility, but they may not be feasible because of the urgency to start cancer therapy, financial limitations, and a lack of access to reproductive endocrinologists. Ovarian tissue freezing is considered experimental, with limited data related to pregnancies, but it minimizes treatment delay. Studies evaluating gonadotropin-releasing hormone analogues have had mixed results, although a recent randomized, prospective study in women with breast cancer demonstrated a protective effect. Fertility preservation programs are increasingly being developed within cancer programs. In this article, we describe risks to infertility and options for preservation, raise psychosocial and ethical issues, and propose elements for establishing an effective fertility preservation program. PMID:25649243

  15. Acid soil infertility effects on peanut yields and yield components

    SciTech Connect

    Blamey, F.P.C.

    1983-01-01

    The interpretation of soil amelioration experiments with peanuts is made difficult by the unpredictibility of the crop and by the many factors altered when ameliorating acid soils. The present study was conducted to investigate the effects of lime and gypsum applications on peanut kernel yield via the three first order yield components, pods per ha, kernels per pod, and kernel mass. On an acid medium sandy loam soil (typic Plinthustult), liming resulted in a highly significant kernel yield increase of 117% whereas gypsum applications were of no significant benefit. As indicated by path coefficient analysis, an increase in the number of pods per ha was markedly more important in increasing yield than an increase in either the number of kernels per pod or kernel mass. Furthermore, exch. Al was found to be particularly detrimental to pod number. It was postulated that poor peanut yields resulting from acid soil infertility were mainly due to the depressive effect of exch. Al on pod number. Exch. Ca appeared to play a secondary role by ameliorating the adverse effects of exch. Al.

  16. Human sperm chromatin epigenetic potential: genomics, proteomics, and male infertility

    PubMed Central

    Castillo, Judit; Estanyol, Josep Maria; Ballesc, Josep Lluis; Oliva, Rafael

    2015-01-01

    The classical idea about the function of the mammalian sperm chromatin is that it serves to transmit a highly protected and transcriptionally inactive paternal genome, largely condensed by protamines, to the next generation. In addition, recent sperm chromatin genome-wide dissection studies indicate the presence of a differential distribution of the genes and repetitive sequences in the protamine-condensed and histone-condensed sperm chromatin domains, which could be potentially involved in regulatory roles after fertilization. Interestingly, recent proteomic studies have shown that sperm chromatin contains many additional proteins, in addition to the abundant histones and protamines, with specific modifications and chromatin affinity features which are also delivered to the oocyte. Both gene and protein signatures seem to be altered in infertile patients and, as such, are consistent with the potential involvement of the sperm chromatin landscape in early embryo development. This present work reviews the available information on the composition of the human sperm chromatin and its epigenetic potential, with a particular focus on recent results derived from high-throughput genomic and proteomic studies. As a complement, we provide experimental evidence for the detection of phosphorylations and acetylations in human protamine 1 using a mass spectrometry approach. The available data indicate that the sperm chromatin is much more complex than what it was previously thought, raising the possibility that it could also serve to transmit crucial paternal epigenetic information to the embryo. PMID:25926607

  17. Male infertility associated with multiple mitochondrial DNA rearrangements.

    PubMed

    Reynier, P; Chrtien, M F; Penisson-Besnier, I; Malthiry, Y; Rohmer, V; Lestienne, P

    1997-08-01

    Male sterility results from a number of characterized exogenous or genetic dysfunctions preventing normal differentiation into mobile spermatozoa. This may now be overcome by intra cytoplasmic sperm injection (ICSI). This practice does not require mobile, or even mature spermatozoa for in vitro fecondation. However, a functional respiratory chain, partly encoded by the mitochondrial DNA (mtDNA), is required for the mobility of the spermatozoa. We report the case of an infertile patient who wished to procreate. ICSI was proposed but he displayed multiple mtDNA deletions of possible nuclear origin in the spermatozoa and in the deltoid muscle. Even though mtDNA is maternally inherited, the possibility of a nuclear-driven mutation affecting the integrity of the mtDNA should be taken into account when ICSI is to be performed. Together with recent genetic in vitro manipulations in mammals, our data point to the importance of studying the mtDNA structure in human spermatozoa, and the potential risks of these non-natural practices for procreation. PMID:9337998

  18. Fellowship training and board certification in reproductive endocrinology and infertility.

    PubMed

    Gambone, Joseph C; Segars, James H; Cedars, Marcelle; Schlaff, William D

    2015-07-01

    Reproductive endocrinology and infertility (REI) is one of the original officially recognized subspecialties in obstetrics and gynecology and among the earlier subspecialties in medicine. Recognized by the American Board of Obstetrics and Gynecology in 1972, fellowship programs are now 3 years in length following an obstetrics and gynecology residency. Originally focused on endocrine problems related to reproductive function, the assisted reproductive technologies (ART) have recently become the larger part of training during REI fellowships. It is likely that the subspecialty of REI strengthens the specialty of obstetrics and gynecology and enhances the educational experience of residents in the field. The value of training and certification in REI is most evident in the remarkable and consistent improvement in the success of ART procedures, particularly in vitro fertilization. The requirement for documented research activity during REI fellowships is likely to stimulate a more rapid adoption (translation) of newer research findings into clinical care after training. Although mandatory reporting of outcomes has been proposed as a reason for this improvement the rapid translation of reproductive research into clinical practice is likely to be a major cause. Looking forward, REI training should emphasize and strengthen education and research into the endocrine, environmental, and genetic aspects of female and male reproduction to improve the reproductive health and fertility of all women. PMID:26048151

  19. Clinical management of infertile men with nonobstructive azoospermia.

    PubMed

    Esteves, Sandro C

    2015-01-01

    The clinical management of men with nonobstructive azoospermia (NOA) seeking fertility has been a challenge for andrologists, urologists, and reproductive medicine specialists alike. This review presents a personal perspective on the clinical management of NOA, including the lessons learned over 15 years dealing with this male infertility condition. A five-consecutive-step algorithm is proposed to manage such patients. First, a differential diagnosis of azoospermia is made to confirm/establish that NOA is due to spermatogenic failure. Second, genetic testing is carried out not only to detect the males in whom NOA is caused by microdeletions of the long arm of the Y chromosome, but also to counsel the affected patients about their chances of having success in sperm retrieval. Third, it is determined whether any intervention prior to a surgical retrieval attempt may be used to increase sperm production. Fourth, the most effective and efficient retrieval method is selected to search for testicular sperm. Lastly, state-of-art laboratory techniques are applied in the handling of retrieved gametes and cultivating the embryos resulting from sperm injections. A coordinated multidisciplinary effort is key to offer the best possible chance of achieving a biological offspring to males with NOA. PMID:25677138

  20. Human sperm chromatin epigenetic potential: genomics, proteomics, and male infertility.

    PubMed

    Castillo, Judit; Estanyol, Josep Maria; Ballescá, Josep Lluis; Oliva, Rafael

    2015-01-01

    The classical idea about the function of the mammalian sperm chromatin is that it serves to transmit a highly protected and transcriptionally inactive paternal genome, largely condensed by protamines, to the next generation. In addition, recent sperm chromatin genome-wide dissection studies indicate the presence of a differential distribution of the genes and repetitive sequences in the protamine-condensed and histone-condensed sperm chromatin domains, which could be potentially involved in regulatory roles after fertilization. Interestingly, recent proteomic studies have shown that sperm chromatin contains many additional proteins, in addition to the abundant histones and protamines, with specific modifications and chromatin affinity features which are also delivered to the oocyte. Both gene and protein signatures seem to be altered in infertile patients and, as such, are consistent with the potential involvement of the sperm chromatin landscape in early embryo development. This present work reviews the available information on the composition of the human sperm chromatin and its epigenetic potential, with a particular focus on recent results derived from high-throughput genomic and proteomic studies. As a complement, we provide experimental evidence for the detection of phosphorylations and acetylations in human protamine 1 using a mass spectrometry approach. The available data indicate that the sperm chromatin is much more complex than what it was previously thought, raising the possibility that it could also serve to transmit crucial paternal epigenetic information to the embryo. PMID:25926607

  1. Infertility among couples in a population-based study in Iran: prevalence and associated risk factors.

    PubMed

    Safarinejad, Mohammad Reza

    2008-06-01

    To explore the prevalence and risk factors of infertility in Iran, a total of 12 285 ever-married women aged 15-50 years old and their husbands (if available) were interviewed by 82 female general practitioners and answered a self-administered questionnaire on several aspects of infertility. They were identified from the national population in 30 counties, and invited to a confidential interview. Data were obtained about their age, education, marital status, toxic habits, medical history, disabilities and illnesses, help-seeking, economy, ethnicity, geographic location, contraceptive use and age at which they had first intercourse. This study used the definition of childlessness proposed by World Health Organization: 'the woman has never conceived despite cohabitation and exposure to pregnancy for a period of 2 years'. The overall prevalence of infertility was 8% (95% CI: 3.2-15.0). The weighted national estimate of primary infertility was 4.6% (95% CI: 3.6-5.2). There was a pronounced regional pattern in the levels of primary infertility. The primary infertility increased significantly from 2.6 to 4.3 to 5.5% for the 1985-1989, 1990-1994 and 1995-2000 marriage cohorts. The prevalence of secondary infertility was 3.4% (95% CI: 2.4-5.1). Overall the prevalence of infertility falls within a relatively wide range being high in the Southern counties, and low in the Northern counties. The probability of first pregnancy at the end of 2 years of marriage was 0.78 for all ever-married women. The prevalence of infertility increased with age (linear chi-square 198.012, 1 d.f., p = 0.01). The age pattern of infertility also varies quite markedly across the counties analysed. No effect of race was detected; neither the intercept (analysis of covariance p = 0.36) nor the slope of the age relationship was influenced by race (analysis of covariance p = 0.41). Infertility were observed as significantly higher in the presence of history of tubo-ovarian surgery [odds ratio (OR): 1.43; 95% CI: 1.28-2.23; p = 0.01], salpingitis (OR: 2.34; 95% CI: 1.31-4.3; p = 0.016), ectopic pregnancy (OR: 2.45; 95% CI: 1.90-3.44; p = 0.04), varicocele (OR: 2.85; 95% CI: 1.61-5.20; p = 0.01) and cryptorchidism (OR: 3.81; 95% CI: 2.51-4.28; p = 0.031). This study provides a quantitative estimate of the prevalence and main risk factors for infertility in Iranian couples. Yet, further studies on the cause of primary and secondary infertility and geographical variations in the incidence and prevalence of infertility in Iran are needed. PMID:17488339

  2. Isolation and molecular identification of mycoplasma genitalium from the secretion of genital tract in infertile male and female

    PubMed Central

    Mohseni Moghadam, Naeime; Kheirkhah, Babak; Mirshekari, Toraj Reza; Fasihi Harandi, Majid; Tafsiri, Elham

    2014-01-01

    Background: Mycoplasmas can cause acute and chronic diseases at multiple sites with wide-range complications and have been implicated as cofactors in diseases. The infections influenced form genital mycoplasmas specifically Mycoplasma hominis and Mycoplasma genitalium potentially affect reproductive disorders, and infertility. Objective: Isolation and molecular identification of Mycoplasma genitalium from the genital tract of infertile male and vaginal discharge of infertile female referred to Infertility Center of Kerman in 2013. Materials and Methods: This study was a randomized, prospective study. We included 100 infertile male and 100 infertile female that were referred to the Infertility Center of Kerman. Then for isolation and molecular identification of Mycoplasma genitalium from urethral and vaginal discharge polymerase chain reaction was performed on Mycoplasma genus and genitalium. Results: From a total of 100 semen samples 45 patients (45%) were mycoplasma-positive and 13 (28.8%) were genitalium species positive. Also, from a total of 100 women samples 43 women (43%) were mycoplasma-positive and 10 (23.2%) were genitalium species positive. Positive samples were sequenced and phylogenetic tree was drawn. Conclusion: According to the results of this study, a high percentage of infertile male and female were infected with the Mycoplasma genitalium. For prevention of harmful and significant consequences of this infection, we suggest a screening program in symptomatic infertile couples. PMID:25469132

  3. Studying the Relationship between the Attitude to Infertility and Coping Strategies in Couples Undergoing Assisted Reproductive Treatments

    PubMed Central

    Yazdani, Fatemeh; Kazemi, Ashraf; Ureizi-Samani, Hamid Reza

    2016-01-01

    Background: Using appropriate coping strategies has a positive influence on moderating mental pressures caused by infertility and the stress during treatment. Using these strategies needs personal skills and they could be influenced by individual's inner psychological and environmental factors. The aim of this study was to assess the relationship between the attitude toward infertility and coping strategies considering the couple's social and financial situation. Methods: This was a cross sectional study conducted on 133 volunteered couples undergoing assisted reproductive treatment. Coping strategies and the attitude toward infertility were assessed using a self-report questionnaire. Higher scores of attitude indicated positive attitudes. Data was analyzed using paired-samples t test and multiple regression model. Results: Independent from demographic information and causes of infertility, using self-blame and self-focused rumination coping strategies were negatively related to attitude toward infertility in both men and women (p<0.05). Also, using self-blame coping strategy had a positive correlation with female infertility and negative correlation with male infertility. Conclusion: Regardless of the economic and social conditions, in infertile couples, downward trend in attitude toward infertility is mostly associated with the use of maladaptive coping strategies. PMID:26962484

  4. Thyroxine treatment may be useful for subclinical hypothyroidism in patients with female infertility.

    PubMed

    Yoshioka, Waka; Amino, Nobuyuki; Ide, Akane; Kang, Shino; Kudo, Takumi; Nishihara, Eijun; Ito, Mitsuru; Nakamura, Hirotoshi; Miyauchi, Akira

    2015-01-01

    Infertile women sometimes associated with subclinical hypothyroidism (SCH). The guidelines of the American Endocrine Society, and American Association of Clinical Endocrinologists and American Thyroid Association recommend treatment with thyroxine (T4) for patients with SCH who want to have children. We examined 69 female infertile patients with SCH and the effects of levothyroxine (l-T4) therapy on pregnancy rates and pregnancy outcomes were observed. Fifty-eight (84.1%) patients successfully conceived during the T4 treatment period (Group A), although 17 patients (29.3%) had miscarriage afterward. The remaining 11 patients continued to be infertile (Group B). The median TSH value in Group A before the T4 treatment was 5.46 ?IU/mL (range 3.1-13.3) and this significantly decreased to 1.25 ?IU/mL (range 0.02-3.75) during the treatment (p<0.001). The estimated duration of infertility before the T4 treatment was 2.81.7 years and the duration until pregnancy after the treatment was significantly shorter at 0.90.9 years (p<0.001). Shortening of the infertile period after the T4 therapy was observed not only in patients who were treated with assisted reproductive technology (ART) but also in patients who conceived spontaneously in Group A. Administered T4 dose was 54.314.2 ?g before pregnancy and 68.522.8 ?g during pregnancy (p<0.001). Anti-thyroid autoantibodies were identified in 42.0% of all patients and no significant difference was observed in positivity between Group A and Group B. High successful pregnancy rate and shorter duration of infertility until pregnancy after T4 treatment strongly suggest that T4 enhanced fertility in infertile patients with SCH. PMID:25312747

  5. Oxidative stress induced sperm DNA damage, a possible reason for male infertility

    PubMed Central

    Hosen, Md Bayejid; Islam, Md Rakibul; Begum, Firoza; Kabir, Yearul; Howlader, M Zakir Hossain

    2015-01-01

    Background: Sperm DNA damage is an important factor in the etiology of male infertility. Objective: The aim of the study was to evaluate the association of oxidative stress induced sperm DNA damage with the pathogenesis of male infertility. Materials and Methods: The study comprised a total of 66 subjects, including fertile men (n=25) and infertile men (n=41) matched by age. Seminal malondialdehyde (MDA), phospholipid hydroperoxide (PHP), superoxide dismutase (SOD), total antioxidant status (TAS) and 8-hydroxy-2'-deoxy guanosine (8-OHdG) were estimated by spectrophotometric and ELISA based methods and the association with the sperm parameters was assessed. Results: The percentages of motile and morphologically normal cells were significantly lower (p < 0.001, p <0.001, respectivly) in infertile men. Seminal levels of MDA, PHP and 8-OHdG were significantly higher (p < 0.001, p < 0.001, and p=0. 02, respectively) while the SOD and TAS were significantly lower (p=0. 0003, p< 0.001, respectively) in infertile men. Sperm parameters were negatively correlated with MDA, PHP and 8-OHdG while positively correlated with SOD and TAS. A positive correlation of 8-OHdG with MDA and PHP and a negative correlation with TAS and SOD were also found. Conclusion: These results suggested that oxidative stress induced sperm DNA damage might have a critical effect on the etiology of infertility. Therefore, evaluation of oxidative status, antioxidant defense systems and DNA damage, together with sperm parameters might be a useful tool for diagnosis and treatment of male infertility. PMID:26568756

  6. A Survey on Oocyte Donation: Turkish Fertile and Infertile Womens Opinions

    PubMed Central

    Akyuz, Aygul; Sever, Nese; Karasahin, Emre; Guvenc, Gulten; Cek, Suzan

    2014-01-01

    Background There are various treatment options for infertility, and new techniques are also being developed as it is an important healthcare problem affecting approximately 15-20% of married couples. The purpose of this study was to evaluate the level of infor- mation of fertile and infertile Turkish women on oocyte donation in order to understand their awareness of the legal, ethical, social and religious issues regarding this technique and to compare these two groups in terms of these variables. Materials and Methods This cross-sectional study included infertile women being treated at the assisted reproductive technologies (ART) program of a university hos- pital and women who had presented at the gynecology outpatients department of the same university for routine check-ups and who had no previous history of infertility. After consulting with specialists in the field and searching the related literature, a data collection form having 22 questions for infertile women and 18 questions for fertile women was prepared. Results The women were asked whether they would use the oocytes of another woman if necessary. The results showed that 67.6% of the fertile women said they would never want to use this method, while 63.9% of the infertile women stated they may accept to use this method under certain conditions (two distinct answers appeared in the answers, some women stated they would prefer donated oocytes from close relatives, while others stated they would prefer oocytes from total strangers), such as from a close relative or from someone they do not know at all. Conclusion Infertile women mentioned that they could use illegal routes if necessary to have a child at much higher rates than stated by fertile women. This shows that desire to have a child is a strong source of motivation in Turkey. PMID:25379158

  7. A review of management of infertility in Nigeria: framing the ethics of a national health policy

    PubMed Central

    Akinloye, Oluyemi; Truter, Ernest J

    2011-01-01

    Infertility has recently been construed to be a serious problem in sub-Saharan Africa. This problem seems to be viewed as of low priority with reference to the effective and efficient allocation of available health resources by national governments as well as by international donors sponsoring either research or service delivery in the public health sector. In this paper the problem of infertility in Nigeria is surveyed with a view to assessing the ethical dimension of proposals to manage infertility as a public sector priority in health care delivery. The population/individual and public/private distinction in the formulation of health policy has ethical implications that cannot simply be ignored and are therefore engaged in critically assessing the problem of infertility. Cost–utility analysis (such as Quality Adjusted Life-Year composite index) in the management of infertility in Nigeria entails the need for caution relevant to the country’s efforts to achieve Millennium Development Goals. This should remain the case whether the ethical evaluation appeals to utilitarian or contractarian (Rawlsian) principles. The “worst off ” category of Nigerians includes (1) underweight children less than 5 years of age, with special concern for infants (0–1 years of age) and (2) the proportion of the population below a minimum level of dietary consumption. The Rawlsian ethic implies that any Federal Ministry of Health policy aimed at establishing public programs for infertility management can be considered a “fair” allocation and expenditure if, and only if, the situation for these two cohorts is not thereby made worse. Nigerian health policy cannot assume this type of increased allocation of its resources to infertility care without it being hard pressed to warrant defensible moral or rational argument. PMID:21892337

  8. Prevalence of Ureaplasma urealyticum and Mycoplasma hominis in High Vaginal Swab Samples of Infertile Females

    PubMed Central

    Seifoleslami, Mehri; Safari, Aghdas; Khayyat Khameneie, Maryam

    2015-01-01

    Background: Mycoplasma hominis and Ureaplasma urealyticum are important causative agents of vaginitis, cervicitis, postpartum sepsis, reproductive infections and infertility in both males and females. Objectives: According to the uncertain prevalence of U. urealyticum and M. hominis in Iranian infertile females, the present study was carried out to determine the prevalence of U. urealyticum and M. hominis in high vaginal swab samples of fertile and infertile females. Patients and Methods: A total of 350 high vaginal swab specimens were taken from fertile and infertile females. Samples were cultured and those that were positive for bacteria were subjected to the polymerase chain reaction (PCR) for further confirmation. Results: Of the 350 collected samples, eleven were positive for M. hominis (3.14%), fifteen were positive for U. urealyticum (4.28%) and five were positive for both of them (1.42%). Prevalence of U. urealyticum and M. hominis in the high vaginal parts of infertile females was higher than fertile females (P < 0.05). The results of traditional method were also confirmed, using the PCR amplification of urease gene of U. urealyticum and 16SrRNA gene of the M. hominis. Ureaplasma urealyticum and M. hominis had a higher prevalence in the high vaginal samples collected during the summer season. Conclusions: Considerable prevalence of M. hominis and U. urealyticum in the high vaginal swab samples of infertile females compared to the low prevalence in fertile females may suggest that these two pathogens can be cause infertility. Application of the PCR method is recommended for rapid and sensitive detection of M. hominis and U. urealyticum in high vaginal swab samples. PMID:26756000

  9. Sperm chromatin structure assay results in Nigerian men with unexplained infertility

    PubMed Central

    Kolade, Charles Oluwabukunmi

    2015-01-01

    Objective Several publications have established a relationship between sperm DNA damage and male factor infertility, based on data from America, Europe, and Asia. This study aimed to compare the extent of sperm DNA damage in sperm samples from Nigerian men with unexplained infertility and in sperm samples from a fertile group composed of sperm donors who had successfully impregnated a female partner naturally or through assisted conception. Methods A total of 404 men underwent male fertility evaluation at Androcare Laboratories and Cryobank participated in this study. Semen analysis and a sperm chromatin structure assay (SCSA) were performed on all subjects. Results The men in the unexplained infertility group were slightly older than the men in the fertile sperm group (3610 years vs. 326 years, p=0.051). No significant difference was observed between the two groups in semen analysis parameters (p?0.05). Men in the unexplained infertility group with normal semen parameters had a significantly higher DNA fragmentation index (DFI) than men in the fertile sperm group (27.5%7.0% vs. 14.1%5.3%, p<0.05). In the unexplained infertility group, 63% of the men had a DFI greater than 20%, compared to 4% in the fertile sperm group. In the unexplained infertility group, 15.2% of the subjects had a DFI greater than 30%, compared to 1% in the fertile sperm group. Conclusion Our study showed that the SCSA may be a more reliable predictor of fertility potential than traditional semen analysis in cases of unexplained infertility. PMID:26473109

  10. Development of a scale for determining violence against infertile women: a scale development study

    PubMed Central

    2014-01-01

    Background To develop a scale to evaluate violence experienced among infertile women. Method Three steps were followed in the development of the scale: Literature review and deep interviews to generate item pool, content validity testing, and administration of draft. Content validity was evaluated by experts. The draft scale was pilot-tested with a convenience sample of 30 women during their treatment. After the pilot-test, 166 infertile females filled the scale in the infertility clinic of a university hospital in Istanbul. Results For evaluation of construct validity, Kaiser-Mayer Olkin was 0.91. Bartlett test was statistically significant (p = 0.00). According to the results of analysis, 5 domains were determined: “domestic violence”, “social pressure”, “punishment”, “exposure to traditional practices” and “exclusion”. The values of correlation of item were between 0.50 and 0.82. Item-total and subscale-total correlation varied between 0.57-0.91. The scale had good internal reliability, with Cronbach’s Alpha coefficient of 0.96. The other coefficients of subscales varied between 0.80-0.94. Conclusions The scale called “Infertile Women’s Exposure to Violence Determination Scale” indicates high reliability, good content and construct validity. Routine screening for domestic violence in infertility clinics is necessary to give affected women an opportunity to access appropriate health care and support services. On the other hand, common use of Infertile Women’s Exposure to Violence Determination Scale in infertility clinics provides increased sensitivity and awareness by caregivers. PMID:24576353

  11. Significant Impact of the MTHFR Polymorphisms and Haplotypes on Male Infertility Risk

    PubMed Central

    Gupta, Nishi; Sarkar, Saumya; David, Archana; Gangwar, Pravin Kumar; Gupta, Richa; Khanna, Gita; Sankhwar, Satya Narayan; Khanna, Anil; Rajender, Singh

    2013-01-01

    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. PMID:23874907

  12. Early stage management of ovarian endometrioma to prevent infertility

    PubMed Central

    Brosens, I.; Puttemans, P.; Gordts, Sy.; Campo, R.; Gordts, S.; Benagiano, G.

