... and abuse of other illegal drugs, emotional stress, obesity and age (fertility gradually decreases in 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 ...
Infertility affects 10–15% of all couples. Pelvic infections are an important cause of infertility, primarily as a result of tubal damage. Damage to the fallopian tubes from infections may be due to adhesions, tubal mucosal damage, or tubal occlusion that interferes with normal ovum transport. The infections most commonly related to infertility include gonorrhea, chlamydia, and pelvic inflammatory disease. Tuberculosis
Diagnosis and treatment of infertility, once a purely empirical process, can now be based on rational exclusion of alternatives. The author reviews the drug treatment of infertility, emphasizing ovulation induction. He also discusses the endocrine treatment of men, drug treatment of endometriosis, and antibiotic treatment of infections. The author recommends referral to a specialist when more invasive drugs, such as gonadotrophins or gonadotrophin-releasing hormone or analogue, are indicated, if the couple continues to be infertile, or when the physician suspects endometriosis.
The diagnosis of cancer and the possibility of iatro-genic infertility secondary to cancer treatment appear to be equal life crises for oncology patients in their reproductive years. These patients require careful screening and sensitive intervention by the oncology team. Case examples illustrate the multiple human costs of neglecting iatrogenic infertility as a clinical problem and examine the painful clinical, ethical,
Michael K. Hubner
Infertility in humans is surprisingly common occurring in approximately 15% of the population wishing to start a family. Despite this, the molecular and genetic factors underlying the cause of infertility remain largely undiscovered. Nevertheless, more and more genetic factors associated with infertility are being identified. This review will focus on our current understanding of the chromosomal basis of male infertility
Gary L Harton; Helen G Tempest
In recent years nurse practitioners have expanded their repertoire of ob/gyn skills to include the provision of infertility care. To minimize the stresses involved in an infertility investigation, couples benefit from a care provider who can educate them about the factors, testing, and treatments involved in infertility. They also need a provider who can support them emotionally through a work-up that touches upon the sensitive aspects of their sexuality, partner relationship, and self-esteem. Nurse practitioners have demonstrated an aptitude in providing competent medical care and health education in the context of a therapeutic relationship. Utilization of the physician/nurse practitioners collaborative team approach offers one successful model for integrating nurse practitioners into the practice of infertility. PMID:6562266
Ollivier, S; Lesser, C; Bell, K B
The analysis of polymorphisms in genes involved in spermatogenesis represents one of the most exciting areas of research in\\u000a the genetics of male infertility. These studies are not only important for identifying genetic risk factors for male infertility,\\u000a but they may also represent an important starting point for searching for genes involved in spermatogenesis through linkage\\u000a analysis. Despite many efforts,
Whether antiphospholipid antibodies (aPL) play a pathogenic role in infertility is highly controversial. aPL have been suggested to represent one potential etiology of infertility, specifically in patients with unexplained implantation failure following in vitro fertilization (IVF). The rationale is appealing, as it represents a logical extension of the demonstrated pathogenicity of aPL in contributing to recurrent spontaneous abortion, where mechanisms
Lisa R. Sammaritano
The inability to conceive children is experienced as a stressful situation by individuals and couples all around the world. The consequences of infertility are manifold and can include societal repercussions and personal suffering. Advances in assisted reproductive technologies, such as IVF, can offer hope to many couples where treatment is available, although barriers exist in terms of medical coverage and affordability. The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood. Evidence is emerging of an association between stress of fertility treatment and patient drop-out and pregnancy rates. Fortunately, psychological interventions, especially those emphasizing stress management and coping-skills training, have been shown to have beneficial effects for infertility patients. Further research is needed to understand the association between distress and fertility outcome, as well as effective psychosocial interventions. PMID:17241818
Cousineau, Tara M; Domar, Alice D
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.
Mehta, Akanksha; Li, Philip S
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
Mehta, Akanksha; Li, Philip S
|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)…
Congress of the U.S., Washington, DC. Office of Technology Assessment.
|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…
Orgebin-Crist, Marie-Claire; And Others
|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…
In the African population, pseudocyesis is not an uncommon gynecologic disorder. The high premium on childbearing, as well as the deep-rooted cultural belief that children are a "security of old age" and continuation of the family, exposes the infertile woman to constant stress. The social and psychological satisfaction of parenthood is very important in this culture; while, for some patients, perception of the economic implication of children enhances the desire to have children. PMID:35415
Ladipo, O A
Background/Objective: Tarlov cysts or spinal perineurial cysts are uncommon lesions. These are mostly incidental findings on magnetic resonance imaging or myelograms. The objectives of this study were to describe Tarlov cysts of the sacral region as a potential cause for retrograde ejaculations and review available management options. Methods: Case report and literature review. Results: A 28-year-old man presented with back pain and retrograde ejaculations resulting in infertility. After microsurgical excision of large perineurial cysts, back pain resolved, but semen quality showed only marginal improvement. Later, the couple successfully conceived by intrauterine insemination. To the best of our knowledge, this is the first reported case of Tarlov cyst associated with retrograde ejaculation and infertility. Conclusions: Despite being mostly asymptomatic and an incidental finding, Tarlov cyst is an important clinical entity because of its tendency to increase in size with time. Tarlov cysts of the sacral and cauda equina region may be a rare underlying cause in otherwise unexplained retrograde ejaculations and infertility. Microsurgical excision may be a good option in a select group of patients.
Singh, Pankaj Kumar; Singh, Vinay Kumar; Azam, Amir; Gupta, Sanjeev
Treating the infertile client with competence and compassion is within the scope of practice for advanced practice clinicians. However, due to both a lack of emphasis on infertility treatment in many advanced practice education programs and confusion regarding diagnosis and treatment by many practitioners, infertility is often undertreated by these providers. A basic infertility evaluation, patient counseling, and prescriptive therapy with oral ovulation-inducing agents by a knowledgeable practitioner is cost-effective and may result in successful pregnancy in women who otherwise may not be adequately and quickly treated prior to referral to a reproductive endocrinologist. A diagnosis of infertility is often stressful and frustrating for a couple. Midwives and advanced practice nurses are uniquely qualified to provide both compassionate care and competent treatment during this time. This article provides the clinician with an overview of infertility diagnosis, evaluation, and initial management with lifestyle modifications and oral ovulation-inducing agents. PMID:23078197
Koroma, Lucy; Stewart, Leslye
Laparotomy continues to be the only method available in India for dealing with female infertility. 45 consecutive cases of laparotomy for infertility were collected from among the new and follow-up patients who attended the Gynecological and Antenatal Clinic of Telco Maternity Hospital, Jamshedpur, India over the January 1977 to April 1979 period. Neither human pituitary gonadotropin nor ergobromocryptine were used in this unit. Only clomiphene citrate was used for treatment of infrequent ovulation. None of the patients had prior laparoscopy. All patients taken for laparotomy had transcervical dye test and transuterine injection of saline to check the tubal patency. All patients had healthy husbands. The proportion of primary and secondary infertility in this series was 62.22% and 37.77%, respectively. The single major indication for laparotomy was bilaterally blocked tubes on hysterosalpingogram which was present in 20 cases. Among other indications infrequent ovulation (with or without bilaterally enlarged ovaries) was present in 10 (22.2%) cases. All the 10 patients had clomiphene citrate in the usual regimen for 3 consecutive cycles in increasing doses up to 150 mg a day but without success. In terms of laparotomy findings, in no case was there any evidence of tuberculosis or pelvic endometriosis (apart from the case who had chocolate cyst). In all the 3 cases where the only abnormality was peritubal adhesions preoperative hysterosalpingograms were normal and in all of them laparotomy was performed as a final method of investigation. Of the 12 cases who showed bilateral cornual block in preoperative hysterosalpingogram, tubal patency tests at laparotomy showed unilateral blockage in 4 and no blockage at all in another 4. Of the 13 cases where no lesion was found, the indication of laparotomy was bilateral cornual block (4 cases) and in 9 cases it was performed simply as a method of investigation. In 10 of the 45 cases, the ovaries appeared to be like those found in Stein Leventhal syndrome. PMID:7430670
Kaur, T; Debdas, A K
In vitro fertilization/embryo transfer (IVF/ART) results have shown significant improvements during the last decade. In the United States the rate of live births per cycle improved gradually to become 27% in 2001. Assisted reproductive techniques (ARTs) are increasingly being used for the treatment of tubal factor infertility. In this review the data are derived largely from our department, where we have treated sufficient numbers of patients and have maintained substantial consistency in our surgical techniques. This 3-part review demonstrates a high success rate of intrauterine pregnancy (IUP) after anastomosis for sterilization reversal. This rate, for those who are < 35 years of age at the time of reversal, is >70%, with most pregnancies occurring within 18 months after surgery. Those who are 35 years of age or more will have a 55% rate of IUP. We note, too, the satisfactory IUP rate (50%) after tubocornual anastomosis for proximal tubal disease. We document the beneficial role of laparoscopic salpingoovariolysis, fimbrioplasty and salpingostomy performed during the initial diagnostic laparoscopy. The IUP rates after salpingoovariolysis and fimbrioplasty are 60% and 50%, respectively. The rates of IUP for salpingostomy are modest in comparison, yet they are 25% for liberal use of salpingostomy during the preliminary laparoscopy. Salpingostomy also provides a beneficial effect upon embryo implantation in both in vivo and in vitro attempts at conception. This stresses the need for an appropriate preliminary investigation and for the subsequent diagnostic laparoscopy to be performed at a center able to perform these procedures. The evidence suggests that surgery should retain its place in the treatment of tubal infertility. Surgery and ART are complementary approaches that can be used singly or in combination to improve the outcome for couples with tubal infertility. PMID:16674012
Gomel, Victor; McComb, Peter F
The initial evaluation of the infertile man includes a diligent search for testicular factors, gonadotoxins, and coital factors so as to identify existing causes of impaired fertility and to prevent further dimunition in fertility. There are also prophylactic measures in the treatment of all men that can prevent future infertility, such as prompt correction of cryptorchidism, testicular torsion, genital infection,
S. T. Thompson
The introduction of microsurgical techniques has revolutionized the treatment of male infertility. As a result of technical advances and innovation over the past 10–15 years, previously infertile couples are now able to conceive naturally or to parent their own biological children with the aid of assisted reproductive technologies. This article reviews the indications, techniques, and outcomes of the various microsurgical
Marc Goldstein; Cigdem Tanrikut
Abstract The objective of this paper was to describe methods to estimate infertility from secondary data collected in nationally representative demographic surveys, such as the World Fertility Surveys and Demographic and Health Surveys. Primary infertility was approximated by the proportion childless after at least seven years of marriage. Secondary infertility was measured by the proportion subsequently infertile among parous women.
Hysteroscopic treatment was provided for 122 of 139 women complaining of primary or secondary infertility. Hysteroscopy revealed intrauterine lesions and the following treatments were carried out: lysis of intrauterine adhesions (61), removal of large endometrial polyps (47), removal of submucous leiomyomas (4), removal of embedded fragmented IUD (4), division of uterine septa (3) and treatment of other unusual conditions (3). The reproductive outcome included 46 term pregnancies, 28 following the division of intrauterine adhesions, 11 after the removal of endometrial polyps, 2 after correction of a septate uterus, one after removal of a pedunculated intrauterine leiomyoma, and 4 after removal of different foreign bodies. There were 8 spontaneous first trimester abortions, and 1 ectopic pregnancy. Removal of the lesion and restoration of a symmetric uterine cavity was successful in 119 patients; only 3 failures occurred, in patients with severe Asherman's syndrome. PMID:6152250
Valle, R F
\\u000a Difficulties in conceiving or carrying a child to term affect 12% of the 62 million American women between ages 15–44 (Chandra,\\u000a Martinez, Mosher, Abma, & Jones, 2005). Involuntary childlessness often leads to disappointment and despair, contributing\\u000a to depression, marital strife and social stigma. Although infertility status, access to infertility care, and response to\\u000a medical treatment are not distributed uniformly among
Sylvia Guendelman; Laura Stachel
\\u000a Patients with severe male factor are more likely to be carriers of chromosomal abnormalities both in their sperm and in their\\u000a lymphocytes. These abnormalities include numerical alterations, structural alterations, and Y chromosome microdeletions. Gene\\u000a mutations that cause male infertility and studies identifying polymorphic regions that, in conjunction with environmental\\u000a factors, may be associated with male infertility have been described. Until
Genetic factors affecting male infertility are reviewed. Male infertility is classified under four general causes: spermatogenic\\u000a disorder, obstruction of the seminal tract, inflammation, sexual disorders. Idiopathic spermatogenic disorder accounts for\\u000a more than 50% of all of them. The cause of spermatogenic disorder is not yet identified. In recent years it has become obvious\\u000a that some of the crucial genes expressed
Infertility in humans is surprisingly common occurring in approximately 15% of the population wishing to start a family. Despite this, the molecular and genetic factors underlying the cause of infertility remain largely undiscovered. Nevertheless, more and more genetic factors associated with infertility are being identified. This review will focus on our current understanding of the chromosomal basis of male infertility specifically: chromosomal aneuploidy, structural and numerical karyotype abnormalities and Y chromosomal microdeletions. Chromosomal aneuploidy is the leading cause of pregnancy loss and developmental disabilities in humans. Aneuploidy is predominantly maternal in origin, but concerns have been raised regarding the safety of intracytoplasmic sperm injection as infertile men have significantly higher levels of sperm aneuploidy compared to their fertile counterparts. Males with numerical or structural karyotype abnormalities are also at an increased risk of producing aneuploid sperm. Our current understanding of how sperm aneuploidy translates to embryo aneuploidy will be reviewed, as well as the application of preimplantation genetic diagnosis (PGD) in such cases. Clinical recommendations where possible will be made, as well as discussion of the use of emerging array technology in PGD and its potential applications in male infertility.
Harton, Gary L; Tempest, Helen G
Background Mixed-handedness, which may reflect atypical brain laterality, has been linked to a number of medical conditions as well as prenatal stress. Aims The aim of the study was to examine whether infertility or infertility treatment was associated with an increased risk of mixed-handedness in children. Study design, subjects and outcome measures We used data from three population-based birth cohorts in Denmark: the Aalborg-Odense Birth Cohort (1984-1987), the Aarhus Birth Cohort (1990-1992) and the Danish National Birth Cohort (1996-2002) (N=7728, 5720 and 29486, respectively). Data on time to pregnancy and infertility treatment was collected during pregnancy. Handedness was reported in a follow-up questionnaire when the children were at least 7 years old. Children were categorized as mixed-handed if the mothers reported that they used both hands equally. Results Children born after infertility treatment, particularly intrauterine insemination, had a higher risk of being mixed-handed compared to children of fertile couples with a time to pregnancy ?12 months (odds ratio 1.41, 95% confidence interval 1.09-1.82). Children of couples with unplanned pregnancies, particularly after an oral contraceptives failure, were also more likely to be mixed-handed. There was no association between a long waiting time to pregnancy and mixed-handedness in children. Conclusions Children born after infertility treatment, particularly intrauterine insemination, and children exposed to oral contraceptives during early gestation may have a higher risk of being mixed-handed.
Zhu, Jin Liang; Obel, Carsten; Basso, Olga; Bech, Bodil Hammer; Henriksen, Tine Brink; Olsen, J?rn
... this chromosome tend to be involved in male sex determination and development. Y chromosome infertility is usually caused ... cryptorchidism ; gene ; infertility ; inheritance ; protease ; protein ; sex chromosomes ; sex determination ; sperm ; syndrome ; testes ; ubiquitin You may find definitions ...
BACKGROUND: The recognition of the distressing character of infertility diagnosis and treatment has led to the development of several psychosocial interventions for infertile couples. At the Leuven University Fertility Centre, a body- mind marital group intervention was developed to help infertile couples cope with the distress related to infertility. METHODS AND RESULTS: This treatment programme was originally adapted from a
G. M. D. Lemmens; M. Vervaeke; P. Enzlin; E. Bakelants; D. Vanderschueren; T. D'Hooghe; K. Demyttenaere
Early pregnancy complications are more common in women who conceive after infertility treatment. Most of these occur before 12 weeks of gestation and include miscarriage, vaginal bleeding, intrauterine hematoma, vanishing twin, and ectopic pregnancy (EP). The incidence of EPs following infertility treatment is much higher compared with that in spontaneous pregnancies. The occurrence of an EP is very distressing to an infertile couple, who has lots of hopes pinned on the treatment outcome, especially because of the cost incurred and the physical and mental trauma both have gone through during the treatment process. The association between infertility and EP is complex, as it can be a consequence of infertility as well as a cause. The two principal risk factors for an EP are genital tract infections and tubal surgeries. Though several etiologies are proposed, but patients with tubal factor infertility are at an increased risk of an EP. Earlier diagnosis of EP helps to improve prognosis and optimize subsequent fertility. It is pivotal to evaluate the likelihood of subsequent occurrence of an EP and be too vigilant when treating. The correct choice of the treatment modality should be made to prevent the recurrence. The early prediction of the pregnancy outcome therefore has great importance for both the couple and clinician. Today with the help of sensitive beta human chorionic gonadotropin (?-hCG) assays and transvaginal sonography, one can diagnose an EP prior to symptoms, and conservative treatment for the preservation of the fallopian tube is possible. Conservative management in the form of expectant and medical management should be considered as a first-line treatment modality, provided that the overall clinical picture suggests that it is safe to do so. If not, laparoscopic management of EPs appears to be the favored approach of management as compared to laparotomy.
Since the identification of thyroid hormone receptors on the testes, thyroid has been suggested to have a significant impact on the male reproductive tract, spermatogenesis, and male fertility. Several research articles on the role of thyroid in spermatogenesis or male infertility have been published in the last three decades. We conducted an exhaustive literature search was conducted in order to create an up-to-date review of literature. This review aims to discuss the impact of thyroid on testicular development, spermatogenesis, hypo- or hyper- thyroidism and male infertility, and the management of thyroid related abnormal semen profile. The literature revealed that thyroid significantly impacts testicular development and that abnormal thyroid profile affects semen quality and male fertility by compromising testicular size, sperm motility and ejaculate volume. A clear link exists between thyroid hormones, testicular development and spermatogenesis. Thyroid disease negatively affects spermatogenesis and consequently may cause male infertility. In such cases, infertility is reversible, but more studies need to be conducted, especially in post-pubertal males to cement the current findings. PMID:21622096
Rajender, Singh; Monica, Marie Gray; Walter, Lee; Agarwal, Ashok
Contents: The Psychological Aspects of Being Infertile, Religious and Secular Perspectives about Infertility Prevention and Treatment; Risks of Infertility Diagnosis and Treatment; Risks of Infertility Diagnosis and Treatment.
C. H. Shapiro B. A. Brody H. B. Holmes A. R. Scialli
\\u000a Recent decades have witnessed a significant rise in the numbers of couples seeking infertility care worldwide (Balen 2008).\\u000a This phenomenon has been driven, in part, by the availability of assisted reproductive therapies (ART) and the social circumstances\\u000a that motivate couples to defer having children until they are older. If both these phenomena persist into the future, we can\\u000a anticipate that
Barbara Chubak; Anthony J. Thomas
Recently, work has shown that azoospermia factor (AZF) microdeletions result from homologous recombination between almost\\u000a identical blocks in this gene region. These microdeletions in the Y chromosome are a common molecular genetic cause of spermatogenetic\\u000a failure leading to male infertility. After completion of the sequencing of the Y chromosome, the classical definition of AZFa,\\u000a AZFb, and AZFc was modified to
Eitetsu Koh; Ho-Su Sin; Masato Fukushima; Mikio Namiki
For years, the management and treatment of male factor infertility has been ‘experience' and not ‘evidence' based. Although not evidence-based, current clinical practice involves extensive use of assisted reproductive techniques (ART). Where specific treatments are not indicated or have failed, ART have become popular adjunctive treatments for alleviating male factor infertility. According to the limited evidence available, intrauterine insemination (IUI) may be considered as a first-line treatment in a couple in which the female partner has a normal fertility status and at least 1×106 progressively motile spermatozoa are recovered after sperm preparation. If no pregnancy is achieved after 3–6 cycles of IUI, optimized in vitro fertilization (IVF) can be proposed. When less than 0.5×106 progressively motile spermatozoa are obtained after seminal fluid processing or sperm are recovered surgically from the testis or epididymis, intracytoplasmic sperm injection (ICSI) should be performed. Although the outcome of no other ART has ever been scrutinized as much before, no large-scale ‘macroproblems' have as yet been observed after ICSI. Yet, ICSI candidates should be rigorously screened before embarking on IVF or ICSI, and thoroughly informed of the limitations of our knowledge on the hereditary aspects of male infertility and the safety aspects of ART.
The Y chromosome contains genes closely related to male gonadal development and spermatogenesis. The azoospermia factor (AZF) is a gene on the long arm of the Y chromosome that regulates spermatogenesis, and its deletion can induce spermatogenic arrest and consequently male infertility. Most researchers subdivide AZF into AZFa, AZFb and AZFc, and some believe there to be another region, AZFd, between AZFa and AZFb. Different AZF deletions lead to different phenotypes. AZFc deletion, as the commonest type that attracts widespread attention of researchers, includes complete AZF deletion and partial AZF deletion, and the latter mainly consists of gr/gr deletion and b2/b3 deletion. The gr/gr deletion can cause infertility in some areas or in human species. The influence of b2/b3 deletion on spermatogenesis has not been confirmed, but its wide spread in haplogroup N has distribution scientists' attention. This review outlines the structures, candidate genes and deletions of AZF, especially AZFc, along with their relationship with spermatogenesis, so as to provide a theoretical basis for clinical prenatal diagnosis and treatment of infertility. PMID:23214242
Introduction Recent improvements in cancer detection, treatment, and technology have increased survivorship rates. These same life-saving treatments, however, can lead to infertility or sterility. Oncofertility, an emerging field at the intersection of cancer and oncology, centers on providing cancer patients with the potential to preserve their biological fertility. Methods We examine the history of how men and women have been treated for infertility and analyze contemporary studies of how women without cancer respond to infertility. Results Both female and male cancer patients and survivors value their fertility, although there is conflicting evidence on the degree to which women and men value fertility. Some studies have found that women and men value their fertility equally while others found that women value their fertility more than men. Gendered norms around fertility and parenthood seem to be changing, which may minimize these discrepancies. Discussions/conclusions Although oncofertility is a nascent field, infertility is a historically relevant medical condition that is characterized by gendered narratives and norms. An analysis of the historical evolution of the understanding and treatment of infertility leads insight into modern conceptualizations of infertility both generally and in the case of cancer. Understanding these historical and current gendered influences helps to define the current context in which cancer patients are confronting potential infertility. Implications for cancer survivors The insight gained from this analysis can be used to inform clinical practice, offering guidance to healthcare providers approaching cancer patients about potential infertility, regardless of gender.
Gardino, Shauna; Rodriguez, Sarah; Campo-Engelstein, Lisa
Female fertility begins to decline many years prior to the onset of menopause despite continued regular ovulatory cycles. Age related infertility is due to oocyte abnormalities and decreased ovarian reserve. Treatment of infertility when the cause is limited to decreased ovarian reserve is empirical at present except for oocyte donation. This mini review of the literature covers all available English
Mohammad Ali Karimzadeh; Sedigheh Ghandi
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…
Louw, D. J.
|Infertile couples' (N=131) consideration of options for dealing with infertility (medical help, adoption, fostering, alternative medicine, and focusing on other life goals) is studied. Options were related to specific motivations including altruistic motives for adoption or foster care. Results, timing of choices, and motivations are discussed.…
van Balen, Frank; Verdurmen, Jacqueline; Ketting, Evert
Clinical vignette: A 29-year-old woman is referred for management of infertility. After menarche at age 12, menses occurred irregularly for a year and then became regular. She initiated use of oral contraceptive pills at the age of 18, then stopped at age 27 to try to conceive. Evaluation revealed hyperprolactinemia with serum prolactin of 90 ng/ml; pituitary MRI showed a 6-mm microadenoma. Other pituitary function tested was normal. Therapy was initiated with bromocriptine, but it was poorly tolerated, with fatigue, nausea, and lightheadedness to the point of syncopal events during her work as a hairdresser. Treatment was changed to cabergoline, with similar difficulties. Prolactin levels declined to the 30s–40s, but she was never able to tolerate the medication sufficiently to attain normal prolactin levels, and menses were sporadic and infrequent, with only 2–3 occurring per year. She and her husband had not conceived despite regular unprotected intercourse. She asks whether other medical treatment options might be available for her infertility.
Kaiser, Ursula B.
Objective To determine whether fetal size differences exist between matched fertile and infertile women and among women with infertility achieving pregnancy through various treatment modalities. Design Retrospective cohort study with propensity score analysis Setting Tertiary care center and affiliated community hospitals Patients 1246 fertile and 461 infertile healthy women with singleton live-births over a ten-year period. Infertile women conceived 1) without medical assistance (WMA), 2) with ovulation induction (OI), or 3) with in vitro fertilization (IVF). Main Outcome Measure(s) Birthweight; secondary outcomes included crown rump length, second trimester estimated fetal weight, and incidence of low birth weight (LBW) and preterm delivery. Results Compared to matched fertile women, infertile women had smaller neonates at birth (3375±21 vs. 3231±21 grams; p<0.0001) and more LBW infants (RR=1.68, 95% CI 1.06, 2.67). Neonates conceived via OI were the smallest of infertility subgroups compared to those of fertile women (3092 ± 46 vs. 3397 ± 44 grams; p<0.001). First trimester fetal size was smaller in infertile vs. fertile women (CRL 7.9±0.1 vs. 8.5±0.1 mm, p<0.01). Within infertility subgroups, no differences in fetal or neonatal size were found. Conclusions The inherent pathologic processes associated with infertility may have a larger impact on fetal growth than infertility therapies.
Cooper, Amber R.; O'Neill, Kathleen E.; Allsworth, Jenifer E.; Jungheim, Emily S.; Odibo, Anthony O.; Gray, Diana L.; Ratts, Valerie S.; Moley, Kelle H.; Odem, Randall R.
This essay reviews the literature on the social psychological impact of infertility, paying special attention to the relationship between gender and the infertility experience. It is convenient to divide the literature into articles which explore the possibility that infertility may have psychological causes (Psychogenic Hypothesis) and those which examine the psychological consequences of infertility (Psychological Consequences Hypothesis). The psychogenic hypothesis
Arthur L. Greil
BACKGROUND Over the past 10 years, there has been a significant increase in the use of assisted reproductive technologies in Canada, however, little is known about the overall prevalence of infertility in the population. The purpose of the present study was to estimate the prevalence of current infertility in Canada according to three definitions of the risk of conception. METHODS Data from the infertility component of the 2009–2010 Canadian Community Health Survey were analyzed for married and common-law couples with a female partner aged 18–44. The three definitions of the risk of conception were derived sequentially starting with birth control use in the previous 12 months, adding reported sexual intercourse in the previous 12 months, then pregnancy intent. Prevalence and odds ratios of current infertility were estimated by selected characteristics. RESULTS Estimates of the prevalence of current infertility ranged from 11.5% (95% CI 10.2, 12.9) to 15.7% (95% CI 14.2, 17.4). Each estimate represented an increase in current infertility prevalence in Canada when compared with previous national estimates. Couples with lower parity (0 or 1 child) had significantly higher odds of experiencing current infertility when the female partner was aged 35–44 years versus 18–34 years. Lower odds of experiencing current infertility were observed for multiparous couples regardless of age group of the female partner, when compared with nulliparous couples. CONCLUSIONS The present study suggests that the prevalence of current infertility has increased since the last time it was measured in Canada, and is associated with the age of the female partner and parity.
Bushnik, Tracey; Cook, Jocelynn L.; Yuzpe, A. Albert; Tough, Suzanne; Collins, John
Male factor infertility is the sole cause of infertility in approximately 20% of infertile couples, with an additional 30%\\u000a to 40% secondary to both male and female factors. Current means of evaluation of male factor infertility remains routine semen\\u000a analysis including seminal volume, pH, sperm concentration, motility, and morphology. However, approximately 15% of patients\\u000a with male factor infertility have a
Ryan T. Schulte; Dana A. Ohl; Mark Sigman; Gary D. Smith
... that could affect fertility treatment outcomes or may cause birth defects. If you choose any form of infertility treatment, ... not advisable for use during pregnancy (e.g., cause birth defects, pregnancy complications) or can be used in moderation ...
Small RNA has become a crucial regulator of protein synthesis during spermatogenesis. Alterations in small RNA function prove to be detrimental to proper spermatogenesis. As many patients suffer from idiopathic infertility, understanding the molecular mechanisms of small RNA identifies possible causes of certain types of infertility. With a comprehensive review of the history of miRNA and piRNA function and specificity in the testis from a wide range of studies offers a view of detrimental defects of small RNA. By combining a concise overview of small RNA mechanism and recent research we explain how some cases of male infertility can be a product of complications in specific small RNA functions. The future direction section offers insight into how infertility treatment may be approached with a novel perspective. PMID:22652870
Rajender, Singh; Meador, Corey; Agarwal, Ashok
In 283 women with infertility HSG results have been analyzed. Fallopian tubes have been found to be patent in 196 subjects, whereas in 87 subjects distal or proximal unilateral or bilateral impatency has been observed. In 28 subjects with impatent fallopian tubes uterus malformations were found. 72 women with impatent oviducts were treated by laparoscopy alongside with oviduct chromotubation. On basis of clinical findings as well as cases reported in literature, HSG relevancy in infertility diagnostics has been proved. PMID:8112623
Tomala, J; Witek, A; Brudnik, A; Bakon, I; Kossowski, P
The evaluation of the infertile male continues to be a clinical challenge of increasing significance with considerable emotional and financial burdens. Many physiological, environmental and genetic factors are implicated; however, the etiology of suboptimal semen quality is poorly understood. This review focuses on the diagnostic testing currently available, as well as future directions that will be helpful for the practicing urologist and other clinicians to fully evaluate the infertile male.
Hwang, Kathleen; Lipshultz, Larry I.; Lamb, Dolores J.
Male infertility is a relatively common condition caused by low sperm production, immobile sperm, or blockages that prevent the delivery of sperm. This condition can be caused by a variety of illnesses, injuries, chronic health problems, lifestyle choices, other factors, or idiopathic, in which abnormal semen parameters occur without an identifiable cause. Medical management traditionally focuses on correcting endocrine abnormalities related to hormone deficiencies. Clomiphene citrate is an antiestrogen thought to increase sperm parameters in males attempting to conceive. The objective of this review was to evaluate the efficacy and safety of clomiphene citrate in the treatment of male patients with infertility. A literature search of MEDLINE (1966-June 2012) and EMBASE (1980-June 2012) was conducted using the medical terms clomiphene and male infertility and 9 clinical studies were identified. Overall, only 1 study detected a statistically significant benefit on the pregnancy rate in the clomiphene group; however, the majority of the studies demonstrated a statistically significant increase in sperm concentrations. At doses used to treat male infertility, clomiphene was well tolerated with no identified serious adverse effects. Based on the reviewed studies there is insufficient evidence to indicate that clomiphene is effective for the treatment of male infertility. PMID:23202725
Willets, Amy E; Corbo, Jason M; Brown, Jamie N
This case is an investigation into the effect of steroids on infertility. Students learn about sperm counts, sperm lab analysis, infertility diagnoses, and how to put together an informative health pamphlet.
... father children. Affected individuals have moderate to severe sensorineural hearing loss, which is caused by abnormalities in the inner ... chromosome ; deletion ; gene ; infertile ; infertility ; prevalence ; recessive ; sensorineural ; sensorineural hearing loss ; sperm ; symptom ; syndrome You may find definitions for ...
BACKGROUND Worldwide more than 70 million couples suffer from infertility, the majority being residents of developing countries. Negative consequences of childlessness are experienced to a greater degree in developing countries when compared with Western societies. Bilateral tubal occlusion due to sexually transmitted diseases and pregnancy-related infections is the most common cause of infertility in developing countries, a condition that is potentially treatable with assisted reproductive technologies (ART). New reproductive technologies are either unavailable or very costly in developing countries. This review provides a comprehensive survey of all important papers on the issue of infertility in developing countries. METHODS Medline, PubMed, Excerpta Medica and EMBASE searches identified relevant papers published between 1978 and 2007 and the keywords used were the combinations of ‘affordable, assisted reproduction, ART, developing countries, health services, infertility, IVF, simplified methods, traditional health care'. RESULTS The exact prevalence of infertility in developing countries is unknown due to a lack of registration and well-performed studies. On the other hand, the implementation of appropriate infertility treatment is currently not a main goal for most international non-profit organizations. Keystones in the successful implementation of infertility care in low-resource settings include simplification of diagnostic and ART procedures, minimizing the complication rate of interventions, providing training-courses for health-care workers and incorporating infertility treatment into sexual and reproductive health-care programmes. CONCLUSIONS Although recognizing the importance of education and prevention, we believe that for the reasons of social justice, infertility treatment in developing countries requires greater attention at National and International levels.
Ombelet, Willem; Cooke, Ian; Dyer, Silke; Serour, Gamal; Devroey, Paul
Background: With regard to the importance of preconception conditions in maternal health and fertility, preconception risk assessment makes treatment trends and pregnancy outcome more successful among infertile couples. This study has tried to investigate preconception risk assessment in infertile couples. Materials and Methods: This is a descriptive analytical survey conducted on 268 subjects, selected by convenient sampling, referring to Isfahan infertility centers (Iran). The data were collected by questionnaires through interview and clients’ medical records. Pre-pregnancy risk assessment including history taking (personal, familial, medical, medications, menstruation, and pregnancy), exams (physical, genital, and vital signs), and routine test requests (routine, cervix, infections, and biochemical tests) was performed in the present study. Results: The results showed that the lowest percentage of taking a complete history was for personal history (0.4%) and the highest was for history of menstruation (100%). The lowest percentage of complete exam was for physical exam (3.4%) and the highest for genital exam (100%). With regard to laboratory assessment, the highest percentage was for routine tests (36.6%) and the lowest was for infection tests (0.4%). Conclusion: Based o the results of the present study, most of the risk assessment components are poorly assessed in infertile couples. With regard to the importance of infertility treatment, spending high costs and time on that, and existence of high-risk individuals as well as treatment failures, health providers should essentially pay special attention to preconception risk assessment in infertile couples in order to enhance the chance of success and promote treatment outcome.
Nekuei, Nafisehsadat; Kazemi, Ashraf; Ehsanpur, Soheila; Beigi, Nastaran Mohammad Ali
The study was planned to evaluate the sexual function in infertile women. In the course of this study, 308 infertile and 308\\u000a fertile women were interviewed. Female Sexual Function Index was used to assess the relationship between infertility and female\\u000a sexual function. The total FSFI score was 24.58 ± 5.45 in the infertile group versus 26.55 (p < 0.01) in the fertile control group.
Umran Yesiltepe Oskay; Nezihe Kizilkaya Beji; Hasan Serdaroglu
Clomiphene citrate, a selective estrogen receptor modulator, has been used to treat infertility in women and men for 50 years. In men, clomiphene citrate has been employed in the management of unexplained infertility, oligo and asthenospermia, hypogonadism, and nonobstructive azoospermia. The available evidence reveals mixed results and suggests that clomiphene citrate may be appropriate for the management of male infertility in specific clinical scenarios. Further research is needed to clarify when clomiphene citrate is indicated in the treatment of male infertility. PMID:23775379
Roth, Lauren W; Ryan, Amanda R; Meacham, Randall B
This study highlighted the problems of infertility among-women in Ilora rural community. The result revealed that in spite of high fertility rate and high rate of pregnancy wastage, 8.7% out of the 400 women studied were found to be infertile. It is interesting to note that in a strictly polygamous environment, almost half of the women suffering from infertility were found to be the only wife of their respective husbands. The African concept as to the solution to the problems was also discussed, and highlighted in relation to awareness of possible hospital treatment of their conditions. PMID:12751569
Yoga and meditation can help women experiencing the challenges of infertility. The practice of meditation and relaxation can help increase the clarity of the mind, maintain healthy body chemistry, and give patients the patience to undergo the rigors of infertility treatments. When one understands and can attain physical relaxation, one tends to feel better about the body itself, and begins to treat the body with more respect. This understanding can lead to healthier lifestyle habits as well as increased sensitivity regarding symptoms and body processes. This is beneficial to both doctor and patient as the patient can report with more clarity and sense cycles and physical issues more readily. PMID:14568288
Khalsa, Hari Kaur
Over the past decade, significant advances have occurred in the diagnosis and treatment of reproductive disorders. In this review, we discuss the routine testing performed to diagnose unexplained infertility. We also discuss additional testing, such as assessment of ovarian reserve, and the potential role of laparoscopy in the complete workup of unexplained infertility. Finally, we outline the available therapeutic options and discuss the efficacy and the cost-effectiveness of the existing treatment modalities. The optimal treatment strategy needs to be based on individual patient characteristics such as age, treatment efficacy, side-effect profile, and cost considerations.
Quaas, Alexander; Dokras, Anuja
|Women and men diagnosed with infertility experience a variety of infertility-related stressors, including changes to their family and social networks, strain on their sexual relationship, and difficulties and unexpected challenges in their relationship. Infertility stress is linked with depression and psychological distress, and can lead to…
Peterson, Brennan D.; Eifert, Georg H.
Objectives: Many employers exclude infertility treatment from coverage under their health benefits plans. However, infertility treatment is often provided under other diagnoses or in association with therapy rendered for other disease processes. This study attempted to estimate those hidden costs and to determine what the impact would be of providing coverage for infertility treatment. Study Design: A 1-year retrospective analysis
Richard E. Blackwell
Oxidative stress (OS) occurs with an overabundance of reactive oxygen species (ROS) generation and the inability of scavengers, i.e. antioxidants, to neutralize excessive loads of ROS. OS has a role in the etiopathologenesis of many factors causing natural infertility. Infertility is a problem of great magnitude affecting 6 million American women. The etiologies of unexplained infertility and recurrent pregnancy loss
Natalie Krajcir; Hyndhavi Chowdary; Sajal Gupta; Ashok Agarwal
Females that are socially bonded to a single male, either in a social monogamy or in a social polygyny, are often sexually polyandrous. Extrapair copulations (EPC) have often been suggested or rejected, on both empirical and theoretical grounds, as an important mechanism that enables females to avoid fertility risks in case their socially bonded male is infertile. Here, we explore
Oren Hasson; Lewi Stone
To obtain estimates of the effect of abdominal myomectomy on infertility, information from studies published in the English language literature between 1982 and 1996 was retrieved. Articles were identified through hand and compu- terized searches using Medline. A total of 27 trials, all published in peer-reviewed journals, was identified, of which four were excluded from the analysis because of methodological
Paolo Vercellini; Silvia Maddalena; Olga De Giorgi; Giorgio Aimi; Pier Giorgio Crosignani
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
Török, Péter; Major, Tamás
As a result of endocrine disruptor studies, there are numerous examples of male related reproductive abnormalities observed in vertebrates. Contrastingly, within the invertebrates there have been considerably less examples both from laboratory and field investigations. This has in part been due to a focus of female related endpoints, inadequate biomarkers and the low number of studies. Whether contaminant induced male infertility is an issue within aquatic invertebrates and their wider communities therefore remains largely unknown and represents a key knowledge gap in our understanding of pollutant impacts in aquatic wildlife. This paper reviews the current knowledge regarding pollutants impacting male infertility across several aquatic invertebrate phyla; which biomarkers are currently being used and where the science needs to be expanded. The limited studies conducted so far have revealed reductions in sperm numbers, examples of poor fertilisation success, DNA damage to spermatozoa and inhibition of sperm motility that can be induced by a range of environmental contaminants. This limited data is mainly comprised from laboratory studies with only a few studies of sperm toxicity in natural populations. Clearly, there is a need for further studies in this area, to include both laboratory and field studies from clean and reference sites, with a focus on broadcast spawners and those with direct fertilisation. Biomarkers developed for measuring sperm quantity and quality in vertebrates are easily transferable to invertebrates but require optimisation for particular species. We discuss how sperm tracking and techniques for measuring DNA strand breaks and sperm viability have been successfully transferred from human infertility clinics to aquatic invertebrate ecotoxicology. Linking sperm toxicity and male infertility effects to higher level impacts on the reproductive biology and dynamics of populations requires a much greater understanding of fertilisation dynamics and sperm competition/limitation for invertebrate species and represents the next challenge in our understanding of male toxicity effects in natural populations. PMID:22640873
Lewis, Ceri; Ford, Alex T
In reproductive medicine, minimally invasive techniques are commonly used to perform various surgeries (e.g., tubal reanastomosis\\u000a and myomectomy) in the infertile patient. In recent years, robotic technology has been utilized to perform these surgeries.\\u000a This article will review the laparoscopic and robotic applications for tubal reanastomosis and myomectomy within the field\\u000a of reproductive medicine. In addition, current robotic techniques utilized
Julie Sroga; Sejal Dharia Patel
This study was performed in order to determine the prevalence and predisposing factors of psychiatric disorders among infertile\\u000a and fertile women attending Vali-e-Asr Hospital. A total of 150 fertile women from Vali-e-Asr Reproduction Health Research\\u000a Center and fertile women from the Gynecology Clinic of Imam Khomeini Hospital were chosen by consecutive sampling. Data included\\u000a demographic information, SCL-90-R, and a semi-structured
Ahmad Ali Noorbala; Fatemeh Ramezanzadeh; Nasrin Abedinia; Mohammad Mehdi Naghizadeh
BACKGROUND: Infertility is a major reproductive health problem in Africa. This paper presents the findings of two studies which focus on the knowledge that infertile women have about fertility and the causes of infertility, their treatment-seeking behaviour and their expectations of an infertility clinic. METHODS: A total of 150 infertile women from a culturally diverse, urban community in South Africa
S. J. Dyer; N. Abrahams; M. Hoffman; Z. M. van der Spuy
Objective: To assess the effect of weight reduction in obese infertile women on conception rate spontaneously as well as with ovulation induction and pregnancy outcome. Study Design: Observational experimental study. Place and Duration of Study: Different private clinics at Mirpurkhas, Thana Bola Khan and Hyderabad, Sindh, Pakistan, from March 2008 to February 2011. Methodology: Infertile women who were obese with the body mass index (BMI) > 30 kg/ m2 and failed to conceive within 2 - 5 years after taking treatment of infertility for many cycles were inducted. These women underwent life style change program related to exercise and diet for 6 months and in the next 6 months they were observed for spontaneous conception. Those women who failed to conceive were prescribed ovulation induction (clomifene citrate) for the next 6 months and were observed for conception. After conception, they visited regularly during antenatal period till delivery. The data was collected and analyzed on SPSS version 17. Results: The mean decrease in the body index observed was 9.6 ± 1.23 kg/m2, spontaneous conception rate was (n = 35, 41.17%) and miscarriage rate was (n = 9, 16.66%). Conclusion: Weight reduction leads to high spontaneous conception rate as well as with ovulation induction therapy and improves the pregnancy outcome. PMID:24169388
Khaskheli, Meharun-Nissa; Baloch, Shahla; Baloch, Aneela Sheeba
In recent years the incidence of male infertility has increased. Many risk factors have been taken into consideration, including viral infections. Investigations into viral agents and male infertility have mainly been focused on human papillomaviruses, while no reports have been published on polyomaviruses and male infertility. The aim of this study was to verify whether JC virus and BK virus are associated with male infertility. Matched semen and urine samples from 106 infertile males and 100 fertile males, as controls, were analyzed. Specific PCR analyses were carried out to detect and quantify large T (Tag) coding sequences of JCV and BKV. DNA sequencing, carried out in Tag JCV-positive samples, was addressed to viral protein 1 (VP1) coding sequences. The prevalence of JCV Tag sequences in semen and urine samples from infertile males was 34% (72/212), whereas the BKV prevalence was 0.94% (2/212). Specifically, JCV Tag sequences were detected in 24.5% (26/106) of semen and 43.4% (46/106) of urine samples from infertile men. In semen and urine samples from controls the prevalence was 11% and 28%, respectively. A statistically significant difference (p<0.05) in JCV prevalence was disclosed in semen and urine samples of cases vs. controls. A higher JC viral DNA load was detected in samples from infertile males than in controls. In samples from infertile males the JC virus type 2 strain, subtype 2b, was more prevalent than ubiquitous type 1. JCV type 2 strain infection has been found to be associated with male infertility. These data suggest that the JC virus should be taken into consideration as an infectious agent which is responsible for male infertility.
Comar, Manola; Zanotta, Nunzia; Croci, Eleonora; Murru, Immacolata; Marci, Roberto; Pancaldi, Cecilia; Dolcet, Ornella; Luppi, Stefania; Martinelli, Monica; Giolo, Elena; Ricci, Giuseppe; Tognon, Mauro
Purpose Androgen replacement therapy has been shown to be safe and effective for most patients with testosterone deficiency. Male partners of infertile couples often report significantly poorer sexual activity and complain androgen deficiency symptoms. We report herein an adverse effect on fertility caused by misusage of androgen replacement therapy in infertile men with hypogonadal symptoms. Materials and Methods The study population consisted of 8 male patients referred from a local clinic for azoospermia or severe oligozoospermia between January 2008 and July 2011. After detailed evaluation at our andrology clinic, all patients were diagnosed with iatrogenic hypogonadism associated with external androgen replacement. We evaluated changes in semen parameters and serum hormone level, and fertility status. Results All patients had received multiple testosterone undecanoate (NebidoR) injections at local clinic due to androgen deficiency symptoms combined with lower serum testosterone level. The median duration of androgen replacement therapy prior to the development of azoospermia was 8 months (range: 4-12 months). After withdrawal of androgen therapy, sperm concentration and serum follicle-stimulating hormone level returned to normal range at a median 8.5 months (range: 7-10 months). Conclusion Misusage of external androgen replacement therapy in infertile men with poor sexual function can cause temporary spermatogenic dysfunction, thus aggravating infertility.