    2013-01-01

    There are now convincing data showing that cystectomy of the endometrioma is not only no cure of infertility, but may harm follicle reserve. The question arises why is cystectomy for an endometrioma, in contrast with other benign cysts, a risk for follicle reserve and how can ovarian damage be prevented. Surgical specimens of ovaries with endometrioma in situ show in the majority of cases manifestly a combined extra-ovarian and intra-ovarian pathology with the cortex invaginated to form a pseudocyst. The extra-ovarian pathology includes endometrial lining of the cortex, bleeding and adhesions with surrounding tissues. The intra-ovarian pathology is characterized by microscopic stromal implants, fibrosis, smooth muscle metaplasia and arteriosclerosis, all affecting follicle reserve in the endometrioma bed. Clinically, ovarioscopy allows differential diagnosis (e.g. luteal cyst) and evaluation of the degree of fibrosis and darkening of the cortical wall. Transvaginal colour Doppler sonography can demonstrate the presence and extent of devascularisation in the endometrioma bed. Given this reality, surgery should be based on evaluation of the pathology of the endometrioma bed, but not on the mere size of the chocolate cyst. The main clinical problem is indeed the delayed diagnosis and consequently advanced irreversible cortical damage. Therefore, the sooner endometriomas are diagnosed, the better, because it increases the chances that vascularisation of the endometrioma bed is preserved. Finally, ablation, but not excision is the treatment of choice. The diagnosis of endometriosis is traditionally based on laparoscopy, but in a sexually active adolescent transvaginal endoscopy can be proposed. PMID:24753958

  13. Sexual dysfunction and infertility as late effects of cancer treatment

    PubMed Central

    Schover, Leslie R.; van der Kaaij, Marleen; van Dorst, Eleonora; Creutzberg, Carien; Huyghe, Eric; Kiserud, Cecilie E.

    2014-01-01

    Sexual dysfunction is a common consequence of cancer treatment, affecting at least half of men and women treated for pelvic malignancies and over a quarter of people with other types of cancer. Problems are usually linked to damage to nerves, blood vessels, and hormones that underlie normal sexual function. Sexual dysfunction also may be associated with depression, anxiety, relationship conflict, and loss of self-esteem. Innovations in cancer treatment such as robotic surgery or more targeted radiation therapy have not had the anticipated result of reducing sexual dysfunction. Some new and effective cancer treatments, including aromatase inhibitors for breast cancer or chemoradiation for anal cancer also have very severe sexual morbidity. Cancer-related infertility is an issue for younger patients, who comprise a much smaller percentage of total cancer survivors. However, the long-term emotional impact of being unable to have a child after cancer can be extremely distressing. Advances in knowledge about how cancer treatments may damage fertility, as well as newer techniques to preserve fertility, offer hope to patients who have not completed their childbearing at cancer diagnosis. Unfortunately, surveys in industrialised nations confirm that many cancer patients are still not informed about potential changes to their sexual function or fertility, and all modalities of fertility preservation remain underutilised. After cancer treatment, many patients continue to have unmet needs for information about restoring sexual function or becoming a parent. Although more research is needed on optimal clinical practice, current studies suggest a multidisciplinary approach, including both medical and psychosocial treatment options. PMID:26217165

  14. Life after infertility treatment: a long-term investigation of marital and sexual function.

    PubMed

    Leiblum, S R; Aviv, A; Hamer, R

    1998-12-01

    After leaving in-vitro fertilization (IVF) treatment, both successful and unsuccessful women are generally lost to follow-up. In order to assess overall life satisfaction as well as marital and sexual adjustment after the completion of infertility treatment, three groups of women were studied: group 1 (n = 41), successful IVF women; group 2 (n = 16), unsuccessful IVF women who adopted; and group 3 (n = 18), unsuccessful IVF women who remained childless. All women who had completed a minimum of three IVF cycles between the years 1982 and 1993 were invited to participate in a 'life after infertility' follow-up study. Those who agreed were mailed a lengthy questionnaire which included questions about their reproductive history and infertility treatment, the impact of infertility on their marital and sexual relationship and their final thoughts about treatment. Four standardized questionnaires were also administered. Results revealed that women who became biological mothers through IVF were significantly more satisfied with their lives than women who were unsuccessful in IVF and remained childless (F = 8.62, P < 0.001). Childless women reported that infertility had exerted a significantly greater negative impact on their marriages than that reported by the other two groups. There were no significant differences, however, between the three groups on the standardized measures of marital and sexual satisfaction. PMID:9886552

  15. Adverse Outcomes of IVF/ICSI Pregnancies Vary Depending on Aetiology of Infertility

    PubMed Central

    Kuivasaari-Pirinen, Paula; Raatikainen, Kaisa; Hippelinen, Maritta; Heinonen, Seppo

    2012-01-01

    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 1.57.1 and AOR 2.1, and 95% CI 1.04.2, resp.), while women in couples with male factor infertility had a twofold risk of admission to neonatal intensive care (AOR 2.5, 95% CI 1.25.3). 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

  16. Metabolomics Analysis of Seminal Plasma in Infertile Males with Kidney-Yang Deficiency: A Preliminary Study

    PubMed Central

    Chen, Xiang; Hu, Chao; Dai, Jican; Chen, Lei

    2015-01-01

    Traditional Chinese medicine (TCM) is an important treatment for male infertility, and its application to therapy is dependent on differentiation of TCM syndromes. This study aims to investigate the changes in metabolites and metabolic pathways in infertile males with Kidney-Yang Deficiency syndrome (KYDS) via metabolomics approaches. Seminal plasma samples were collected from 18 infertile males with KYDS and 18 fertile males. Liquid chromatography and mass spectrometry were used to characterize metabolomics profiles. Principal component analysis (PCA), partial least squares-discriminate analysis (PLS-DA), and pathway analysis were used for pattern recognition and metabolite identification. PCA and PLS-DA results differentiated the two groups of patients. Forty-one discriminating metabolites (18 in positive mode and 23 in negative mode) were identified. Seven metabolites were related to five potential metabolic pathways associated with biosynthesis and metabolism of aromatic amino acids, tricarboxylic acid cycle, and sphingolipid metabolism. The changes in metabolic pathways may play an important role in the origin of KYDS-associated male infertility. Metabolomics analysis of seminal plasma may be used to differentiate TCM syndromes of infertile males, but further research must be conducted. PMID:25945117

  17. Is global access to infertility care realistic? The Walking Egg Project.

    PubMed

    Ombelet, Willem

    2014-03-01

    Until very recently, the problem of infertility in developing countries has been ignored at all levels of healthcare management. Because many preventable or treatable diseases still claim millions of lives, and due to limited resources, provision of infertility care is not on the resource allocation agenda at all, prevention of sexually transmitted diseases remaining the number one priority. Tubal infertility due to sexually transmitted diseases, unsafe abortion and post-partum pelvic infections is the main cause of infertility. Most cases are only treatable with assisted reproduction technology, which are either unavailable or too costly. In December 2007, an expert meeting was organized in Arusha, Tanzania by the Walking Egg non-profit organization in co-operation with ESHRE. The meeting was the start of a global project aimed at increasing diagnostic and therapeutic options for childless couples in resource-poor countries. From the start, the Walking Egg Project has approached this problem in a multidisciplinary and global manner. It gathers medical, social, ethical, epidemiological, juridical and economic scientists to discuss and work together towards its goal. The final objective of the Walking Egg Project is the implementation of infertility services in many developing countries, preferably integrated in existing family planning and mother care services. PMID:24444813

  18. The epidemiology of infertility: a review with particular reference to sub-Saharan Africa*

    PubMed Central

    Belsey, Mark A.

    1976-01-01

    The problem of infertility, with particular reference to Africa south of the Sahara, is reviewed. In many areas, up to 40% of women are reported to have completed their reproductive years without bearing a child. The condition is widely distributed, but also often localized in pockets corresponding to geographical or tribal units. Most available demographic data provide estimates of childlessness but it is not sufficient to define the problem in terms of primary and secondary infertility, pregnancy wastage, and infant and child mortality. The major underlying cause for the high levels of infertility appears to be the sequelae of Neisseria gonorrhoeae infection in both men and women, manifested as obstructive azoospermia and tubal occlusion. Other infections, such as those that may follow abortion or delivery, or systemic infections, may be important in some areas. The available data suggest that different patterns of infertility and pregnancy wastage, and different etiological agents and processes, contribute to the problem of infertility in the different areas. The need for a systematic, standardized research approach in several areas is clearly indicated. PMID:798639

  19. Association of polymorphisms in ART3 gene with male infertility in the Chinese population

    PubMed Central

    Lin, Feiyan; Jiang, Lei; Yang, Haiyan; Yang, Xu; Wu, Jianbo; Huang, Xuefeng; Ni, Wuhua

    2015-01-01

    The ADP-ribosyltransferase 3 gene (ART3) has been reported to be associated with non-obstructive azoospermia (NOA) in the Japanese population. In this study, we aim to explore the possible association between the four single nucleotide polymorphisms (SNPs) (rs11097230, rs17001385, rs14773 and rs6836703) in ART3 gene and male infertility with spermatogenesis impairment in the Chinese population. The study population included 321 idiopathic infertile males with azoospermia or oligozoospermia and 250 fertile males. Four SNPs of ART3 gene were genotyped using the method of SNaPshot. The results showed that an SNP (rs6836703) in the intron11 region of ART3 gene is significantly associated with male infertility (odds ratio: 0.632, 95% confidence interval: 0.440-0.910). No significant associations were found between any of the other three variants (rs11097230, rs17001385 and rs14773) in ART3 gene and male infertility. SNP rs6836703 in ART3 gene may contribute to male infertility risk in the Chinese population. PMID:26221352

  20. The Effect of Mirtazapine on Cisplatin-Induced Oxidative Damage and Infertility in Rat Ovaries

    PubMed Central

    Altuner, Durdu; Gulaboglu, Mine; Yapca, Omer Erkan; Cetin, Nihal

    2013-01-01

    Cisplatin causes infertility due to ovarian toxicity. The toxicity mechanism is unknown, but evidence suggests oxidative stress. In this study, the effect of mirtazapine on cisplatin-induced infertility and oxidative stress in rats was investigated. 64 female rats were divided into 4 groups of 16. Except for the controls that received physiologic saline only, all were administered with cisplatin (5 mg/kg i.p.) and mirtazapine (15 mg/kg p.o.) or mirtazapine (30 mg/kg p.o.) for 10 days. After this period, six rats from each group were randomly selected, and malondialdehyde (MDA), myeloperoxidase (MPO), nitric oxide (NO), total gluthatione (tGSH), gluthatione peroxidase (GPx), superoxide dismutase (SOD), and 8-hydroxy-2 deoxyguanine (8-OH Gua) levels were measured in their ovarian tissues. Reproductive functions of the remaining rats were examined for 6 months. The MDA, MPO, NO groups and 8-OH Gua levels were higher in the cisplatin-treated groups than the controls, which was not observed in the mirtazapine and cisplatin groups. GSH, GPx, and SOD levels were reduced by cisplatin, which was prevented by mirtazapine. Cisplatin caused infertility by 70%. The infertility rates were, respectively, 40% and 10% for the 15 and 30 mg/kg mirtazapine administered groups. In conclusion, oxidative stress induced by cisplatin in the rat ovary tissue causes infertility in the female rats. Mirtazapine reverses this in a dose-dependent manner. PMID:23737712

  1. High Prevalence of Vitamin D Deficiency in Infertile Women Referring for Assisted Reproduction.

    PubMed

    Pagliardini, Luca; Vigano', Paola; Molgora, Michela; Persico, Paola; Salonia, Andrea; Vailati, Simona Helda; Paffoni, Alessio; Somigliana, Edgardo; Papaleo, Enrico; Candiani, Massimo

    2015-01-01

    A comprehensive analysis of the vitamin D status of infertile women is the first step in understanding hypovitaminosis impact on reproductive potential. We sought to determine vitamin D profiles of women attending an infertility center and to investigate non-dietary determinants of vitamin D status in this population. In this cross-sectional analysis, a cohort of 1072 women (mean age standard deviation 36.3 4.4 years) attending an academic infertility center was used to examine serum 25-hydroxy-vitamin D (25(OH)D) levels in relation to demographic characteristics, seasons and general health risk factors. Both unadjusted and adjusted levels of serum 25(OH)D were examined. Median 25(OH)D concentration was below 30 ng/mL for 89% of the entire year. Over the whole year, 6.5% of patients had 25(OH)D levels ?10 ng/mL, 40.1% ?20 ng/mL, and 77.4% ?30 ng/mL. Global solar radiation was weakly correlated with 25(OH)D levels. At multivariable analysis, 25(OH)D levels were inversely associated with BMI; conversely, 25(OH)D levels were positively associated with height and endometriosis history. Serum 25(OH)D levels are highly deficient in women seeking medical help for couple's infertility. Levels are significantly associated with body composition, seasonal modifications and causes of infertility. Importantly, this deficiency status may last during pregnancy with more severe consequences. PMID:26633484

  2. Effect of lifestyle on quality of life of couples receiving infertility treatment.

    PubMed

    Teskereci, Gamze; Oncel, Selma

    2013-01-01

    This study investigated the effect of lifestyle on the quality of life among couples undergoing infertility treatment. The research universe consisted of 200 couples undergoing infertility treatment in Akdeniz University's Center of Reproductive Endocrinology and Assisted Reproductive Techniques. The data collection tools the authors used were a personal information form requesting sociodemographic characteristics and history of infertility, the SF-36 Quality of Life Scale, and the Healthy Lifestyle Behaviors Scale. This study revealed that the quality of life of the women in the study was lower than that of the men. The authors also found that the couples' quality of life was reduced by variables such as advanced age, low education level, unemployment status, lower income, long duration of infertility, high body mass index, history of andrological surgery, and previous experience of assisted reproduction techniques three or more times. Last, it was determined that the couples' quality of life improved as their healthy lifestyle behaviors increased. Demonstrating positive health behavior is likely to improve the quality of life of couples undergoing infertility treatment. PMID:23631703

  3. Regional and geographical variations in infertility: effects of environmental, cultural, and socioeconomic factors.

    PubMed Central

    Leke, R J; Oduma, J A; Bassol-Mayagoitia, S; Bacha, A M; Grigor, K M

    1993-01-01

    Fertility is affected by many different cultural, environmental, and socioeconomic factors, especially in developing countries where poverty and infections are commonplace. Environmental factors play a major role in infertility in Africa. One of the most important health problems in sub-Saharan Africa is the high rate of infertility and childlessness. The African society has a strong traditional heritage, and the study of the patterns of infertility in this part of the world would be incomplete without consideration of the sociocultural and environmental factors. The most cost-effective approach to solving the infertility problems in Africa is prevention and education. In Mexico, problems of reproductive health are associated with pregnancy in adolescents, sexually transmitted diseases and genitourinary neoplasms. Infertility affects 10% of couples, usually as a result of asymptomatic infection. Education, poverty, nutrition, and pollution are problems that must be tackled. The government has taken positive action in the State of São Paulo in Brazil, where gender discrimination is a major factor affecting women's health and reproductive outcomes. The implementation of new policies with adequate funding has resulted in marked improvements. PMID:8243409

  4. Regional and geographical variations in infertility: effects of environmental, cultural, and socioeconomic factors.

    PubMed

    Leke, R J; Oduma, J A; Bassol-Mayagoitia, S; Bacha, A M; Grigor, K M

    1993-07-01

    Fertility is affected by many different cultural, environmental, and socioeconomic factors, especially in developing countries where poverty and infections are commonplace. Environmental factors play a major role in infertility in Africa. One of the most important health problems in sub-Saharan Africa is the high rate of infertility and childlessness. The African society has a strong traditional heritage, and the study of the patterns of infertility in this part of the world would be incomplete without consideration of the sociocultural and environmental factors. The most cost-effective approach to solving the infertility problems in Africa is prevention and education. In Mexico, problems of reproductive health are associated with pregnancy in adolescents, sexually transmitted diseases and genitourinary neoplasms. Infertility affects 10% of couples, usually as a result of asymptomatic infection. Education, poverty, nutrition, and pollution are problems that must be tackled. The government has taken positive action in the State of São Paulo in Brazil, where gender discrimination is a major factor affecting women's health and reproductive outcomes. The implementation of new policies with adequate funding has resulted in marked improvements. PMID:8243409

  5. Semen quality, testicular B-mode and Doppler ultrasound, and serum testosterone concentrations in dogs with established infertility.

    PubMed

    de Souza, Mrley Barbosa; England, Gary C W; Mota Filho, Antnio Cavalcante; Ackermann, Camila Louise; Sousa, Carmen Vldia Soares; de Carvalho, Gabriela Guedelha; Silva, Herlon Victor Rodrigues; Pinto, Jos Nicodemos; Linhares, Jussiara Candeira Spndola; Oba, Eunice; da Silva, Lcia Daniel Machado

    2015-09-15

    Retrospective examination of breeding records enabled the identification of 10 dogs of normal fertility and 10 dogs with established infertility of at least 12 months of duration. Comparisons of testicular palpation, semen evaluation, testicular ultrasound examination, Doppler ultrasound measurement of testicular artery blood flow, and measurement of serum testosterone concentration were made between the two groups over weekly examinations performed on three occasions. There were no differences in testicular volume (cm(3)) between the two groups (fertile right testis = 10.77 1.66; fertile left testis = 12.17 2.22); (infertile right testis = 10.25 3.33; infertile left testis = 11.37 3.30), although the infertile dogs all had subjectively softer testes compared with the fertile dogs. Infertile dogs were either azoospermic or when they ejaculated, they had lower sperm concentration, sperm motility, and percentage of morphologically normal spermatozoa than fertile dogs. Furthermore, infertile dogs had reduced sperm membrane integrity measured via the hypoosmotic swelling test. Infertile dogs had significantly lower basal serum testosterone concentrations (1.40 0.62 ng/mL) than fertile dogs (1.81 0.87 ng/mL; P < 0.05). There were subjective differences in testicular echogenicity in some of the infertile dogs, and important differences in testicular artery blood flow with lower peak systolic and end-diastolic velocities measured in the distal supratesticular artery, marginal testicular artery, and intratesticular artery of infertile dogs (P < 0.05). Notably, resistance index and pulsatility index did not differ between infertile and fertile dogs. These findings report important differences between infertile and fertile dogs which may be detected within an expanded breeding soundness examination. PMID:26116053

  6. Caffeine intake and delayed conception: a European multicenter study on infertility and subfecundity. European Study Group on Infertility Subfecundity.

    PubMed

    Bolmar, F; Olsen, J; Rebagliato, M; Bisanti, L

    1997-02-15

    The effects of caffeine consumption on delayed conception were evaluated in a European multicenter study on risk factors of infertility. Information was collected retrospectively on time of unprotected intercourse for the first pregnancy and the most recent waiting time episode in a randomly selected sample of 3,187 women aged 25-44 years from five European countries (Denmark, Germany, Italy, Poland, and Spain) between August 1991 and February 1993. The consumption of caffeinated beverages at the beginning of the waiting time was used to estimate daily caffeine intake, which was categorized as 0-100, 101-300, 301-500, and > or = 501 mg. Risk of subfecundity (> or = 9.5 months) and the fecundability ratio, respectively, were assessed by logistic regression and Cox proportional hazard analyses, adjusting for age, parity, smoking, alcohol consumption, frequency of intercourse, educational level, working status, use of oral contraceptives, and country. A significantly increased odds ratio (OR) of 1.45 (95% confidence interval (CI) 1.03-2.04) for subfecundity in the first pregnancy was observed for women drinking more than 500 mg of caffeine per day, the effect being relatively stronger in smokers (OR = 1.56, 95% CI 0.92-2.63) than in nonsmokers (OR = 1.38, 95% CI 0.85-2.23). Women in the highest level of consumption had an increase in the time leading to the first pregnancy of 11% (hazard ratio = 0.90, 95% CI 0.78-1.03). These associations were observed consistently in all countries as well as for the most recent waiting time episode. The authors conclude that high levels of caffeine intake may delay conception among fertile women. PMID:9054236

  7. AB22. Role of varicocele repair for male infertility in the era of assisted reproductive technologies

    PubMed Central

    Nagao, Koichi

    2014-01-01

    Introduction Although infertile couples may include men with a varicocele, IVF/ICSI as primary treatment for male-factor infertility has greatly increased and can potentially decrease direct medical intervention for infertile men when they seek treatment from a urologist specializing in male infertility. Such series of treatment strategy might increase the risk of unnecessary interventions for the female partner, which could lead to potentially serious complications of ART, such as multiple pregnancies and ovarian hyperstimulation syndrome. In addition, repeat IVF/ICSI can be a considerable economic burden for infertile couples. However, using the internet, patients now have greater access to information on feasible treatment options for male infertility. This knowledge might motivate infertile couples to visit a male infertility clinic. In such cases, physicians and patients must choose the most appropriate treatment from the variety of treatments available for male-factor infertility. Treatment indications and varicocele management Clinical varicoceles are classified into three grades: grade 1, palpable only during the Valsalva maneuver; grade 2, palpable distension while the patient is standing; and grade 3, visible distension. The 2013 European Association of Urology (EAU) guideline, as well as 2012 EAU guideline recommends that varicocele repair should be considered in cases of clinical varicocele, oligospermia, duration of infertility greater than 2 years, and otherwise unexplained infertility in a couple, which is classified as evidence level A. The WHO reported that physical examination had a sensitivity of only about 50% in detecting varicoceles. Jarow et al. used ultrasound to examine vein diameters. Men who had spermatic veins with a diameter greater than 3.0 mm had significantly better semen characteristics after varicocele repair than did men with veins less than 3.0 mm in diameter. The most widely accepted criterion is presence of multiple veins with a diameter greater than 3.0-3.5 mm in conjunction with reversal of flow on color Doppler ultrasound. There are a number of unresolved issues in the management and treatment of varicoceles in adolescents. The 2013 EAU guideline recommends varicocele treatment for adolescents with progressive failure of testicular development, as documented by serial clinical examinations. Approaches to varicocele repair Most recent reviews concluded that microsurgical varicocele repair has clear advantages over the other techniques, namely, better pregnancy outcomes, lower complication rates, and lower recurrence rates, although this technique requires specific training in microsurgery. Several reports mentioned that laparoscopic surgery under general anesthesia was more invasive than subinguinal microsurgical repair with local anesthesia. Effectiveness of varicocele repair in treating male infertility A number of studies reported that varicocele repair improves semen parameters such as sperm concentration, sperm motility, and progressive sperm motility. The recent meta-analysis and review from Baazeem et al. summarized the effectiveness of varicocele repair in improving semen parameters. In that analysis, the authors selected 22 prospective studies of men with abnormal semen parameters and clinical varicoceles, and observed sperm concentration before and after surgery. The mean improvement in sperm concentration for the 22 studies was 12.3 million sperm/mL (95% CI, 7.07-14.65; P<0.001). Similarly, after varicocele repair, improvement in sperm total motility in 17 prospective studies and progressive sperm motility in 5 prospective studies was 10.86% (95% CI, 7.07-14.65; P<0.001) and 9.69% (95% CI, 4.86-14.52; P=0.003), respectively, which were statistically significant increases. In summary, current evidence indicates that varicocele repair improves semen parameters; however, evidence regarding spontaneous pregnancy rates is equivocal. New role of varicocele repair in the ART era Varicocele repair for couples who undergo IVF/ICSI. Esteves et al. studied 242 men with infert

  8. Simultaneous Serous Cyst Adenoma and Ovarian Pregnancy in An Infertile Woman

    PubMed Central

    Ebrahimi, Mahbod; Akbari Asbagh, Firoozeh

    2014-01-01

    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

  9. Markers of oxidative stress in follicular fluid of women with endometriosis and tubal infertility undergoing IVF.

    PubMed

    Singh, Abhay K; Chattopadhyay, Ratna; Chakravarty, Baidyanath; Chaudhury, Koel

    2013-12-01

    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

  10. Specific antibodies to porcine zona pellucida detected by quantitative radioimmunoassay in both fertile and infertile women

    SciTech Connect

    Kurachi, H.; Wakimoto, H.; Sakumoto, T.; Aono, T.; Kurachi, K.