Bang, Jeong Kyoon; Lim, Jung Jin; Choi, Jin; Won, Hyung Jae; Yoon, Tae Ki; Hong, Jae Yup; Park, Dong Soo
We had previously demonstrated that Coenzyme Q10 [(CoQ10) also commonly called ubiquinone] is present in well-measurable levels in human seminal fluid, where it probably exerts important metabolic and antioxidant functions; seminal CoQ10 concentrations show a direct correlation with seminal parameters (count and motility). Alterations of CoQ10 content were also shown in conditions associated with male infertility, such as asthenozoospermia and varicocele (VAR). The physiological role of this molecule was further clarified by inquiring into its variations in concentrations induced by different medical or surgical procedures used in male infertility treatment. We therefore evaluated CoQ10 concentration and distribution between seminal plasma and spermatozoa in VAR, before and after surgical treatment, and in infertile patients after recombinant human FSH therapy. The effect of CoQ10 on sperm motility and function had been addressed only through some in vitro experiments. In two distinct studies conducted by our group, 22 and 60 patients affected by idiopathic asthenozoospermia were enrolled, respectively. CoQ10 and its reduced form, ubiquinol, increased significantly both in seminal plasma and sperm cells after treatment, as well as spermatozoa motility. A weak linear dependence among the relative variations, at baseline and after treatment, of seminal plasma or intracellular CoQ10, ubiquinol levels and kinetic parameters was found in the treated group. Patients with lower baseline value of motility and CoQ10 levels had a statistically significant higher probability to be responders to the treatment. In conclusion, the exogenous administration of CoQ10 increases both ubiquinone and ubiquinol levels in semen and can be effective in improving sperm kinetic features in patients affected by idiopathic asthenozoospermia. PMID:19509475
Balercia, G; Mancini, A; Paggi, F; Tiano, L; Pontecorvi, A; Boscaro, M; Lenzi, A; Littarru, G P
Introduction Recent improvements in cancer detection, treatment, and technology have increased survivorship rates. These same life-saving\\u000a treatments, however, can lead to infertility or sterility. Oncofertility, an emerging field at the intersection of cancer\\u000a and oncology, centers on providing cancer patients with the potential to preserve their biological fertility.\\u000a \\u000a \\u000a \\u000a \\u000a Methods We examine the history of how men and women have been treated for
Shauna Gardino; Sarah Rodriguez; Lisa Campo-Engelstein
Pivotal genetic information has been derived for a host of rare genetic disorders, but progress has been much slower in relation to the common causes of female infertility. In this chapter, we shall illustrate the approaches being applied in elucidating conditions causing infertility that are inherited in a polygenic\\/multifactorial fashion. The task is to determine the number of genes responsible
Joe Leigh Simpson
Male infertility lies at the crossroads of genetic determinants and environmental effects. Although the exact genetic mechanisms of male infertility are still unclear, this disorder is associated with a host of medical diseases, including testicular cancer. Testicular dysgenesis syndrome, the Hiwi protein and chromosome 12 aneuploidy, DNA mismatch repair, and Y-chromosome instability have been postulated as possible connections between male
James M. Hotaling; Thomas J. Walsh
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
Joseph G. Schenker
A clinically significant proportion of couples experience difficulty in conceiving a child. In about half of these cases male infertility is the cause and often genetic factors are involved. Despite advances in clinical diagnostics ?50% of male infertility cases remain idiopathic. Based on this, further analysis of infertile males is required to identify new genetic factors involved in male infertility. This review focuses on cation channel of sperm (CATSPER)-related male infertility. It is based on PubMed literature searches using the keywords ‘CATSPER', ‘male infertility', ‘male contraception', ‘immunocontraception' and ‘pharmacologic contraception' (publication dates from January 1979 to December 2009). Previously, contiguous gene deletions including the CATSPER2 gene implicated the sperm-specific CATSPER channel in syndromic male infertility (SMI). Recently, we identified insertion mutations of the CATSPER1 gene in families with recessively inherited nonsyndromic male infertility (NSMI). The CATSPER channel therefore represents a novel human male fertility factor. In this review we summarize the genetic and clinical data showing the role of CATSPER mutation in human forms of NSMI and SMI. In addition, we discuss clinical management and therapeutic options for these patients. Finally, we describe how the CATSPER channel could be used as a target for development of a male contraceptive.
Hildebrand, Michael S; Avenarius, Matthew R; Fellous, Marc; Zhang, Yuzhou; Meyer, Nicole C; Auer, Jana; Serres, Catherine; Kahrizi, Kimia; Najmabadi, Hossein; Beckmann, Jacques S; Smith, Richard J H
Reproduction is required for the survival of all mammalian species, and thousands of essential 'sex' genes are conserved through evolution. Basic research helps to define these genes and the mechanisms responsible for the development, function and regulation of the male and female reproductive systems. However, many infertile couples continue to be labeled with the diagnosis of idiopathic infertility or given
Martin M Matzuk; Dolores J Lamb
Specialist infertility practice was studied in a group of 708 couples within a population of residents of a single health district in England. They represented an annual incidence of 1.2 couples for every 1000 of the population. At least one in six couples needed specialist help at some time in their lives because of an average of infertility of 21/2 years, 71% of whom were trying for their first baby. Those attending gynaecology clinics made up 10% of new and 22% of all attendances. Failure of ovulation (amenorrhoea or oligomenorrhoea) occurred in 21% of cases and was successfully treated (two year conception rates of 96% and 78%). Tubal damage (14%) had a poor outlook (19%) despite surgery. Endometriosis accounted for infertility in 6%, although seldom because of tubal damage, cervical mucus defects or dysfunction in 3%, and coital failure in up to 6%. Sperm defects or dysfunction were the commonest defined cause of infertility (24%) and led to a poor chance of pregnancy (0-27%) without donor insemination. Obstructive azoospermia or primary spermatogenic failure was uncommon (2%) and hormonal causes of male infertility rare. Infertility was unexplained in 28% and the chance of pregnancy (overall 72%) was mainly determined by duration of infertility. In vitro fertilisation could benefit 80% of cases of tubal damage and 25% of unexplained infertility--that is, 18% of all cases, representing up to 216 new cases each year per million of the total population. PMID:3935248
Hull, M G; Glazener, C M; Kelly, N J; Conway, D I; Foster, P A; Hinton, R A; Coulson, C; Lambert, P A; Watt, E M; Desai, K M
BACKGROUND: The study explores the relationship between serum chlamydia antibody titres (CATs) and detec- tion of tubal damage in infertile women. METHODS: The tubal status and pelvic findings in 1006 women undergo- ing laparoscopy for infertility were related to CAT, which was measured using the whole-cell inclusion immunofluorescence test. RESULTS: A negative correlation between CAT and age was noted. A
Valentine A. Akande; Linda P. Hunt; David J. Cahill; E. Owen Caul; W. Christopher; L. Ford; Julian M. Jenkins
BACKGROUND: The reproductive axis is closely linked to nutritional status. The purpose of this study was to compare the nutritional status in two groups of young infertile women, without clinically overt eating disorders: hypothalamic amenorrhea (HA) and polycystic ovary syndrome (PCOS). METHODS: Eighteen young infertile women (10 HA, 8 PCOS) attending an outpatient gynecological endocrinology unit, underwent evaluation of anthropometry,
Ottavia Colombo; Giovanna Pinelli; Mario Comelli; Pierpaolo Marchetti; Sabina Sieri; Furio Brighenti; Rossella E Nappi; Anna Tagliabue
Objective: To determine the main causes and management options of infertility in Kuwait. Methodology: Clinical evaluation, hormone profile of LH, FSH, prolactin and testosterone and midluteal phase progesterone, tubal patency tests, semen analysis and antisperm antibodies were assessed. Treatment included medical and surgical induction of ovulation. Male factor infertility was treated with antibiotics and immunosuppression when indicated, and empirically with
A. E. Omu; F. Al-Qattan; A. A. Ismail; S. I. Al-Taher; N. Al-Busiri; A. Bandar
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…
In 2002, 2 million American women of reproductive age were infertile. Infertility is also common among men. The Centers for Disease Control and Prevention (CDC) conducts surveillance and research on the causes of infertility, monitors the safety and efficacy of infertility treatment, and sponsors national prevention programs. A CDC-wide working group found that, despite this effort, considerable gaps and opportunities exist in surveillance, research, communication, and program and policy development. We intend to consult with other federal agencies, professional and consumer organizations, the scientific community, the health care community, industry, and other stakeholders, and participate in the development of a national public health plan for the prevention, detection, and management of infertility. PMID:18992879
Macaluso, Maurizio; Wright-Schnapp, Tracie J; Chandra, Anjani; Johnson, Robert; Satterwhite, Catherine L; Pulver, Amy; Berman, Stuart M; Wang, Richard Y; Farr, Sherry L; Pollack, Lori A
Apoptosis is characterized by a variety of changes resulting in the recognition and phagocytosis of apoptotic cells. Caspases (cysteinyl aspartate-specific proteinases) play a central role in the regulation of apoptosis in the human seminiferous epithelium. They are expressed as inactive proenzymes and participate in a cascade triggered in response to pro-apoptotic signals. To date, 14 caspases have been implicated in the human apoptotic pathway cascade. Among these, caspase-3 is considered to be a major executioner protease. Since apoptosis is a universal suicide system in almost all cells, a close control via molecular, endocrine and physical factors establishes homeostasis of cell growth and death. The proper regulation of the caspase cascade plays an important role in sperm differentiation and testicular maturity. However, caspases have been implicated in the pathogenesis of multiple andrological pathologies such as impaired spermatogenesis, decreased sperm motility and increased levels of sperm DNA fragmentation, testicular torsion, varicocele and immunological infertility. Future research may provide a better understanding of the regulation of caspases, which may help us to manipulate the apoptotic machinery for therapeutic benefits. In this review, we summarize the consequences of caspase activation, aiming to clarify their role in the pathogenesis of male infertility. PMID:15005463
Said, Tamer M; Paasch, Uwe; Glander, Hans-Juergen; Agarwal, Ashok
The spermatogonial stem cells (SSCs) are responsible for the transmission of genetic information from an individual to the next generation. SSCs play critical roles in understanding the basic reproductive biology of gametes and treatments of human infertility. SSCs not only maintain normal spermatogenesis, but also sustain fertility by critically balancing both SSC self-renewal and differentiation. This self-renewal and differentiation in turn is tightly regulated by a combination of intrinsic gene expression within the SSC as well as the extrinsic gene signals from the niche. Increased SSCs self-renewal at the expense of differentiation result in germ cell tumors, on the other hand, higher differentiation at the expense of self-renewal can result in male sterility. Testicular germ cell cancers are the most frequent cancers among young men in industrialized countries. However, understanding the pathogenesis of testis cancer has been difficult because it is formed during fetal development. Recent studies suggest that SSCs can be reprogrammed to become embryonic stem (ES)-like cells to acquire pluripotency. In the present review, we summarize the recent developments in SSCs biology and role of SSC in testicular cancer. We believe that studying the biology of SSCs will not only provide better understanding of stem cell regulation in the testis but eventually will also be a novel target for male infertility and testicular cancers.
Singh, Shree Ram; Burnicka-Turek, Ozanna; Chauhan, Chhavi; Hou, Steven X.
Objective: The main purpose of this study is to detect the frequency and type of both chromosomal abnormalities and Y chromosome microdeletions in patients with severe male factor infertility and fertile control subjects. The association between the genetic abnormality and clinical parameters was also evaluated. Methods: This study was carried out in 208 infertile and 20 fertile men. Results of
Arzu Vicdan; Kubilay Vicdan; Serdar Günalp; Aykut Kence; Cem Akarsu; Ahmet Zeki I??k; Eran Sözen
Aim and Objective: To study the serum prolactin levels and the serum TSH in primary infertile females. Material and Method: In this study, we investigated thirty women who were diagnosed cases of primary infertility, who attended the Biochemistry Department, Sir JJ Group of Hospitals, Mumbai, India, for hormonal evaluations. Thirty fertile women with similar ages were enrolled as the controls. The status of the thyroid dysfunction and the levels of serum prolactin were reviewed in infertile women and in the controls. The serum Prolactin and the thyroid stimulating hormone levels were measured by using Siemens kits in IMMULITE 1000 chemiluminescence immunoassays. Results: In our study, the serum prolactin levels in the infertile group were found to be high as compared to those in the control group and they were highly significant (p<0.0001). The serum TSH levels in the infertile group were found to be high, as compared to those of control group and they were highly significant (p<0.0001). Conclusion: There is a higher incidence of hyperprolactinaemia in infertile patients. There is also a greater propensity for thyroid disorders in infertile women than in the fertile ones. The incidence of hypothyroidism in the hyperprolactinaemic subjects in the study population was found to be highly significant than the normal controls. PMID:23814712
Turankar, Sunita; Sonone, Kanchan; Turankar, Avinash
Fifty-seven patients who underwent hysteroscopic septum resection between January 1991 and December 1996 were studied; nine patients presented with recurrent abortions, 46 with infertility (26 primary and 20 secondary), one with dysmenorrhoea and one with an asymptomatic complete septum. Their reproductive history included 78 pregnancies: 69 (88.4%) abortions, two (2.6%) ectopics, two (2.6%) preterm deliveries and five (6.4%) term deliveries. In patients with infertility, the incidence of unexplained infertility was 19.6% and the incidence of endometriosis was 26.1%. After hysteroscopic septum resection, 42 patients were interested in pregnancy. All patients with recurrent abortions conceived spontaneously. Twenty-one (63.6%) infertile patients achieved a pregnancy, 13 (61.9%) of them after treatment with various assisted reproduction techniques. The reproductive outcome after septum resection yielded 44 pregnancies, including three sets of twins and one set of triplets reduced to twins: 11 (25%) abortions, one (2.3%) ectopic pregnancy, two (4.5%) preterm deliveries (both twins), 28 (63.7%) term deliveries and two (4.5%) as-yet ongoing pregnancies. It seems that the hysteroscopic treatment of uterine septum has a beneficial effect on pregnancy outcome. A septate uterus does not seem to be an infertility factor. The achievement of pregnancy is normal in patients with recurrent abortions, while the chances of conception in patients with infertility seem to be similar to those for the general infertile population. PMID:9647545
Grimbizis, G; Camus, M; Clasen, K; Tournaye, H; De Munck, L; Devroey, P
The most common cause of male infertility is idiopathic. Standard investigations reveal no abnormality in such cases. The aim of the study was to investigate the levels of sperm DNA damage and seminal oxidative stress and their relationships with idiopathic infertility. The study included 30 normozoospermic infertile men seeking infertility treatment and 20 fertile donors. Semen analysis was performed according
Fatma Ferda Verit; Ayhan Verit; Abdurrahim Kocyigit; Halil Ciftci; Hakim Celik; Mete Koksal
Infertility has traditionally been viewed as a female problem and women have been expected to suffer greater psychological distress due to infertility. This paper investigates the nature of gender differences and sex-role identification in the psychological sequelae associated with infertility treatment. The expectation that infertile women experience higher distress levels than men was not supported by these data. No gender
Barbara J. Berg; John F. Wilson; Paul J. Weingartner
The authors discuss 84 cases of laparoscopic examination of women with primary or secondary infertility. The patients qualified for this examination had undergone at least 26 weeks of conventional treatment with no effect. In 7 cases the reproductive organ was found to be in order, with fallopian tubes fully patent. In 43 cases tubular inpatency was found. The remaining patients suffered from other reproductive organ disorders. Therefore, the laparoscopic examination made detailed recognition of the causes of infertility possible and thus helped to establish the proper treatment. Additionally, in some cases it enabled the immediate removal of the source of infertility. PMID:8112628
Popiela, A; Kasiak, J; Heimrath, T; Cis?o, M
Anovulatory disorders are a primary cause of female infertility. Polycystic ovarian syndrome is the major cause of anovulation and is generally associated with obesity. Lifestyle changes to encourage weight loss are the initial therapy for overweight and obese patients, followed by clomiphene citrate for ovulation induction. For those patients who fail to ovulate on clomiphene citrate, alternatives, such as letrozole; gonadotropins; and complimentary agents to enhance clomiphene citrate, such as metformin and glucocorticoids, are reviewed. Women with unexplained infertility (no identifiable cause of infertility on a routine evaluation) may benefit from ovulation induction with clomiphene citrate, letrozole, or gonadotropins. PMID:23182557
Propst, Anthony M; Bates, G Wright
Infertility is the inability to become pregnant after one year of regular, unprotected sexual intercourse. Among active component service women, 16,807 received a diagnosis of female infertility during the 13-year surveillance period. The incidence rate of infertility diagnoses increased during the period, mainly due to increasing rates of infertility of unspecified origin. Infertility of tubal origin and anovulation were the most common specified types of infertility. Incidence rates of infertility were highest among women in their thirties; however, rates increased the most in women in their forties. Black, non-Hispanic women had the highest rates of infertility overall and in infertility of tubal and uterine origin. The higher rates among women in their thirties and forties may reflect high and increasing rates of clinical care seeking for infertility among women who elect to delay pregnancy until older ages and an increase in treatment options for women who have been unable to become pregnant. PMID:24093958
Objective: To assess the total costs of infertility coverage, determine the proportion of healthcare costs related to infertility, compare infertility costs to those of other diseases, and calculate a per member per month cost of an infertility benefit.Design: Historical prospective analysis.Setting: A university-based, self-insured, fee-for-service healthcare plan.Patient(s): Healthcare policy members from January 1993 through December 1995.Intervention(s): General and infertility-specific healthcare
Dale W Stovall; Brian D Allen; Amy E. T Sparks; Craig H Syrop; Richard G Saunders; Bradley J VanVoorhis
The emotional response to infertility, a major circumstantial loss, is frequently likened to bereavement. It is described as circumstantial because it does not happen to everyone, unlike a necessary loss, such as being weaned both nutritionally and emotionally. Another circumstantial loss is the death of someone, particularly if one has close emotional ties to this person. It is not surprising to find that a conceptual framework, developed to understand mourning a death, is used to make sense of the reaction to infertility; but this framework alone is not sufficient. The understanding of stigmatization and learned helplessness also assist helping the infertile to come to terms with their loss. It is suggested that the pronatalist tendency of British society results in denial of the stressful nature of infertility which compounds the difficulty in the loss being recognized and makes it exceptionally difficult to grieve. PMID:9433978
Syme, G B
Diagnostic hysteroscopy should be included routinely in the work-up of invasive examinations for infertility patients. Anyhow, one can rarely expect to find the definite underlying reason for infertility. In infertile patients about 20% of hysteroscopic examinations show some grade of intrauterine abnormalities. Congenital uterine malformations are the most frequently found disorders. In the group of patients with habitual abortions abnormalities are found much more often and can also be more often interpreted as the mainly underlying factor for the repeated abortions. Operative hysteroscopy has become the surgical method of first choice for the treatment of uterine septa, submucous myomas, polyps and synechia. After septum dissection results are excellent. Myoma removal also shows beneficial effects on fertility; nevertheless, cases are not too frequent among infertility patients. In cases of high-grade Asherman's syndrome, the prognosis after hysteroscopic surgery is still often poor. PMID:11791275
Hucke, J; De Bruyne, F; Balan, P
Adenosine deaminase (ADA; E.C.220.127.116.11) catalyses the deamination of adenosine to inosine. In the human reproductive system, the importance of enzymes that affect metabolism of adenosine, particularly adenosine deaminase, has been noticed. The purpose of this study was to determine the plasma activities of total adenosine deaminase (ADAT), and its isoenzymes, ADA1 and ADA2, in fertile and infertile men. Plasma activities of ADA and its isoenzymes were measured in 55 fertile men and 70 infertile men. There was a significant difference in the ADA1 and ADA2 activities between fertile and infertile individuals (P < 0.01). The activity of ADAT, ADA2 and ADA1 in infertile men was higher than that in fertile individuals. This alteration in ADA activity can lead to reduced adenosine levels, which may be involved in disturbing the fertility process. PMID:21919946
Rostampour, F; Biglari, M; Vaisi-Raygani, A; Salimi, S; Tavilani, H
The results of an examination of 5800 couples in 33 World Health Organization centers in 25 countries have provided the most comprehensive information on infertility in both developed and developing countries. Prior infection and bilateral tubal blockages were frequently traced as the cause of infertility. In the African sample; up to 64% of female patients had prior infection as the cause of infertility. A gynecological history of sexually transmitted disease, pelvic inflammatory disease (PID) and infection-related pregnancy complications of normal childbirth and abortion were directly related to infertility. 49% of the African couples and 11-15% of other patients in other parts of the world had infectious tubal disease. Westrom's study found that after PID 6-60% of patients became infertile. The factors affecting the infertility were the number and severity of infections, and the age when initial infection occurred. Between 1960 and 1980, in Sweden and the US, infertility doubled. Cates in the US has estimated that after 3 PID infections more than 50% of patients will be infertile. Ectopic pregnancy is another outcome of pelvic infection and sexually transmitted disease. Common PID infections are caused by Chlamydia trachomatis and Neisseria gonorrhea. These infections can cause tubal obstruction or pelvic adhesions and destructive tubal damage. After an ectopic pregnancy, 50% of patients are infertile and 10% have subsequent ectopic pregnancies. Some infertility may be treated. Microsurgery can be performed for tubal disease. Hysteroscopy can be used to treat intrauterine adhesions (Asherman's syndrome). Success has been better with hysteroscopy. Tubal microsurgery had led to conceptions in only 30-30% of patients, and a very high percentage of tubal pregnancies. The most successful results have come from tubal reanastomosis for reversal of tubal sterilization. The most promising results have come from "in vitro" fertilization and other methods of assisted reproduction. However, there must be a more simplified technology, improved results, and reduced costs before large numbers worldwide can benefit. The best approach is prevention and early detection of infection, and risk assessment. Culturally sensitive education programs will generally alert the population to precursor conditions of infertility. PMID:12345542
Sciarra, J J
Introduction Endometriosis is defined as overgrowth of endometrial tissue outside the uterine cavity. Endometriosis may be asymptomatic or associated with dysmenorrheal symptoms, dyspareunia, pelvic pain, abnormal uterine bleeding and infertility. The aim of this study was to explore the risk factors related to endometriosis among infertile Iranian women. Material and methods In this case control study, infertile women referred for laparoscopy and infertility workup to two referral infertility clinics in Tehran, Iran were studied. According to the laparoscopy findings, women were divided into case (women who had pelvic endometriosis) and control (women with normal pelvis) groups. The case group was divided into two subgroups: stage I and II of endometriosis were considered as mild while stage III and IV were categorized as severe endometriosis. A questionnaire was completed for each patient. Results Logistic regression showed that age, duration of infertility, body mass index (BMI), duration of menstrual cycle, abortion history, dyspareunia, pelvic pain and family history of endometriosis are independent predictive factors for any type of endometriosis. In addition, it was shown that education, duration of infertility, BMI, amount and duration of menstrual bleeding, menstrual pattern, dyspareunia, pelvic pain and family history of endometriosis are independent predictive factors of severe endometriosis. The AUCs for these models were 0.781 (0.735-0.827) and 0.855 (0.810-0.901) for any type of endometriosis and severe endometriosis, respectively. Conclusions It seems that any type of endometriosis and severe ones could be predicted according to demographic, menstrual and reproductive characteristics of infertile women.
Malekzadeh, Farideh; Amirchaghmaghi, Elham; Kashfi, Fahimeh; Akhoond, Mohammad Reza; Saei, Maryam; Mirbolok, Mohammad Hossein
Infertility is a reproductive health problem that affects many couples in the human population. About 13–18% of couple suffers\\u000a from it and approximately one-half of all cases can be traced to either partner. Regardless of whether it is primary or secondary\\u000a infertility, affected couples suffer from enormous emotional and psychological trauma and it can constitute a major life crisis\\u000a in
Polani B. Seshagiri
Genetic factors contribute upto 15%–30% cases of male infertility. Formation of spermatozoa occurs in a sequential manner with mitotic, meiotic, and postmeiotic differentiation phases each of which is controlled by an intricate genetic program. Genes control a variety of physiologic processes, such as hypothalamus–pituitary–gonadal axis, germ cell development, and differentiation. In the era of assisted reproduction technology, it is important to understand the genetic basis of infertility to provide maximum adapted therapeutics and counseling to the couple.
Shamsi, M. B.; Kumar, K.; Dada, R.
Objective: To identify the levels of grief and depression and the coping mechanisms of women with infertility problems who participated in in vitro fertilization (IVF) or ovulation-induction medication.Methods: Pretest and post-test data were obtained from 50 IVF and 50 ovulation-induction medication patients receiving treatment at two urban infertility centers.Results: Both groups of women experienced measurable levels of grief and depression
Michelle P Lukse; Nicholas A Vacc
Human papillomavirus (HPV) is one of the most common sexually transmitted diseases which comprises a group of small DNA viruses that infect both cutaneous and mucous squamous epithelia. Liquid bead microarray technology (LBMA) were used to evaluate 24 HPV genotypes in confirmed fertile and infertile males of North China so that the effects of HPV infection on semen parameters and relationship with male infertility could be discussed. A total of 1138 subjects were recruited in this study; 142 were HPV-positive (12.48%). Among 523 confirmed fertile males, only 35 were HPV-positive (6.70%), and two of them had multiple infections. Among 615 infertile males, 107 were HPV-positive (17.4%), and 29 of them had multiple infections. Infertile males had a relatively high HPV infection rate compared with confirmed fertile males. Sperm progressive motility (PR) and the normal morphology rate were significantly decreased in HPV-positive subjects. HPV-45, HPV-52, HPV-18, HPV-59 and HPV-16 infections were more frequently in infertile males. Hence, HPV infection is closely related to male infertility which will decrease sperm PR and morphology. HPV-45, HPV-52, HPV-18, HPV-59 and HPV-16 infection seems to be major risk factors.
Yang, Yang; Jia, Chan-Wei; Ma, Yan-Min; Zhou, Li-Ying; Wang, Shu-Yu
This article reviews the research related to parenting after assisted reproduction and uses that research to discuss clinical implications for nurses who work to support these families and the development of their children. The worldwide diagnosis of infertility continues to rise and now hovers near 20%. The increased availability and success of assisted reproductive technologies (ARTs) provides a potential option for infertile families to conceive and begin a family, but as nurses know, infertility treatments are not easy to tolerate, are time-consuming, physically taxing, and expensive. In addition, a positive outcome is far from guaranteed. Even when infertile couples successfully give birth, they can continue to struggle with the psychological aspects of infertility and the ongoing care of a child who may be premature, low birth weight, or afflicted with another high-risk condition such as long-term developmental or behavioral problems. Unfortunately, the psychological needs of the couple and the family may not be addressed during ART treatment or after the birth of a child. Parenting is a challenging life task; parenting when the partners may have to work through the psychological aspects of infertility and the care of a high-risk child is even more complex and may have long-lasting effects on the partners as well as their children. PMID:20453593
McGrath, Jacqueline M; Samra, Haifa A; Zukowsky, Ksenia; Baker, Brenda
Although perforation of the appendix is considered a risk factor for female tubal infertility, the epidemiologic evidence supporting this relation is inconsistent. Risk factors for tubal infertility were compared for 121 women with documented primary tubal infertility attending in vitro fertilization clinics in Toronto, Canada, from July to December 1998 and 490 controls who were pregnant during the same time period. Self-administered questionnaires and review of medical records were used to assess exposures. The authors found that neither history of acute appendicitis nor perforation of the appendix was a statistically significant risk factor for tubal infertility. The crude odds ratio for perforated appendicitis was 3.4 (95% confidence interval (CI): 0.9, 12.9), and the adjusted odds ratio was 1.4 (95% CI: 0.3, 6.2). In addition to increased age and annual income, cigarette smoking (odds ratio (OR) = 2.0, 95% CI: 1.2, 3.2), history of endometriosis (OR = 6.0, 95% CI: 2.8,12.8), and history of pelvic inflammatory disease (OR = 6.0, 95% CI: 2.8, 12.8) were significantly associated with tubal infertility in multivariate analysis. These data do not provide substantial evidence that perforation of the appendix is an important risk factor for female tubal infertility. PMID:11257064
Urbach, D R; Marrett, L D; Kung, R; Cohen, M M
Objective: To assess the diagnostic benefit of laparoscopy in infertile women with normal hysterosalpingography (HSG) or suspected unilateral pathology on HSG. Study design: Charts of infertile women that underwent complete infertility evaluation between 1996 and 1998 were retrospectively reviewed. Eighty-six patients in whom both HSG and laparoscopy were performed were included in the study. HSG results were compared with laparoscopic
Yuval Lavy; Ahinoam Lev-Sagie; Hananel Holtzer; Ariel Revel; Arye Hurwitz
OBJECTIVE--To provide reliable prognostic information for couples seeking assisted conception. DESIGN--Analysis of four years' practice (1988-91). SETTING--Private university service linked with NHS reproductive medicine services. PATIENTS--804 couples with various causes of subfertility, median duration five years, median age of women 34 years. INTERVENTIONS--1280 completed cycles: 950 in vitro fertilisation, 144 gamete intrafallopian transfer, and 186 intrauterine insemination and superovulation. MAIN OUTCOME MEASURES--Pregnancy and birth rates per cycle and cumulative pregnancy and take home baby rates per couple. RESULTS--In women under 40 years and men with normal sperm, whatever the cause of infertility, results with in vitro fertilisation improved steadily reaching a pregnancy rate per cycle of 30% (95% confidence interval 26% to 35%) during 1990-1 and birth rate per cycle of 29% (23% to 35%) in 1990. Pregnancy and birth rates for gamete intrafallopian transfer were 36% (28% to 44%) and 26% (17% to 37%) and for intrauterine insemination 18% (12% to 24%) and 16% (10% to 22%). After six cycles cumulative probability of pregnancy was 82% and cumulative take home baby rate 70%. Considering only in vitro fertilisation and gamete intrafallopian transfer after four cycles the pregnancy rate was 78% (66% to 91%). CONCLUSIONS--Conception is less likely in women over 40 and men with sperm dysfunction. For other couples the prognosis for a live birth is at least as good as for fertile couples if they persist with treatment.
Hull, M. G.; Eddowes, H. A.; Fahy, U.; Abuzeid, M. I.; Mills, M. S.; Cahill, D. J.; Fleming, C. F.; Wardle, P. G.; Ford, W. C.; McDermott, A.
BACKGROUND We examine variation in fertility-specific distress (FSD) and general distress according to different experiences of infertility among 1027 US women who have experienced infertility within the previous 10 years. METHODS General distress was measured by a short form of the Center for Epidemiological Studies-Depression. Multiple regression analysis was conducted on self-report data (based on a telephone interview) from a probability-based sample of US women aged 25–45 years. We compare women with infertility who have had a prior pregnancy (secondary infertility, n = 628) to women with infertility with no prior pregnancies (primary infertility, n = 399). We further distinguish between women with infertility who were actually ‘trying’ to become pregnant (the infertile with intent) with those who met the medical definition of infertile but did not describe themselves as trying to become pregnant (infertile without intent). RESULTS Both types of infertility (primary versus secondary) (? = 0.31*) and intentionality (infertile with and without intent) (? = 0.08*) are associated with FSD. These associations persist when we control for resource and demographic variables, life course variables, social support and social pressure variables. General distress does not vary by infertility type or intentionality. CONCLUSIONS Results reveal variation in women's recalled experiences of infertility and that FSD is more sensitive to effects of different experiences than general distress. Women with primary infertility who were explicitly trying to become pregnant at the time of the infertility episode stand out as a particularly distressed group. Caregivers should be aware that the emotional needs of women with primary infertility may differ from those with secondary infertility.
Greil, Arthur L.; Shreffler, Karina M.; Schmidt, Lone; McQuillan, Julia
Although methylenetetrahydrofolate reductase, a folate enzyme gene, has been associated with idiopathic male infertility, few studies have examined other folate-related metabolites and genes. We investigated whether idiopathic male infertility is associated with variants in folate, vitamin B12 (B12) and total homocysteine (tHcy)-related genes and measured these metabolites in blood. We conducted a case–control study that included 153 men with idiopathic infertility and 184 fertile male controls recruited at the Fertility Center and Antenatal Care Center, University Hospital, Malmö 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.
Murphy, Laurel E; Mills, James L; Molloy, Anne M; Qian, Cong; Carter, Tonia C; Strevens, Helena; Wide-Swensson, Dag; Giwercman, Aleksander; Levine, Richard J
Background Body Image as a multidimensional entity is related to both physical and psychological aspects of the image one has of his or her own body. Lack/absence of an acceptable body image is one of the reasons of mental distress in infertile individuals. Methods In this study, an equal number (No=120) of fertile and infertile men attending Avicenna Infertility Clinic (AIC) were enrolled. The participants were compared in regard to body image variables based on the "Multidimensional Body-Self Relations Questionnaire (MBSRQ)" consisting of 10 subscales. Data was analyzed by SPSS, version 11.5, using Chi square and independent t-tests. Results Fertile men had a more positive body image as compared to infertile individuals. Significant statistical differences were observed when body image subscales were compared in both groups; in other words appearance evaluation, appearance orientation, Novy, health evaluation, health orientation, illness orientation, body satisfaction, overweight preoccupation and self-classified weight showed differences, while no significant difference was observed in regard to fitness orientation. Conclusion It seems that the ability and efficiency of body image is affected by infertility leading to dissatisfaction of one's body image.
Akhondi, Mohammad Mehdi; Dadkhah, Asghar; Bagherpour, Ahmad; Ardakani, Zohreh Behjati; Kamali, Kourosh; Binaafar, Sima; Kosari, Haleh; Ghorbani, Behzad
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.
Matzuk, Martin M; Lamb, Dolores J
Concerns exist regarding reproductive health, including potential infertility, among young adults with military-related occupational exposures. This study evaluated infertility diagnoses in a large population of healthy young adults in relation to prior s...
C. J. Sevick G. R. Gumbs I. G. Jacobson M. A. Ryan T. C. Smith
In Turkey, as in many other countries, infertility is generally regarded as a negative phenomenon in a woman's life and is associated with a lot of stigma by society. In other words, female infertility and having a baby using Assisted Reproductive Technologies (ART) have to be taken into consideration with respect to gender motherhood, social factors, religion and law. Yet if a woman chooses to use ART she has to deal with the consequences of her decision, such as being ostracized by society. Other types of procedures in this area, such as sperm and ova donation or surrogate motherhood, are not permitted in law. However; both before and after the development of this techonology, society has been finding its own solutions which are rarely questioned and are still performed This article will discuss what these practices are and try to reach some pragmatic conclusions concerning female infertility, the concept of motherhood and some traditional practices in Turkey. PMID:22533036
Sahinoglu, Serap; Buken, Nuket Ornek
Predicting infertility is central to reproductive biology, medicine and evolutionary biology. In-vitro studies suggest that oxidative sperm damage causes infertility. Oxidative sperm damage can be reduced via two fundamental pathways: the removal of oxygen radicals by antioxidants, or the interference with cell metabolism to reduce the formation of oxygen radicals. Oxidative damage protection of spermatozoa should evolve frequently, especially during female sperm storage. However, in-vivo evidence linking oxidative protection and fertility is rare. We show that the intra-sperm production rate of oxygen radicals and the sperm metabolic rate were reduced in female bedbugs, Cimex lectularius, compared to males, and females laid fertile eggs. Females became infertile when sperm oxygen radicals and sperm metabolic rate increased to male levels. Our results link female fitness to sublethal sperm damage, imply adaptive benefits of interfering with sperm metabolism and offer the hypothesis that polyandry may serve to replace low-quality sperm.
Reinhardt, Klaus; Ribou, Anne-Cecile
It is often presumed that infertility is not a problem in resource-poor areas where fertility rates are high. This is challenged by consistent evidence that the consequences of childlessness are very severe in low-income countries, particularly for women. In these settings, childless women are frequently stigmatized, isolated, ostracized, disinherited and neglected by the family and local community. This may result in physical and psychological abuse, polygamy and even suicide. Attitudes among people in high-income countries towards provision of infertility care in low-income countries have mostly been either dismissive or indifferent as it is argued that scarce healthcare resources should be directed towards reducing fertility and restricting population growth. However, recognition of the plight of infertile couples in low-income settings is growing. One of the United Nation's Millennium Development Goals was for universal access to reproductive health care by 2015, and WHO has recommended that infertility be considered a global health problem and stated the need for adaptation of assisted reproductive technology in low-resource countries. This paper challenges the construct that infertility is not a serious problem in resource-constrained settings and argues that there is a need for infertility care, including affordable assisted reproduction treatment, in these settings. It is often presumed that infertility is not a problem in densely populated, resource-poor areas where fertility rates are high. This presumption is challenged by consistent evidence that the consequences of childlessness are very severe in low-income countries, particularly for women. In these settings, childless women are frequently stigmatized, isolated, ostracized, disinherited and neglected by the family and local community. This may result in physical and psychological abuse, polygamy and even suicide. Because many families in low-income countries depend on children for economic survival, childlessness and having fewer children than the number identified as appropriate are social and public health matters, not only medical problems. Attitudes among people in high-income countries towards provision of infertility care in low-income countries have mostly been either dismissive or indifferent as it is argued that scarce healthcare resources and family planning activities should be directed towards reducing fertility and restricting population growth. However, recognition of the plight of infertile couples in low-income settings is growing. One of the United Nation's Millennium Development Goals was for universal access to reproductive health care by 2015, and WHO has recommended that infertility be considered a global health problem and stated the need for adaptation of assisted reproduction technology in low-resource countries. In this paper, we challenge the construct that infertility is not a serious problem in resource-constrained settings and argue that there is a need for infertility care, including affordable assisted reproduction treatment, in these settings. PMID:23260034
Hammarberg, Karin; Kirkman, Maggie
Resilience in couples experiencing infertility is critical to decrease the impact of infertility-related stress and sustain\\u000a positive interactions and collective perceptions in couples. The Infertility Resilience Model (IRM) presented in this article\\u000a provides a framework within which various individual, couple, and external factors that influence resilience can be understood.\\u000a Although numerous approaches have been applied to infertility, few of them
Aaron F. Ridenour; Jeremy B. Yorgason; Brennan Peterson
Chlamydia-positive genitourinary infections are common causes of male and female infertility. Semen abnormalities are often associated with Chlamydia infections. A large population of male patients, admitted to our clinic for genitourinary infection, were examined for genitourinary pathogens, including Chlamydia, and for semen abnormalities. There were higher abnormalities semen in Chlamydia-infected patients than either non-Chlamydia-infected or healthy controls. Chlamydia therapy by antimicrobial agents improved semen characteristics. Chlamydia infection contributes to seminal fluid abnormalities and probably to male infertility. A search for chlamydial infection is warranted whenever semen abnormalities are noted. An antimicrobial therapy improves semen quality when effective in eradicating Chlamydia. PMID:2694996
Custo, G M; Lauro, V; Saitto, C; Frongillo, R F
The management of infertility rests on correct diagnosis of the reasons for failure to conceive. Both marriage partners must be examined and an adequate history taken of both. Dealing with infertility in women involves taking complete menstrual history, testing for endometriosis, examination of the cervix, testing for sperm antibody and investigation of the tubal factor. Endocrine disorders deserve special attention, especially those which point to failure to ovulate. Finally, there are many cases where no adequate reason for failure to conceive can be found—for these cases supportive therapy is the only treatment.
Mitton, D. M.; Macleod, S. C.
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
Sher, G; Katz, M
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…
Hammerli, Katja; Znoj, Hansjorg; Berger, Thomas
Infertility in females is multifactorial in origin. Though hysterolaparoscopy is the gold-standard investigation, USG is usually the first-line investigation. MRI has expanded the usefulness of imaging in female infertility. This pictorial essay reviews the role of imaging in the evaluation of female infertility.
Infertility affects 13 -1 8% of couples and growing evidence from clinical and epidemiological studies suggests an increasing incidence of male reproductive problems. There is a male factor involved in up to half of all infertile couples. The pathogenesis of male infertility can be reflected by defective spermatogenesis due to failure in germ cell proliferation and differentiation. We report here
Karim Nayernia; Manyu Li; Lukasz Jaroszynski; Rustem Khusainov; Gerald Wulf; Iris Schwandt; Monika Korabiowska; Hans W. Michelmann; Andreas Meinhardt; Wolfgang Engel
Background: Reactive Oxygen Species (ROS) are a group of free radicals that in excessive amounts have negative influence on sperm quality and function. Objective: We compared ROS levels in seminal plasma of infertile men with this level in healthy donors. We also determined the ROS level in semen of infertile men according to the etiology of infertility, and also the
Mohammad Reza Moein; Vali Ollah Dehghani; Nasim Tabibnejad; Serajadin Vahidi
Male factor infertility is the sole reason in approximately 25% of couples who suffer from infertility. Genetic factors such as numerical and structural chromosomal abnormalities and microdeletions of the Y chromosome might be the cause of poor semen parameters. The results of karyotype analyses and Y-chromosome microdeletions of 1935 patients with severe male factor infertility, which is the largest series
Yakup Kumtepe; Cagr? Beyazyurek; Cigdem Cinar; Isa Ozbey; Semih Ozkan; Kadir Cetinkaya; Güvenc Karlikaya; Hale Karagozoglu; Semra Kahraman
BACKGROUND: Although several authors have suggested an important pathogenic role for psychosocial factors in 'functional' infertility, the extent to which depression, anxiety and expressed emotional patterns correlate to infertility is not yet clear. METHODS: This study included 156 infertile couples (recruited at intake) and 80 fertile couples, whose personal characteristics were recorded. They were examined using scales for the evaluation
S. Fassino; A. Piero; S. Boggio; V. Piccioni; L. Garzaro
Male infertility, which contributes to roughly 60â€“70% of infertility cases in the Middle East, is especially agonizing in this region, where fatherhood is crucial to achieving masculine adulthood and community standing. In this paper, we compare the infertility experience of two groups of Palestinian men, one living in Israel and the other in Lebanon. The study is based on ethnographic
Daphna Birenbaum-Carmeli; Marcia C. Inhorn
Despite the great number of studies conducted to examine the impact of infertility on the psychological status of women undergoing infertility treatment, little is known about the psychological impact of infertility when it is due to male or female factors and its role in the cause of higher levels of anxiety and stress. The aim of this cross?sectional study was
Katerina Lykeridou; Kleanthi Gourounti; Anna Deltsidou; Dimitrios Loutradis; Grigorios Vaslamatzis
The purpose of this grounded theory study was to understand African American women's experience of infertility and gain a comprehensive understanding of the psychological, emotional, and social consequences of infertility on African American women. Semi-structured interviews were conducted with 10 African American women diagnosed with infertility. Open, axial, and selective themes were identified. The grounded theory emerged from a total
Purposes To investigate the frequencies of AZF microdeletions and chromosomal abnormalities in infertile men from Northeastern China.\\u000a Moreover, to compare the prevalence of these abnormalities with other countries and regions in the world.\\u000a \\u000a \\u000a \\u000a \\u000a Methods 305 infertile men were enrolled. A complete semen analysis and reproductive hormones were measured according to standard methods.\\u000a Multiplex polymerase chain reaction (PCR) amplification using nine specific sequence-tagged
Rui-Xue Wang; Chao Fu; Ya-Ping Yang; Rong-Rong Han; Yuan Dong; Ru-Lin Dai; Rui-Zhi Liu
Objective To compare the clinical characteristics of primarily and secondarily infertile men with varicocele. Design Cross-sectional analysis. Setting Male infertility clinic, tertiary health care center. Patient(s) Two hundred ninety-five infertile men with palpable varicoceles. Intervention(s) Clinical evaluation including patient reproductive history (including assessment of primary or secondary infertility), physical examination, hormonal assessment and at least two semen analyses. Main Outcome Measure(s) Differences in the characteristics of men with primary vs. secondary infertility. Result(s) Two hundred five subjects were identified with primary infertility and 90 with secondary infertility. Secondarily infertile men were older (39.6 years vs. 35.0 years), with older partners (35.4 years vs. 33.2 years), but had higher sperm densities (51.3 vs. 36.0 million/mL) and a greater percentage of morphologically normal sperm (30.6% vs. 24.1%). A lower proportion of secondarily infertile men had total motile sperm count (TMC) <20 million compared with primarily infertile men (31.1% vs. 46.5%). Groups did not differ regarding infertility duration, tobacco or alcohol use, varicocele grade or laterality, testis volumes, or hormonal parameters. In multivariate modeling, secondary infertility (vs. primary) was an independent predictor of TMC >20 million (odds ratio 1.9). Conclusion(s) Men with secondary infertility are older and have older partners than primarily infertile men, yet they have significantly better sperm concentrations. Infertility in this group may be influenced by maternal reproductive potential.
Walsh, Thomas J.; Wu, Alex K.; Croughan, Mary S.; Turek, Paul J.