    1984-02-01

    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.

  11. Women's Perceptions of Immediate and Long-Term Effects of Failed Infertility Treatment on Marital and Sexual Satisfaction.

    ERIC Educational Resources Information Center

    Pepe, Margaret V.; Byrne, T. Jean

    1991-01-01

    Examined immediate and long-term effects of infertility treatment on the marital and sexual relationship, as perceived by women (n=40) who failed to become pregnant during treatment. Results indicated infertility treatment significantly affected both marital and sexual satisfaction after treatment was terminated, as well as during treatment. (ABL)

  12. Infertility and Subjective Well-Being: The Mediating Roles of Self-Esteem, Internal Control, and Interpersonal Conflict.

    ERIC Educational Resources Information Center

    Abbey, Antonia; And Others

    1992-01-01

    Examined relationship between self-esteem, perceived control, interpersonal conflict between spouses, global and intimacy life quality, and stress produced by infertility in 185 married infertile couples. Found that fertility problem stress had indirect negative effects on life quality via its mediating effects on self-esteem, internal control,…

  13. How Husbands Cope When Pregnancy Fails: A Longitudinal Study of Infertility and Psychosocial Generativity. Working Paper No. 167.

    ERIC Educational Resources Information Center

    Snarey, John; And Others

    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…

  14. Elevated antithyroid peroxidase antibodies indicating Hashimoto's thyroiditis are associated with the treatment response in infertile women with polycystic ovary syndrome.

    PubMed

    Ott, Johannes; Aust, Stefanie; Kurz, Christine; Nouri, Kazem; Wirth, Stefan; Huber, Johannes C; Mayerhofer, Klaus

    2010-12-01

    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

  15. Infertility and Subjective Well-Being: The Mediating Roles of Self-Esteem, Internal Control, and Interpersonal Conflict.

    ERIC Educational Resources Information Center

    Abbey, Antonia; And Others

    1992-01-01

    Examined relationship between self-esteem, perceived control, interpersonal conflict between spouses, global and intimacy life quality, and stress produced by infertility in 185 married infertile couples. Found that fertility problem stress had indirect negative effects on life quality via its mediating effects on self-esteem, internal control,

  16. Association of CCR5, TLR2, TLR4 and MBL genetic variations with genital tract infections and tubal factor infertility.

    PubMed

    Laisk, Triin; Peters, Maire; Saare, Merli; Haller-Kikkatalo, Kadri; Karro, Helle; Salumets, Andres

    2010-12-01

    Upper genital tract infections can inflict inadequate immune response and cause Fallopian tube damage and concomitant female infertility. However, the exact role of host genetic variation in the development of tubal factor infertility remains unclear. We selected nine genetic variations in four genes involved in immune response modulation (CCR5, TLR2, TLR4 and MBL2) and assessed their association with tubal factor infertility by comparing genotype frequencies among 163 women with tubal factor infertility and 400 control individuals. The CCR5, TLR2 and TLR4 genotypes were not associated with tubal factor infertility, although the TLR4 Asp299Gly and Thr399Ile heterozygosity was associated with a decreased incidence of pathogens associated with genital tract infections in tubal factor infertility patients. In contrast, MBL2 low-producing genotypes were associated with an increased incidence of such pathogens. In addition, hyper-producing MBL2 genotype HYA/HYA and low-producing MBL2 genotypes were associated with susceptibility to tubal factor infertility, while a protective effect was associated with the high-producing MBL2 genotype HYA/LYA. Overall, these data suggest that polymorphisms in TLR4 and MBL2 play a role in receptiveness to pathogens causing genital tract infections, while MBL2 genotypes contribute to susceptibility to tubal factor infertility. PMID:20598754

  17. Prevalence; Characteristics and Management of Endometriosis Amongst Infertile Women: A One Year Retrospective Study

    PubMed Central

    Gaddagi, Rashmi A; Aggarwal, Rohina; Choudhary, Sumesh; Sharma, Urmila; Patel, Ushma

    2015-01-01

    Background Endometriosis appears to affect every aspect of a womens reproductive system resulting in infertility and spontaneous pregnancy loss. This study aims to find out the prevalence & clinical characteristics of endometriosis amongst infertile women. Settings and Design A Hospital based retrospective study over a period of one year. Materials and Methods It is a retrospective study conducted in the gynaecology department in Institute of Kidney Diseases & Research Centre; Ahmedabad from April 2012 to March 2013 amongst women with a primary complaint of infertility (Primary/Secondary).A total of 372 patients underwent diagnostic hysterolaparoscopy and of these 180 patients who had laparoscopic evidence of endometriosis was included in the study. All of these patients and their findings were analysed with respect to the clinical signs and symptoms. The outcome after appropriate management was analysed in subsequent follow up. Statistical Analysis All collected data was entered into the SPSS version 20. Categorical data are expressed in frequency or percentage. Chi-Square test and Fisher-Exact test has been performed to carry out p-value for categorical data. P-value <0.05 shows statistically significant difference. Results The frequency of endometriosis among women with infertility subjected to diagnostic hysterolaparoscopy was found to be 48.38%. Statistical significant association with severity of disease was associated with symptoms like dysmenorrhea, chronic pelvic pain, restricted uterine mobility and adnexal tenderness. (p <0.01) Ultrasound finding of endometrioma with ground glas appearance also had statistical significant association with staging of disease (p <0.01). Conclusion Endometriosis amongst infertile women is increasingly being detected due to greater use of laparoscopy in evaluation of infertility.Though most signs do not correlate with severity of disease however the presence of restricted uterine mobility, adnexal tenderness & chronic pelvic pain should always raise the suspicion of endometriosis. Laparoscopy remains the gold standard for diagnosing and staging endometriosis. PMID:26266170

  18. Identification of human candidate genes for male infertility by digital differential display.

    PubMed

    Olesen, C; Hansen, C; Bendsen, E; Byskov, A G; Schwinger, E; Lopez-Pajares, I; Jensen, P K; Kristoffersson, U; Schubert, R; Van Assche, E; Wahlstroem, J; Lespinasse, J; Tommerup, N

    2001-01-01

    Evidence for the importance of genetic factors in male fertility is accumulating. In the literature and the Mendelian Cytogenetics Network database, 265 cases of infertile males with balanced reciprocal translocations have been described. The candidacy for infertility of 14 testis-expressed transcripts (TETs) were examined by comparing their chromosomal mapping position to the position of balanced reciprocal translocation breakpoints found in the 265 infertile males. The 14 TETs were selected by using digital differential display (electronic subtraction) to search for apparently testis-specific transcripts in the TIGR database. The testis specificity of the 14 TETs was further examined by reverse transcription-polymerase chain reaction (RT-PCR) on adult and fetal tissues showing that four TETs (TET1 to TET4) were testis-expressed only, six TETs (TET5 to TET10) appeared to be differentially expressed and the remaining four TETs (TET11 to TET14) were ubiquitously expressed. Interestingly, the two tesis expressed-only transcripts, TET1 and TET2, mapped to chromosomal regions where seven and six translocation breakpoints have been reported in infertile males respectively. Furthermore, one ubiquitously, but predominantly testis-expressed, transcript, TET11, mapped to 1p32-33, where 13 translocation breakpoints have been found in infertile males. Interestingly, the mouse mutation, skeletal fusions with sterility, sks, maps to the syntenic region in the mouse genome. Another transcript, TET7, was the human homologue of rat Tpx-1, which functions in the specific interaction of spermatogenic cells with Sertoli cells. TPX-1 maps to 6p21 where three cases of chromosomal breakpoints in infertile males have been reported. Finally, TET8 was a novel transcript which in the fetal stage is testis-specific, but in the adult is expressed in multiple tissues, including testis. We named this novel transcript fetal and adult testis-expressed transcript (FATE). PMID:11134355

  19. The Walking Egg Project: Universal access to infertility care – from dream to reality

    PubMed Central

    Ombelet, W.

    2013-01-01

    Childlessness and infertility care are neglected aspects of family planning in resource-poor countries, although the consequences of involuntary childlessness are much more dramatic and can create more wide ranging societal problems compared to Western societies, particularly for women. Because many families in developing countries completely depend on children for economic survival, childlessness has to be regarded as a social and public health issue and not only as an individual medical problem. In the Walking Egg Project we strive to raise awareness surrounding childlessness in resource-poor countries and to make infertility care in all its aspects, including assisted reproductive technologies, available and accessible for a much larger part of the world population. We hope to achieve this goal through innovation and research, advocacy and networking, training and capacity building and service delivery. The Walking Egg non-profit organization has chosen a holistic approach of reproductive health and therefore strengthening infertility care should go together with strengthening other aspects of family planning and mother care. Right from the start The Walking Project has approached the problem of infertility in a multidisciplinary and global manner. It gathers medical, social, ethical, epidemiological, juridical and economical scientists and experts along with artists and philosophers to discuss and work together towards its goal. We recently developed a simplified tWE lab IVF culture system with excellent results. According to our first cost calculation, the price of a single IVF cycle using the methodologies and protocols we described, seems to be less than 200 Euros. We realize that universal access to infertility care can only be achieved when good quality but affordable infertility care is linked to effective family planning and safe motherhood programmes. Only a global project with respect to sociocultural, ethical, economical and political differences can be successful. PMID:24753941

  20. Knowledge, attitude and practice towards child adoption amongst women attending infertility clinics in Lagos State, Nigeria

    PubMed Central

    Kofoworola, Odeyemi

    2011-01-01

    Abstract Background Child adoption is a recommended alternative form of infertility management. Infertility is of public health importance in Nigeria and many other developing nations. This is a result of its high prevalence and especially because of its serious social implications as the African society places a passionate premium on procreation in any family setting. Objectives The aim of this study was to determine the knowledge, attitude and practice of child adoption amongst women attending infertility clinics in teaching hospitals in Lagos State and to determine the factors that influence their attitude and practice towards it. Method A cross-sectional descriptive design was used. Data were collected by using a structured questionnaire which was interviewer-administered. The study was conducted in the two teaching hospitals in Lagos State (LUTH [Lagos University Teaching Hospital] and LASUTH [Lagos State University Teaching Hospital]) from amongst 350 women attending the gynaecological clinics. All the patients under management for infertility at the gynaecology clinics during the period of the study were interviewed. Results Many respondents (85.7%) had heard of child adoption and 59.3% of them knew the correct meaning of the term. More than half of the respondents (68.3%) said that they could love an adopted child but less than half of them (33.7%) were willing to consider adoption. Only 13.9% has ever adopted a child. The major reason given for their unwillingness to adopt was their desire to have their own biological child. Factors that were favourable towards child adoption were Igbo tribe identity, an age above 40 years, duration of infertility above 15 years, and knowing the correct meaning of child adoption. Conclusion There is a poor attitude to adoption even amongst infertile couples. Interventions need to be implemented to educate the public on child adoption, to improve their attitude towards adoption and to make it more acceptable.

  1. The Walking Egg Project: Universal access to infertility care - from dream to reality.

    PubMed

    Ombelet, W

    2013-01-01

    Childlessness and infertility care are neglected aspects of family planning in resource-poor countries, although the consequences of involuntary childlessness are much more dramatic and can create more wide ranging societal problems compared to Western societies, particularly for women. Because many families in developing countries completely depend on children for economic survival, childlessness has to be regarded as a social and public health issue and not only as an individual medical problem. In the Walking Egg Project we strive to raise awareness surrounding childlessness in resource-poor countries and to make infertility care in all its aspects, including assisted reproductive technologies, available and accessible for a much larger part of the world population. We hope to achieve this goal through innovation and research, advocacy and networking, training and capacity building and service delivery. The Walking Egg non-profit organization has chosen a holistic approach of reproductive health and therefore strengthening infertility care should go together with strengthening other aspects of family planning and mother care. Right from the start The Walking Project has approached the problem of infertility in a multidisciplinary and global manner. It gathers medical, social, ethical, epidemiological, juridical and economical scientists and experts along with artists and philosophers to discuss and work together towards its goal. We recently developed a simplified tWE lab IVF culture system with excellent results. According to our first cost calculation, the price of a single IVF cycle using the methodologies and protocols we described, seems to be less than 200 Euros. We realize that universal access to infertility care can only be achieved when good quality but affordable infertility care is linked to effective family planning and safe motherhood programmes. Only a global project with respect to sociocultural, ethical, economical and political differences can be successful. PMID:24753941

  2. Epigenetic regulation of the RHOX homeobox gene cluster and its association with human male infertility

    PubMed Central

    Richardson, Marcy E.; Bleiziffer, Andreas; Tttelmann, Frank; Gromoll, Jrg; Wilkinson, Miles F.

    2014-01-01

    The X-linked RHOX cluster encodes a set of homeobox genes that are selectively expressed in the reproductive tract. Members of the RHOX cluster regulate target genes important for spermatogenesis promote male fertility in mice. Studies show that demethylating agents strongly upregulate the expression of mouse Rhox genes, suggesting that they are regulated by DNA methylation. However, whether this extends to human RHOX genes, whether DNA methylation directly regulates RHOX gene transcription and how this relates to human male infertility are unknown. To address these issues, we first defined the promoter regions of human RHOX genes and performed gain- and loss-of-function experiments to determine whether human RHOX gene transcription is regulated by DNA methylation. Our results indicated that DNA methylation is necessary and sufficient to silence human RHOX gene expression. To determine whether RHOX cluster methylation associates with male infertility, we evaluated the methylation status of RHOX genes in sperm from a large cohort of infertility patients. Linear regression analysis revealed a strong association between RHOX gene cluster hypermethylation and three independent types of semen abnormalities. Hypermethylation was restricted specifically to the RHOX cluster; we did not observe it in genes immediately adjacent to it on the X chromosome. Our results strongly suggest that human RHOX homeobox genes are under an epigenetic control mechanism that is aberrantly regulated in infertility patients. We propose that hypermethylation of the RHOX gene cluster serves as a marker for idiopathic infertility and that it is a candidate to exert a causal role in male infertility. PMID:23943794

  3. AB23. Male infertility: forgotten issue in mens health

    PubMed Central

    Soebadi, Doddy M.

    2014-01-01

    In general, the mans response to infertility has been viewed as taking less of an emotionally than his partners. While the findings on quality of life (QoL) of infertile women have shown mainly agreement, this seems not to be the case in men. Studies on mens QoL have resulted in inconclusive findings. It is clear that male infertility is one of important issues in mens health as it could alter the mens self-esteem (read: quality of life). Medical recommendations to resolve male infertility problems can be classified into three categories; surgical or medical therapy, donor insemination (DI), and assisted reproductive technologies (ART). Psychological research and consultation have been most implicated with the latter two recommendations. The fact that some infertile couples can realize their goal of forming a biological family when here to fore such as possibility was denied them, serves to strengthen the family unit. In vitro fertilization (IVF) offers a chance to produce a child for those men who are sub-fertile, that is, have a low sperm count, poor sperm motility or morphology. Overall, there is much evidence to show that women react more intensely to IVF than men. Research has shown that prior to IVF, women report more anxiety and depression, and after treatment failure depressive symptomatology is less common in men. More surprisingly are recent findings, which show that men and women are similar in terms of how they respond to different stages of an IVF cycle. Authors experience with PESA and TESE showed good results in the treatment of male factor infertility, with good participation of the males partner.

  4. CYP19 gene variant confers susceptibility to endometriosis-associated infertility in Chinese women

    PubMed Central

    Wang, Ledan; Lu, Xiaosheng; Wang, Danhan; Qu, Wanglei; Li, Wenju; Xu, Xiaowen; Huang, Qiusui; Han, Xueying; Lv, Jieqiang

    2014-01-01

    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 casecontrol 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 (2.066.50)) 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

  5. Sexual Satisfaction and Sexual Reactivity in Infertile Women: The Contribution of The Dyadic Functioning and Clinical Variables

    PubMed Central

    Czyżkowska, Anna; Awruk, Katarzyna; Janowski, Konrad

    2016-01-01

    Background Infertility is a factor which has been linked to higher prevalence of sexual dysfunctions in women; however, ambiguous results have been reported about the impact of infertility on women’s sexual satisfaction. The purpose of this study was to compare sexual and dyadic functioning in infertile and fertile women. Furthermore, the associations between sexual variables and clinical variables (depressive symptoms, period trying to conceive, and treatment period) were assessed in infertile women sample. Materials and Methods The cross-sectional study involved 50 women with the history of infertility and 50 fertile women recruited from the general population. The Sexual Satisfaction Scale (SSS), Mell-Krat Scale (women’s version), Family Assessment Measure (FAM-III), and Beck Depression Inventory (BDI) were administered to all participants. Results Infertile women reported lower sexual satisfaction and more maladaptive patterns of dyadic functioning in comparison to the control group. As many as 45 (90%) of infertile women, compared to 13 (26%) of the control group, reported the scores on the Mell-Krat Scale indicative of the presence of dysfunctions in sexual reactivity (P≤0.001). Infertile women reported significantly higher levels of depressive symptoms than the women from the control group (P≤0.001). Negative correlations were observed between sexual satisfaction and dyadic functioning in both groups (P≤0.05); however, the patterns of these associations were different in infertile and fertile women. For example, negative correlations were found between satisfaction with control and task accomplishment, role performance, affective involvement, and values and norms in infertile women. However, these relationships were not observed in the control group. No correlations were revealed between sexual reactivity and dyadic functioning in infertile women and the control group. Negative correlations were observed between satisfaction with control and relationship duration and treatment period as well as between sexual reactivity and period of trying to conceive. Multiple regression analyses also revealed different predictors of sexual satisfaction in both groups: affective involvement (P≤0.05) and relationship duration (P≤0.05) in infertile women, whereas communication (P≤0.05), affective expression (P≤0.05) and depressive symptoms (P≤0.05) in the control group. Conclusion Infertility is an important factor affecting sexual and dyadic functioning and is linked to higher depressive symptoms in infertile women. PMID:26985333

  6. [Developmental and environnemental origin of male infertility: role of endocrine disruptors].

    PubMed

    Mauduit, Claire; Siddeek, Bénazir; Benahmed, Mohamed

    2016-01-01

    Human and wildlife exposure to chemicals is thought to be extensive and particularly to endocrine-disrupting chemicals (EDCs) suspected to alter male reproductive tract. When the exposure occurs during perinatal period (fetal, neonatal periods or puberty) the reproductive health alterations are irreversible suggesting a developmental origin to male infertility. This concept is supported by numerous epidemiologic and experimental studies. This review summarizes the data concerning the epigenetic mechanisms (DNA methylation, chromatin remodelling, small-non coding RNAs) involved in developmentally-induced male infertility. These data open potentially to new diagnosis tools and new trails to assessment of EDCs risks. PMID:26850606

  7. Service utilization patterns for presumed infertile women in the Islamic Republic of Iran, 2004-2005.

    PubMed

    Ardalan, Ali; Vahidi, Serajeldin; Mohammad, Kazem; Russel, Mehdi

    2010-01-01

    Understanding the utilization pattern of infertility health and medical services can assist health system managers in providing better and more efficient care to affected population. This study aims to investigate the patterns in the utilization of infertility services in Iran.We performed a survey of 10 783 women in 28 provinces from 2004 to 2005. We used a systematic sampling method to draw a total of 400 clusters, the probability for selection being proportional to the size of the urban and rural population in each province. The categorization of the woman as "presumed infertile" was based on her own report of infertility at some time during her married life. We also studied the measures taken for the latest episode of presumed infertility. For each of these measures, we recorded the reason(s), the year in which it was taken, and the time interval separating it from contraceptive discontinuation. Data analysis, using the software package STATA 8.0, included descriptive statistics and computation of 95% confidence intervals (CI) as well as chi(2) and logistic regression procedures adapted to the complex sampling design.A total of 1592 women had presumed infertility at some period after their marriage (14.8%, CI0.95 = 13.8-15.7%), and 1291 subjects had taken measures to deal with the problem (81.1%, CI0.95 = 78.7-83.5%). These rates did not show any significant differences between urban and rural women (p > 0.05). In 70% of these cases, the first measure was a visit to a specialist physician and in 70% the woman had sought care in the private sector. Visits to specialists and private health care facilities had increased over the last three decades, with fewer visits to general practitioners (GPs) and midwives and less use of self-medication or traditional/local therapies. The most common motive for those who had not taken any treatment was their unwillingness to have their problem known and discussed by others (29.3%). The determinants of treatment-seeking behavior were current primary infertility (OR = 4.15, CI0.95 = 2.53-6.80), higher education (OR = 1.39, CI0.95 = 1.04-1.86) and living with husband (OR = 1.83, CI0.95 = 1.01-3.32).The current study is the first attempt to present a population-based pattern of service utilization by infertile women in Iran. It shows that for these patients, the first contact with the health system takes the form of a visit to a specialist physician, and is more likely to involve the private sector. PMID:20066667

  8. Hysteroscopic metroplasty in women with primary infertility and septate uterus: reproductive performance after surgery.