Background The reproductive axis is closely linked to nutritional status. The purpose of this study was to compare the nutritional status in two groups of young infertile women, without clinically overt eating disorders: hypothalamic amenorrhea (HA) and polycystic ovary syndrome (PCOS). Methods Eighteen young infertile women (10 HA, 8 PCOS) attending an outpatient gynecological endocrinology unit, underwent evaluation of anthropometry, body composition, dietary intakes by means of a food frequency questionnaire (FFQ) and a seven-day food diary (7DD), and psychological characteristics by means of EDI2 and SCL90 tests. Results HA women had lower BMI and body fat compared to PCOS women. Habitual intake derived from FFQs showed a similar macronutrient distribution between groups (about 16% protein, 33% fat, 52% carbohydrates). The psychometric profiles of the two groups did not differ significantly. The underreporting of dietary intakes (measured as habitual energy intake by FFQs/basal metabolic rate) was found to be negatively correlated with the interpersonal sensitivity SCL-90 subscale scores (r = -0.54, p = 0.02). Conclusion Our study identified differences in body composition but not in dietary habits between HA and PCOS infertile women. We documented, for the first time, a relationship between the accuracy of dietary surveys and the psychological characteristics of subjects with anovulation. This finding suggests that it may be important to be aware of the psychological terrain when planning a dietary survey in infertile women.
This study investigated the effect of treatment with the proprietary standardized, water-soluble extract of the root of the Malaysian plant, Eurycoma longifolia Jack, which is thought to enhance male fertility with regard to higher semen volumes, sperm concentrations, the percentage of normal sperm morphology and sperm motility in male partners of sub-fertile couples with idiopathic infertility. A total of 350
Mohd Ismail Bin Mohd Tambi; M. Kamarul Imran
This article provides empirical data on the dynamics of marital bargaining in the use of in vitro fertilization (IVF) in male infertility and the extent of the woman's agency in trying to resolve the situation, using interview data from nine married couples and three additional wives. Although there were too few cases for demographic variation among the categories, the research
JUDITH LORBER; LAKSHMI BANDLAMUDI
Epididymal defects in infertile domestic species and transgenic mice demonstrate the role of the epididymis in influencing sperm function. Spermatozoa from these males cannot negotiate the female tract as they fail to regulate their volume. The latter is necessary to counter the osmotic stresses encountered in the female tract. Reduced epididymal provision of osmolytes or their premature loss is discussed
Trevor G. Cooper; Jennifer P. Barfield
Spermatogenesis is a complex process that involves stem-cell renewal, genome reorganization and genome repackaging, and that culminates in the production of motile gametes. Problems at all stages of spermatogenesis contribute to human infertility, but few of them can be modelled in vitro or in cell culture. Targeted mutagenesis in the mouse provides a powerful method to analyse these steps and
Howard J. Cooke; Philippa T. K. Saunders
Throughout the 1980s and 1990s the crude human birth rate (live births per 1000 population) declined, indicating reduced fertility and suggesting a potential decline in fecundity (the potential to conceive). Detection of environmental contaminants in human tissues, together with reports of a global decline in semen quality, further fueled speculation that human infertility rates are increasing and environmental toxicants are
Warren G. Foster; Michael S. Neal; Myoung-Soek Han; Miguel M. Dominguez
Polycystic ovarian syndrome (PCOS) is the most common cause of anovulatory infertility accounting for about 75% of cases. It is defined as a syndrome of ovarian dysfunction associated with hyperandrogenism and polycystic ovary morphology. The diagnosis of PCOS is based on the presence of at least two of three criteria including: (1) olig-\\/anovulation; (2) hyperandrogenaemia (clinical and\\/or biochemical); and (3)
Saad A. K. Amer
BACKGROUND: An increasing number of reports suggest that chemical and physical agents in the environment, introduced and spread by human activity, may affect male fertility in humans. We investigated the relationships between exposure to environmental agents and seminal characteristics, and the concentrations of reproductive hormones in the serum of men seeking infertility treatment. METHODS: We studied 225 male partners from
Alejandro Oliva; Alfred Spira; Luc Multigner
There has been a tremendous increase in the use of mobile phones in the past decade and concerns are growing about the possible hazardous effects of radio-frequency electromagnetic waves (EMW) emitted by these devices on human health. Preliminary studies, though with limitations in study design, suggest a possible link between cell phone use and infertility. A recent study found that
Fnu Deepinder; Kartikeya Makker; Ashok Agarwal
|Infertility creates challenges affecting various aspects of couples' intimate lives. Practices regarding reproduction are often shaped by cultural messages. Culturally sensitive treatment methods help counselors provide effective therapy to couples with fertility problems. This article describes cultural influences, challenges, and counseling…
Burnett, Judith A.
Finnish women's experiences of infertility treatment were investigated by examining their satisfaction and dissatisfaction, and their most positive and negative experiences with the treatment. Three hundred and forty four (16%) out of the 2189 women respondents to a 1994 postal survey (response rate 74%) had experienced difficulties in having a baby. Two-thirds had sought medical help, generally from private gynaecologists.
Maili Malin; Elina Hemminki; Outi Räikkönen; Sinikka Sihvo; M-L Perälä
Background Secondary infertility in developing countries is mostly attributable to blockage of the fallopian tubes due to adhesions caused by reproductive tract infections. There is a dearth of information on the prevalence and causes of secondary infertility from Pakistan. This paper presents results on factors associated with secondary infertility among married women in Karachi, Pakistan. Methods A matched case-control study was conducted. Cases were women aged 15–35 years with history of at least one previous conception and currently seeking treatment for secondary infertility. Controls were women residing in the neighborhood of cases with at least one live birth and not taking treatment for secondary infertility. The age of controls was matched by ±5 years to that of cases. Data was collected from June to August 2003. Conditional logistic regression was used to determine crude and adjusted odds ratios (OR) with corresponding 95% confidence intervals (CI) for factors associated with secondary infertility. Results The final multivariate logistic regression model revealed that after adjusting for age, cases were more likely to be the housewives (AOR?=?2.6, 95% CI:1.5–4.4), had used inappropriate material to absorb blood during menstruation (AOR?=?9.0, 95% CI: 5.0–16.4), and at their last delivery, had a birth attendant who did not wash hands with soap and water (AOR?=?3.0, 95% CI: 1.4–5.7). Moreover, women with secondary infertility were more likely to report current or past history of having STI symptoms (AOR?=?3.6, 95% CI: 2.4–5.6) and use of intra-vaginal indigenous medicines during their last post-partum period (AOR?=?3.1, 95% CI: 1.6–5.7). Conclusion We recommend health education and awareness messages for safe practices during menstruation, delivery, and the postpartum period for women in general. Additionally, sanitary napkins should be made available at an affordable cost, and safe delivery kits should contain educational/pictorial brochures for appropriate hand washing skills.
Sami, Neelofar; Ali, Tazeen Saeed; Wasim, Saba; Saleem, Sarah
OBJECTIVES: The diagnostic laparoscopy has long been the key consideration in the export of female infertility. This place is being reconsidered, especially in the case of normal hysterosalpingogrophy (HSG), because of the advent of assisted reproductive technologies which are more efficient, and because of the improvement of medical imaging techniques which are more sensitive and specific. We wanted to clarify the place of the diagnostic laparoscopy in the balance of female infertility in normal HSG. PATIENTS AND METHODS: It is a retrospective study on a series of 100 observations of infertile patients with a normal HSG and having a diagnostic laparoscopy in the department of Gynecology and Obstetrics at Farhat Hached hospital in Sousse (Tunisia) from 1st January 1993 to 1st March 2003. RESULTS: The mean age was 32.3years; the mean duration of infertility was 70.47months. Laparoscopy revealed pelvic abnormalities in 45% of cases, dominated by disease tubo-adhesions (23%), endometriosis was found in 6% of cases. These anomalies are considered major in 23% of cases and minor in 22% of cases. Conducting a surgical procedure in the same operating time (adhesiolysis, tubal plastic surgery, electrocoagulation of endometriosis implants) could improve the prognosis of fertility. Only 20 patients were followed among the 45 with pelvic abnormalities, seven pregnancies have been completed (35% of cases). DISCUSSION AND CONCLUSION: Laparoscopy has improved the prognosis for the fertility of our patients by treating abnormalities involved in infertility. It is estimated that the prognosis can be improved by selecting patients with risk factors for pelvic abnormalities. PMID:23462340
Fatnassi, R; Kaabia, O; Laadhari, S; Briki, R; Dimassi, Z; Bibi, M; Hidar, S; Ben Regaya, L; Khairi, H
Background Indonesia has high levels of biological need for infertility treatment, great sociological and psychological demand for children, and yet existing infertility services are underutilized. Access to adequate comprehensive reproductive health services, including infertility care, is a basic reproductive right regardless of the economic circumstances in which individuals are born into. Thus, identifying and implementing strategies to improve access to assisted reproductive technology (ART) in Indonesia is imperative. The principle objectives of this article are to improve our understanding of infertility patients’ patterns of health seeking behaviour and their patterns of access to infertility treatment in Indonesia, in order to highlight the possibilities for improving access. Methods An interviewer-administered survey was conducted with 212 female infertility patients recruited through three Indonesian infertility clinics between July and September 2011. Participants were self-selected and data was subject to descriptive statistical analysis. Results Patients identified a number of barriers to access, including: low confidence in infertility treatment and high rates of switching between providers due to perceived treatment failure; the number and location of clinics; the lack of a well established referral system; the cost of treatment; and patients also experienced fear of receiving a diagnosis of sterility, of vaginal examinations and of embarrassment. Women’s age of marriage and the timing of their initial presentation to gynaecologists were not found to be barriers to timely access to infertility care. Conclusions The findings based on the responses of 212 female infertility patients indicated four key areas of opportunity for improving access to infertility care. Firstly, greater patient education about the nature and progression of infertility care was required among this group of women. Secondly, increased resources in terms of the number and distribution of infertility clinics would reduce the substantial travel required to access infertility care. Thirdly, improvements in the financial accessibility of infertility care would have promoted ease of access to care in this sample. Finally, the expansion of poorly developed referral systems would also have enhanced the efficiency with which this group of patients were able to access appropriate care.
Background 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.
Scientific knowledge of the emotional repercussions of infertility on men remains limited and has only recently become the focus of social science research. Firstly, the current developments in research on the psychosocial impact of infertility on men through a search of the literature over the last 10 years are outlined in this paper. In the second section, issues raised in pretreatment counselling for men and their partner who consider donor insemination are described as this treatment typically raises many emotional issues. The results of more recent studies with sophisticated methodological design show that the emotional impact of infertility may be nearly balanced, suggesting that men do suffer as well and that they have to be addressed in infertility counselling too. The emotional and clinical aspects of donor insemination support the hypothesis that the emotional repercussions of infertility affect both sexes. In general, male factor infertility seems to be more stigmatized than other infertility diagnoses. Forthcoming studies have to differentiate between the psychological impact of infertility on women and men and their respective abilities to communicate easily about this distress. More studies on infertile men in non-Western societies need to be conducted in order to understand the cultural impact on infertility. According to an American study, almost half of the women but only 15% of the men consider infertility the most upsetting experience of their lives. It would be easy to assume that infertility is predominantly a female problem. However, this assumption is likely to be based on out-dated gender stereotypes and inadequate methodology. The results of much of the formerly available research supporting women's greater overt distress in response to infertility may well reflect differences in the ways men and women have been socialized to cope with negative affect. More recent qualitative and quantitative research indicates that the emotional impact may be nearly balanced, suggesting that men do suffer as well and that they have to be addressed in infertility counselling too. In many cultures, male infertility remains a stigmatized condition and associated with a lack of virility and masculinity. For men, this may result in secrecy surrounding diagnosis, sometimes to the point where the female partner takes the blame for the couple's inability to conceive. Based on qualitative and of recent quantitative research, this article will outline important aspects of (male) infertility and challenge the notion of the "emotionally unaffected" male. It will also draw on typical emotional and clinical aspects of donor insemination, a family-building alternative in which many emotional issues of male infertility culminate, thus supporting the hypothesis that the emotional repercussions of infertility affect both sexes similarly. PMID:23876974
Wischmann, Tewes; Thorn, Petra
Seventy two infertile men were studied. History of small pox and mumps infection was noted in 4 and 3 patients respectively. Seven patients had varicocele (9.2%), and small atrophic testes were found in 9 (12.5%). Azoospermia was reported in 41 (58.3%) and oligospermia in 17 (23.6%), and 14 patients (19.4%) had normal sperm counts. Mycoplasma were grown from urethral swabs in 25 (35%) patients. Mean LH and FSH were elevated in azoospermics (p less than 0.001), E2-17B in oligospermics (p less than 0.001) and FSH in normospermic (p less than 0.01) patients. Hypergonadotropism suggestive of primary testicular failure was recorded in 43 (59.7%) patients. Hypogonadotropism was noted in 3 (4%) and hyperprolactinemia due to pituitary microadenoma induced infertility in only one patient. No aetiology could be determined in 11 (16%) patients. PMID:1634475
Nalini, K; Sethi, B K; Sharma, M; Dash, R J
Findings in 325 consecutive primary seminal analysis done at the Infertility Treatment Centre of IPGMR, are discussed. The clinical profile of the infertile couples was recorded. Semen was examined for quantity, sperm density, motility and morphology. An attempt was also made to correlate past illnesses with the quality of semen. 65 patients (20%) showed azoospermia, while 29 (8.9%) showed sperm count of less than 10 million/ml. History of past illnesses which contribute to azoospermia/oligospermia was obtained in 46% of azoospermia cases compared to only 10% in subjects showing sperm count of over 10 million/ml. Commonest association between azoospermia and past illness was found in the case of small-pox, where out of 31 subjects with past history of small-pox, 15 showed complete azoospermia, one showed sperm density of less then 10 million/ml. PMID:7347601
Chowdhury, T A; Habib, F; Khanam, S T
Objective. To study incidence of abnormal hysteroscopic findings according to age. Methods. We retrospectively studied 557 consecutive office hysteroscopies in patients referred for incapacity to conceive lasting at least 1 year or prior to in vitro fertilization. Rates of abnormal findings were reviewed according to age. Results. In 219 cases, hysteroscopy showed an abnormality and more than a third of our population had abnormal findings that could be related to infertility. Rates of abnormal findings ranged from 30% at 30 years to more than 60% after 42 years. Risk of abnormal finding was multiplied by a factor of 1.5 every 5 years. Conclusion. Our data are an additional argument to propose office hysteroscopy as part of first-line exams in infertile woman, regardless of age.
Koskas, Martin; Mergui, Jean-Luc; Yazbeck, Chadi; Uzan, Serge; Nizard, Jacky
Rhabdoid meningioma (RM) is a rare aggressive phenotype and is classified as a grade III neoplasm by the World Health Organization. A 29-year-old woman initiated treatment with clomiphene citrate for infertility. Two weeks later, she presented with acute headache and nausea. Brain computed tomography and magnetic resonance imaging demonstrated a tumor with hematoma in the left frontoparietal region. Surgical resection was performed, and the tumor was subtotally removed. The tumor was diagnosed as a rhabdoid meningioma (RM). Despite radiation and chemotherapy, she experienced regrowth and dissemination to the spinal cord. She died 11 months after onset of symptoms. Spontaneous hemorrhage is an unusual presentation of RM. In our case, infertility treatment may have triggered progression and bleeding because of an imbalance of sex hormones. PMID:22350616
Motegi, Hiroaki; Kobayashi, Hiroyuki; Terasaka, Shunsuke; Ishii, Nobuaki; Ito, Masaki; Shimbo, Daisuke; Kubota, Kanako; Houkin, Kiyohiro
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: 20.8–50.3). 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.
Kang, Myungja; Shin, Sangseop; Choi, Eunmi; Kwon, Sukyung; Wee, Hyosun; Nam, Bonghyun; Kaptchuk, Ted J.
Infertility has been associated with stigma and negative psychosocial functioning. However, only a small proportion of this\\u000a population actually receives care. Fertility patients predominantly use the Internet for information gathering, social support,\\u000a and assistance with decision-making; yet, available web resources are unreliable sources of mental health care. Web-based\\u000a alternatives also have the potential to assist with intervention access difficulties and
Minden B. Sexton; Michelle R. Byrd; William T. O’Donohue; Negar Nicole Jacobs
The controlled generation of very low amounts of reactive oxygen species (ROS) appears to regulate normal sperm functions, while high levels of ROS endanger sperm viability and function. Oxidative stress (OS) develops as a consequence of excessive production of ROS and/or impaired antioxidant defense system. It is proposed that such OS precipitates a range of pathologies currently thought to afflict male reproductive function. ROS-mediated peroxidative damage to the sperm plasma membrane may account for defective sperm function observed in a high proportion of infertility patients. Excessive generation of ROS may also attack integrity of DNA in the sperm nucleus. DNA bases are susceptible to oxidative stress, and peroxidation of these structures can cause base modification, DNA strand breaks and chromatin cross-linking. DNA damage induced by excessive ROS may accelerate the process of germ cell apoptosis, leading to decline in sperm counts associated with male infertility, and may explain the apparent deterioration of semen quality observed during the past four to five decades. For almost a decade, our research team in the Cleveland Clinic Foundation has identified the critical role of OS in male infertility. The main objective of our research was to transfer this important knowledge from the research bench to clinical practice. We designed studies with the aims of: 1. understanding the exact mechanisms by which OS develops in semen, which we thought will help setup strategies to overcome the problem, 2. establishing assays for accurate assessment of OS status and running the quality control studies for this purpose, 3. testing the correlation between OS and sperm nuclear DNA damage, and 4. identifying the clinical significance of seminal OS assessment in male infertility practice. PMID:12479038
Agarwal, Ashok; Saleh, Ramadan Abdou
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
Schenker, J G
Reproductive behaviour in modern western society has changed dramatically in the last two decades. Parenthood is now well\\u000a planned. If planned pregnancies do not occur as expected, early infertility care is often demanded with the risk of over-treatment.\\u000a Live birth rates in untreated subfertile couples reach nearly 55% in 36 months. During this period, self-monitoring with natural\\u000a family planning (NFP)
Christian Gnoth; Petra Frank-Herrmann; Günter Freundl
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
Tan, Li; Tong, Yao; Sze, Stephen Cho Wing; Xu, Mei; Shi, Yang; Song, Xin-yang; Zhang, Ting-ting
The Hippocratic text 'On the winds, waters and places' contains a fairly long description of an ancient Scythian tribe, the nomadic Sauromats. In this tribe the gender roles appear to have been inverted to some degree. The virgin women fight from horseback with swords, bows and arrows, and are not allowed to marry before they have killed three enemies. The married women are often infertile. The Hippocratic author ascribes this to the pronounced fatness of these women. Many men suffer from impotence and as a consequence dress as women, talk like them and carry out feminine household work. The Hippocratic author emphasises that the male impotence and the female infertility stem from the cold, damp climate and the Scythians' way of living, particularly the men spending most of their time riding. In contrast Herodotus states that the male impotence is Aphrodite's revenge because the Scythians ravaged her temple in Ascalon many years earlier. The difference between the Hippocratic emphasis on natural explanations for all natural phenomena, including health and disease and the occasional divine intervention promoted by Herodotus is underlined. There seems to be no plausible modern explanation for the impotence and infertility as described by the Hippocratic author. PMID:22332473
This work shows that an overload of dietary cholesterol causes complete infertility in dyslipidemic male mice (the Liver X Receptor-deficient mouse model). Infertility resulted from post-testicular defects affecting the fertilizing potential of spermatozoa. Spermatozoa of cholesterol-fed lxr?/? animals were found to be dramatically less viable and motile, and highly susceptible to undergo a premature acrosome reaction. We also provide evidence, that this lipid-induced infertility is associated with the accelerated appearance of a highly regionalized epididymal phenotype in segments 1 and 2 of the caput epididymidis that was otherwise only observed in aged LXR-deficient males. The epididymal epithelial phenotype is characterized by peritubular accumulation of cholesteryl ester lipid droplets in smooth muscle cells lining the epididymal duct, leading to their transdifferentiation into foam cells that eventually migrate through the duct wall, a situation that resembles the inflammatory atherosclerotic process. These findings establish the high level of susceptibility of epididymal sperm maturation to dietary cholesterol overload and could partly explain reproductive failures encountered by young dyslipidemic men as well as ageing males wishing to reproduce.
Ouvrier, Aurelia; Alves, Georges; Damon-Soubeyrand, Christelle; Marceau, Geoffroy; Cadet, Remi; Janny, Laurent; Brugnon, Florence; Kocer, Ayhan; Pommier, Aurelien; Lobaccaro, Jean-Marc A.; Drevet, Joel R.; Saez, Fabrice
Thyroid autoimmunity is the most prevalent autoimmune state that affects up to 5-20% of women during the age of fertility. Prevalence of thyroid autoimmunity is significantly higher among infertile women, especially when the cause of infertility is endometriosis or polycystic ovary syndrome. Presence of thyroid autoimmunity does not interfere with normal embryo implantation and have been observed comparable pregnancy rates after assisted reproduction techniques in patients with or without thyroid autoimmunity. Instead, the risk of early miscarriage is substantially raised with the presence of thyroid autoimmunity, even if there was a condition of euthyroidism before pregnancy. Furthermore the controlled ovarian hyperstimulation, used as preparation for assisted reproduction techniques, can severely impair thyroid function increasing circulating estrogen levels. Systematic screening for thyroid disorders in women with a female cause of infertility is controversial but might be important to detect thyroid autoimmunity before to use assisted reproduction techniques and to follow-up these parameters in these patients after controlled ovarian hyperstimulation and during pregnancy. PMID:22835333
Artini, Paolo Giovanni; Uccelli, Alessia; Papini, Francesca; Simi, Giovanna; Di Berardino, Olga Maria; Ruggiero, Maria; Cela, Vito
A prevalence study of Ureaplasma urealyticum (UU) infection of the male genital tract was carried out in Shanghai between March 1992 and June 1995. Significantly higher frequency of UU infection was found among infertile males (549/1416) as compared to fertile controls (34/375). Examination of 8 specimens each from infertile men and fertile subjects by electron microscopy, immunogold and immunofluorescence techniques, demonstrated adhesion of Ureaplasma urealyticum to the membrane of spermatozoa and exfoliated germ cells. In addition, gold particles on Ureaplasma urealyticum were found to be adhered to the sperm surface in 4 of the 8 samples. Strong specific anti-UU fluorescence was detected in 6 of 8 samples, mainly on the midpieces and post-acrosomal regions of the spermatozoa. To further study the effects of Ureaplasma urealyticum on fertility, 47 male Sprague-Dawley (SD) rats were infected artificially with Ureaplasma urealyticum serotype 8 (T960). Morphological changes in the seminiferous tubules were observed 3-5 weeks after inoculation in the sacrificed animals. Dramatic impairment of spermatogenesis of both testes was found in 11 rats. Mating experiment confirmed infertility in 12 of 40 rats. Offsprings of the infected rats were significantly smaller than those of controls in terms of prenatal weights and birthweights. PMID:9263572
Xu, C; Sun, G F; Zhu, Y F; Wang, Y F
The spermatogenesis failure with a genetic defect is one of the major causes of male infertility. The Y chromosome is considered a lack of important functional genes. It was the discovery of the sex determining region Y that rekindled scientists'attention to the Y chromosome. The successful sequencing of the Y chromosome uncovered its actual structure and the molecular base of its microdeletion. Of the 220 Y chromosome genes (104 coding genes, 111 pseudogenes, and 5 other uncategorized genes), 16 coding genes have been found in the azoospermia factor region (AZF) and related with male fertility. To date, more than 12 Y chromosome microdeletions have been discovered in the AZF region. The amplicons regions in the Y chromosome are the genetic base of microdeletion occurrence. The Y chromosome microdeletions in the AZF region have been identified as a relatively common cause of male infertility and diagnosed by multiplex PCR in the clinical laboratory. Genomics has brought many revolutionized tools beneficial for better understanding the genetics of mal infertility and defining the role of the Y chromosome gene in spermatogenesis. PMID:20684316
To assess the clinical practice of quantitative fluorescence PCR (QF-PCR) in genetic diagnosis of male infertility patients, 78 nonobstructive male infertility patients were pooled for semen routine screening and sexual hormone determination; QF-PCR was applied to detect the polymorphic short tandem repeat (STR) and specific sequence tagged site (STS) of sex chromosomes; routine chromosome G-band was used for karyotype analysis and PCR was used for the detection of AZF microdeletion. Routine screening of semen found 18 azoospermia and 20 oligospermia patients (48.72%). Three patients with 47, XXY, two with 46,XX(SRY+)and one with AZFc microdeletion were detected using QF-PCR technique which were verified by chromosome G-band and PCR. This study suggests that QF-PCR is a comprehensive, rapid and reliable method for detecting abnormal chromosomal regions and microstructures compared with traditional tests and provides a better candidate for diagnosis of male infertility caused by chromosomal anomalies and gene mutation. PMID:21831806
Qi, Man-Long; Zhang, Yuan-Yuan; Liu, Xiao-Liang; He, Rong; Zhao, Yan-Yan
Infertile men have higher levels of semen reactive oxygen species (ROS) than do fertile men. High levels of semen ROS can cause sperm dysfunction, sperm DNA damage and reduced male reproductive potential. This observation has led clinicians to treat infertile men with antioxidant supplements. The purpose of this article is to discuss the rationale for antioxidant therapy in infertile men and to evaluate the data on the efficacy of dietary and in vitro antioxidant preparations on sperm function and DNA damage. To date, most clinical studies suggest that dietary antioxidant supplements are beneficial in terms of improving sperm function and DNA integrity. However, the exact mechanism of action of dietary antioxidants and the optimal dietary supplement have not been established. Moreover, most of the clinical studies are small and few have evaluated pregnancy rates. A beneficial effect of in vitro antioxidant supplements in protecting spermatozoa from exogenous oxidants has been demonstrated in most studies; however, the effect of these antioxidants in protecting sperm from endogenous ROS, gentle sperm processing and cryopreservation has not been established conclusively.
Zini, Armand; Al-Hathal, Naif
Celiac disease (CD) is a permanent intolerance to gluten characterized by destructions of the small intestinal villi and malabsorption. The gluten-free diet (GFD) results in healing of the mucosa, resolution of the malabsorpitive states, and reversal of great part of CD effects. Among the extradigestive complications associated with CD, unexplained infertility has been reported since the 70's. The prevalence of CD among women with unexplained infertility is 2.5-3.5%, higher, although not always significantly, than control population. To date, it is widely accepted that untreated CD represents a risk for abortion, low birth weight babies and short-breast feeding period. These features can be corrected by GFD. Some discrepancies could stem from the heterogeneity of the studies. Regarding a potential pathogenic mechanism, since CD causes malabsorption of folic acid and other nutrients, this pathway has been proposed to explain the unfavourable outcomes of pregnancy. However, this remains a speculation. In conclusion, each woman with unexplained infertility should be screened for CD. PMID:17592443
Pellicano, R; Astegiano, M; Bruno, M; Fagoonee, S; Rizzetto, M
Background. The prevalence of infertility in Pakistan is 22% with primary infertility at 4% and secondary infertility at 18%. This study explored perceptions and experiences of women in Karachi, Pakistan regarding the causes, treatment-seeking behavior for and consequences of secondary infertility. Methods. Focus group discussions and in-depth interviews with married women explored their perceptions and experiences for issues related to secondary infertility. Results. The knowledge of women about the causes and scientific treatment options for infertility was limited resulting in inclination for traditional unsafe health care. Infertility was stated to result in marital instability, stigmatization and abuse specially for women with no live child. Conclusions. Since infertility can have a serious effect on both the psychological well-being and the social status of women in Pakistan, effective interventions are the need of the day. There is a dire need for health education and counseling to be integrated into infertility management plans.
Sami, Neelofar; Saeed Ali, Tazeen
Objective: To assess the value of diagnostic hysteroscopy in a primary workup of infertility. Methods: We performed a retrospective analysis (Canadian Task Force Classification II-2) of 221 infertile patients referred to the Outpatient Center for Uterine Cavity Evaluation and the Tel-Aviv University affiliated Assaf Harofe Medical Center for evaluation of the uterine cavity. Patients underwent a diagnostic office hysteroscopy. Results: Hysteroscopy revealed an abnormal uterine cavity in 30% of women evaluated for either primary or secondary infertility. No significance was found regarding the total number of intrauterine pathologies when comparing the groups of primary versus secondary infertility. Conclusion: Routine diagnostic hysteroscopy should be part of an infertility workup in primary and secondary infertility.
Feingold, Michal; Sagi, Ron; Herman, Arie; Schneider, David; Halperin, Reuvit
To describe the characteristics of women seeking infertility treatment and the types of fertility treatment sought within a population-based sample. We analyzed data from the cross-sectional Pregnancy Risk Assessment Monitoring System (PRAMS) of women with a live birth using data from seven states. Logistic regression was used to determine factors associated with infertility treatment utilization. Infertility treatment was reported by 10.5% of women who were trying to become pregnant. The most common treatment reported was fertility enhancing drugs (29%), followed by assisted reproductive technology including in vitro fertilization (21%), and artificial insemination together with fertility enhancing drugs (15%). Some women reported using other types of treatment (23%). The PRAMS data provide insights into the use of infertility treatment among women giving birth in the United States. Further research is needed to understand the true prevalence of infertility, factors that influence treatment choices, and the longitudinal impact of infertility treatment on outcomes. PMID:21559776
Simonsen, Sara E; Baksh, Laurie; Stanford, Joseph B
BACKGROUND: Infertile couples might experience psychological distress and suffer from impaired health-related quality of life. This study aimed to examine health-related quality of life in infertile couples receiving either in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. METHODS: This was a cross-sectional study of quality of life in infertile couples attending to Vali-e-Asr Reproductive Health Research Center or Royan
Batool Rashidi; Ali Montazeri; Fatemeh Ramezanzadeh; Mamak Shariat; Nasrin Abedinia; Mahnaz Ashrafi
Disability is a complex phenomenon. It reflects an interaction between features of a person's body and features of the society in which he or she lives. International Classification of Functioning, Disability and Health (ICF), lays stress on the functional as well as the structural problem of a person. All the definitions of disability also include the disorders of the reproductive and endocrine system. So infertility and impotency should also be included in the category of disability. It affects the participation in areas of life and can have a disabling affect on an individual. Like any other disability the couple has to adapt and integrate infertility in their sense of self thus infertility comes as a major life crisis. Medically, infertility, in most cases, is considered to be the result of a physical impairment or a genetic abnormality. Socially, couples are incapable of their reproductive or parental roles. On social level, infertility in most cultures remains associated with social stigma and taboo just like the social model of disability. Couples who are unable to reproduce may be looked down upon due to social stigmatisation. Infertility can lead to divorces and separation leading to a broken family life. Without labelling infertility as a disability, it is difficult for the people to access services and welfare benefits offered by the government. Infertility treatments are highly sophisticated so they are very expensive and are even not covered by insurance and government aid. In the light of all this it becomes imperative to categorise infertility as disability.
Khetarpal, Abha; Singh, Satendra
Objective To determine predictors of low birth weight (LBW) and preterm delivery (PTD) in singleton pregnancies conceived by women with and without a history of infertility. Design Retrospective cohort study. Setting Eleven infertility clinics in Northern California. Patients Three groups of women who carried singleton pregnancies to ? 20 weeks gestation: 542 infertile women who conceived after treatment, 441 infertile women who conceived spontaneously, and 1008 fertile women for comparison. Interventions Chart review. Main Outcome Measures Association of LBW or PTD with infertility treatment, maternal age, parity, obesity, or development of gestational diabetes. Results Infertile women who conceived with treatment were more likely to be obese, develop gestational diabetes, and have ovarian, ovulatory, or male factor infertility than infertile women who conceived spontaneously. Infertile women who conceived after treatment had 1.61 (95% CI 1.08– 2.41) times greater odds of having a LBW infant. Nulliparity was an independent predictor of LBW 1.54 (95% CI 1.09– 2.16) and PTD (OR 1.72, 95% CI 1.20–2.49) in all three groups after controlling for maternal age, history of infertility, infertility treatment, obesity, and gestational diabetes. Conclusions Nulliparous women and women with a history of infertility who conceive a singleton after treatment may be at increased odds for having a LBW infant. Infertile women do not appear to be at increased odds for PTD.
Camarano, Loretta; Alkon, Abbey; Nachtigall, Robert D.; Schembri, Michael; Weiss, Sandra; Croughan, Mary S.
OBJECTIVE: To test the hypothesis that infertile Nigerian women have higher serum levels of antibodies against Neisseria gonorrhoea and Treponema pallidum compared with fertile controls. DESIGN: The prevalence of serum antibodies against N gonorrhoea and T pallidum was compared in fertile and infertile Nigerian women. SETTING: Population based case-control study in Ile-Ife, southwestern Nigeria. SUBJECTS: 60 women with infertility identified from a community based questionnaire survey of 1075 women were compared with 53 age matched fertile controls. METHODS: Sera of fertile and infertile women were tested for the presence of gonococcal antibodies with indirect agglutination test and syphilis antibodies using rapid reagin method. MAIN OUTCOME MEASURES: Prevalence of anti-gonococcal and anti-treponemal antibodies in cases and controls. Frequency of self reports of sexually transmitted infections (STIs) in cases and controls. RESULTS: In comparison with fertile women, infertile women were more likely to report having had repeated lower abdominal pains (p < 0.01), yellow vaginal discharge (p < 0.004), and whitish vaginal discharge (p < 0.02). There was no significant difference between cases and controls in the proportions reporting previous STI diagnoses. However, two infertile women reported previous gonococcal infection compared with none in the fertile group. Sixteen of the infertile women (26.7%) demonstrated anti-gonococcal antibodies in their sera compared with only four of the 53 fertile controls (7.5%) (p < 0.02; OR 4.5). There was no significant difference between fertile and infertile women in the proportion showing serological reactivity to T pallidum. CONCLUSION: Infertile women have a higher prevalence of anti-gonococcal antibodies compared with fertile controls. Infertile women are also more likely to report previous lower abdominal pains and vaginal discharge. These results provide credible evidence implicating STIs and N gonorrhoea in particular as important factors contributing to female infertility in this population. Public health measures are warranted to address the high rate of STIs and N gonorrhoea in Nigeria.
Okonofua, F E; Snow, R C; Alemnji, G A; Okoruwa, A; Ijaware, C O
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.
The content of this work is conceived on the research of the consequences of surrogate motherhood as a process of assisted procreation, which represent a way of parenthood in cases when it is not possible to realize parenthood through a natural way. Surrogate motherhood is a process in which a woman (surrogate mother) agrees to carry a pregnancy with the intent to give the child to the couple with whom she has made a contract on surrogate maternity after the birth. This process of conception and birth makes the determination of the child's origin on its mother's side hard to determine, because of the distinction of the genetic and gestation phases of the two women. The concept of surrogate motherhood is to appear in two forms, depending on the existence or the non-existence of the genetic link between the surrogate mother and the child she gives birth to. There are gestation (full) and genetic (partial) surrogates each with different modalities and legal and ethical implications. In Serbia, Infertility Treatment and the Bio-medically Assisted Procreation Act from 2009 explicitly forbids surrogate motherhood, despite the fact that an infertile couple decides to use it, as a rule, after having tried all other treatment procedures, in cases when there is a diagnosis but the conventional treatment applied has not produced the desired results. Given the fact that no one has the right to ignore the sufferings of people who cannot procreate naturally, the medical practice and legal science in our country plead for a formulation of a legal framework in which to apply surrogate motherhood as an infertility treatment, under particular conditions. PMID:21528795
Jovic, Olga S
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
Hirsh, Anthony V.
Background SOX9 is a widely expressed transcription factor playing several relevant functions during development and essential for testes differentiation. It is considered to be the direct target gene of the protein encoded by SRY and its overexpression in an XX murine gonad can lead to male development in the absence of Sry. Recently, a family was reported with a 178 kb duplication in the gene desert region ending about 500 kb upstream of SOX9 in which 46,XY duplicated persons were completely normal and fertile whereas the 46,XX ones were males who came to clinical attention because of infertility. Methods and results We report a family with two azoospermic brothers, both 46,XX, SRY negative, having a 96 kb triplication 500 kb upstream of SOX9. Both subjects have been analyzed trough oligonucleotide array-CGH and the triplication was confirmed and characterised through qPCR, defining the minimal region of amplification upstream of SOX9 associated with 46,XX infertile males, SRY negative. Conclusions Our results confirm that even in absence of SRY, complete male differentiation may occur, possibly driven by overexpression of SOX9 in the gonadal ridge, as a consequence of the amplification of a gene desert region. We hypothesize that this region contains gonadal specific long-range regulation elements whose alteration may impair the normal sex development. Our data show that normal XX males, with alteration in copy number or, possibly, in the critical sequence upstream to SOX9 are a new category of infertility inherited in a dominant way with expression limited to the XX background.
Vetro, Annalisa; Ciccone, Roberto; Giorda, Roberto; Patricelli, Maria Grazia; Della Mina, Erika; Forlino, Antonella
We measured pulse waves in 22 infertile women from the beginning of in vitro fertilization-embryo transfer (IVF-ET) through to pregnancy testing. The largest Lyapunov exponent (LLE) and autonomic nerve balance in the pregnancy group were significantly lower than that in the non-pregnancy group. In this study, we measured plethysmograms of four women who became pregnant and 18 who did not, ten times from each. We calculated LLE and a value for the autonomic nerve balance; from this analysis, we conclude that a mental state that allows for the possibility of becoming pregnant is necessary for a successful pregnancy.
Takahashi, Yuko; Tomiyama, Tatsuhiro; Matsubayashi, Hidehiko; Tsukamoto, Asami; Oyama-Higa, Mayumi
Laparoscopy has become the most important investigative tool for the evaluation of tubal disease in developed countries of the world. In this report of 218 diagnostic laparoscopies performed on infertile Nigerian women, bilateral tubal occlusion was found in 35.3% and unilateral occlusion in 9.6%. Pelvic adhesions were present in 55.0% out of which 25.2% and 21.1% were moderate or severe, respectively. Endometriosis and uterine fibroids were present in 1.4% and 26.6% of patients, respectively. The implications of these findings for management of tubal disease in Nigerian women is discussed. PMID:2883045
Otolorin, E O; Ojengbede, O; Falase, A O
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 physician’s 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.
Tham, Elizabeth; Schliep, Karen; Stanford, Joseph
Recently, there is increasing evidence suggesting that oxidative sperm DNA damage is closely associated with impaired sperm function and male infertility. 8-Hydroxydeoxyguanosine (8- OHdG) is considered to be a precise and sensitive biomarker of oxidative DNA damage. The present study was thus designed to evaluate the extent of oxidative DNA damage in sperm and its as- sociation with male infertility
HAN-MING SHEN; SIN-ENG CHIA; CHOON-NAM ONG
Study design: Male infertility caused by anejaculation is common among patients with spinal cord injury (SCIP). The fertility options for SCIP have improved impressively over the past 10 years. We present the Israeli experience in the treatment of infertility in a large series of SCIP. The issues which are addressed include the treatment of ejaculatory dysfunction, seminal quality and fertility
RJ Heruti; H Katz; Y Menashe; R Weissenberg; G Raviv; I Madjar; A Ohry; Heruti RJ
Background & objectives: Recently, a significantly higher ratio of nucleotide changes in the mtDNA genes: COII, ATPase 6, ATPase 8, ND2, ND3, ND4, and ND5 was reported in spermatozoa from populations of infertile Indian men, compared suggesting that screening for mtDNA mutations could provide insight into the aetiology of male infertility. In this study, we examined the published data and found serious errors in the original acquisition and analysis of the data. Methods: The mtDNA data associated with male infertility in Indian populations were retrieved from the published sources. The mtDNA substitution values of infertile and control groups were evaluated using phylogenetic methods and previously published mtDNA phylogenies. Results: Most of the mtDNA polymorphisms reported as significantly correlated with infertility were more commonly found in general populations. Further, our analysis showed that some of the mtDNA substitutions were erroneously overestimated in the infertile groups and underestimated in the control groups, and vice-versa. Interpretation & conclusions: Contrary to earlier claims, our analysis demonstrated no significant association between the mtDNA polymorphisms and male infertility in these studies. Further, these errors in the published data impune the usefulness of mitochondrial molecular analyses in male infertility diagnosis.
Palanichamy, Malliya Gounder; Zhang, Ya-Ping
|We introduce a new instrument for family size, infertility, to investigate the causal relationship between children and female labor force participation. Infertility mimics an experiment where nature assigns an upper bound for family size, independent of a woman's background. This new instrument allows us to investigate the differential labor…
Aguero, Jorge M.; Marks, Mindy S.
The aim of this study was to investigate the impact of lifestyle on the quality of life among couples undergoing infertility treatment. The research universe consisted of the couples undergoing infertility treatment in Akdeniz University's Center of Reproductive Endocrinology and Assisted Reproductive Techniques. A total of 200 couples were included in the research. The data collection tools were a “Personal
Gamze Teskereci; Selma Oncel
Microdeletions of the long arm of the human Y chromosome are associated with spermatogenic failure and have been used to define three regions of Yq (AZFa, AZFb, and AZFc) that are recurrently deleted in infertile males. In a blind study we screened 131 infertile males (46 idiopathic and 85 nonidiopathic) for Y chromosome mi- crodeletions. Nineteen percent of idiopathic males,
C. Krausz; L. QUINTANA-MURCI; S. BARBAUX; J.-P. SIFFROI; H. ROUBA; D. DELAFONTAINE; N. SOULEYREAU-THERVILLE; G. ARVIS; J. M. ANTOINE; E. ERDEI; J. P. TAAR; A. TAR; E. JEANDIDIER; G. PLESSIS; T. BOURGERON; J.-P. DADOUNE; M. FELLOUS; K. MCELREAVEY
Background: The most frustrated patients and the most frustrating to take care of are couples with unexplained infertility. The incidence of unexplained infertility appears to be approximately 15%. The different lines adopted for therapy are costly. The tubal fluid contains ovarian protein, K, Ca, Mg, Na. We could demonstrate gonadotropin-releasing hormone for the first time and the improved pregnancy rate
Ali Farid Mohamed Ali; Baha Fateen; Ahmed Ezzet; Hoda Badawy; Asherf Ramadan; Alaa El-tobge
BACKGROUND: More than 10% of babies are born to couples taking >1 year to conceive (a common definition of infertility). Some evidence indicates that such pregnancies are at increased risk of preterm delivery and other adverse birth outcomes, but the problem has rarely been addressed in large, longitudinal studies enrolling couples irrespective of infertility treatment. METHODS: We used data from
Olga Basso; Donna D. Baird
Tubal disease constitutes a major factor in infertility especially in developing countries. This study was undertaken to assess the hysterosalpingographic patterns seen in infertile patients in an urban centre in Lagos. Two hundred and twenty patients who reported from the gynaecology clinic to the radiology department of Lagos State University…
Akinola, R. A.; Akinola, O. I.; Fabamwo, A. O.
Background In the previous studies, the rate of primary infertility was reported differently. It seems the main reasons are related to the different methods of data collection and information analysis. Therefore, introducing a precise method to determine the infertile couples and the population exposed to the risk of infertility is an important issue to study primary infertility. Methods: The proposed methodology for assessing primary infertility rate has been designed and applied by Avicenna Research Institute in a national survey. Sampling was conducted based on probability proportional to size cluster method. In this survey, after reviewing the former studies, the reproductive history was used as a basis for data collection. Every reproductive event was recorded with a code and a date in the questionnaire. To introduce a precise method, all possible events were considered thoroughly and for each situation, it was determined whether these cases should be considered in numerator, denominator or it should be eliminated from the study. Also in some situations where the correct diagnosis of infertility was not possible, a sensitivity analysis was recommended to see the variability of results under different scenarios. Conclusion: The proposed methodology can precisely define the infertile women and the population exposed to the risk of infertility. So, this method is more accurate than other available data collection strategies. To avoid bias and make a consistent methodology, using this method is recommended in future prevalence studies.
Akhondi, MM; Kamali, K; Ranjbar, F; Shafeghati, S; Ardakani, Z Behjati; Shirzad, M; Eslamifar, M; Mohammad, K; Parsaeian, M
BACKGROUND: Infertility itself and also assisted reproductive treatment increase the incidence of some obstetric complications. Women with unexplained infertility are reported to be at an increased risk of intrauterine growth restriction during pregnancy, but not for other perinatal complications. METHODS: A matched case-control study was performed on care during pregnancy and delivery, obstetric complications and infant perinatal outcomes of 107
R. Isaksson; M. Gissler; A. Tiitinen
Background Infertility has potentially inappropriate effects on quality of life in infertile couples. Various general and specific questionnaires have been structured for assessing different aspects of quality of life in infertile men, women, or couples. The present systematic review was designed to assess these questionnaires and also identify different factors affecting infertile couples based on the aforesaid questionnaires. Methods The research strategy involved general and specific terms in relation to couples's infertility and their quality of life. A review was done for studies published from 1982 to 2012 that were indexed in Medline, ISI Web of Science and Scopus as well as abstract books on this subject. We also corresponded with the authors of the references in related studies for introducing more resources and references. Results In all reviewed studies, different aspects of the quality of life in couples were evaluated including sexual, psychological, social, communicational, environmental, occupational, medical, as well as economical ones. In total, after initial screening of all studies, 10 general and 2 specific questionnaires were retrieved. Although no meta-analysis was found in the review, infertility had a negative effect on quality of life in couples. Conclusion This study revealed that some general questionnaires such as SF-36 and WHO-QOL were mostly used for assessing quality of life in infertile couples and some specific questionnaires such as FERTI-QoL and Fertility Problem Inventory were rarely used. Thus, it seems that the evaluation of quality of life in infertile couples needs valid instruments for measurement.