    TOXLINE Toxicology Bibliographic Information

    Dalal RJ; Pai HD; Palshetkar NP; Takhtani M; Pai RD; Saxena N

    2012-01-01

    OBJECTIVE: To assess reproductive performance in women with septate uterus and otherwise unexplained infertility after hysteroscopic metroplasty.STUDY DESIGN: A total of 72 women with septate uterus and otherwise unexplained primary infertility were included in the study. All of the women underwent hysteroscopic septal resection. Reproductive performance of these women within one year of surgery was studied and analyzed.RESULTS: Thirty-three women (45.83%) conceived within one year of surgery. Only 4 women (12%) had spontaneous abortions, and only 5 (15%) had preterm delivery.CONCLUSION: Hysteroscopic metroplasty in women with septate uterus significantly improves reproductive outcomes.

  9. The Potential Use of Intrauterine Insemination as a Basic Option for Infertility: A Review for Technology-Limited Medical Settings

    PubMed Central

    Abdelkader, Abdelrahman M.; Yeh, John

    2009-01-01

    Objective. There is an asymmetric allocation of technology and other resources for infertility services. Intrauterine insemination (IUI) is a process of placing washed spermatozoa transcervically into the uterine cavity for treatment of infertility. This is a review of literature for the potential use of IUI as a basic infertility treatment in technology-limited settings. Study design. Review of articles on treatment of infertility using IUI. Results. Aspects regarding the use of IUI are reviewed, including ovarian stimulation, semen parameters associated with good outcomes, methods of sperm preparation, timing of IUI, and number of inseminations. Implications of the finding in light of the needs of low-technology medical settings are summarized. Conclusion. The reviewed evidence suggests that IUI is less expensive, less invasive, and comparably effective for selected patients as a first-line treatment for couples with unexplained or male factor infertility. Those couples may be offered three to six IUI cycles in technology-limited settings. PMID:20011061

  10. The problem of infertility in high fertility populations: meanings, consequences and coping mechanisms in two Nigerian communities.

    PubMed

    Hollos, Marida; Larsen, Ulla; Obono, Oka; Whitehouse, Bruce

    2009-06-01

    This paper examines how socio-economic contexts shape local meanings of infertility, how the prevalence of infertility affects these meanings, and how the above affect community responses, life experiences and infertility treatment-seeking behaviors in two African communities. The paper is based on interdisciplinary research conducted among the Ijo and the Yakurr people of southern Nigeria that included a survey of approximately 100 infertile women and a matching sample of 100 fertile women, as well as in-depth ethnographic interviews with infertile and fertile women in two communities: Amakiri in Delta State and Lopon in Cross River State. In-depth interview results show that female infertility is more problematic among the Ijo in Amakiri, where kinship is patrilineal (traced through the father's side), than among the Yakurr in Lopon, where kinship is double unilineal (traced through both parents). Childless women in Ijo society are not only disadvantaged economically but are prevented from attaining full adult womanhood. They therefore leave the community more often than other members. In Lopon there is also a strong preoccupation with fertility as a central fact of life, but infertile women receive support from maternal kin as well as voluntary associations serving as support groups. Our survey data confirm that there are significant differences between the life experiences of infertile and fertile women and between the infertile women of the two communities. The overall findings indicate that while there are variations in the extent to which infertility is considered problematic, the necessity for a woman to have a child remains basic in this region. Motherhood continues to define an individual woman's treatment in the community, her self-respect and her understanding of womanhood. PMID:19356835

  11. Male infertility in long-term survivors of pediatric cancer: A report from the Childhood Cancer Survivor Study

    PubMed Central

    Wasilewski-Masker, K; Seidel, K D; Leisenring, W; Mertens, A C; Shnorhavorian, M; Ritenour, C W; Stovall, M; Green, D M; Sklar, C A; Armstrong, G T; Robison, L L; Meacham, L R

    2014-01-01

    Purpose The purpose of this study was to assess the prevalence of male infertility and treatment-related risk factors in childhood cancer survivors. Methods Within the Childhood Cancer Survivor Study, 1622 survivors and 274 siblings completed the Male Health Questionnaire. The analysis was restricted to survivors (938/1622; 57.8%) and siblings (174/274; 63.5%) who tried to become pregnant. Relative risks (RR) and 95% confidence intervals (CI) for the prevalence of self-reported infertility were calculated using generalized linear models for demographic variables and treatment-related factors to account for correlation among survivors and siblings of the same family. All statistical tests were two-sided. Results Among those who provided self-report data, the prevalence of infertility was 46.0% in survivors versus 17.5% in siblings (RR=2.64, 95% CI 1.88-3.70, p < 0.001). Of survivors who met the definition for infertility, 37% had reported at least one pregnancy with a female partner that resulted in a live birth. In a multivariable analysis, risk factors for infertility included an alkylating agent dose score (AAD) ? 3 (RR= 2.13, 95% CI 1.69-2.68 for AAD ? 3 versus AAD<3), surgical excision of any organ of the genital tract (RR=1.63, 95% CI 1.20-2.21), testicular radiation ? 4Gy (RR=1.99, 95% CI 1.52-2.61), and exposure to bleomycin (RR=1.55, 95% CI 1.20-2.01). Conclusion Many survivors who experience infertility father their own children suggesting episodes of both fertility and infertility. This and the novel association of infertility with bleomycin warrant further investigation. Implications for Cancer Survivors Though infertility is common, male survivors reporting infertility often father their own children. Bleomycin may pose some fertility risk. PMID:24711092

  12. The problem of infertility in high fertility populations: Meanings, consequences and coping mechanisms in two Nigerian communities

    PubMed Central

    Hollos, Marida; Larsen, Ulla; Obono, Oka; Whitehouse, Bruce

    2014-01-01

    This paper examines how socio-economic contexts shape local meanings of infertility, how the prevalence of infertility affects these meanings, and how the above affect community responses, life experiences and infertility treatment-seeking behaviors in two African communities. The paper is based on interdisciplinary research conducted among the Ijo and the Yakurr people of southern Nigeria that included a survey of approximately 100 infertile women and a matching sample of 100 fertile women, as well as in-depth ethnographic interviews with infertile and fertile women in two communities: Amakiri in Delta State and Lopon in Cross River State. In-depth interview results show that female infertility is more problematic among the Ijo in Amakiri, where kinship is patrilineal (traced through the father's side), than among the Yakurr in Lopon, where kinship is double unilineal (traced through both parents). Childless women in Ijo society are not only disadvantaged economically but are prevented from attaining full adult womanhood. They therefore leave the community more often than other members. In Lopon there is also a strong preoccupation with fertility as a central fact of life, but infertile women receive support from maternal kin as well as voluntary associations serving as support groups. Our survey data confirm that there are significant differences between the life experiences of infertile and fertile women and between the infertile women of the two communities. The overall findings indicate that while there are variations in the extent to which infertility is considered problematic, the necessity for a woman to have a child remains basic in this region. Motherhood continues to define an individual woman's treatment in the community, her self-respect and her understanding of womanhood. PMID:19356835

  13. Where are all the men? The marginalization of men in social scientific research on infertility.

    PubMed

    Culley, Lorraine; Hudson, Nicky; Lohan, Maria

    2013-09-01

    There is a wealth of research exploring the psychological consequences of infertility and assisted reproduction technology, a substantial body of sociological and anthropological work on 'reproductive disruptions' of many kinds and a small but growing literature on patient perspectives of the quality of care in assisted reproduction. In all these fields, research studies are far more likely to be focused on the understandings and experiences of women than those of men. This paper discusses reasons for the relative exclusion of men in what has been called the 'psycho-social' literature on infertility, comments on research on men from psychological and social perspectives and recent work on the quality of patient care, and makes suggestions for a reframing of the research agenda on men and assisted reproduction. Further research is needed in all areas, including: perceptions of infertility and infertility treatment seeking; experiences of treatment; information and support needs; decisions to end treatment; fatherhood post assisted conception; and the motivation and experiences of sperm donors and men who seek fatherhood through surrogacy or co-parenting. This paper argues for multimethod, interdisciplinary research that includes broader populations of men which can contribute to improved clinical practice and support for users of assisted reproduction treatment. PMID:23871364

  14. [The role and contribution of transvaginal endoscopy to diagnostics and treatment of infertility].

    PubMed

    Kopitovi?, Vesna; Pjevi?, Aleksandra Trnini?; Milatovi?, Stevan

    2013-01-01

    Transvaginal endoscopy (TVE) presents minimal invasive endoscopic method that involves hysteroscopy, transvaginal laparoscopy and salpingoscopy. It gives a new approach to both basic evaluation of marital infertility and its treatment. The role of TVE is a subject of controversies regarding its justification as standard infertility treatment. Another aspect is a role of TVE prior to methods of assisted reproductive technologies (ART). The aim of this paper was to try, through the analysis of the available literature, to clarify the role of TVE in reproductive medicine, as well as to show our experience. The concept of one-day diagnostics, which is so-called one stop fertility clinic, is performed in the Clinical Center of Vojvodina, Department of Gynecology and Obstetrics on a daily basis. It consists of history, gynecology and ultrasound exam, spermiogram, hormone tests, and TVE. Patients are informed about results on the very same day and advised on the proper infertility treatment. By forming the infertility diagnostics protocols, which use the methods of TVE, we consider it possible to evaluate adequately and accurately the fertility within the shortest possible time. It replaced standard laparoscopy in certain indication fields; it eventually confirmed the necessity of its use in recurrent IVF implantation failure, raising the question of its routine use prior to the first IVF cycle that is a topic requiring further randomized trials. PMID:24502108

  15. Comparing the effectiveness of infertility treatments by numbers needed to treat (NNT).

    PubMed

    Comhaire, F; Decleer, W

    2012-12-01

    To compare the clinical efficiency of different modes of treatment of infertile couples and to estimate the possible benefit of nutraceutical food supplementation (NFS), the numbers needed to treat (NNT) was calculated in 4143 infertile couples based on controlled trials in recent literature and personal data. The NNT expresses the number of individuals who need to be treated to obtain one complementary pregnancy. In female infertility, the NNT of mild or moderate endometriosis was 8.4, and in anti-estrogens treatment of anovulation, it was 5.9. In tamoxifen treatment of idiopathic oligozoospermia, NNT was 3.9, and in antioxidant supplementation, it was 7.8. Treatment of varicocele yielded NNT of 6.3 and 6.8 after 1year in multi- or single-centre trials, respectively, and NFS lowered the NNT after 3months to 2.6. Adding NFS to the male partner increased the ongoing pregnancy rate by IVF with NNT of 8.3, and adding NFS to both partners reduced the NNT to 4.0. Although these results were obtained in heterogeneous trials and populations, it is suggested that the NNT should be useful for comparing the effectiveness of different modes of treatment of the infertile couple, and that complementary nutraceutical food supplementation may be beneficial. PMID:22536793

  16. Hippo signaling disruption and Akt stimulation of ovarian follicles for infertility treatment.

    PubMed

    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

    2013-10-22

    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. PMID:24082083

  17. Coenzyme Q10, ?-Tocopherol, and Oxidative Stress Could Be Important Metabolic Biomarkers of Male Infertility

    PubMed Central

    Kucharsk, Jarmila; Dubravicky, Jozef; Mojto, Viliam; Singh, Ram B.

    2015-01-01

    Oxidative stress, decreased antioxidant capacity, and impaired sperm mitochondrial function are the main factors contributing to male infertility. The goal of the present study was to assess the effect of the per os treatment with Carni-Q-Nol (440?mg L-carnitine fumarate + 30?mg ubiquinol + 75?IU vitamin E + 12?mg vitamin C in each softsule) in infertile men on sperm parameters, concentration of antioxidants (coenzyme Q10,??CoQ10-TOTAL, ?, and ?-tocopherols), and oxidative stress in blood plasma and seminal fluid. Forty infertile men were supplemented daily with two or three Carni-Q-Nol softsules. After 3 and 6 months of treatment, improved sperm density was observed (by 48.9% and 80.9%, resp.) and after 3-month treatment the sperm pathology decreased by 25.8%. Concentrations of CoQ10-TOTAL (ubiquinone + ubiquinol) and ?-tocopherol were significantly increased and the oxidative stress was decreased. In conclusion, the effect of supplementary therapy with Carni-Q-Nol showed benefits on sperm function in men, resulting in 45% pregnancies of their women. We assume that assessment of oxidative stress, CoQ10-TOTAL, and ?-tocopherol in blood plasma and seminal fluid could be important metabolic biomarkers in both diagnosis and treatment of male infertility. PMID:25810566

  18. Coenzyme Q??, ?-tocopherol, and oxidative stress could be important metabolic biomarkers of male infertility.

    PubMed

    Gvozdjkov, Anna; Kucharsk, Jarmila; Dubravicky, Jozef; Mojto, Viliam; Singh, Ram B

    2015-01-01

    Oxidative stress, decreased antioxidant capacity, and impaired sperm mitochondrial function are the main factors contributing to male infertility. The goal of the present study was to assess the effect of the per os treatment with Carni-Q-Nol (440?mg L-carnitine fumarate + 30?mg ubiquinol + 75?IU vitamin E + 12?mg vitamin C in each softsule) in infertile men on sperm parameters, concentration of antioxidants (coenzyme Q10,??CoQ(10-TOTAL), ?, and ?-tocopherols), and oxidative stress in blood plasma and seminal fluid. Forty infertile men were supplemented daily with two or three Carni-Q-Nol softsules. After 3 and 6 months of treatment, improved sperm density was observed (by 48.9% and 80.9%, resp.) and after 3-month treatment the sperm pathology decreased by 25.8%. Concentrations of CoQ(10-TOTAL) (ubiquinone + ubiquinol) and ?-tocopherol were significantly increased and the oxidative stress was decreased. In conclusion, the effect of supplementary therapy with Carni-Q-Nol showed benefits on sperm function in men, resulting in 45% pregnancies of their women. We assume that assessment of oxidative stress, CoQ(10-TOTAL), and ?-tocopherol in blood plasma and seminal fluid could be important metabolic biomarkers in both diagnosis and treatment of male infertility. PMID:25810566

  19. The History and Challenges Surrounding Ovarian Stimulation in the Treatment of Infertility

    PubMed Central

    Beall, Stephanie A.; Decherney, Alan

    2014-01-01

    OBJECTIVE To examine the history of superovulation for ovulation induction, its contributions to reproductive medicine and its impact on multiple births. DESIGN A search of the relevant literature using Pubmed and other online tools. RESULT(S) Infertility has been a condition known and studied for thousands of years. However, it was not until this past century that effective treatments were developed. With the advancement of our knowledge of the hypothalamic-pituitary axis, therapies utilizing gonadotropins were developed to stimulate ovulation. Not only were we now able to treat anovulatory infertility, but also induce superovulation for in vitro fertilization. With these successes came consequences, including increased multiple pregnancies. Several countries recognized the high costs associated with multiple births and implemented regulations on the infertility industry. The rate of triplet and higher-order multiples has declined over the past decade. This is largely attributed to a decreased number of embryos transferred. Nonetheless, the twin rate has remained consistently high. CONCLUSION(S) Superovulation has become a routine medical therapy used for ovulation induction and in vitro fertilization. With the development of this technology have come effective therapies for infertility and new ethical and medical challenges. Since the advent of gonadotropin therapy we have already developed technologies to improve monitoring and decrease hyperstimulation and high order multiple pregnancies. In the future, we anticipate new tools devised to optimize one embryo for one singleton live birth. PMID:22463773

  20. Preovulatory uterine flushing with saline as a treatment for unexplained infertility: a randomised controlled trial protocol

    PubMed Central

    Dodin, Sylvie; Moore, Lynne; Bujold, Emmanuel; Lefebvre, Jessica; Bergeron, Marie-Ève

    2016-01-01

    Introduction In vitro fertilisation (IVF) is the treatment of choice for unexplained infertility. Preovulatory uterine flushing could reduce intrauterine debris and inflammatory factors preventing pregnancy and constitute an alternative to IVF. Our objective is to assess the efficacy of preovulatory uterine flushing with physiological saline for the treatment of unexplained infertility. Methods and analysis We will perform a randomised controlled trial based on consecutive women aged between 18 and 37 years consulting for unexplained infertility for at least 1 year. On the day of their luteinising hormone surge, 192 participants will be randomised in two equal groups to either receive 20 mL of physiological saline by an intrauterine catheter or 10 mL of saline intravaginally. We will assess relative risk of live birth (primary outcome), as well as pregnancy (secondary outcome) over one cycle of treatment. We will report the side effects, complications and acceptability of the intervention. Ethics and dissemination This project was approved by the Ethics committee of the Centre Hospitatlier Universitaire de Quebec (no 2015–1146). Uterine flushing is usually well tolerated by women and would constitute a simple, affordable and minimally invasive treatment for unexplained infertility. We plan to communicate the results of the review by presenting research abstracts at conferences and by publishing the results in a peer-reviewed journal. Trial registration number NCT02539290; Pre-results. PMID:26739737

  1. Effect of Sperm Count on Success of Intrauterine Insemination in Couples Diagnosed with Male Factor Infertility

    PubMed Central

    Zhang, Erhong; Tao, Xin; Xing, Weijie; Cai, Liuhong; Zhang, Bin

    2014-01-01

    Objective: To exam semen parameters in predicting intrauterine insemination (IUI) outcomes in couples with male factor. Study design: This retrospective study was performed at department of infertility and sexual medicine from September 2007 to February 2014. 307 couples with male factor infertility were included and 672 IUI cycles were analyzed. Results: From 672 inseminations performed on 307 couples, there are 27.36% couples get pregnancy (84 out of 307) and the overall pregnancy rate was 12.95% (87 out of 672) of IUI. With the increase of post total progressive sperm count, the clinical pregnancy rate increased. When the initial progressive sperm count was lower than 5*106, there was no pregnant in the IUI cycle. At the end of the third cycle, 85 clinical pregnancies had been achieved (97.70%). Conclusions: The initial total progressive sperm count lower than 5*106 means the poor outcome of IUI in the infertile couples with male factor. If the infertile couples with male factor dont get pregnancy after three IUI cycles, the couples should receive re-assessment or other artificial reproductive technology. PMID:25568631

  2. VALUING REDUCTIONS IN ENVIRONMENTAL SOURCES OF INFERTILITY RISK USING THE EFFICIENT HOUSEHOLD FRAMEWORK

    EPA Science Inventory

    There is an increasing body evidence suggesting that a broad range of pollutants have the potential to alter human endocrine systems. One disturbing consequence of exposures to these endocrine disruptors is that they may significantly increase the incidence of infertility in exp...

  3. Infertility and Crisis: Self-Discovery and Healing through Poetry Writing.

    ERIC Educational Resources Information Center

    Barney, Anne

    1992-01-01

    Offers a personal narrative on how the author's own poetry helped her cope with the crisis of infertility, serving as a tool for self-discovery and healing. Suggests that specific advantages of poetry writing within the context of psychotherapy include problem solving; expression of feelings; insight; couple communication; and individual and…

  4. Partnered Decisions? U.S. Couples and Medical Help-Seeking for Infertility

    ERIC Educational Resources Information Center

    Johnson, Katherine M.; Johnson, David R.

    2009-01-01

    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…

  5. Couple Infertility: From the Perspective of the Close-Relationship Model.

    ERIC Educational Resources Information Center

    Higgins, Barbara S.

    1990-01-01

    Presents Close-Relationship Model as comprehensive framework in which to examine interrelated nature of causes and effects of infertility on marital relationship. Includes these factors: physical and psychological characteristics of both partners; joint, couple characteristics; physical and social environment; and relationship itself. Discusses…

  6. Treating Faith-Based Infertile Couples Using Cognitive-Behavioral Counseling Strategies: A Preliminary Investigation

    ERIC Educational Resources Information Center

    Smith, June A.; Smith, Alanzo H.

    2004-01-01

    The authors have found no study that addressed the influence of religious practices, biblical texts, and a spiritual environment on the dynamics of coping with crises often experienced by couples who are infertile and who transition into childlessness. Twenty-five couples from the greater New York area who were referred by religious leaders

  7. Epidemic seasonal infertility a hypothesis for the cause of seasonal variation of births

    NASA Astrophysics Data System (ADS)

    Miura, T.; Shimura, M.

    1980-03-01

    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 may possibly be immune or different in their susceptibility to these infertile factors. Therefore, mothers born in a particular low birth rate season would tend to bear babies more frequently in that season than the others. To examine this hypothesis, birth records in 1930 of two maternity hospitals in Tokyo were investigated. These years were chosen for a period when seasonality of birth was most prominent in Japan. First babies were excluded to eliminate disturbances by season of marriages and other possible non-biological factors. The results show that among 1038 mothers born in a low birthrate season, May July, 245 (23.6%) had babies in May July, while the other mothers had significantly less babies (19.0%, 819/4302, P<0.001) in the same season. This may imply that seasonality of birth may have been influenced by some immunogenic infertile factors epidemic in a particular season.

  8. The Efficiency of a Group-Specific Mandated Benefit Revisited: The Effect of Infertility Mandates

    ERIC Educational Resources Information Center

    Lahey, Joanna N.

    2012-01-01

    This paper examines the labor market effects of state health insurance mandates that increase the cost of employing a demographically identifiable group. State mandates requiring that health insurance plans cover infertility treatment raise the relative cost of insuring older women of child-bearing age. Empirically, wages in this group are

  9. TNF-? -308 polymorphisms and male infertility risk: A meta-analysis and systematic review.

    PubMed

    Mostafa, Taymour; Taymour, Mai

    2016-03-01

    This study aimed to conduct a systematic review and meta-analysis of prospective studies discussing TNF-? -308 polymorphism and male infertility. This study was conformed to Preferred Reported Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase and Scopus databases were searched to identify relevant studies by two independent reviewers. Hazard ratios were pooled using fixed-effect or random-effects models when appropriate. Q-test was performed to evaluate study heterogeneity and publication bias appraised using funnel plots. The search yielded five studies (three of Caucasians ethnicity and 2 of Asian ethnicity) comprising 2939 men (2262 infertile men and 677 fertile controls). Most of the studied cases were carried out on TNF-? promoter region at positions -308 G/A (four studies) where -308 C/T was dealt with in one study. Overall, significant associations between TNF-? -308 gene polymorphisms and idiopathic male infertility risk were observed (fixed effect: OR=0.472, 95% CI: 0.378-0.589; P=0.001; random effect: OR=0.407, 95% CI: 0.211-0.785; P=0.007) with robust findings according to sensitivity analyses. Funnel plot inspections did not give evidences of publication bias. A stratified analysis performed for ethnic groups revealed significant association in both Caucasian and Asian populations. It is concluded that there are evidences of associations between TNF-? -308 gene polymorphisms and male infertility risk. PMID:26966560

  10. Infertility and Crisis: Self-Discovery and Healing through Poetry Writing.

    ERIC Educational Resources Information Center

    Barney, Anne

    1992-01-01

    Offers a personal narrative on how the author's own poetry helped her cope with the crisis of infertility, serving as a tool for self-discovery and healing. Suggests that specific advantages of poetry writing within the context of psychotherapy include problem solving; expression of feelings; insight; couple communication; and individual and

  11. Partnered Decisions? U.S. Couples and Medical Help-Seeking for Infertility

    ERIC Educational Resources Information Center

    Johnson, Katherine M.; Johnson, David R.

    2009-01-01

    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

  12. The Efficiency of a Group-Specific Mandated Benefit Revisited: The Effect of Infertility Mandates

    ERIC Educational Resources Information Center

    Lahey, Joanna N.

    2012-01-01

    This paper examines the labor market effects of state health insurance mandates that increase the cost of employing a demographically identifiable group. State mandates requiring that health insurance plans cover infertility treatment raise the relative cost of insuring older women of child-bearing age. Empirically, wages in this group are…

  13. MOLECULAR ANALYSIS OF HUMAN SPERMATOZOA: POTENTIAL FOR INFERTILITY RESEARCH AND SCREENING

    EPA Science Inventory

    Molecular Analysis of Human Spermatozoa: Potential for Infertility Research and Screening
    David Miller1, David Dix2, Robert Reid3, Susan Wykes3 and Stephen Krawetz3
    1Reproductive Biology Group, University of Leeds, UK
    2Reproductive Toxicology Division, U.S. Environmenta...

  14. 'Everybody is moving on': infertility, relationality and the aesthetics of family among British-Pakistani Muslims.

    PubMed

    Hampshire, Katherine R; Blell, Mwenza T; Simpson, Bob

    2012-04-01

    It is now widely recognised that experiences of infertility are socially and culturally contingent. Drawing on reproductive narratives of 108 British-Pakistani Muslims living in Northeast England (collected from 2007 to 2010), we show that subjective experiences of infertility in this population can take many forms, from 'straightforward' childlessness to concerns about inability to fulfil a range of reproductive expectations, desires and obligations, regarding timing, gender balance and number of offspring. Extended family relations are pivotal in the processes through which reproduction (or lack thereof) becomes defined as problematic. Changing family aesthetics can thus shape individuals' experiences of infertility in important ways. A growing emphasis on conjugal relationships for some couples offers a greater range of reproductive possibilities (enabling, for example, a period of voluntary childlessness). For others, increasing nuclearisation of family life reduces the possibilities for extended families to 'plug the gap' by providing proxy-children and a normalised social role for infertile couples. Moreover, such social roles may be time-limited, creating serious challenges for the long-term childless, who find themselves caught 'betwixt and between' two disparate sets of values. PMID:22349077

  15. Human and Pathogen Factors Associated with Chlamydia trachomatis-Related Infertility in Women.

    PubMed

    Menon, S; Timms, P; Allan, J A; Alexander, K; Rombauts, L; Horner, P; Keltz, M; Hocking, J; Huston, W M

    2015-10-01

    Chlamydia trachomatis is the most common bacterial sexually transmitted pathogen worldwide. Infection can result in serious reproductive pathologies, including pelvic inflammatory disease, ectopic pregnancy, and infertility, in women. However, the processes that result in these reproductive pathologies have not been well defined. Here we review the evidence for the human disease burden of these chlamydial reproductive pathologies. We then review human-based evidence that links Chlamydia with reproductive pathologies in women. We present data supporting the idea that host, immunological, epidemiological, and pathogen factors may all contribute to the development of infertility. Specifically, we review the existing evidence that host and pathogen genotypes, host hormone status, age of sexual debut, sexual behavior, coinfections, and repeat infections are all likely to be contributory factors in development of infertility. Pathogen factors such as infectious burden, treatment failure, and tissue tropisms or ascension capacity are also potential contributory factors. We present four possible processes of pathology development and how these processes are supported by the published data. We highlight the limitations of the evidence and propose future studies that could improve our understanding of how chlamydial infertility in women occurs and possible future interventions to reduce this disease burden. PMID:26310245

  16. Evaluation of sperm retrieval rate with bilateral testicular sperm extraction in infertile patients with azoospermia

    PubMed Central

    Moein, Mohammad Reza; Moein, Mahmoud Reza; Ghasemzadeh, Jalal; Pourmasoumi, Soheila

    2015-01-01

    Background: About 10% to 15% of infertile men have azoospermia, which could be obstructive or non-obstructive. Diagnostic biopsy from the testis and recently testicular sperm extraction (TESE) are the most precise investigations in these patients. Testicular biopsy can be done unilaterally or bilaterally. The worth of unilateral or bilateral testicular biopsy in men with azoospermia is controversial. Objective: To evaluate the necessity of bilateral diagnostic biopsy from the testis in new era of diagnosis and treatment of male infertility. Materials and Methods: In this retrospective study, we reviewed the results of testis biopsy in 419 azoospermic men, referred to Yazd Research and Clinical Center for Infertility from 2009-2013. Patients with known obstructive azoospermia were excluded from the study. Results: In totally, 254 infertile men (60.6%) were underwent unilateral TESE, which in 175 patients (88.4%) sperm were extracted from their testes successfully. Bilateral testis biopsy was done in 165 patients (39.4%) which in 37 patients (22.4%), sperm were found in their testes tissues. Conclusion: Due to the low probability of positive bilateral TESE results especially when we can’t found sperm in the first side, we recommend that physicians re-evaluate the risk and benefit of this procedure in era of newer and more precise technique of sperm retrieval like micro TESE. PMID:26730246

  17. Hippo signaling disruption and Akt stimulation of ovarian follicles for infertility treatment

    PubMed Central

    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.

    2013-01-01

    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 fragmentationin 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. PMID:24082083

  18. Mapping men's anticipations and experiences in the reproductive realm: (in)fertility journeys.

    PubMed

    Hinton, Lisa; Miller, Tina

    2013-09-01

    This paper examines men's experiences of fertility/infertility against a backdrop of changing understandings of men's role in society and medical possibilities. It presents findings from two qualitative research projects on men's experiences of engagement with reproductive health services as they sought to become fathers and anticipate impending fatherhood. The findings from both projects provide insights into men's experiences of (in)fertility and their engagement with services set against cultural ideals of masculinity. Discussions of reproduction have historically focused most centrally upon women's bodies and maternal processes, leaving little space for consideration of men's experiences and perspectives. While women's experiences of infertility/fertility have been characterized in relation to productive or faulty biological processes, male infertility has been largely invisible and male fertility typically assumed. This context provides a difficult terrain for men in which to contemplate the potential of not being able to father a child. The findings discussed in this paper illuminate the ways in which men talk about and make sense of their reproductive journeys. In doing so, it challenges current understandings of masculinity and reproductive bodies and highlights the need to rethink how men are treated in reproductive spheres and how services to men are delivered. PMID:23871363

  19. Diagnostic diversity: the role of social class in diagnostic experiences of infertility.

    PubMed

    Bell, Ann V

    2014-05-01

    Research in the area of the sociology of diagnosis has recently expanded. Despite this development, the foundations of the social aspects of diagnoses, including race, class and gender, are relatively unexplored. Understanding such diversity is important, however, as researchers have shown that diagnoses have significant repercussions on the illness experience. This article is an effort to overcome this gap in the literature by examining class diversity in interpretations and understandings of diagnoses. Using the medicalised condition of infertility as a case example of class differences around diagnoses, I conducted 58 in-depth interviews with infertile women of various class backgrounds in the USA. By comparing the lived experiences of infertility between higher and lower class women, I explore differences in the understanding, interpretation and outcomes of diagnoses, specifically. Furthermore, among lower class women, I examine how they understand infertility outside the medical diagnostic framework. The findings reveal how interpretations and experiences of diagnoses vary depending on an individual's social location. In other words, the study demonstrates that class matters in terms of diagnoses and their understanding. PMID:24147827

  20. Ethical Dilemma and Management of Infertility in HIV Seropositive Discordant Couples: A Case Study in Nigeria.

    PubMed

    Umeora, Ouj; Chukwuneke, Fn

    2013-01-01

    The traditional African society places an invaluable premium on procreation and, in some communities, a woman's place in her matrimony is only confirmed on positive reproductive outcome. Infertility is rife in Nigeria, and HIV/acquired immunodeficiency syndrome (AIDS) infection is a global pandemic, which has led to a drop in life expectancy across the world. In Nigeria, a number of cultural norms relating to gender roles and power dynamics constitute a serious barrier to issues of sexuality and infertility. Couples are concerned about their infertility diagnostic test being disclosed to each other, especially before marriage. This concern is understandable, especially in an environment that lacks the modern concepts and attitude toward sexual matters. This is complicated by the advent of HIV/AIDS infection and the societal mind-set that look at seropostive individuals as transgressors. At present, sexual and reproductive health rights are currently not in place because ethical issues are not given prominence by many physicians in Nigeria. A case of an infertile and seropostive discordant couple, which raised a lot of medical and ethical concerns, is presented here to awaken the consciousness of Nigerian physicians and stimulate discussions on the ethical matters such as this in clinical practice. PMID:23634339

  1. Infertility resulting from transgenic I-PpoI male Anopheles gambiae in large cage trials

    PubMed Central

    Klein, T A; Windbichler, N; Deredec, A; Burt, A; Benedict, M Q

    2012-01-01

    Objectives Anopheles gambiae is the primary vector of malaria in sub-Saharan Africa and is a potential target of genetic control programs. We determined the capacity of male A. gambiae created by germline transformation to introduce infertility into stable age-distribution populations. We also determined effects of the transgenes on life history. Methods Stable age-distribution populations of A. gambiae mosquitoes were established in large indoor cages. Male mosquitoes carrying an I-PpoI homing endonuclease gene were introduced at 5 and 10 release rates where they competed with target male mosquitoes for matings. Similar trials were conducted in small cages with an additional 1 release level. Results Infertility was successfully introduced into all target populations. In supporting experiments, complete female infertility was observed in all strains and species of the A. gambiae complex to which transgenic males were mated. Life history experiments demonstrated that reductions in I-PpoI male vigor exist in the form of reduced adult male emergence, longevity and competitiveness. Discussion A. gambiae I-PpoI males are capable of introducing high levels of infertility in target populations in indoor cage trials. This was accomplished despite losses of vigor resulting from the HEG transgene. These results motivate further trials of sexually I-PpoI A. gambiae in outdoor cage and field trials. PMID:22595271

  2. Excess cholesterol induces mouse egg activation and may cause female infertility

    PubMed Central

    Yesilaltay, Ayce; Dokshin, Gregoriy A.; Busso, Dolores; Wang, Li; Galiani, Dalia; Chavarria, Tony; Vasile, Eliza; Quilaqueo, Linda; Orellana, Juan Andrés; Walzer, Dalia; Shalgi, Ruth; Dekel, Nava; Albertini, David F.; Rigotti, Attilio; Page, David C.; Krieger, Monty

    2014-01-01

    The HDL receptor scavenger receptor, class B type I (SR-BI) controls the structure and fate of plasma HDL. Female SR-BI KO mice are infertile, apparently because of their abnormal cholesterol-enriched HDL particles. We examined the growth and meiotic progression of SR-BI KO oocytes and found that they underwent normal germinal vesicle breakdown; however, SR-BI KO eggs, which had accumulated excess cholesterol in vivo, spontaneously activated, and they escaped metaphase II (MII) arrest and progressed to pronuclear, MIII, and anaphase/telophase III stages. Eggs from fertile WT mice were activated when loaded in vitro with excess cholesterol by a cholesterol/methyl-β-cyclodextrin complex, phenocopying SR-BI KO oocytes. In vitro cholesterol loading of eggs induced reduction in maturation promoting factor and MAPK activities, elevation of intracellular calcium, extrusion of a second polar body, and progression to meiotic stages beyond MII. These results suggest that the infertility of SR-BI KO females is caused, at least in part, by excess cholesterol in eggs inducing premature activation and that cholesterol can activate WT mouse eggs to escape from MII arrest. Analysis of SR-BI KO female infertility raises the possibility that abnormalities in cholesterol metabolism might underlie some cases of human female infertility of unknown etiology. PMID:25368174

  3. Bisphenol-A and Female Infertility: A Possible Role of Gene-Environment Interactions

    PubMed Central

    Huo, Xiaona; Chen, Dan; He, Yonghua; Zhu, Wenting; Zhou, Wei; Zhang, Jun

    2015-01-01

    Background: Bisphenol-A (BPA) is widely used and ubiquitous in the environment. Animal studies indicate that BPA affects reproduction, however, the gene-environment interaction mechanism(s) involved in this association remains unclear. We performed a literature review to summarize the evidence on this topic. Methods: A comprehensive search was conducted in PubMed using as keywords BPA, gene, infertility and female reproduction. Full-text articles in both human and animals published in English prior to December 2014 were selected. Results: Evidence shows that BPA can interfere with endocrine function of hypothalamic-pituitary axis, such as by changing gonadotropin-releasing hormones (GnRH) secretion in hypothalamus and promoting pituitary proliferation. Such actions affect puberty, ovulation and may even result in infertility. Ovary, uterus and other reproductive organs are also targets of BPA. BPA exposure impairs the structure and functions of female reproductive system in different times of life cycle and may contribute to infertility. Both epidemiological and experimental evidences demonstrate that BPA affects reproduction-related gene expression and epigenetic modification that are closely associated with infertility. The detrimental effects on reproduction may be lifelong and transgenerational. Conclusions: Evidence on gene-environment interactions, especially from human studies, is still limited. Further research on this topic is warranted. PMID:26371021

  4. USING DNA MICROARRAYS TO CHARACTERIZE GENE EXPRESSION IN TESTES OF FERTILE AND INFERTILE HUMANS AND MICE

    EPA Science Inventory

    USING DNA MICROARRAYS TO CHARACTERIZE GENE EXPRESSION
    IN TESTES OF FERTILE AND INFERTILE HUMANS AND MICE

    John C. Rockett1, J. Christopher Luft1, J. Brian Garges1, M. Stacey Ricci2, Pasquale Patrizio2, Norman B. Hecht2 and David J. Dix1
    Reproductive Toxicology Divisio...

  5. Terminal Mannose Residues in Seminal Plasma Glycoproteins of Infertile Men Compared to Fertile Donors.

    PubMed

    Olejnik, Beata; Jarz?b, Anna; Kratz, Ewa M; Zimmer, Mariusz; Gamian, Andrzej; Ferens-Sieczkowska, Miros?awa

    2015-01-01

    The impact of seminal plasma components on the fertilization outcomes in humans is still under question. The increasing number of couples facing problems with conception raises the need for predictive biomarkers. Detailed understanding of the molecular mechanisms accompanying fertilization remains another challenge. Carbohydrate-protein recognition may be of key importance in this complex field. In this study, we analyzed the unique glycosylation pattern of seminal plasma proteins, the display of high-mannose and hybrid-type oligosaccharides, by means of their reactivity with mannose-specific Galanthus nivalis lectin. Normozoospermic infertile subjects presented decreased amounts of lectin-reactive glycoepitopes compared to fertile donors and infertile patients with abnormal semen parameters. Glycoproteins containing unveiled mannose were isolated in affinity chromatography, and 17 glycoproteins were identified in liquid chromatography-tandem mass spectrometry with electrospray ionization. The N-glycome of the isolated glycoproteins was examined in matrix-assisted laser desorption ionization mass spectrometry. Eleven out of 27 identified oligosaccharides expressed terminal mannose residues, responsible for lectin binding. We suggest that lowered content of high-mannose and hybrid type glycans in normozoospermic infertile patients may be associated with impaired sperm protection from preterm capacitation and should be considered in the search for new infertility markers. PMID:26147424

  6. Complementary and Alternative Medicine Use in Infertility: Cultural and Religious Influences in a Multicultural Canadian Setting

    PubMed Central

    Read, Suzanne C.; Carrier, Marie-Eve; Whitley, Rob; Gold, Ian; Tulandi, Togas

    2014-01-01

    Abstract Objectives: To explore the use of complementary and alternative medicine (CAM) for infertility in a multicultural healthcare setting and to compare Western and non-Western infertility patients' reasons for using CAM and the meanings they attribute to CAM use. Design: Qualitative semi-structured interviews using thematic analysis. Settings/location: Two infertility clinics in Montreal, Quebec, Canada. Participants: An ethnoculturally varied sample of 32 heterosexual infertile couples. Results: CAM used included lifestyle changes (e.g., changing diet, exercise), alternative medicine (e.g., acupuncture, herbal medicines), and religious methods (e.g., prayers, religious talismans). Patients expressed three attitudes toward CAM: desperate hope, casual optimism, and amused skepticism. Participants' CAM use was consistent with cultural traditions of health and fertility: Westerners relied primarily on biomedicine and used CAM mainly for relaxation, whereas non-Westerners' CAM use was often influenced by culture-specific knowledge of health, illness and fertility. Conclusions: Understanding patients' CAM use may help clinicians provide culturally sensitive, patient-centered care. PMID:25127071

  7. Traditional Chinese medical herbs staged therapy in infertile women with endometriosis: a clinical study

    PubMed Central

    Ding, Zhaorong; Lian, Fang

    2015-01-01

    Background: Endometriosis is a common gynecological disease defined as the presence of endometrioid tissue (glands and stroma) outside the uterus. About 30 to 40% patients with endometriosis are infertile. In traditional Chinese medical system, endometriosis associated infertility is mostly caused by kidney deficiency and blood stasis. The herb of reinforcing kidney and removing blood stasis is designed to treat the disease. Material and methods: All the 80 up-to-standard patients were divided into two different groups exactly according to the random principle. They were treated with hormone and traditional Chinese medical herb separately. After half years therapy, all the patients received one years follow-up. Their transvaginal ultrasonographic changes, serum hormone levels and pregnancy rate were recorded to analysis the effect. Results: No significant difference happened in two groups demographic and clinical characteristics (P > 0.05). After the treatment, the effect on serum hormone levels and specific markers are significant (P < 0.05). The transvaginal ultrasonographic changes were positive, too. The text on hepatic and renal function confirmed to the safety of the herb. Compared to hormone therapy, the traditional Chinese medical herb is safe and effective for endometriosis patients with infertility. Conclusion: Compared with hormone therapy, traditional Chinese medical herbs two-staged therapy is effective and safe for endometriosis patients with infertility. PMID:26550373

  8. Terminal Mannose Residues in Seminal Plasma Glycoproteins of Infertile Men Compared to Fertile Donors

    PubMed Central

    Olejnik, Beata; Jarz?b, Anna; Kratz, Ewa M.; Zimmer, Mariusz; Gamian, Andrzej; Ferens-Sieczkowska, Miros?awa

    2015-01-01

    The impact of seminal plasma components on the fertilization outcomes in humans is still under question. The increasing number of couples facing problems with conception raises the need for predictive biomarkers. Detailed understanding of the molecular mechanisms accompanying fertilization remains another challenge. Carbohydrateprotein recognition may be of key importance in this complex field. In this study, we analyzed the unique glycosylation pattern of seminal plasma proteins, the display of high-mannose and hybrid-type oligosaccharides, by means of their reactivity with mannose-specific Galanthus nivalis lectin. Normozoospermic infertile subjects presented decreased amounts of lectin-reactive glycoepitopes compared to fertile donors and infertile patients with abnormal semen parameters. Glycoproteins containing unveiled mannose were isolated in affinity chromatography, and 17 glycoproteins were identified in liquid chromatography-tandem mass spectrometry with electrospray ionization. The N-glycome of the isolated glycoproteins was examined in matrix-assisted laser desorption ionization mass spectrometry. Eleven out of 27 identified oligosaccharides expressed terminal mannose residues, responsible for lectin binding. We suggest that lowered content of high-mannose and hybrid type glycans in normozoospermic infertile patients may be associated with impaired sperm protection from preterm capacitation and should be considered in the search for new infertility markers. PMID:26147424

  9. An association study of HFE gene mutation with idiopathic male infertility in the Chinese Han population

    PubMed Central

    Yu, Xiao-Ying; Wang, Bin-Bin; Xin, Zhong-Cheng; Liu, Tao; Ma, Ke; Jiang, Jian; Fang, Xiang; Yu, Li-Hua; Peng, Yi-Feng; Ma, Xu

    2012-01-01

    Mutations in the haemochromatosis gene (HFE) influence iron status in the general population of Northern Europe, and excess iron is associated with the impairment of spermatogenesis. The aim of this study is to investigate the association between three mutations (C282Y, H63D and S65C) in the HFE gene with idiopathic male infertility in the Chinese Han population. Two groups of Chinese men were recruited: 444 infertile men (including 169 with idiopathic azoospermia) and 423 controls with proven fertility. The HFE gene was detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The experimental results demonstrated that no C282Y or S65C mutations were detected. Idiopathic male infertility was not significantly associated with heterozygous H63D mutation (odds ratio=0.801, 95% confidence interval=0.452–1.421, χ2=0.577, P=0.448). The H63D mutation frequency did not correlate significantly with the serum luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone (T) levels in infertile men (P=0.896, P=0.404 and P=0.05, respectively). Our data suggest that the HFE H63D mutation is not associated with idiopathic male reproductive dysfunction. PMID:22504868

  10. Depletion of Selenoprotein GPx4 in Spermatocytes Causes Male Infertility in Mice*

    PubMed Central

    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

    2009-01-01

    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, 674683). 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. PMID:19783653

  11. Lessons learned from the implementation of an online infertility community into an IVF clinic's daily practice.

    PubMed

    Aarts, Johanna W M; Faber, Marjan J; Cohlen, Ben J; Van Oers, Anne; Nelen, WillianNe L D M; Kremer, Jan A M

    2015-12-01

    The Internet is expected to innovate healthcare, in particular patient-centredness of care. Within fertility care, information provision, communication with healthcare providers and support from peers are important components of patient-centred care. An online infertility community added to an in vitro fertilisation or IVF clinic's practice provides tools to healthcare providers to meet these. This study's online infertility community facilitates peer-to-peer support, information provision to patients and patient provider communication within one clinic. Unfortunately, these interventions often fail to become part of clinical routines. The analysis of a first introduction into usual care can provide lessons for the implementation in everyday health practice. The aim was to explore experiences of professionals and patients with the implementation of an infertility community into a clinic's care practice. We performed semi-structured interviews with both professionals and patients to collect these experiences. These interviews were analyzed using the Normalisation Process Model. Assignment of a community manager, multidisciplinary division of tasks, clear instructions to staff in advance and periodical evaluations could contribute to the integration of this online community. Interviews with patients provided insights into the possible impact on daily care. This study provides lessons to healthcare providers on the implementation of an online infertility community into their practice. PMID:26167659

  12. Another functional frame-shift polymorphism of DEFB126 (rs11467497) associated with male infertility

    PubMed Central

    Duan, Shiwei; Shi, Changgeng; Chen, Guowu; Zheng, Ju-fen; Wu, Bin; Diao, Hua; Ji, Lindan; Gu, Yihua; Xin, Aijie; Wu, Yancheng; Zhou, Weijin; Miao, Maohua; Xu, Limin; Li, Zheng; Yuan, Yao; Wang, Peng; Shi, Huijuan

    2015-01-01

    DEFB126 rs140685149 mutation was shown to cause sperm dysfunction and subfertility. Indel rs11467497 is another 4-nucleotide frame-shift mutation (151bp upstream of rs140685149) that leads to the premature termination of translation and the expression of peptide truncated at the carboxyl terminus. In the present study, we performed a comprehensive association study to check the contribution of rs140685149 and rs11467497 to male infertility. Our results confirmed the previous findings that there was no association between rs140685149 and sperm motility. In contrast, we found a significant association of another indel rs11467497 with male infertility. Moreover, rs11467497 was shown to be associated with higher number of round cells in the infertile males with low sperm motility. Surprisingly, the two mutations commonly existed in the sperm donors (n = 672), suggesting a potential application of the two indels in the screening for eligible sperm donors. Western blotting assays showed the sperms with rs140685149 2-nt deletion tended to have unstable DEFB126 protein in contrast of no DEFB126 protein expressed in the sperms with rs11467497 4-nt deletion, suggesting a more severe consequence caused by rs11467497 mutation. In conclusion, our study presented a significant contribution of another functional frame-shift polymorphism of DEFB126 (rs11467497) to male infertility. PMID:25721098