Mousavi, Seyyed Abbas; Masoumi, Seyyedeh Zahra; Keramat, Afsaneh; Pooralajal, Jalal; Shobeiri, Fatemeh
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
Christian Olesen; Claus Hansen; Eske Bendsen; Anne Grete Byskov; Eberhard Schwinger; Isidora Lopez-Pajares; Peter K. A. Jensen; Ulf Kristoffersson; Regine Schubert; Elvira Van Assche; Jan Wahlstroem; James Lespinasse; Niels Tommerup
Male infertility is considered to be a difficult-to-treat condition because it is not a single entity, but rather reflects a variety of different pathologic conditions, thus making it difficult to use a single treatment strategy. Structural alterations in the Y chromosome have been the principal factor responsible for male infertility. We examined 26 family members of 13 patients with male
R. G. Rodovalho; J. T. Arruda; K. K. V. O. Moura
Intervals V and VI of Yq11.23 regions contain responsible genes for spermatogenesis, and are named as “azoospermia factor locus” (AZF). Deletions in these genes are thought to be pathogenetically involved in some cases of male infertility associated with azoospermia or oligozoospermia. The aim of this study was to establish the prevalence of microdeletions on the Y chromosome in infertile Turkish
Canan Figen Sarg?n; Sibel Berker-Karaüzüm; Esra Manguo?lu; Tibet Erdo?ru; ?eyda Karaveli; Kemal Hakan Gülkesen; Mehmet Baykara; Güven Lüleci
Immature oocyte retrieval followed by in-vitro maturation (IVM) is a promising potential treatment option, especially for women who are infertile through polycystic ovarian syndrome (PCOS). Although the pregnancy and implantation rates of IVM treatment are not as high as conventional IVF treatment, IVM treatment has many advantages for infertile women with PCOS, because this group of patients is extremely sensitive
BACKGROUND: The likelihood of spontaneous conception in subsequent cycles is important for a balanced man- agement of infertility. Previous studies on time to pregnancy are mostly retrospective and biased because of exclu- sion of truly infertile couples. The study aim was to present a non-parametric estimation of cumulative probabilities of conception (CPC) in natural family planning (NFP) users illustrating an
C. Gnoth; D. Godehardt; E. Godehardt; P. Frank-Herrmann; G. Freundl
For millions of couples, the inability to have a child is a personal tragedy and a large proportion of childless people are confronted with social stigmatization (blame) and personal frustration. Formerly assigned to women, infertility of a couple is nowadays equitably distributed between the two sexes. Among the methods used to treat male infertility problems, medicinal plants have been used
E. A. Nantia; P. F. Moundipa; T. K. Monsees; S. Carreau
|Tubal disease constitutes a major factor in infertility especially in developing countries. This study was undertaken to assess the hysterosalpingographic patterns seen in infertile patients in an urban centre in Lagos. Two hundred and twenty patients who reported from the gynaecology clinic to the radiology department of Lagos State University…
Akinola, R. A.; Akinola, O. I.; Fabamwo, A. O.
The clinical fertility tests, available in the market, fail to define the exact cause of male infertility in almost half of the cases and point toward a crucial need of developing better ways of infertility investigations. The protein biomarkers may help us toward better understanding of unknown cases of male infertility that, in turn, can guide us to find better therapeutic solutions. Many clinical attempts have been made to identify biomarkers of male infertility in sperm proteome but only few studies have targeted seminal plasma. Human seminal plasma is a rich source of proteins that are essentially required for development of sperm and successful fertilization. This viewpoint article highlights the importance of human seminal plasma proteome in reproductive physiology and suggests that differential proteomics integrated with functional analysis may help us in searching potential biomarkers of male infertility. PMID:22532450
Tomar, Anil Kumar; Sooch, Balwinder Singh; Singh, Sarman; Yadav, Savita
This paper reports differences observed in the elemental content of fertile and infertile human spermatozoa used in an in vitro fertilization (IVF) program. “Fertile” and “infertile” were designated by the successful penetration or failure to penetrate an oocyte in vitro. We report morphological and morphometric differences which, together with elemental changes, may be causes of infertility in apparently normal spermatozoa.
T. C. Appleton; S. B. Fishel
This study was aimed at assessing presence and predictors of a trend towards more advanced paternal age at presentation in a cohort of 1283 Caucasian-European infertile couples with male factor infertility (MFI) over a short time frame. Multivariate linear regression analysis tested the association between predictors [namely, partners' age, length of infertility at first presentation, patients' comorbidities as scored with the Charlson Comorbidity Index (CCI) and educational status] and patient's age at presentation. Using anova, patient's age at presentation (F ratio: 2.43; p = 0.024) and patients' educational status (?(2) trend: 142.38; p < 0.001) significantly increased over time. In contrast, length of infertility at first presentation, CCI and partners' age did not significantly change over time (all p ? 0.05). Linear regression analyses showed that CCI, educational status and year of presentation were not correlated with patients' age at presentation (all p ? 0.05), whereas partners' age (? = 0.170; p < 0.001) and length of infertility (? = 0.123; p = 0.004) were independent predictors of delayed fatherhood. These results showed a significant shift towards advanced paternal age, but a non-significant increase of maternal age at first presentation among Caucasian-European infertile couples with MFI over a short time frame. PMID:21696399
Salonia, A; Matloob, R; Saccŕ, A; Ferrari, M; Gallina, A; Castiglione, F; Abdollah, F; Raber, M; Brigante, C; Candiani, M; Rigatti, P; Montorsi, F
Microorganisms which are present in the human urogenital tract may be involved in the development of inflammatory changes negatively affecting the genitals in both men and women. Pathological conditions due to inflammatory alterations may result in complete loss of fertility. Infections of the urogenital tract are responsible for 15% of all cases of infertility in couples. Negative impact on the human reproduction is mainly caused by direct damage to the genital tract mucosa by metabolic products of microorganisms or by induction of pro-inflammatory responses of the body. Another mechanism is indirect impact of microorganisms on the genital function. Moreover, the effect of bacteria on spermatogenesis and semen quality is important in men. Infections mainly caused by Chlamydia trachomatis or Neisseria gonorrhoeae represent the greatest risk in terms of permanent consequences for human reproduction. As for other sexually transmitted disorders, such as infections caused by Gardnerella vaginalis, urogenital mycoplasmas or ureaplasmas, the link between infection and infertility has been intensively researched. PMID:23768092
Radek, Sleha; Vanda, Boštíková; Miloslav, Salavec; Petra, Mosio; Eva, Kusáková; Rudolf, Kukla; Jaroslava, Mazurová; Miroslav, Spli?o
The semen samples of 1,110 (one thousand, one hundred and ten) Igbo males attending infertility clinic, aged between 30-50 years were collected and analyzed. The specimens were collected and analysed in the microbiology laboratory of the University of Nigeria Teaching Hospital (UNTH) Enugu, Eastern Nigeria. The standard method of masturbation after 3-5 days of prior abstinence from sex before sample collection was applied. The samples were examined for semen volume and microscopically as a wet preparation for sperm motility, morphology and count. The semen volume result showed that 91.07 % were normal. 6.3% sperm samples were motile. In the sperm count, only 7.3% had normal cells, 62.0% showed abnormal morphology. The aetiology of male infertility in the population studied seems to be related to the sperm count, motility and morphology but not volume. Racial factor seems to play no role and it is important to abstain from sexual intercourse some days before collection of semen for analysis. PMID:17242721
Nwafia, W C; Igweh, J C; Udebuani, I N
The link between high fertility and poverty is well established. However, this paper shows how infertility may also generate poverty among childless families in Bangladesh. An ethnographic study was conducted, involving various qualitative research methods that revealed economic consequences to be one of the crucial sequelae of childlessness in Bangladesh. This paper details how the poverty/fertility relationship is dependent on social and institutional characteristics, including patriarchal values, education, urban-rural location and health services. Empirical data show that childlessness generates poverty in various ways, including the deprivation of children's earnings, decline in women's mobility, demoralisation of men to earn an income, marriage devaluation by the husband, disbursements for treatment and denial of microcredit (very small loans to those in poverty, which support them to become self-employed to generate income). The current study shows that the infertility/poverty relationship is mostly contingent upon class and gender. It is therefore the rural poor childless women who are most badly affected economically in Bangladesh rather than the urban middle class childless women. In other words, this study reveal that along with gender, class plays a dominant role in terms of the economic consequences of childlessness in Bangladesh. It sheds light on a different and unusual aspect of poverty and aims to contribute to the gender discussion of livelihood and poverty. PMID:22313219
There has been a tremendous increase in the use of mobile phones in the past decade and concerns are growing about the possible hazardous effects of radio-frequency electromagnetic waves (EMW) emitted by these devices on human health. Preliminary studies, though with limitations in study design, suggest a possible link between cell phone use and infertility. A recent study found that use of cell phones adversely affects the quality of semen by decreasing the sperm counts, motility, viability and morphology. Evidence of detrimental effect of mobile phones on male fertility is still equivocal as studies have revealed a wide spectrum of possible effects ranging from insignificant effects to variable degrees of testicular damage. Although previous studies suggested a role of cell phone use in male infertility, the mode of action of EMW emitted from cell phones on the male reproductive system is still unclear. EMW can affect the reproductive system via an EMW-specific effect, thermal molecular effect or combination of both. Studies performed on human males are scarce and therefore further studies with a careful design are needed to determine the effect of cell phone use on male-fertilizing potential. PMID:17854521
Deepinder, Fnu; Makker, Kartikeya; Agarwal, Ashok
OBJECTIVE--To investigate the possibility that infertile Nigerian women have a higher rate of cervical colonisation with pathogenic and facultative organisms than fertile controls. DESIGN--The prevalence of common microorganisms in the vagina and endocervical canals of infertile women was compared with that of pregnant controls. SETTING--The Obafemi Awolowo University Hospital Maternity Centre. SUBJECTS--92 infertile women were compared with 86 pregnant controls. MAIN OUTCOME MEASURES--rates of isolation of Neisseria gonorrhoeae, Candida albicans, Trichomonas vaginalis and other facultative organisms in cases and controls. RESULTS--The rate of isolation of Neisseria gonorrheae was 17.4% among infertile women compared with 10.5% in the group of pregnant women (p > 0.05). There was no significant difference between the groups in the rate of isolation of Candida albicans, Trichomonas vaginalis and other facultative organisms. High rates of isolation of microorganisms were observed in both groups. However, women with secondary infertility had higher rate of carriage of Neisseria gonorrheae, Candida albicans and Staphylococcus aureus as compared with women with primary infertility. Nearly 15% of infertile women had previous episodes of pelvic inflammatory disease and 26% had had induced abortions. A positive history of vaginal discharge was a poor predictor of vagina and endocervical carriage of microorganisms. CONCLUSIONS--High rates of pathogenic organisms exist in the lower genital tract of infertile women and controls. Women with secondary infertility are more likely to have pathogenic organisms than women with primary infertility. A policy of routinely screening women for lower genital tract infections should be pursued in this population because of the high rate of infection.
Okonofua, F E; Ako-Nai, K A; Dighitoghi, M D
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.
Kocelak, Piotr; Chudek, Jerzy; Naworska, Beata; Bak-Sosnowska, Monika; Kotlarz, Barbara; Mazurek, Monika; Madej, Pawel; Skrzypulec-Plinta, Violetta; Skalba, Piotr; Olszanecka-Glinianowicz, Magdalena
Background Chlamydia trachomatis infection is a worldwide-distributed sexually transmitted infection that may lead to infertility. Objectives This study aims to report the prevalence of Chlamydia trachomatis infection among infertile women in Saudi Arabia. Patients and methods A community-based study carried out at the obstetrics and gynecology clinic at Jazan General Hospital, Saudi Arabia. The study group included 640 Saudi infertile women who were aged between 18 and 40 years and who attended the gynecology clinic for infertility examination throughout 1 year of study (from July 1, 2011 to June 30, 2012). The randomized control group included 100 Saudi fertile women who attended the obstetrics clinic for routine antenatal care. All recruited women were screened for chlamydia infection by enzyme-linked immunosorbent assay (ELISA) for detection of serum-specific antibodies and then retested by the McCoy cell culture technique. Results The prevalence of Chlamydia trachomatis infection among infertile women was high, at 15.0%. The rate of chlamydia infection detected by ELISA was 9.84%, and it was 12.03% by the culture method (P = 0.2443). Conclusion The high prevalence of Chlamydia trachomatis infection among Saudi infertile women demands a national screening program for early detection among infertile couples. ELISA is available as a simple screening test alternative to the culture method.
Kamel, Remah M
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.
Rodgers, Allison K.; Budrys, Nicole M.; Gong, Siqi; Wang, Jie; Holden, Alan; Schenken, Robert S.; Zhong, Guangming
Immunological factors have been implicated as a cause of unexplained infertility. Previous studies have demonstrated increased levels of sperm-bound antibody in infertile men with varicoceles and have postulated their role in varicocele-related infertility. However, these studies were performed using an enzyme-linked immunosorbent assay. We evaluated retrospectively 111 male patients referred for infertility using a direct immunobead assay. Of the patients 29 had grade II or III varicoceles (that is palpable or easily visualized) and 82 were without varicocele. Four patients who had undergone vasovasostomy were included as controls for the assay. A direct immunobead assay was performed for isotype IgG and IgA sperm-bound antibody using a standard protocol. A computerized semen analysis was also performed. Greater than 20% binding, excluding tail tip activity, was considered significant. Of 29 patients with and 82 without a varicocele significant binding was identified in 5 (17%) and 9 (11%), respectively. Chi-square statistical analysis did not reveal this difference to be significant (p < 0.05). All 4 vasovasostomy patients demonstrated significant binding. We conclude from this study that infertile men with varicoceles do not demonstrate significantly increased levels of sperm-bound antibody compared to infertile controls and, therefore, sperm-bound antibody does not appear to have a significant role in varicocele-related infertility. PMID:8345603
Oshinsky, G S; Rodriguez, M V; Mellinger, B C
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 (Pinteraction=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.
Huang, Cong; Liu, Wei; Ji, Gui-Xiang; Gu, Ai-Hua; Qu, Jian-Hua; Song, Ling; Wang, Xin-Ru
This study aimed to determine the prevalence of lifetime and current primary infertility in Iran. The study was conducted in 2004-5 in all the 28 provinces of Iran. A cluster sampling method was used to select 10 783 women aged 19 to 49 years for the survey. Lifetime primary infertility was defined based on 1 of 2 contraception scenarios immediately after marriage to find experience of infertility despite 1 year of unprotected intercourse. The term "current primary infertility" designated a woman who, in addition to meeting the definition of lifetime infertility, had been unable to conceive up to the study time. A complex sampling design and SVY commands in the software package STATA 8.0 were used to derive 95% confidence intervals. A history of lifetime primary infertility was present in 24.9% of the subjects (95% CI: 23.5-26.2), and the prevalence of current primary infertility was 3.4% (95% CI: 3.0-3.8). As for age trends in lifetime primary infertility, the highest prevalence rates were observed in individuals with the lowest age at marriage. Minimum prevalence (17.2%) occurred with marriage age of 21 to 26 years, and the rates rose with higher age at marriage. About one fourth of the Iranian couples experience primary infertility at some point in their lives and 3.4% suffer from this problem at any time. For a correct interpretation of prevalence rates and the implications in terms of health care and service delivery, factors such as age at marriage and the couple's fertility potential must be taken into consideration. PMID:19443880
Vahidi, Serajeldin; Ardalan, Ali; Mohammad, Kazem
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
Shukla Upadhyaya, Kamayani; Karunagoda, Kaumadi; Dei, L P
This study investigated the effect of treatment with the proprietary standardized, water-soluble extract of the root of the Malaysian plant, Eurycoma longifolia Jack, which is thought to enhance male fertility with regard to higher semen volumes, sperm concentrations, the percentage of normal sperm morphology and sperm motility in male partners of sub-fertile couples with idiopathic infertility. A total of 350 patients were given 200 mg of the extract daily and follow-up semen analyses were performed every 3 months for 9 months. Of these 350 patients, 75 patients completed one full cycle of 3 months. Follow-up semen analyses in these patients showed significant improvement in all semen parameters. The proprietary extract of Eurycoma longifolia Jack significantly improved the sperm quality in these patients, allowing for 11 (14.7%) spontaneous pregnancies.
Bin Mohd Tambi, Mohd Ismail; Imran, M. Kamarul
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
With the demands of the modern western world of today, women delay the conception of their first child and this adversely impacts on their fertility. Vast attempts have been made to diagnose and counter ageing women infertility. In this literature review article, we bring forward theories which may account for the age-related decline of fertility and explained about the assessment and treatment modalities currently available. After concluding that ovarian stimulation with the use of gonadotrophins and clomiphene citrate is not useful in women of 40 year and over, it leaves us with in-vitro fertilization as the most suitable method of increasing the rate of successful pregnancies and live birth rates. It is important to campaign the effects age has on fertility since, even highly educated women, are not aware of the full impacts age has on fertility. PMID:23232532
Weeg, N; Shalom-Paz, E; Wiser, A
Though widely used, there is uncertainty about the effectiveness and adverse effects of metformin and clomiphene citrate (CC) for infertility in polycystic ovary syndrome (PCOS). A systematic review (SR) of the best available evidence suggests that both CC and metformin are better than placebo for increasing ovulation and pregnancy rates, but CC is more effective than metformin for ovulation, pregnancy and live-birth rates, in PCOS patients with body mass index (BMI) >30. A combination of CC and metformin is superior to either metformin alone or CC alone, depending on the BMI and CC sensitivity of the patient. This SR provides key messages to guide clinicians and consumers on the use of these interventions in different subgroups of women with PCOS. PMID:22939889
Misso, Marie L; Teede, Helena J; Hart, Roger; Wong, Jennifer; Rombauts, Luk; Melder, Angela M; Norman, Robert J; Costello, Michael F
Both the bioenergetic and the antioxidant role of CoQ(10) suggest a possible involvement in sperm biochemistry and male infertility. CoQ(10) can be quantified in seminal fluid, where its concentration correlates with sperm count and motility. It was found that distribution of CoQ(10) between sperm cells and seminal plasma was altered in varicocele patients, who also presented a higher level of oxidative stress and lower total antioxidant capacity. The effect of vericocelectomy on partially reversing these biochemical abnormalities is discussed. The redox status of coenzyme Q(10) in seminal fluid was also determined: an inverse correlation was found between ubiquinol/ubiquinone ratio and hydroperoxide levels and between this ratio and the percentage of abnormal sperm forms. After the first in vitro observations CoQ(10) was administered to infertile patients affected by idiopathic asthenozoospermia, originally in an open label study and then in three randomized placebo-controlled trials; doses were around 200-300 mg/day and treatment lasted 6 months. A significant increase in the concentration of CoQ(10) was found, both in seminal plasma and sperm cells. Treatment also led to a certain improvement in sperm motility. In one of the studies there was also a decrease in plasma levels of follicle stimulating horhone (FSH) and luteinizine horhone (LH). Administration of CoQ(10) may play a positive role in the treatment of asthenozoospermia, possibly related to not only to its function in the mitochondrial respiratory chain but also to its antioxidant properties. Further studies are needed in order to determine whether there is also an effect on fertility rate. PMID:21989906
Mancini, Antonio; Balercia, Giancarlo
Ethanol is generally regarded as a reproductive toxin. However, the mechanism(s) of ethanol-induced infertility remain poorly understood. As male fertility depends upon the ability of spermatozoa to fertilize ova, it was the purpose of the present study to examine the effects of chronic ethanol treatment on several parameters related to sperm fertility. Male C57Bl/6J mice of proven fertility were administered liquid diets as follows: 5% (v/v) ethanol for either 1) 5 weeks; 2) 10 weeks; 3) 20 weeks; or 4) 6% (v/v) ethanol for 5 weeks. After each treatment, epididymal spermatozoa were evaluated with respect to quantity, motility, morphology and the ability to fertilize. A biphasic effect on sperm content was noted: 5- and 10-week treatments with 5% ethanol increased content by 80 and 65%, respectively, whereas 20-week treatment with 5% ethanol and 5-week treatment with 6% ethanol decreased content by 52 and 71%, respectively. Although the proportion of motile spermatozoa was unaffected by ethanol, average forward progression velocity was reduced, the effect being dependent on ethanol dose and duration of exposure. Similarly, the frequency of abnormal spermatozoa was increased; 20-week treatment with 5% ethanol and 5-week treatment with 6% ethanol increased the frequency of sperm morphological anomalies by 50 and 40%, respectively. Fertility of spermatozoa was reduced as a function of ethanol dose and duration of exposure. The ability of sperm to fertilize mouse ova in vitro was reduced by 34% (P less than .02) and 62% (P less than .001) subsequent to 20-week treatment with 5% ethanol and 5-week treatment with 6% ethanol, respectively. An animal model has been developed which describes ethanol-induced male infertility. The degree of reproductive impairment varies with the amount of ethanol ingested, and the duration of ethanol exposure. The continuum of effects should make possible the evaluation of putative mechanisms of male sterility resulting from chronic ethanol consumption. PMID:6682442
Anderson, R A; Willis, B R; Oswald, C; Zaneveld, L J
Couple infertility commonly results from the synergistic negative influence of several factors. External factors, related to life-style and environmental exposure, reinforce the effects of congenital or acquired damage through direct toxicity, hormone disruption and overload of reactive oxygen species. Combating obesity, correcting inappropriate diet, and banning the abuse of tobacco and alcohol are part of the integrated approach of the infertile couple. Nutraceuticals are judiciously formulated food supplements containing particular vitamins, antioxidants, minerals and plant extracts. There is strong evidence that complementary treatment with an appropriate nutraceutical improves the natural conception rate of infertile couples and increases the success rate of assisted reproductive techniques. PMID:20860632
Background The reported prevalence of infertility in Pakistan is approximately 22% with 4% primary and 18% secondary infertility. Infertility is not only a medical but also a social problem in our society as cultural customs and perceived religious dictums may equate infertility with failure on a personal, interpersonal, or social level. It is imperative that people have adequate knowledge about infertility so couples can seek timely medical care and misconceptions can be rectified. We aim to assess the knowledge, perception and myths regarding infertility and suggest ways to improve it. Methods A cross-sectional survey was carried out by interviewing a sample of 447 adults who were accompanying the patients at two tertiary care hospitals in Karachi, Pakistan. They were interviewed one-on-one with the help of a pretested questionnaire drafted by the team after a thorough literature review and in consultation with infertility specialists. Results The correct knowledge of infertility was found to be limited amongst the participants. Only 25% correctly identified when infertility is pathological and only 46% knew about the fertile period in women's cycle. People are misinformed that use of IUCD (53%) and OCPs (61%) may cause infertility. Beliefs in evil forces and supernatural powers as a cause of infertility are still prevalent especially amongst people with lower level of education. Seeking alternative treatment for infertility remains a popular option for 28% of the participant as a primary preference and 75% as a secondary preference. IVF remains an unfamiliar (78%) and an unacceptable option (55%). Conclusions Knowledge about infertility is limited in the population and a lot of misconceptions and myths are prevalent in the society. Alternative medicine is a popular option for seeking infertility treatment. The cultural and religious perspective about assisted reproductive technologies is unclear, which has resulted in its reduced acceptability.