  13. Genetic screening and evaluation for chromosomal abnormalities of infertile males in Jilin Province, China.

    PubMed

    Zhang, M; Fan, H-T; Zhang, Q-S; Wang, X-Y; Yang, X; Tian, W-J; Li, R-W

    2015-01-01

    Chromosomal abnormality is the most common genetic cause of male infertility, particularly in cases of azoospermia, oligozoospermia, and recurrent spontaneous abortion. Chromosomal rearrangement may interrupt an important gene or exert position effects. The functionality of genes at specific breakpoints, perhaps with a specific role in spermatogenesis, may be altered by such rearrangements. Structural chromosome abnormalities are furthermore known to increase the risk of pregnancy loss. In this study, we aimed to assess chromosomal defects in infertile men from Jilin Province, China, by genetic screening and to evaluate the relationship between structural chromosome abnormalities and male infertility. The prevalence of chromosomal abnormalities among the study participants (receiving genetic counseling in Jilin Province, China) was 10.55%. The most common chromosome abnormality was Klinefelter syndrome, and the study findings suggested that azoospermia and oligospermia may result from structural chromosomal abnormalities. Chromosome 1 was shown to be most commonly involved in male infertility and balanced chromosomal translocation was identified as one of the causes of recurrent spontaneous abortion. Chromosomes 4, 7, and 10 were the most commonly involved chromosomes in male partners of women experiencing repeated abortion. PMID:26662410

  14. Infertile Individuals Marital Relationship Status, Happiness, and Mental Health: A Causal Model

    PubMed Central

    Ahmadi Forooshany, Seyed Habiballah; Yazdkhasti, Fariba; Safari Hajataghaie, Saiede; Nasr Esfahani, Mohammad Hossein

    2014-01-01

    Background This study examined the causal model of relation between marital relation- ship status, happiness, and mental health in infertile individuals. Materials and Methods In this descriptive study, 155 subjects (men: 52 and women: 78), who had been visited in one of the infertility Centers, voluntarily participated in a self-evaluation. Golombok Rust Inventory of Marital Status, Oxford Happiness Ques- tionnaire, and General Health Questionnaire were used as instruments of the study. Data was analyzed by SPSS17 and Amos 5 software using descriptive statistics, independent sample t test, and path analysis. Results Disregarding the gender factor, marital relationship status was directly related to happiness (p<0.05) and happiness was directly related to mental health, (p<0.05). Also, indirect relation between marital relationship status and mental health was significant (p<0.05). These results were confirmed in women participants but in men participants only the direct relation between happiness and mental health was significant (p<0.05). Conclusion Based on goodness of model fit in fitness indexes, happiness had a mediator role in relation between marital relationship status and mental health in infertile individu- als disregarding the gender factor. Also, considering the gender factor, only in infertile women, marital relationship status can directly and indirectly affect happiness and mental health. PMID:25379161

  15. Association of azoospermia factor region deletions in infertile male subjects among Malaysians.

    PubMed

    Hussein, A A; Vasudevan, R; Patimah, I; Prashant, N; Nora, F A

    2015-03-01

    Azoospermia factor region (AZF) deletions (AZFa, AZFb, AZFc and AZFd) in the Y chromosome were analysed in male infertility subjects in various populations with conflicting results. This study comprised of 54 infertile males and 63 fertile controls, and the frequency of AZFa, AZFb, AZFc and AZFd deletions were determined using conventional polymerase chain reaction (PCR) as well as real-time PCR-high resolution melting analysis-based methods. The results of this study showed that, three of 54 cases (5.55%) had AZF (a, b and c) deletions (two had AZFc and one had AZFa deletions). Four cases were found to have AZFd deletions (7.4%) with two of them being associated with AZFc deletions (P = 0.028). The frequency of AZF (a, b and c) deletions in Malaysian infertile male subjects was found to be comparable with other populations. AZFd deletions were found to be significant (P < 0.05) in male infertility and it may be associated with other types of AZF deletions. PMID:24528375

  16. Body image and its relationship with sexual function and marital adjustment in infertile women

    PubMed Central

    Karamidehkordi, Akram; Roudsari, Robab Latifnejad

    2014-01-01

    Background: Body image is related to cognitive, emotional, and physical aspects of women's life. Therefore, it is expected to have an important role in women's sexual health and marital adjustment too. This issue seems to be salient in infertile women who suffer from psychological consequences of infertility. This study was conducted to investigate the relationship of body image with sexual function and marital adjustment in infertile women in 2011 in Mashhad, Iran. Materials and Methods: This correlational study was performed on 130 infertile women who referred to Montaserieh Infertility Research Centre in Mashhad, Iran. Subjects were selected using convenient sampling method. To collect data, valid and reliable questionnaires including demographic and infertility-related data tool, modified Younesi Body Image Questionnaire, Rosen Female Sexual Function Index (FSFI), and Spanier Dyadic Adjustment Scale (DAS) were used. Data analysis was performed by SPSS software using Student's t-test, correlation, analysis of variance (ANOVA), and Tukey post-hoc test. Results: The mean scores of body image, sexual function, and marital adjustment in women were 308.1 45.8, 27.23 3.80, and 113.8 19.73, respectively. There was a direct correlation between overall body image and subscales of sexual function including sexual arousal (P = 0.003), sexual desire (P = 0.024), vaginal moisture (P = 0.001), orgasm (P < 0.001), sexual satisfaction (P < 0.001), and dyspareunia (P = 0.007). A direct correlation was also observed between overall body image and subscales of marital adjustment including agreement and consent (P < 0.001), satisfaction with life (P < 0.001), continuity of life (P = 0.007), and expressing emotions within the family environment (P < 0.001). Conclusions: Improved sexual function and marital adjustment in cases with higher body image provides evidence that one of the solutions to reduce sexual dysfunction and marital dispute in infertile women could be planning educational and counseling programs to improve women's body image. PMID:25949252

  17. Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis and Mycoplasma genitalium infections and semen quality of infertile men

    PubMed Central

    Gdoura, Radhouane; Kchaou, Wiem; Chaari, Chiraz; Znazen, Abir; Keskes, Leila; Rebai, Tarek; Hammami, Adnane

    2007-01-01

    Background Genital ureaplasmas (Ureaplasma urealyticum and Ureaplasma parvum) and mycoplasmas (Mycoplasma genitalium and Mycoplasma hominis) are potentially pathogenic species playing an etiologic role in both genital infections and male infertility. Reports are, however, controversial regarding the effects of these microorganisms infections in the sperm seminological variables. This study aimed at determining the frequency of genital ureplasmas and mycoplasmas in semen specimens collected from infertile men, and at comparing the seminological variables of semen from infected and non-infected men with these microorganisms. Methods A total of 120 semen samples collected from infertile men were investigated. Semen specimens were examined by in-house PCR-microtiter plate hybridization assay for the presence of genital ureaplasmas and mycoplasmas DNA. Semen analysis was assessed according to the guidelines of the World Health Organization. Standard parametric techniques (t-tests) and nonparametric techniques (Wilcoxon tests) were used for statistical analysis. Results The frequency of genital ureaplasmas and mycoplasmas detected in semen samples of infertile men was respectively 19.2% (23/120) and 15.8% (19/120). The frequency of Ureaplasma urealyticum (15%) was higher than that of Mycoplasma hominis (10.8%), Ureaplasma parvum (4.2%) and Mycoplasma genitalium (5%). Mixed species of mycoplasmas and ureaplasmas were detected in 6.7% of semen samples. Comparison of the parameters of the standard semen analysis between the male partners of the infertile couples with and without genital ureaplasmas and mycoplasmas infection showed that the presence of Mycoplasma hominis DNA in semen samples is associated with low sperm concentration (p = 0.007) and abnormal sperm morphology (p = 0.03) and a negative correlation between sperm concentration and the detection of Mycoplasma genitalium in semen samples of infertile men (p = 0.05). The mean values of seminal volume, pH, vitality, motility and leukocyte count were not significantly related either to the detection of genital mycoplasmas DNA or to the detection of ureaplasmas DNA in semen specimens. Conclusion Our results demonstrate that genital mycoplasmas and ureaplasmas seem to be widespread among the male partners of infertile couples in Tunisia. Genital mycoplasmas infections of the male genital tract could negatively influence semen quality. Our results also indicate that PCR-microtiter plate hybridization assay method provides a rapid and effective technique to detect human genital mycoplasmas and ureaplasmas which is useful for etiological and epidemiological studies of these pathogens. PMID:17988404

  18. A population-based study on infertility and its influencing factors in four selected provinces in Iran (2008-2010)

    PubMed Central

    Rostami Dovom, Marzieh; Ramezani Tehrani, Fahimeh; Abedini, Mehrandokht; Amirshekari, Golshan; Hashemi, Somayeh; Noroozzadeh, Mahsa

    2014-01-01

    Background: Infertility has a varied impact on multiple dimensions of health and functioning of women. Objective: We aimed to identify the burden of infertility and its influencing factors based on a population based study conducted in four provinces of Iran. Materials and Methods: A sample of 1126 women, aged 18-45 years, was selected using the multi stage, stratified probability sampling procedure; those met the eligibility criteria were invited for further comprehensive interview. This study used the definition of infertility proposed by World Health Organization the woman has never conceived despite cohabitation and exposure to pregnancy for a period of 1 year. Results : The overall prevalence of lifetime infertility and current primary infertility were 21.1% (95% CI: 18.4- 23.8) and 6.4% (95% CI: 4.8-8) respectively. The probability of first pregnancy at the end of 2 years of marriage was 94% for all ever-married women. Infertility were observed as significantly higher among women age 31-35 (OR: 4.6; 95% CI: 1.9-11.5; p=0.001) and women with more than 9 years of education (OR: 2.8; 95% CI: 1.5-3.3; p<0.0001). Conclusion: The necessities of modern living have compelled many women to postpone childbearing to their late reproductive years; however they must be informed of being at risk of infertility with ageing. PMID:25408706

  19. Global access to infertility care in developing countries: a case of human rights, equity and social justice.

    PubMed

    Ombelet, W

    2011-01-01

    According to WHO data more than 180 million couples in developing countries suffer from primary or secondary infertility. The social stigma of childlessness still leads to isolation and abandonment in many developing countries. Differences between the developed and developing world are emerging because of the different availability in infertility care and different socio-cultural value surrounding procreation and childlessness. Although reproductive health education and prevention of infertility are number one priorities, the need for accessible diagnostic procedures and new reproductive technologies (ART) is very high. The success and sustainability of ART in resource-poor settings will depend to a large extend on our ability to optimise these techniques in terms of availability, affordability and effectiveness. Accessible infertility treatment can only be successfully introduced in developing countries if socio-cultural and economic prerequisites are fulfilled and governments can be persuaded to support their introduction. We have to liaise with the relevant authorities to discuss the strengthening of infertility services, at the core of which lies the integration of infertility, contraceptive and maternal health services within public health care structures. After a fascinating period of more than 30 years of IVF, only a small part of the world population benefits from these new technologies. Time has come to give equitable access to effective and safe infertility care in resource-poor countries as well. PMID:24753875

  20. Seminal Tumour necrosis factor-related apoptosis-inducing ligand and its relationship to infertility in Egyptian patients with varicocele.

    PubMed

    Eid, A A; Younan, D N

    2015-11-01

    Germ cell apoptosis has been proposed as one of the mechanisms by which varicocele can influence fertility. The aim of this study was to investigate the relationship between seminal tumour necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) levels and male infertility in patients with varicocele. This study included 112 males: 30 fertile males with varicocele, 44 infertile males with varicocele and 38 healthy fertile control subjects without varicocele. Semen analysis was performed, and serum levels of reproductive hormones were measured. Seminal TRAIL levels in the infertile varicocele group were significantly higher than in the fertile varicocele and the control groups (P = 0.014). A significant negative correlation was found between seminal TRAIL and progressive (P < 0.001) and total motility scores (P < 0.001) in the infertile varicocele group. A significant negative correlation was also detected between seminal TRAIL levels and normal sperm morphology in the fertile varicocele (P = 0.007) and infertile varicocele patients (P = 0.047). Seminal TRAIL was significantly correlated with varicocele grade whether the patients were fertile (P = 0.001) or infertile (P = 0.035). Seminal TRAIL may thus have a potential role in varicocele-associated male infertility through its negative effect on sperm motility and morphology. PMID:25351208

  1. Personal Overview of the Application of LLLT in Severely Infertile Japanese Females

    PubMed Central

    2012-01-01

    Background and Aims: The rapidly graying population in Japan is being compounded by the rapidly-dropping birth rate. The latter is mostly due to the later ages at which women are giving birth as the marriage age has also been increasing. Giving birth at a later stage is associated with problems for both mother and child, but for older would-be mothers the greatest problem is infertility, sometimes severe. The present article will show how the application of low level laser therapy (LLLT) is a potentially effective treatment for severe infertility. Subjects and Methods: Seventy-four females (average age 39.28 yr) with severe infertility in whom assisted reproductive technology (ART) had been unsuccessful (average of 9.13 yr) participated in the first part of a study from October 1996 April 2000. LLLT was applied (830 nm, CW, GaAlAs 60 mW diode LLLT) in Ohshiro's proximal priority technique (average 21.08 sessions) with or without other ART approaches. Based on successful outcomes, the study was then extended to March 2012, amassing a final total of 701 patients. Results: Pregnancy was achieved in the first part of the trial in 16 patients (21.7% of 74) of whom 11 (68%) achieved successful live delivery. In the extended trial, pregnancy was achieved in 156 (22.3% of 701) with 79 live deliveries (50.1%). Conclusions: The use of 830 nm LLLT in the proximal priority technique at the parameters used in the present study, on its own or as an adjunct to other techniques, resulted in successful induction of pregnancy in just over 21% of severely infertile females, with a substantial number of these achieving live births. No adverse events were noted in any patient. LLLT is a pain-free and sideeffect free modality which could give hope to the increasing numbers of older females with infertility in Japan and potentially worldwide. Multinational studies are warranted. PMID:24610987

  2. Investigation of infertility management in primary care with open access hysterosalpingography (HSG): a pilot study.

    PubMed

    Wilkes, Scott; Murdoch, Alison; Rubin, Greg; Chinn, David; Wilsdon, John

    2006-03-01

    Infertility affects one in seven couples in the United Kingdom. The National Institute for Clinical Excellence (NICE) issued guidance on the management of the infertile couple in February 2004, which included the statement "for the assessment of tubal damage, women not known to have co-morbidities (pelvic inflammatory disease, endometriosis or previous ectopic pregnancy) should be offered hysterosalpingography (HSG)". We made HSG available to six general practices in Newcastle upon Tyne as an open access investigation. Our aim was to evaluate the uptake of open access HSG, speed of access to specialist services and the quality of the information recorded in the referral letter. Using hospital clinical records we tracked the outcome of all infertile couples from the six pilot practices over a nine-month period. Of the 39 referrals identified, 10 women were eligible for open access HSG, of which six HSGs were organized by GPs. Couples who had open access HSG reached a diagnosis and management plan four weeks earlier than those who were referred directly (mean difference 4.0 weeks, 95% confidence interval (CI) -8.8 to 0.4 weeks). The information recorded in the referral letter was generally poor. However, all referrals made via the open access HSG service had the prerequisite tests done. Open access HSG allowed prompter access to specialist services with more complete information passed on in the referral letter. Open access HSG was used in 15% of all infertile couples and 60% of those who fitted the criteria for its use. Open access HSG together with semen analysis and endocrine blood tests may allow GPs to manage the initial stages of the infertile couple and make a diagnosis. PMID:16581721

  3. Childhood Thyroid Radioiodine Exposure and Subsequent Infertility in the Intermountain Fallout Cohort

    PubMed Central

    Stone, Mary Bishop; Lyon, Joseph L.; VanDerslice, James A.; Alder, Stephen C.

    2012-01-01

    Background: Above-ground and underground nuclear weapon detonation at the Nevada Test Site (1951–1992) has resulted in radioiodine exposure for nearby populations. Although the long-term effect of environmental radioiodine exposure on thyroid disease has been well studied, little is known regarding the effect of childhood radioiodine exposure on subsequent fertility. Objectives: We investigated early childhood thyroid radiation exposure from nuclear testing fallout (supplied predominantly by radioactive isotopes of iodine) and self-reported lifetime incidence of male or female infertility or sterility. Methods: Participants were members of the 1965 Intermountain Fallout Cohort, schoolchildren at the time of exposure who were reexamined during two subsequent study phases to collect dietary and reproductive histories. Thyroid radiation exposure was calculated via an updated dosimetry model. We used multivariable logistic regression with robust sandwich estimators to estimate odds ratios for infertility, adjusted for potential confounders and (in separate models) for a medically confirmed history of thyroid disease. Results: Of 1,389 participants with dosimetry and known fertility history, 274 were classified as infertile, including 30 classified as sterile. Childhood thyroid radiation dose was possibly associated with infertility [adjusted odds ratio (AOR) = 1.17; 95% CI: 0.82, 1.67 and AOR = 1.35; 95% CI: 0.96, 1.90 for the middle and upper tertiles vs. the first tertile of exposure, respectively]. The odds ratios were attenuated (AOR = 1.08; 95% CI: 0.75, 1.55 and AOR = 1.29; 95% CI: 0.91, 1.83 for the middle and upper tertiles, respectively) after adjusting for thyroid disease. There was no association of childhood radiation dose and sterility. Conclusion: Our findings suggest that childhood radioiodine exposure from nuclear testing may be related to subsequent adult infertility. Further research is required to confirm this. PMID:23099433

  4. Nitroreductase-mediated gonadal dysgenesis for infertility control of genetically modified zebrafish.

    PubMed

    Hu, Shao-Yang; Lin, Pei-Yu; Liao, Chia-Hsuan; Gong, Hong-Yi; Lin, Gen-Hwa; Kawakami, Koichi; Wu, Jen-Leih

    2010-10-01

    Genetically modified (GM) fish with desirable features such as rapid growth, disease resistance, and cold tolerance, among other traits, have been established in aquaculture. However, commercially available GM fish are restricted because of global concerns over the incomplete assessments of food safety and ecological impact. The ecological impact concerns include gene flow and escape of the GM fish, which may cause extinction of wild natural fish stocks. Infertility control is a core technology for overcoming this obstacle. Although polyploidy technology, GnRH-specific antisense RNA, and RNAi against GnRH gene expression have been used to cause infertility in fish, these approaches are not 100% reliable and are not heritable. In the present study, zebrafish was used as a model to establish an inducible platform of infertility control in GM fish. Nitroreductase, which converts metronidazole substrate into cytotoxin, was fused with EGFP and expressed specifically by oocytes in the Tg(ZP:NTR-EGFP) by a zona pellucida promoter. Through consecutive immersion of metronidazole from 28 to 42days posthatching, oocyte-specific EGFP expression was eliminated, and atrophy of the gonads was detected by anatomical analysis. These findings reveal that oocyte-specific nitroreductase-mediated catalysis of metronidazole blocks oogenesis and leads to an undeveloped oocyte. Furthermore, oocyte cell death via apoptosis was detected by a TUNEL assay. We found that the gonadal dysgenesis induced by metronidazole resulted in activation of the ovarian killer gene bok, which is a proapoptotic gene member of the Bcl-2 family and led to infertility. These results show that oocyte-specific nitroreductase-mediated catalysis of metronidazole can cause reliable infertility in zebrafish and could potentially be used as a model for other aquaculture fish species. PMID:19941022

  5. High Prevalence of Vitamin D Deficiency in Infertile Women Referring for Assisted Reproduction

    PubMed Central

    Pagliardini, Luca; Vigano’, Paola; Molgora, Michela; Persico, Paola; Salonia, Andrea; Vailati, Simona Helda; Paffoni, Alessio; Somigliana, Edgardo; Papaleo, Enrico; Candiani, Massimo

    2015-01-01

    A comprehensive analysis of the vitamin D status of infertile women is the first step in understanding hypovitaminosis impact on reproductive potential. We sought to determine vitamin D profiles of women attending an infertility center and to investigate non-dietary determinants of vitamin D status in this population. In this cross-sectional analysis, a cohort of 1072 women (mean age ± standard deviation 36.3 ± 4.4 years) attending an academic infertility center was used to examine serum 25-hydroxy-vitamin D (25(OH)D) levels in relation to demographic characteristics, seasons and general health risk factors. Both unadjusted and adjusted levels of serum 25(OH)D were examined. Median 25(OH)D concentration was below 30 ng/mL for 89% of the entire year. Over the whole year, 6.5% of patients had 25(OH)D levels ≤10 ng/mL, 40.1% ≤20 ng/mL, and 77.4% ≤30 ng/mL. Global solar radiation was weakly correlated with 25(OH)D levels. At multivariable analysis, 25(OH)D levels were inversely associated with BMI; conversely, 25(OH)D levels were positively associated with height and endometriosis history. Serum 25(OH)D levels are highly deficient in women seeking medical help for couple’s infertility. Levels are significantly associated with body composition, seasonal modifications and causes of infertility. Importantly, this deficiency status may last during pregnancy with more severe consequences. PMID:26633484

  6. Somatic cytogenetic and azoospermia factor gene microdeletion studies in infertile men.

    PubMed

    Pina-Neto, J M; Carrara, R C V; Bisinella, R; Mazzucatto, L F; Martins, M D; Sartoratto, E; Yamasaki, R

    2006-04-01

    The objective of the present study was to determine the frequency of somatic chromosomal anomalies and Y chromosomal microdeletions (azoospermia factor genes, AZF) in infertile males who seek assisted reproduction. These studies are very important because the assisted reproduction techniques (mainly intracytoplasmic sperm injection) bypass the natural selection process and some classical chromosomal abnormalities, microdeletions of AZF genes or some deleterious genic mutations could pass through generations. These genetic abnormalities can cause in the offspring of these patients male infertility, ambiguous external genitalia, mental retardation, and other birth defects. We studied 165 infertile men whose infertility was attributable to testicular problems (60 were azoospermic, 100 were oligospermic and 5 were asthenospermic). We studied 100 metaphases per patient with GTG banding obtained from temporary lymphocyte culture for chromosomal abnormality detection and performed a genomic DNA analysis using 28 Y chromosome-specific sequence-tagged sites for Y AZF microdeletion detection. Karyotyping revealed somatic anomalies in 16 subjects (16/165 = 9.6%). Of these 16, 12 were in the azoospermic group (12/60 = 20%) and 4 were in the oligospermic group (4/100 = 4%). The most common chromosomal anomaly was Klinefelter syndrome (10/165 = 6%). Microdeletions of AZF genes were detected in 12 subjects (12/160 = 7.5%). The frequencies detected are similar to those described previously. These results show the importance of genetic evaluation of infertile males prior to assisted reproduction. Such evaluation can lead to genetic counseling and, consequently, to primary and secondary prevention of mental retardation and birth defects. PMID:16612480

  7. Association between DNMT3L polymorphic variants and the risk of endometriosis-associated infertility.

    PubMed

    Mostowska, Adrianna; Szczepa?ska, Malgorzata; Wirstlein, Przemyslaw; Skrzypczak, Jana; Jagodzi?ski, Pawe? P

    2016-01-01

    Endometriosis is considered to be an epigenetic disease. It has previously been reported that the DNA methyltransferase 3-like (DNMT3L) rs8129776 single nucleotide polymorphism (SNP) contributes to endometrioma. In the present study, high?resolution melting curve analysis was used to investigate the risks associated with the DNMT3L c.910?635A/G (rs8129776), c.832C/T (rs7354779), c.812C/T (rs113593938) and c.344+62C/T (rs2276248) SNPs on stageI?II endometriosis?associated infertility. Included in the present study were patients presenting with stageI?II endometriosis?associated infertility (n=154) and a control cohort of healthy patients with confirmed fertility (n=383). No significant association between the above?listed DNMT3L SNPs and the development of endometriosis?associated infertility was identified. The lowest P?values generated from trend analysis were observed in the DNMT3L c.832C/T (rs7354779) SNP (Ptrend=0.114). Furthermore, haplotype analyses of the DNMT3L SNPs failed to reveal any risk association between the development of endometriosis?associated infertility and the above?listed polymorphisms, even when the SNPs were present in combinations. Finally, a meta?analysis was performed to examine the association between the DNMT3L rs8129776 SNP and the development of endometrioma, from which no association between the two was identified. On the basis of these results, the present study has demonstrated that variations in the DNMT3L gene do not contribute to stageI-II endometriosis-associated infertility. PMID:26647998

  8. AB28. Management of male factor infertility: present on the assisted reproductive technology

    PubMed Central

    Lee, Sang-Chan

    2014-01-01

    Infertility is a common yet complex problem affecting approximately 10-15% of couples attempting to conceive a baby. Especially, 40-50% of these factors are known as male-related disorders. Unlike female infertility, the cause of which is often easily identified, diagnosing male factors can be difficult. Male infertility is due to low sperm production, abnormal sperm function or blockages of sperm transport. Classical semen analysis in laboratory, which include sperm concentration, motility and morphology gives an approximate evaluation of the functional competence of spermatozoa, but does not always reflect the quality of sperm DNA. The fertilizing potential of sperm depends not only on the functional competence of spermatozoa but also on sperm DNA integrity. The most commonly used techniques to assess sperm DNA integrity are the TUNEL assay, Comet assay, SCSA assay and hallo sperm assay. Recent studies have highlighted the significance of sperm DNA integrity as an important factor which affects functional competence of the sperm. Sperm DNA damage has been closely associated with numerous indicators of reproductive health including fertilization, embryo quality, implantation, spontaneous abortion, congenital malformations. To overcome male infertility, there are variety of surgical and non-surgical urological procedures and medical-pharmacological interventions, and advanced assisted reproductive technologies (ART). Among the surgically retrieved methods, there are TESE, TFNA, PESA and MESA that is used with ICSI. The ART, augmented with ICSI in moderate to serve cases, efficiently treat a variety of male infertility disorders by constituting validated and successfully treatment methods. Also, this technique is employed because the limited numbers and functional capacity of motile sperm that can be obtained. Especially, there are technologies such as IMSI and PICSI that are used to select healthy sperms.

  9. Should diagnostic hysteroscopy be a routine procedure during diagnostic laparoscopy in infertile women?

    PubMed

    Godinjak, Zulfo; Idrizbegović, Edin

    2008-02-01

    The aim of this study was to clarify the role of simultaneous combined diagnostic approach using laparoscopy and hysteroscopy in the evaluation of female infertility. In a retrospective study, 360 infertile women underwent complete fertility evaluation. All the patients were examined by simultaneous combined laparoscopy and hysteroscopy as a part of the routine infertility evaluation. Laparoscopy and hysteroscopy were successful in 360 patients. Bilateral tubes were blocked in 18 (5%) and unilateral tubal occlusion were in 30 (8,33%) of patients. Pelvic adhesions were revealed in 40 (11,11%), and myomas in 42 (11,65%) out of that 31 (8,6%) were revealed by laparoscopy and 11 (3,05%) by hysteroscopy. Endometrial polyps were revealed in 26 (7,22%) and Syndrome Asherman in 3(0,83%) of patients. Uterine anomaly was found in 19 (5,27%) of cases and out of that septate uterus in 7 (37,15%), bicornuate uterus in 5 (26,31%), arcuate uterus in 4 (21,26%) and uterus unicornu cum cornu rudimentario in 3 (15,27%) of uterine anomalies. Endometriosis was found in 51 (14,16%), dermoid cysts in 8 (2,22%) and in 16 (4,44%) functional cysts of patients. Also, Fitz-Hugh-Curtis syndrome was revealed in 23 (6,11%) of our patients. Laparoscopy and hysteroscopy play very important role as diagnostic tools in the infertility women. Combined diagnostic simultaneous laparoscopy and hysteroscopy should be performed in all infertile patients before the treatment. PMID:18318671

  10. Preliminary study of blood methylmercury effects on reproductive hormones and relevant factors among infertile and pregnant women in Taiwan.

    PubMed

    Lei, Hsiao-Ling; Wei, Hsiao-Jui; Chen, Po-Hsi; Hsi, Hsing-Cheng; Chien, Ling-Chu

    2015-09-01

    Methylmercury (MeHg) is the most poisonous mercury species and an endocrine-disrupting chemical that could cause reproductive and developmental harm effects in animals. In this study, we recruited 310 infertile women and 57 pregnant women and investigated their blood MeHg levels. The distribution of blood reproductive hormone, selenium and zinc levels, and the difference of relevant factors by the reference level of blood MeHg (5.8 ?g/L) of infertile women were further examined. Results showed that greater percentages of sashimi consumption, frequencies of Chinese herbal medicine use, alcohol consumption, and lack of physical activity were observed in infertile women than those for pregnant women. Blood MeHg concentration was significantly greater in infertile than that in pregnant women. Significant concentration differences for FSH and LH by the dichotomized reference level of blood MeHg (5.8 ?g/L) in infertile women were not observed, which may stem from that these reproductive hormones in participated infertile women were mostly in the normal reference range. Consumption of fish and sashimi represented the major source of MeHg exposure in infertile women. MeHg levels were elevated in infertile women, and consistent with fish consumption frequency. Compared to the referent level of blood MeHg levels <5.8 ?g/L, the elevated blood MeHg levels (?5.8 ?g/L) in infertile women were 3.35 and 4.42 folds risk in categorized frequencies of fish consumption 1-2 meals per week and more than 3 meals per week, respectively. The obtained results provide evidences and help updating the advisory of fish consumption and improving women's reproductive health. PMID:26002048

  11. More attention should be paid to the treatment of male infertility with drugstestosterone: to use it or not?

    PubMed Central

    Li, Hong-Jun

    2014-01-01

    Testosterone replacement is strictly contraindicated for the treatment of male infertility was the advanced view from the 2013 European Association of Urology (EAU) guidelines on male infertility, and this view brings extensive concern and questions. Although sufficient numbers of well-performed and controlled clinical trials that provide evidence supporting drug treatment of male infertility are not available at present, the opportunity to prove that these drugs are effective should not be prevented, and rigorous examination of drug therapy should be encouraged and strengthened. Therefore, I believe the above conclusion in the EAU guidelines is poorly conceived. PMID:24435051

  12. National, Regional, and Global Trends in Infertility Prevalence Since 1990: A Systematic Analysis of 277 Health Surveys

    PubMed Central

    Boerma, Ties; Vanderpoel, Sheryl; Stevens, Gretchen A.

    2012-01-01

    Background Global, regional, and national estimates of prevalence of and tends in infertility are needed to target prevention and treatment efforts. By applying a consistent algorithm to demographic and reproductive surveys available from developed and developing countries, we estimate infertility prevalence and trends, 1990 to 2010, by country and region. Methods and Findings We accessed and analyzed household survey data from 277 demographic and reproductive health surveys using a consistent algorithm to calculate infertility. We used a demographic infertility measure with live birth as the outcome and a 5-y exposure period based on union status, contraceptive use, and desire for a child. We corrected for biases arising from the use of incomplete information on past union status and contraceptive use. We used a Bayesian hierarchical model to estimate prevalence of and trends in infertility in 190 countries and territories. In 2010, among women 2044 y of age who were exposed to the risk of pregnancy, 1.9% (95% uncertainty interval 1.7%, 2.2%) were unable to attain a live birth (primary infertility). Out of women who had had at least one live birth and were exposed to the risk of pregnancy, 10.5% (9.5%, 11.7%) were unable to have another child (secondary infertility). Infertility prevalence was highest in South Asia, Sub-Saharan Africa, North Africa/Middle East, and Central/Eastern Europe and Central Asia. Levels of infertility in 2010 were similar to those in 1990 in most world regions, apart from declines in primary and secondary infertility in Sub-Saharan Africa and primary infertility in South Asia (posterior probability [pp] ?0.99). Although there were no statistically significant changes in the prevalence of infertility in most regions amongst women who were exposed to the risk of pregnancy, reduced child-seeking behavior resulted in a reduction of primary infertility among all women from 1.6% to 1.5% (pp?=?0.90) and a reduction of secondary infertility among all women from 3.9% to 3.0% (pp>0.99) from 1990 to 2010. Due to population growth, however, the absolute number of couples affected by infertility increased from 42.0 million (39.6 million, 44.8 million) in 1990 to 48.5 million (45.0 million, 52.6 million) in 2010. Limitations of the study include gaps in survey data for some countries and the use of proxies to determine exposure to pregnancy. Conclusions We analyzed demographic and reproductive household survey data to reveal global patterns and trends in infertility. Independent from population growth and worldwide declines in the preferred number of children, we found little evidence of changes in infertility over two decades, apart from in the regions of Sub-Saharan Africa and South Asia. Further research is needed to identify the etiological causes of these patterns and trends. Please see later in the article for the Editors' Summary PMID:23271957

  13. Academy of Medicine-Ministry of Health Clinical Practice Guidelines: Assessment and Management of Infertility at Primary Healthcare Level

    PubMed Central

    Loh, Seong Feei; Agarwal, Rachna; Chan, Jerry; Chia, Sing Joo; Cho, Li Wei; Lim, Lean Huat; Lau, Matthew Sie Kuei; Loh, Sheila Kia Ee; Hendricks, Marianne Sybille; Nair, Suresh; Quah, Joanne Hui Min; Tan, Heng Hao; Wong, PC; Yeong, Cheng Toh; Yu, Su Ling

    2014-01-01

    The Academy of Medicine (AMS) and Ministry of Health (MOH) have developed the clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level to provide doctors and patients in Singapore with evidence-based treatment for infertility. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the AMS-MOH clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_ medical/2013/cpgmed_infertility.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines. PMID:24570313

  14. The role of estrogens and estrogen receptor signaling pathways in cancer and infertility: the case of schistosomes.

    PubMed

    Botelho, Mnica C; Alves, Helena; Barros, Alberto; Rinaldi, Gabriel; Brindley, Paul J; Sousa, Mrio

    2015-06-01

    Schistosoma haematobium, a parasitic flatworm that infects more than 100 million people, mostly in the developing world, is the causative agent of urogenital schistosomiasis, and is associated with a high incidence of squamous cell carcinoma (SCC) of the bladder. Schistosomiasis haematobia also appears to negatively influence fertility, and is particularly associated with female infertility. Given that estrogens and estrogen receptors are key players in human reproduction, we speculate that schistosome estrogen-like molecules may contribute to infertility through hormonal imbalances. Here, we review recent findings on the role of estrogens and estrogen receptors on both carcinogenesis and infertility associated with urogenital schistosomiasis and discuss the basic hormonal mechanisms that might be common in cancer and infertility. PMID:25837311

  15. The Prevalence of Infertility and Loneliness among Women Aged 18-49 Years Who Are Living in Semi-Rural Areas in Western Turkey

    PubMed Central

    Gokler, Mehmet Enes; Unsal, Alaettin; Arslantas, Didem

    2014-01-01

    Background To determine the correlates and the prevalence of infertility in a group of women. Materials and Methods This cross-sectional study was carried out on 570 subjects aged 18-49 years in a town of western Turkey between July and August 2012. Women who have inability to become pregnant despite regular sexual intercourse during the last year were considered to be infertile. UCLA Loneliness Scale was used to assess the severity of loneliness. The data were analyzed by Kruskal-Wallis, Mann Whitney U and Chi-square tests. Results The mean age of the participants was 35.48 8.39 years. The frequency of the infertility in our study was 12.8% (n=73). The prevalence of infertility was higher in those with a history of gynecological disease or gynecologic surgery and in those with menstrual irregularity (p<0.05; for each). The mean score on the UCLA Loneliness Scale was 32.16 9.49 (from 20 to 70). In this study, no difference was found between the level of loneliness and who is responsible for infertility among infertile/fertile women (p?0.05). Level of loneliness among the women with primary infertility was higher compared to the women with secondary infertility (p<0.05). Conclusion The prevalence of infertility among the women was relatively high. It was concluded that prospective studies are needed in order to expose the relationship between the infertility and the level of loneliness in women. PMID:25083180

  16. From Infertility to Successful Third-Party Reproduction: The Trajectory of Greek Women.

    PubMed

    Papadatou, Danai; Papaligoura, Zaira G; Bellali, Thalia

    2016-02-01

    The purpose of our phenomenological hermeneutic study was to explore the lived experiences of Greek infertile women who achieve a pregnancy through the use of sperm, oocyte, or embryo donation or surrogate motherhood. Semistructured interviews were conducted with 15 infertile women. Findings suggest that conceiving a child through assisted reproductive technologies (ART) is lived as a highly distressing experience, comprising long waiting periods for medical results, several failed attempts, and treatment options with uncertain outcomes. The analysis of women's accounts revealed a constitutive pattern, journeying between hope and despair, and three associated themes: (a) coping with uncertainty and treatment failures, (b) exploring options and decision making, and (c) being supported by spouse and professionals. Findings illuminate the specific meaning-based coping processes, decision-making patterns, and sources of support that help women who pursue treatment until they give birth to a child, to manage highly stressful situations and critical decisions. PMID:25568093

  17. [Health of children born after the infertility treatment with Assisted Reproduction Technology].

    PubMed

    Wo?czy?ski, S?awomir; Zbucka, Monika; Le?niewska, Monika

    2005-01-01

    Since the birth of Louise Brown in July 1978 and the birth of the first intracytoplasmic sperm injection (ICSI) child in January 1992 many couples with female-factor or male-factor infertility can be helped to overcome their infertility resulting in a delivery and birth of a child. Over a million children have been born from assisted conception worldwide. Newer techniques being introduced appear less and less 'natural', such as intracytoplasmic sperm injection (ICSI), but there is little information on these children beyond the neonatal period. This risk varied according to the patient's age, the type of ART procedure performed, the number of embryos transferred, and embryo availability. ART is associated with low increase risk of congenital malformations, major birth defects and genetic and imprinting disorders. PMID:16821222

  18. Causes and risk factors for male-factor infertility in Nigeria: a review.

    PubMed

    Abarikwu, Sunny O

    2013-12-01

    In recent times there has been a decline in the semen quality of young healthy men worldwide, with similar findings being reported in Nigeria. Although little is known about what is responsible for the decline in male sperm count worldwide, significant associations have been reported between impaired semen quality including sperm count, motility as well as morphology and exposures to heavy metals such as cadmium and lead, mycotoxins such as aflatoxins, pesticides, industrial chemicals and endocrine factors. In Nigeria, the problem is further compounded by a variety of factors such as sexually transmitted infections, genito-urinary tract infections/inflammations and deficiencies of dietary antioxidant nutrients, thereby increasing male-factor contribution to infertility in the population. In this article, we analyze data from different sources and present evidence of the possible etiology and risk factors for male-factor infertility in Nigeria. PMID:24558791

  19. The efficiency of a group-specific mandated benefit revisited: the effect of infertility mandates.

    PubMed

    Lahey, Joanna N

    2012-01-01

    This paper examines the labor market effects of state health insurance mandates that increase the cost of employing a demographically identifiable group. State mandates requiring that health insurance plans cover infertility treatment raise the relative cost of insuring older women of child-bearing age. Empirically, wages in this group are unaffected, but their total labor input decreases. Workers do not value infertility mandates at cost, and so will not take wage cuts in exchange, leading employers to decrease their demand for this affected and identifiable group. Differences in the empirical effects of mandates found in the literature are explained by a model including variations in the elasticity of demand, moral hazard, ability to identify a group, and adverse selection. PMID:22180892

  20. Study of the frequency of occurrence of genetic and acquired thrombophilia in infertile women prior IVF.

    PubMed

    Petukhova, N L; Tsaturova, K A; Vartanian, E V; Schigoleva, A V; Markin, A V

    2014-10-01

    This study of infertile women prior in vitro fertilization (IVF) is focused at the genetic and acquired thrombophilia before the IVF program, the identification of the frequency of occurrence of thrombophilia in them, the impact of thrombophilia of the offensive, the course and outcome of pregnancies, to improve the quality of cycles in terms of a pregnancy and childbirth. Forty-five women with infertility were examined. Thirty-two (71%) were identified thrombophilia: genetic thrombophilia in 32 cases (100%), among them a combination of several forms of genetic thrombophilia - 21 (63%) of them, other forms of thrombophilia (genetic and acquired) - in 5 of them (16%). In IVF 23 (72%) women became pregnant. In 87% of pregnancies ended in spontaneous birth, in 13% of cases of preterm birth. PMID:25200826

  1. [Association between sperm abnormalities and occupational environment among male consulting for couple infertility].

    PubMed

    Ould Hamouda, S; Perrin, J; Achard, V; Courbire, B; Grillo, J-M; Sari-Minodier, I

    2016-01-01

    Alteration of sperm parameters related to occupational exposures is the subject of several studies, often on a case-control approach. The study populations usually comprise men consulting in infertility clinics for couple infertility. The objective of this review is to identify, from these case-control studies, the main occupational factors that may be associated with altered sperm parameters. We selected 13 articles in the PubMed database. Participation in these studies varied from 61 to 2619 subjects, with great methodological heterogeneity, particularly in the characterization of exposure. The main occupations that appear significantly associated with a risk of altered sperm parameters are workmen, painters, farmers, welders, plumbers and technicians. When analysis focuses on occupational exposures, a significant result is reported for solvents, heavy metals, heat, vibrations and non-ionizing radiation. None of the selected studies has found a link with exposure to pesticides. PMID:26387599

  2. Bioethical dilemmas of assisted reproduction in the opinions of Polish women in infertility treatment: a research report.

    PubMed

    Dembinska, Aleksandra

    2012-12-01

    Infertility Accepted treatment is replete with bioethical dilemmas regarding the limits of available medical therapies. Poland has no legal acts regulating the ethical problems associated with infertility treatment and work on such legislation has been in progress for a long time, arousing very intense emotions in Polish society. The purpose of the present study was to find out what Polish women undergoing infertility treatment think about the most disputable and controversial bioethical problems of assisted reproduction. An Attitudes towards Bioethical Problems of Infertility Scale was constructed specifically for this study. Items were taken from the Bioethics Bills currently under discussion in Polish Parliament (Seym). 312 women were enrolled in the study. Women experiencing infertility favoured more liberal legislation. Participants disagreed, for example, with the following regulations: prohibition of embryo freezing, prohibition of preimplantation genetic diagnosis of embryos, age limits for women using in vitro fertilisation and prohibition of in vitro fertilisation for single women. The opinions of patients undergoing infertility treatment are an important voice in the Polish debate on the Bioethics Bills. PMID:22977062

  3. Use of complementary and alternative medicines by a sample of Turkish women for infertility enhancement: a descriptive study

    PubMed Central

    2010-01-01

    Background Infertility patients are a vulnerable group that often seeks a non-medical solution for their failure to conceive. World-wide, women use CAM for productive health, but only a limited number of studies report on CAM use to enhance fertility. Little is known about traditional and religious forms of therapies that are used in relation to conventional medicine in Turkey. We investigated the prevalence and types of complementary and alternative medicine (CAM) used by infertile Turkish women for fertility enhancement. Methods A face-to-face questionnaire inquiring demographic information and types of CAM used for fertility enhancement were completed by hundred infertility patients admitted to a primary care family planning centre in Van, Turkey between January and July 2009. Results The vast majority of infertile women had used CAM at least once for infertility. CAM use included religious interventions, herbal products and recommendations of traditional "hodja's" (faith healers). Of these women, 87.8% were abused in the last 12 months, 36.6% felt not being supported by her partner and 80.5% had never spoken with a physician about CAM. Conclusions Infertile Turkish women use complementary medicine frequently for fertility enhancement and are in need of information about CAM. Religious and traditional therapies are used as an adjunct to, rather than a substitute for, conventional medical therapy. Physicians need to approach fertility patients with sensitivity and should be able to council their patients about CAM accordingly. PMID:20307291

  4. Zinc levels in seminal plasma and their correlation with male infertility: A systematic review and meta-analysis

    PubMed Central

    Zhao, Jiang; Dong, Xingyou; Hu, Xiaoyan; Long, Zhou; Wang, Liang; Liu, Qian; Sun, Bishao; Wang, Qingqing; Wu, Qingjian; Li, Longkun

    2016-01-01

    Zinc is an essential trace mineral for the normal functioning of the male reproductive system. Current studies have investigated the relationship between seminal plasma zinc and male infertility but have shown inconsistent results. Hence, we systematically searched PubMed, EMBASE, Science Direct/Elsevier, CNKI and the Cochrane Library for studies that examined the relationship between seminal plasma zinc and male infertility, as well as the effects of zinc supplementation on sperm parameters. Twenty studies were identified, including 2,600 cases and 867 controls. Our meta-analysis results indicated that the seminal plasma zinc concentrations from infertile males were significantly lower than those from normal controls (SMD (standard mean differences) [95% CI] −0.64 [−1.01, −0.28]). Zinc supplementation was found to significantly increase the semen volume, sperm motility and the percentage of normal sperm morphology (SMD [95% CI]: −0.99 [−1.60, −0.38], −1.82 [−2.63, −1.01], and −0.75 [−1.37, −0.14], respectively). The present study showed that the zinc level in the seminal plasma of infertile males was significantly lower than that of normal males. Zinc supplementation could significantly increase the sperm quality of infertile males. However, further studies are needed to better elucidate the correlation between seminal plasma zinc and male infertility. PMID:26932683

  5. Consequences of infertility in developing countries: results of a questionnaire and interview survey in the South of Vietnam

    PubMed Central

    Wiersema, Nicole J; Drukker, Anouck J; Dung, Mai Ba Tien; Nhu, Giang Huynh; Nhu, Nguyen Thanh; Lambalk, Cornelis B

    2006-01-01

    Background This study explores the psychological, socio-cultural and economic consequences of infertility on couples' life. The purpose of this research is to improve knowledge about the potentially serious implications of infertility in the South of Vietnam. Methods This study included 118 infertile couples who filled in questionnaires and 28 men and women who were interviewed. Results Data of the questionnaire show men and women do not differ in their responses and attitudes towards infertility. Almost one-third of the participants require psychological support. Interviewees experience secrecy, social pressure and economic hardship. Conclusion Offspring are very important to Vietnamese couples. Their future depends on children. Family plays an important role in the experiences of the infertile couple. Economic consequences are a particular distressing factor. There is a need for psychological counselling in the treatment of infertile couples in the South of Vietnam. It should be realised that in developing countries, despite overpopulation, unwanted childlessness is an important social and economical burden that needs attention. PMID:17192178

  6. Unusually low prevalence of Mycoplasma genitalium in urine samples from infertile men and healthy controls: a prevalence study

    PubMed Central

    Plecko, Vanda; Zele-Starcevic, Lidija; Tripkovic, Vesna; Skerlev, Mihael; Ljubojevic, Suzana; Plesko, Sanja; Marekovic, Ivana; Jensen, Jorgen Skov

    2014-01-01

    Objective To detect Mycoplasma genitalium in urine samples of infertile men and men without any signs of infection in order to investigate whether M. genitalium and other genital mycoplasmas (Mycoplasma hominis and Ureaplasma spp) are found more often in urine samples of infertile men than in asymptomatic controls and to determine resistance to macrolides. Methods The study included first void urine samples taken from 145 infertile men and 49 men with no symptoms of urethritis. M. genitalium, Chlamydia trachomatis and Neisseria gonorrhoeae were detected by commercial PCR. Trichomonas vaginalis was detected by microscopy and culture. M. hominis and Ureaplasma spp were detected by culture. M. genitalium was detected by in-house conventional and real-time PCR. Results Two M. genitalium positive samples were found among samples obtained from infertile men. All asymptomatic men were M. genitalium negative. Macrolide resistance was not found in either of the two positive samples. Conclusions In comparison with reported data, an unusually low prevalence of M. genitalium was found in infertile men. The reasons for this unexpected result are not known; possibly, local demographic and social characteristics of the population influenced the result. Further studies to investigate M. genitalium in infertile and other groups of patients are needed. PMID:25157184

  7. Zinc levels in seminal plasma and their correlation with male infertility: A systematic review and meta-analysis.

    PubMed

    Zhao, Jiang; Dong, Xingyou; Hu, Xiaoyan; Long, Zhou; Wang, Liang; Liu, Qian; Sun, Bishao; Wang, Qingqing; Wu, Qingjian; Li, Longkun

    2016-01-01

    Zinc is an essential trace mineral for the normal functioning of the male reproductive system. Current studies have investigated the relationship between seminal plasma zinc and male infertility but have shown inconsistent results. Hence, we systematically searched PubMed, EMBASE, Science Direct/Elsevier, CNKI and the Cochrane Library for studies that examined the relationship between seminal plasma zinc and male infertility, as well as the effects of zinc supplementation on sperm parameters. Twenty studies were identified, including 2,600 cases and 867 controls. Our meta-analysis results indicated that the seminal plasma zinc concentrations from infertile males were significantly lower than those from normal controls (SMD (standard mean differences) [95% CI] -0.64 [-1.01, -0.28]). Zinc supplementation was found to significantly increase the semen volume, sperm motility and the percentage of normal sperm morphology (SMD [95% CI]: -0.99 [-1.60, -0.38], -1.82 [-2.63, -1.01], and -0.75 [-1.37, -0.14], respectively). The present study showed that the zinc level in the seminal plasma of infertile males was significantly lower than that of normal males. Zinc supplementation could significantly increase the sperm quality of infertile males. However, further studies are needed to better elucidate the correlation between seminal plasma zinc and male infertility. PMID:26932683

  8. Antral follicle count in normal (fertility-proven) and infertile Indian women

    PubMed Central

    Agarwal, Arjit; Verma, Ashish; Agarwal, Shubhra; Shukla, Ram Chandra; Jain, Madhu; Srivastava, Arvind

    2014-01-01

    Background: Antral follicle count (AFC) has been labeled as the most accurate biomarker to assess female fecundity. Unfortunately, no baseline Indian data exists, and we continue using surrogate values from the Western literature (inferred from studies on women, grossly different than Indian women in morphology and genetic makeup). Aims: (1) To establish the role of AFC as a function of ovarian reserve in fertility-proven and in subfertile Indian women. (2) To establish baseline cut-off AFC values for Indian women. Settings and Design: Prospective observational case-control study. Materials and Methods: Thirty patients undergoing workup for infertility were included and compared to equal number of controls (women with proven fertility). The basal ovarian volume and AFC were measured by endovaginal. USG the relevant clinical data and hormonal assays were charted for every patient. Statistical Analysis Used: SPSS platform was used to perform the Student's t-test and Mann-Whitney U-test for intergroup comparisons. Correlations were determined by Pearson's ranked correlation coefficient. Results: Regression analysis revealed the highest correlation of AFC and age in fertile and infertile patients with difference in mean AFC of both the groups. Comparison of the data recorded for cases and controls showed no significant difference in the mean ovarian volume. Conclusions: AFC has the closest association with chronological age in normal and infertile Indian women. The same is lower in infertile women than in matched controls. Baseline and cut-off values in Indian women are lower than that mentioned in the Western literature. PMID:25114395

  9. Association of androgen receptor GGN repeat length polymorphism and male infertility in Khuzestan, Iran

    PubMed Central

    Moghadam, Mohamad; Khatami, Saied Reza; Galehdari, Hamid

    2015-01-01

    Background: Androgens play critical role in secondary sexual and male gonads differentiations such as spermatogenesis, via androgen receptor. The human androgen receptor (AR) encoding gene contains two regions with three nucleotide polymorphic repeats (CAG and GGN) in the first exon. Unlike the CAG repeats, the GGN has been less studied because of technical difficulties, so the functional role of these polymorphic repeats is still unclear. Objective: The goal of this study was to investigate any relationship between GGN repeat length in the first exon of AR gene and idiopathic male infertility in southwest of Iran. Materials and Methods: This is the first study on GGN repeat of AR gene in infertile male in Khuzestan, Iran. We used polymerase chain reaction (PCR) and polyacrylamide gel electrophoresis to categorize GGN repeat lengths in 72 infertile and 72 fertile men. Afterwards we sequenced the PCR products to determine the exact length of GGN repeat in each category. Our samples included 36 azoospermic and 36 oligozoospermic men as cases and 72 fertile men as control group. Results: We found that the numbers of repeats in the cases range from 18 to 25, while in the controls this range is from 20 to 28. The results showed a significant relation between the length of GGN repeat and fertility (p=0.015). The most frequent alleles were alleles with 24 and 25 repeats respectively in case and control groups. On the other hand no significant differences were found between Arab and non-Arab cases by considering GGN repeat lengths (p=0.234). Conclusion: Due to our results, there is a significant association between the presence of allele with 24 repeats and susceptibility to male infertility. Therefore this polymorphism should be considered in future studies to clarify etiology of disorders related to androgen receptor activity. PMID:26221130

  10. Reassured or fobbed off? Perspectives on infertility consultations in primary care: a qualitative study

    PubMed Central

    Hinton, Lisa; Kurinczuk, Jenny J; Ziebland, Sue

    2012-01-01

    Background Infertility affects 9% of couples in the UK. Most couples who visit their GP because they are worried about their fertility will ultimately conceive, but a few will not. Treatment usually happens in secondary care, but GPs can have an invaluable role in starting investigations, referring, and giving support throughout treatment and beyond. Aim To inform clinical practice by exploring primary care experiences of infertility treatment among females and males, and discussing findings with a reference group of GPs to explore practice experience. Design and setting A qualitative patient interview and GP focus group study. Interviews were conducted in patients homes in England and Scotland; the focus group was held at a national conference. Method An in-depth interview study was conducted with 27 females and 11 males. A maximum variation sample was sought and interviews were transcribed for thematic analysis. Results were discussed with a focus group of GPs to elicit their views. Results Feeling that they were being taken seriously was very important to patients. Some felt that their concerns were not taken seriously, or that their GP did not appear to be well informed about infertility. The focus group of GPs highlighted the role of protocols in their management of patients who are infertile, as well as the difficulty GPs faced in communicating both reassurance and engagement. Conclusion Simple things that GPs say and do, such as describing the action plan at the first consultation, could make a real difference to demonstrating that they are taking the fertility problem seriously. PMID:22687237

  11. Female Reproductive Hormones and Biomarkers of Oxidative Stress in Genital Chlamydia Infection in Tubal Factor Infertility

    PubMed Central

    Nsonwu-Anyanwu, Augusta Chinyere; Charles-Davies, Mabel Ayebantoyo; Taiwo, Victor Olusegun; Li, Bin; Oni, Anthony Alabar; Bello, Folashade Adenike

    2015-01-01

    Background Genital Chlamydia infection (GCI) and the associated pathologies have been implicated in tubal infertility. Though the actual pathologic mechanisms are still uncertain, oxidative stress and other factors have been implicated. The purpose of the study was to determine the possible contribution of female reproductive hormones and biomarkers of oxidative stress in genital Chlamydial infection to tubal occlusion. Methods This prospective case control study was carried out by recruiting 150 age matched women grouped into infertile Chlamydia positive women (n = 50), fertile Chlamydia positive women (n = 50) and fertile Chlamydia negative women as controls (n = 50). High vaginal swabs and endocervical swabs were collected for screening Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Treponema pallidum, Staphylococcus aureus, and Candida albicans. Sera were collected for estimation of Chlamydia trachomatis antibody, female reproductive hormones [Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Oestradiol (E2), Progesterone (P4), Prolactin (PRL)] and biomarkers of oxidative stress [Total Antioxidant Capacity (TAC) and 8-hydroxyl-2-deoxyguanosine (8-OHdG)] by enzyme immunoassay (EIA). Data were analyzed using chi square, analysis of variance and LSD Post hoc to determine mean differences at p = 0.05. Results Among women with GCI, higher levels of LH and 8-OHdG were observed in infertile Chlamydia positive women compared to fertile Chlamydia positive women (p < 0.05). Higher levels of LH and 8-OHdG and lower TAC levels were observed in infertile Chlamydia positive women compared to fertile Chlamydia negative controls (p < 0.05). Conclusion Mechanisms including oxidative DNA damage and reduced antioxidant capacity may be involved in the pathology of Chlamydia induced tubal damage. PMID:25927024

  12. Y Choromosomal Microdeletion Screening in The Workup of Male Infertility and Its Current Status in India

    PubMed Central

    Suganthi, Ramaswamy; Vijesh, Vijayabhavanath Vijayakumaran; Vandana, Nambiar; Fathima Ali Benazir, Jahangir

    2014-01-01

    Spermatogenesis is an essential stage in human male gamete development, which is regulated by many Y chromosome specific genes. Most of these genes are centred in a specific region located on the long arm of the human Y chromosome known as the azoospermia factor region (AZF). Deletion events are common in Y chromosome because of its peculiar structural organization. Astonishingly, among the several known genetic causes of male infertility, Y chromosomal microdeletions emerged as the most frequent structural chromosome anomaly associated with the quantitative reduction of sperm. The development of assisted reproductive techniques (ART) like intra-cytoplasmic sperm injection (ICSI) and testicular sperm extraction (TESE) helps to bypass the natural barriers of fertilization, but it increases the concern about the transmission of genetic defects. Experimental evidence suggested that the men with Y chromosomal microdeletions vertically transmitted their deletion as well as related fertility disorders to their offspring via these ART techniques. In India, infertility is on alarming rise. ART centres have opened up in virtually every state but still most of the infertility centres in India do not choose to perform Y chromosomal microdeletion diagnosis because of some advanced theoretical reasons. Moreover, there is no consensus among the clinicians about the diagnosis and management of Y chromosomal microdeletion defects. The current review discusses thoroughly the role of Y chromosome microdeletion screening in the workup of male infertility, its significance as a diagnostic test, novel approaches for screening Y deletions and finally a systematic review on the current status of Y chromosome microdeletion deletion screening in India. PMID:24520494

  13. A rare case of respiratory disorders associated with two autosomal recessive diseases and male infertility

    PubMed Central

    Costa, Sergio Lpez; Scigliano, Sergio; Menga, Guillermo; Demiceu, Sergio; Palaoro, Luis Alberto

    2013-01-01

    The study of nasal ciliary beat frequency (CBF) and ultrastructure may contribute to the understanding of pathognomonic cases of male infertility associated with defects in sperm motility. This study was designed to report a particular case of male infertility, characterized by the association of two respiratory autosomal recessive genetic diseases (alpha-1-antitrypsin deficiency [AAT-D] and primary ciliary dyskinesia [PCD]). A 39-year-old patient with complete sperm immotility, AAT-D, and bronchiectasis was studied in the Laboratory of Male Fertility, the Department of Urology, the Respiratory Center of a Pediatric Hospital, and in the Department of Clinical Medicine of a Rehabilitation Respiratory Hospital. Family history, physical examination, hormonal analysis, microbial assays, semen analysis, nasal ciliary function, and structure study by digital high-speed video photography and transmission electron microscopy are described. A noninvasive nasal biopsy to retrieve ciliated epithelium lining the inferior surface of the inferior nasal turbinates was performed and CBF was determined. Beat pattern was slightly curved and rigid, not wide, and metacronic in all the observed fields analyzed. CBF was 8.2 Hz in average (reference value, 1015 Hz) Ultrastructural assay revealed absence of the inner dynein arms in 97% of the cilia observed. The final infertility accurate diagnosis was achieved by the study of nasal CBF and ultrastructure contributing to the patient health management and genetic counseling while deciding fatherhood. Beyond this particular case, the present report may open a new field of studies in male infertility, mainly in cases of asthenozoospermia. PMID:23772318

  14. Psychosocial and contextual determinants of health among infertile women: a cross-cultural study.

    PubMed

    Batool, Shahida Syeda; de Visser, Richard Oliver

    2014-01-01

    The purpose of this study was to assess the impact of emotional intelligence, social support and contextual factors on the general health of infertile women. A sample of involuntarily childless women aged 25-45 living in the UK (n?=?148) and Pakistan (n?=?164) completed a self-administered questionnaire. Although there were no significant differences in total scores on the General Health Questionnaire (GHQ), British women reported greater anxiety, insomnia and social dysfunction, and Pakistani women reported greater depression and somatic symptoms. Important differences in putative correlates of GHQ scores were found between the samples. British women reported significantly greater emotional satisfaction, greater satisfaction with medical information, greater satisfaction with medical care, and greater actual received support Pakistani women reported greater emotional intelligence. Regression analysis to identify correlates of higher GHQ scores revealed that greater received social support was a common correlate of better GHQ scores among British and Pakistani women. Additional correlates of better GHQ scores among British women were greater emotional intelligence and more emotional satisfaction in their relationships (overall R(2) = 0.41). Additional correlates among Pakistani women were greater education, greater perceived available social support and a nuclear family system rather than an extended family (overall R(2) =0. 40). Results suggest that psychological facets of infertility should be addressed as part of a holistic approach to the care of infertile women. They highlight a need to improve social support and to incorporate emotional intelligence training in therapeutic interventions to improve the psychological well-being of infertile women. PMID:24479424

  15. Effect of infertility treatment and pregnancy-related hormones on breast cell proliferation in vitro

    PubMed Central

    Cooley, Anne; Matthews, Laura; Zelivianski, Stanislav; Hardy, Ashley; Jeruss, Jacqueline S.

    2012-01-01

    BACKGROUND Breast cancer development involves a series of mutations in a heterogeneous group of proto-oncogenes/tumor suppressor genes that alter mammary cells to create a microenvironment permissive to tumorigenesis. Exposure to hormones during infertility treatment may have a mutagenic effect on normal mammary epithelial cells, high-risk breast lesions and early-stage breast cancers. Our goal was to understand the association between infertility treatment and normal and cancerous breast cell proliferation. METHODS MCF-10A normal mammary cells and the breast cancer cell lines MCF-7 [estrogen receptor (ER)-positive, well differentiated] and HCC 1937 (ER-negative, aggressive, BRCA1 mutation) were treated with the weak ER activator clomiphene citrate and hormones that are increased during infertility treatment. Direct effects of treatment on cell proliferation and colony growth were determined. RESULTS While clomiphene citrate had no effect on MCF-10A cells or MCF-7 breast cancer cells, it decreased proliferation of HCC 1937 versus untreated cells (P= 0.003). Estrogen had no effect on either MCF-10A or HCC 1937 cells but, as expected, increased cell proliferation (20–100 nM; P≤0.002) and colony growth (10–30 nM; P< 0.0001) of MCF-7 cells versus control. Conversely, progesterone decreased both proliferation (P= 0.001) and colony growth (P= 0.01) of MCF-10A cells, inhibited colony size of MCF-7 cells (P= 0.01) and decreased proliferation of HCC 1937 cells (P= 0.008) versus control. hCG (100 mIU/ml) decreased both proliferation (P ≤ 0.01) and colony growth (P ≤ 0.002) of all three cell lines. CONCLUSIONS Although these data are preclinical, they support possible indirect estrogenic effects of infertility regimens on ER-positive breast cancer cells and validate the potential protective effect of pregnancy-related exposure to hCG. PMID:22081245

  16. Beneficial effect of tamoxifen on sperm recovery in infertile men with nonobstructive azoospermia.

    TOXLINE Toxicology Bibliographic Information

    Moein MR; Tabibnejad N; Ghasemzadeh J

    2012-05-01

    About 10% of infertile men have azoospermia. After the introduction of microinjection [intracytoplasmic sperm injection (ICSI)], many of these men obtain the chance to be a father. But still in many cases of nonobstructive azoospermia, we are not able to find spermatozoa for ICSI. Medications may be able to increase the chance of finding spermatozoa in testis samples. So in this study, we evaluated the effect of tamoxifen citrate on the results of sperm recovery from testis tissue in infertile men with nonobstructive azoospermia. Thirty-two azoospermic infertile men with proved nonobstructive azoospermia were selected. Tamoxifen was administered for 3 months. Semen samples and in the cases of azoospermia second testis biopsy were taken, and the results were compared with the first samples. According to first testis samples, 13 patients had hypospermatogenesis, 9 had maturation arrest and 10 patients sertoli cell syndrome. After tamoxifen treatment, six patients showed spermatozoa in their ejaculates. From other patients all in hypospermatogenesis group, 75% in maturation arrest group and 20% in sertoli cell group showed spermatozoa in their second testis samples. Our study showed that treatment of patients with nonobstructive azoospermia with anti-oestrogenic drugs like tamoxifen can improve the results of sperm recovery in testis samples and also increase the chance of pregnancy by microinjection.

  17. Beneficial effect of tamoxifen on sperm recovery in infertile men with nonobstructive azoospermia.

    PubMed

    Moein, M-R; Tabibnejad, N; Ghasemzadeh, J

    2012-05-01

    About 10% of infertile men have azoospermia. After the introduction of microinjection [intracytoplasmic sperm injection (ICSI)], many of these men obtain the chance to be a father. But still in many cases of nonobstructive azoospermia, we are not able to find spermatozoa for ICSI. Medications may be able to increase the chance of finding spermatozoa in testis samples. So in this study, we evaluated the effect of tamoxifen citrate on the results of sperm recovery from testis tissue in infertile men with nonobstructive azoospermia. Thirty-two azoospermic infertile men with proved nonobstructive azoospermia were selected. Tamoxifen was administered for 3 months. Semen samples and in the cases of azoospermia second testis biopsy were taken, and the results were compared with the first samples. According to first testis samples, 13 patients had hypospermatogenesis, 9 had maturation arrest and 10 patients sertoli cell syndrome. After tamoxifen treatment, six patients showed spermatozoa in their ejaculates. From other patients all in hypospermatogenesis group, 75% in maturation arrest group and 20% in sertoli cell group showed spermatozoa in their second testis samples. Our study showed that treatment of patients with nonobstructive azoospermia with anti-oestrogenic drugs like tamoxifen can improve the results of sperm recovery in testis samples and also increase the chance of pregnancy by microinjection. PMID:21651602

  18. Bacteriospermia and Its Impact on Basic Semen Parameters among Infertile Men

    PubMed Central

    Kandasamy, Balan; Jayachandran, Abiramy Lakshmy; Sathiyanarayanan, Sarasa; Tanjore Singaravelu, Vijayalakshmi; Krishnamurthy, Veeraraghavan; Elangovan, Vanithadevi

    2016-01-01

    Introduction. Semen analysis is considered as the surrogate marker for male fecundity while assessing infertile men. There are several reasons for altered semen quality and bacteriospermia could be one among them. Thereby the aim of our work is to study the semen culture and its impact on semen parameters among infertile men. Materials and Methods. Semen samples were collected from men attending infertility clinic. Semen parameters were analysed based on WHO guidelines. Also, samples were subjected to culture using standard bacteriological techniques. Results. A total of 85 samples were collected. A number of 47 (55.30%) had normal sperm count, 37 (43.50%) had oligozoospermia, and one (1.17%) had azoospermia. Teratozoospermia was the most common abnormality observed (81.17%) followed by asthenozoospermia (28.23%). The prevalence of bacteriospermia was 35.3%. Enterococcus faecalis (30%) was the most common organism isolated followed by Coagulase negative Staphylococcus (23.33%), Staphylococcus aureus (20%), and E. coli (10%). Other less frequently isolated organisms were Klebsiella pneumoniae (6.66%), Proteus sp. (6.66%), and Citrobacter sp. (3.33%). Conclusion. The presence of asymptomatic bacteriospermia did not correlate with abnormal semen parameters. PMID:26880908

  19. Higher SOD1 Gene Expression in Cumulus Cells From Infertile Women With Moderate and Severe Endometriosis.

    PubMed

    Donabela, Flvia Cappello; Meola, Juliana; Padovan, Cristiana Carolina; de Paz, Cludia Cristina Paro; Navarro, Paula Andrea

    2015-11-01

    It is questioned whether worsening of oocyte quality and oxidative stress (OS) are involved in the pathogenesis of infertility related to endometriosis and in compromised intracytoplasmic sperm injection (ICSI) outcomes. Cumulus cells (CCs) protect oocytes from entering apoptosis induced by OS. Thus, we carried out a case-control study comparing expression of superoxide dismutase 1 (SOD1), superoxide dismutase 2 (SOD2), and glutathione peroxidase 4 (GPX4; genes encoding for the main antioxidant enzymes) in CCs from mature oocytes of 26 infertile patients with minimal/mild endometriosis, 14 patients with moderate/severe endometriosis, and 41 controls undergoing controlled ovarian stimulation for ICSI, using real-time polymerase chain reaction. As a secondary objective, we investigated the interaction between the expression of these genes and clinical pregnancy (CP) by a statistical model. Only infertile women with moderate/severe endometriosis showed increased expression of the SOD1 in CCs compared to women with minimal/mild endometriosis and controls, with a positive interaction between increased expression and the occurrence of CP, suggesting that SOD1 might be a potential biomarker of CP following ICSI. PMID:25947891

  20. Pretreatment of sperm with human follicular fluid for borderline male infertility.

    PubMed

    Blumenfeld, Z; Nahhas, F

    1989-05-01

    To test the usefulness of human follicular fluid (FF) in treating male infertility, we incubated washed sperm specimens from 31 couples undergoing intrauterine insemination (IUI), for male and/or unexplained infertility, with either FF or Ham's F-10 medium (Gibco, Grand Island, NY), in alternating cycles in a randomized manner. Semen specimens from 28 men were incubated with either medium or FF. Incubations with FF have increased sperm penetration assay (SPA) scores from 24.8 +/- 17.3 to 34.3 +/- 13.6 (P less than 0.01). Incubation with heat-inactivized FF also has increased SPA scores, although to a lesser extent than noninactivized FF. Seventeen pregnancies occurred in the 31 couples treated by IUI (54.8%), 16 of them in FF-treated cycles (51.6%) and one in "control" IUI cycles (3.2%, P less than 0.01). All pregnancies occurred within four treatment cycles. Thus, IUI after sperm wash and preincubation with FF may be suggested for four to six cycles to couples with male factor and/or unexplained infertility who are reluctant to resort to artificial insemination by donor or adoption, before attempting the more costly and complex in vitro fertilization-embryo transfer procedure. PMID:2707464