Objective The aim of the paper is to examine how those working in, using and regulating assisted conception clinics discussed infertility counselling and its provision within the context of embryo donation and in vitro fertilisation. Method 35 participants were recruited for semi-structured, face-to-face interviews. All data were analysed using thematic analysis. Results The thematic analysis revealed recurring themes based upon the portrayals of infertility counselling, embryo donation and in vitro fertilisation. Conclusions This paper suggests that an implicit hierarchy exists around those using assisted conception techniques and their infertility counselling requirements, which was dependent upon the assisted conception technique used. As a result, some people using assisted conception techniques felt that their needs had been overlooked due to this covert hierarchy. Practice implications Those working in, using or regulating assisted conception clinics should not view infertility counselling as restricted to treatments involving donation, or solely for people within the clinical system.
The migration of radionuclide through the genital tract was observed, comparing 20 patients with endometriosis and infertility with a control group of 23 infertile patients who had a normal pelvis. All patients had patent tubes at laparoscopy and chromopertubation, performed in both groups for the investigation of infertility and to diagnose the presence and extent of endometriosis. A radionuclide tubal test, using human albumin microspheres labelled with 99m-technetium (99mTc) was subsequently undertaken to observe the extent of genital tract migration of radionuclide to uterus, Fallopian tube and peritoneal cavity. The results show that radionuclide migration to the peritoneal cavity was impaired in patients with endometriosis, compared with the control group (30 versus 83%, respectively; P < 0.001). There was no relationship between migration and the severity of endometriosis. We conclude that impaired tubal function may be a cause of infertility in some patients with endometriosis. PMID:8288759
McQueen, D; McKillop, J H; Gray, H W; Callaghan, M; Monaghan, C; Bessent, R G
ObjectiveTo compare blood mercury concentrations of infertile couples with those of fertile couples in Hong Kong, and to examine the relationship between blood mercury concentrations and seafood consumption.
Christine M. Y Choy; Christopher W. K Lam; Lorena T. F Cheung; Christine M Briton-Jones; L. P Cheung; Christopher J Haines
BACKGROUND: Infertility affects approximately 10%-15% of couples in reproductive age. In half of the couples, causes are male-related, associated with impaired spermatogenesis. There is a complex correlation between genetics and infertility. Several factors affect on gametogenesis, from which factors that lead to chromosomal abnormalities are one of the best known. The aim of this study was to determine type and rate of chromosomal abnormalities in infertile azoospermic and oligospermic males in Iranian population. MATERIALS AND METHODS: The records of a total of 222 participants were evaluated retrospectively. RESULTS: As a whole we observed 13.96% chromosomal abnormality, from which 12.15% showed numerical and 1.8% showed structural abnormalities. CONCLUSION: Comparison of our results with the review of the literature shows a higher incidence (4- fold) of gonosomal, in particular, numerical gonosomal, chromosomal anomalies. Cytogenetic analysis is strongly suggested for infertile men, particularly in those who suffer from azoospermia.
Akbari, Mohammad T.; Behjati, F.; Pourmand, G. R.; Asbagh, F. Akbari; Kachoui, M. Ataei
Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility. Lifestyle change alone is considered the first-line treatment for the management of infertile anovulatory PCOS women who are overweight or obese. First-line medical ovulation induction therapy to improve fertility outcomes is clomiphene citrate, whilst gonadotrophins, laparoscopic ovarian surgery or possibly metformin are second line in clomiphene citrate-resistant PCOS women. There is currently insufficient evidence to recommend aromatase inhibitors over that of clomiphene citrate in infertile anovulatory PCOS women in general or specifically in therapy naive or clomiphene citrate-resistant PCOS women. IVF/ICSI treatment is recommended either as a third-line treatment or in the presence of other infertility factors. PMID:22639834
Costello, Michael F; Misso, Marie L; Wong, Jennifer; Hart, Roger; Rombauts, Luk; Melder, Angela; Norman, Robert J; Teede, Helena J
BACKGROUND Male factor and idiopathic infertility contribute significantly to global infertility, with abnormal testicular gene expression considered to be a major cause. Certain types of male infertility are caused by failure of the sperm to activate the oocyte, a process normally regulated by calcium oscillations, thought to be induced by a sperm-specific phospholipase C, PLCzeta (PLC?). Previously, we identified a point mutation in an infertile male resulting in the substitution of histidine for proline at position 398 of the protein sequence (PLC?H398P), leading to abnormal PLC? function and infertility. METHODS AND RESULTS Here, using a combination of direct-sequencing and mini-sequencing of the PLC? gene from the patient and his family, we report the identification of a second PLC? mutation in the same patient resulting in a histidine to leucine substitution at position 233 (PLC?H233L), which is predicted to disrupt local protein interactions in a manner similar to PLC?H398P and was shown to exhibit abnormal calcium oscillatory ability following predictive 3D modelling and cRNA injection in mouse oocytes respectively. We show that PLC?H233L and PLC?H398P exist on distinct parental chromosomes, the former inherited from the patient's mother and the latter from his father. Neither mutation was detected utilizing custom-made single-nucleotide polymorphism assays in 100 fertile males and females, or 8 infertile males with characterized oocyte activation deficiency. CONCLUSIONS Collectively, our findings provide further evidence regarding the importance of PLC? at oocyte activation and forms of male infertility where this is deficient. Additionally, we show that the inheritance patterns underlying male infertility are more complex than previously thought and may involve maternal mechanisms.
Kashir, Junaid; Konstantinidis, Michalis; Jones, Celine; Lemmon, Bernadette; Chang Lee, Hoi; Hamer, Rebecca; Heindryckx, Bjorn; Deane, Charlotte M.; De Sutter, Petra; Fissore, Rafael A.; Parrington, John; Wells, Dagan; Coward, Kevin
Background\\/Aims: To determine whether genetic alterations in the CD9 gene are associated with female infertility in humans. Methods: We sequenced the entire coding region of this gene in 86 Japanese women with unexplained infertility and further conducted a case-control study of six tagging single nucleotide polymorphisms (SNPs) in this gene using an additional 164 samples obtained from a fertile control
Sachie Nishiyama; Taro Kishi; Takema Kato; Machiko Suzuki; Haruki Nishizawa; Kanako Pryor-Koishi; Tomio Sawada; Yukio Nishiyama; Nakao Iwata; Yasuhiro Udagawa; Hiroki Kurahashi
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.
Rachootin, P.; Olsen, J.
Objectives: To determine the attitudes toward gestational surrogacy and egg donation amongst the Turkish married infertile females. Methodology: This descriptive study was carried out in a maternity hospital. Patients were 250 married women who had applied for infertility treatment. Results: Of the participants (n=250), 60 females (24.0%) answered positive attitude for surrogate motherhood and 65 (26.0%) for egg donation. Among
Selim Kilic; Muharrem Ucar; Hakan Yaren; Mahir Gulec; Adnan Atac; Fatma Demirel; Ceren Karabulut; Ozlem Demirel
This study was carried out to determine the prevalence of the bacterial agents Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoeae), Mycoplasma hominis (M. hominis) and Ureaplasma urealyticum (U. urealyticum) and the conditions which may play a role in the development of female infertility, in the county of Ia?i in North-Eastern Romania. Cervical and blood samples were collected from 176 infertile women and 45 pregnant women in the third trimester. Classical methods and real time PCR were applied to each cervical sample to detect the presence of these sexually transmitted microorganisms; the ELISA method was applied to blood samples to detect C. trachomatis antibodies (IgA, IgM and IgG). The proportion of C. trachomatis IgG was significantly higher in the infertile group (23.8%) than in the pregnant group (4.4%), p < 0.05. For C. trachomatis antigen (Ag) and N. gonorrhoeae Ag no differences were observed between the two groups. The prevalence of mycoplasma genital infections was higher in the pregnant group (U. urealyticum - 53.3% and M. hominis - 20%) than in the infertile group (U. urealyticum - 39.7% and M. hominis - 7.3%). Higher rate of co-infection with C. trachomatis and mycoplasma were observed among the infertile women (25.7%) than among the pregnant women (7.7%). This combination could be involved in the appearance of pelvic inflammatory disease (PID) and its sequela, including infertility. C. trachomatis IgG determination still remains the gold standard for the diagnosis of PID and should be used as a screening test for the prediction of tubal damage in infertile women. In view of the large number of cases involving the co-existence of genital infections with C. trachomatis, M. hominis and U. urealyticum, it is clearly necessary to perform screening for all three microorganisms among all women of reproductive age but especially those who are infertile. PMID:23529298
Miron, Nora Dumitriu; Socolov, Demetra; Mare?, Mihai; Anton, Gabriela; Nastasa, Valentin; Moraru, Ramona Florina; Virág, Katalin; Anghelache-Lupa?cu, Ivona; Deák, Judit
This study was aimed at identifying practices during the menstrual, partum and postpartum periods posing possible risk factors contributing towards secondary infertility in women of a selected popu- lation in Karachi, Pakistan. A matched case-control study was conducted from April 2003 to March 2004. Four hundred cases were selected from five infertility clinics affiliated with tertiary-care hospitals, and 400 age-matched
Tazeen Saeed Ali; Neelofar Sami; Ali Khan Khuwaja
Objective: To gather information about demographic characteristics, medical status, mode of Internet participation, and psychological well-being of participants whose only outlets (OOs) for talking about infertility are Internet medical and support forums and to compare them with persons who have additional outlets (AOs).Design: Prospective Internet-based survey.Setting: Website of a nonprofit international infertility organization.Patient(s): Five hundred eighty-nine persons submitting fully completed
Yakov M Epstein; Helane S Rosenberg; Theresa Venet Grant; Nancy Hemenway B. A
Defective sperm function is the most common cause of infertility. A prospective study was carried out to correlate the concentration\\u000a of nitrite (the stable metabolite of nitric oxide) in seminal plasma with leukocytospermia, and sperm membrane integrity.\\u000a Total Fifty-seven normozoospermic subjects with and without leukocytospermia visiting the Infertility clinic at KH and MRC,\\u000a Karad, were included in the present study.
Sunil B. Yadav; Adinath N. Suryakar; Anil D. Huddedar; Pramod S. Shukla
Study Objective To provide insight into the experience of low income immigrant Latino couples seeking infertility treatment. Design Qualitative interview study. Setting Infertility Clinic at a University-affiliated urban public teaching hospital. Patients Infertile low-income immigrant Latino couples (105 women and 40 men). Interventions In-depth tape-recorded interviews. Main Outcome Measures After transcription and translation, the interviews were coded and analyzed for thematic content. Results We identified four major challenges to providing infertility services to this population: (1) Communication: Language and cultural barriers resulted in patients having difficulty both in understanding diagnoses and treatments and in communicating their questions, concerns and experiences to physicians; (2) Continuity: Because medical student and residents rotated frequently, patients usually saw a different physician at each visit. (3) Bureaucracy: Patients reported having difficulty with appointment scheduling, follow-up visits, and timed laboratory procedures. (4) Accessibility: Patients faced issues of limited availability and affordability of treatment. Conclusions At a large, urban, University-affiliated infertility clinic, challenges related to communication, comprehension, continuity, bureaucracy, accessibility, availability, and affordability impeded the delivery of optimal infertility care to many low income immigrant Latino patients. We recommend a greater availability of translators and both patient and physician cultural orientations to address these health care barriers.
Nachtigall, Robert D.; Castrillo, Martha; Shah, Nina; Turner, Dylan; Harrington, Jennifer; Jackson, Rebecca
Azoospermia factor (AZF) microdeletions are the most frequent genetic cause of male infertility after Klinefelter's syndrome. Although some assisted reproductive techniques such as intracytoplasmic sperm injection (ICSI) have been successfully introduced to clinical treatment for infertile males, the AZF microdeletions might be transmitted from infertile fathers to their male offspring during these procedures. Thus, it is important to carefully evaluate AZF microdeletions in infertile males before assisted reproductive techniques are performed. In this article, we aimed to investigate the frequencies of AZF microdeletions in 137 infertile males with azoospermia and severe oligozoospermia from Jilin province of China and analyse the relationship between the levels of reproductive hormones and AZF microdeletions. Result analysis showed that AZF microdeletions were present in 8 (8.70%) azoospermic males and 3 (6.67%) severely oligozoospermic males. The most frequent microdeletions were detected in the AZFc region, followed by AZFb + c, AZFb and AZFa. And there was no significant correlation between the AZF microdeletion and the levels of reproductive hormones. These findings reinforce the necessity of AZF microdeletion testing among infertile males prior to employment of assisted reproduction techniques in Jilin province of China. PMID:23701642
Zhang, Y-S; Dai, R-L; Wang, R-X; Zhang, Z-H; Fadlalla, E; Liu, R-Z
Evidence concerning the relationship between the ratio of lean mass to body fat in the female body and the maintenance of female reproductive functions was examined, and the results of a US clinical study in which a weight gain regime was used to treat unexplained in fertility in 29 fashionabely slim women were presented. During the female pubertal process, there is an average increase in the lean body weight of 44% and a mean increase in the body fat of 120%. Apparently, the accummulation of fat is a necessary prerequisite for the onset of menarche and the establishment and maintenance of regular ovulatory cycles. A small change in body weight produces a relatively large shift in the body weight to fat ratio. As a result, weight loss is frequently followed by amenorrhea. Studies of the endocrine and central nervous system changes in patients with anorexia nervosa, an extreme form of overzealous weight control, provides clues for understanding the effects of less extreme weight control practices on reproductive functions. The gonadotropin secretory pattern of anorexia nervosa patients is similar to the prepubertal pattern. When gonadotropin-releasing hormone (GnRH) is administered to patients with 53%-64% of their ideal body weight (IBW), they have a weak luteinizing hormone (LH) response and a normal follicle-stimulating hormone (FSH) response. As their weight increases, the LH response becomes stronger, and at 90%-94% of their IBW, the LH response is frequently exaggerated. Other studies indicate that an exaggerated LH response also occurs when GnRH is administered to fashionably slim women. This finding suggests that gonadotropin secretory studies should be conducted when evaluating women with weight related menstrual dysfunctions. In the present study, 29 patients with unexplained infertility were identified as being overly, but not excessively, concerned with maintaining a slim body image. On the average, they were 91% below their IBW. The women were asked to increase their body weight until they reached their IBW. Serum LH/FSH ratios were monitored. Blood samples were taken during the midfollicular phase of the menstrual cycle and at random times among those patients with amenorrhea. 3 women withdrew from the study as they did not want to gain weight. The remaining 26 women attained at least 98% of their IBW. At 95% of their IBW, the women attained normal LH/FSH ratios, and at 98% of their IBW, the women attained normal ovulatory cycles. 19 of the women eventually conceived. Clinicians who wise to use this technique for treating infertility should first rule out other possible causes for infertility. If weight gain treatment appears to be appropriate, the physician should be sensitive to the woman's concerns about her body image. The patient will require considerable encouragement during the weight gaining process. Patients should be advised to expect changes in breast size and configuration and an increase in endocervical canal secretions. The increased body fat will be unevenly distributed in the body, and patients should be instructed not to undertake fat redistribution exercises. Physicians should refrain from administering clomiphene citrate as a supplement to the weight gain regime. PMID:3931948
Bates, G W
The HIV epidemic has continued to grow and remains a major challenge to mankind. In the past, ethical considerations about the resulting child and risks of sexual, vertical and nosocomial transmission of HIV prevented practitioners from offering fertility services to people living with HIV. In recent times however, the use of highly active antiretroviral therapy (HAART), has not only improved the life expectancy and quality of life of those infected but also reduced the risk of HIV transmission. The need for fertility services in the HIV-positive population has thus increased and may be employed for management of infertility and protection from transmission or acquisition of HIV infection. As such, preconception counseling, sexual health and fertility screening have become routine in the management of HIV-positive couples. The option of care include adoption, self insemination with husband sperm, embryo donation from couples who have been verified to be HIV negative, insemination with donor sperm, timed unprotected intercourse (TUI) and sperm washing combined with intrauterine insemination (IUI) and assisted reproductive technology (ART) including in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Access to these fertility services by HIV-positive clients should be facilitated as part of efforts to promote their reproductive health and rights. PMID:23444539
Agboghoroma, Chris O; Giwa-Osagie, Osato F
Ectopic pregnancy (EP) is a major event in a woman's reproductive life. It complicates infertility treatment and must be recognized early to simplify the treatment strategy, which must always be directed towards optimizing subsequent fertility. Epidemiological findings indicate that tubal history and smoking are the principal risk factors of those EP that are considered reproductive (rather than contraceptive) failures. Adding together the attributable risks for EP allows the construction of a risk scale to determine its probability for any given patient. This risk calculation makes it easier to establish a diagnostic strategy that uses abdominal and transvaginal ultrasound and hCG assays. Progesterone assays are useful only for determining the activity of the pregnancy but do not help to identify its site. Conservative treatment is to be preferred unless the EP occurs on a known hydrosalpinx. All the treatment trials and the Cochrane database meta-analysis show that medical treatment with methotrexate, preferably multidose, is equivalent in efficacy to conservative treatment with laparoscopy in the populations studied. Heterotopic pregnancies, which occur most often after assisted reproduction technology (1-3%), should preferably be treated by salpingectomy except in interstitial sites. There is no consensus that IVF is indicated after EP. The patient's age is probably the determining factor: fertility treatment should not be delayed to an age where the results would be altered, especially with the risk of a recurrent EP. PMID:15388673
Fernandez, Herve; Gervaise, Amelie
In recent years, investigators have noted a trend toward a declining proportion of male births in many industrialized nations. While men bear the sex-determining chromosome, the role of the female partner as it pertains to fertilization or miscarriage may also alter the gender ratio. We attempted to determine a man's secondary sex ratio (F1 generation) by directly examining the sex chromosomes of his sperm. We examined our male infertility clinic database for all men who had undergone a semen fluorescence in situ hybridization (FISH). Patient demographic and semen parameters were recorded. Chi-squared analysis was used to compare gender ratios (Y chromosomes/total chromosomes). Multivariable logistic regression was used to predict the odds of possessing a Y-bearing sperm after accounting for demographic and semen parameters. A total of 185 men underwent sperm FISH. For the entire cohort, the proportion of Y chromosome-bearing sperm was 51.5%. Men with less than five million motile sperm had a significantly lower proportion of Y chromosome-bearing sperm (50.8%) compared to men with higher sperm counts (51.6%; P=0.02). After multivariable adjustment, a higher sperm concentration, total motile sperm count and semen volume significantly increased the odds of having a Y chromosome-bearing sperm (P<0.01). As a man's sperm production declines, so does the proportion of Y chromosome-bearing sperm. Thus, a man's reproductive potential may predict his ability to sire male offspring. PMID:22842703
Eisenberg, Michael L; Murthy, Lata; Hwang, Kathleen; Lamb, Dolores J; Lipshultz, Larry I
In recent years, investigators have noted a trend toward a declining proportion of male births in many industrialized nations. While men bear the sex-determining chromosome, the role of the female partner as it pertains to fertilization or miscarriage may also alter the gender ratio. We attempted to determine a man's secondary sex ratio (F1 generation) by directly examining the sex chromosomes of his sperm. We examined our male infertility clinic database for all men who had undergone a semen fluorescence in situ hybridization (FISH). Patient demographic and semen parameters were recorded. Chi-squared analysis was used to compare gender ratios (Y chromosomes/total chromosomes). Multivariable logistic regression was used to predict the odds of possessing a Y-bearing sperm after accounting for demographic and semen parameters. A total of 185 men underwent sperm FISH. For the entire cohort, the proportion of Y chromosome-bearing sperm was 51.5%. Men with less than five million motile sperm had a significantly lower proportion of Y chromosome-bearing sperm (50.8%) compared to men with higher sperm counts (51.6% P=0.02). After multivariable adjustment, a higher sperm concentration, total motile sperm count and semen volume significantly increased the odds of having a Y chromosome-bearing sperm (P<0.01). As a man's sperm production declines, so does the proportion of Y chromosome-bearing sperm. Thus, a man's reproductive potential may predict his ability to sire male offspring.
Eisenberg, Michael L; Murthy, Lata; Hwang, Kathleen; Lamb, Dolores J; Lipshultz, Larry I
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.
Balanced diet is the natural source of micronutrients, such as folate and vitamins, vital for proper functioning of the body. One-carbon metabolic pathway along with folate and other vitamins plays an important role in DNA synthesis and in the establishment of epigenetic modifications like DNA/histone methylation. Spermatogenesis involves distinct cellular, genetic, and chromatin changes during the course of production of male gamete sperm. Folate and normal activity of 1-carbon metabolic pathway enzymes are central to nucleotide synthesis, methylation, and maintenance of genomic integrity as well as protection from DNA damage. As a result, polymorphisms in 1-carbon metabolic pathway genes affecting several physiological processes also have an impact on spermatogenesis and may affect directly or indirectly quality of sperm. Alterations in these processes may be a consequence of additive effect resulting from altered expression of 1-carbon metabolic pathway genes and/or inadequate folate/micronutrients supplementation. The present review provides an overview of different cellular and molecular events regulated by 1-carbon metabolic pathway enzymes and their impact on male reproductive health. It also summarizes the different studies where polymorphisms in the enzymes of 1-carbon metabolic pathway or folate deficiency are associated with male infertility and future prospects. PMID:23138010
Singh, Kiran; Jaiswal, Deepika
Several Chinese herbal medicines have been used to treat patients with idiopathic male infertility and have been reported to improve semen quality. The clinical efficacy of these medicines was reviewed. The therapeutic effect of Hochu-ekki-to based on the pretreatment traditional diagnosis (Sho) was examined. Three months after the administration of Hochu-ekki-to, the semen count and motility significantly increased in comparison with pretreatment values. When the patients were classified into 3 categories based on "Sho", Hochu-ekki-to was effective in semen motility in patients with vacuity pattern (Kyo-Sho). Seminal plasma soluble Fas (sFas) levels before and three months after the administration of drug were analyzed. Seminal plasma sFas level elevated significantly after the administration of Hochu-ekki-to. After the administration of Hochu-ekki-to, seminal plasma sFas levels significantly correlated with sperm concentration. To make the best use of traditional medicine, it is important to give medication according to the traditional diagnosis (Sho). PMID:15471074
Furuya, Yuzo; Akashi, Takuya; Fuse, Hideki
The aim of this study is to present the authors' experience in the diagnosis and treatment of tubal proximal disease by means of hysteroscopy. The study includes 96 patients with tubal infertility to which hysteroscopy was performed in 1998-2003 in the 2nd Clinic of Obstetrics and Gynecology, Ia?i. The average age was 32.5 +/- 1.2 years. The indication was proximal tubal obstruction diagnosed by hysterosalpingography or sono-hysterosalpingography. The hysteroscopy revealed lesions affecting fertility that were treated in the same operative sequence. Proximal tubal obstruction was present in 50 cases (52%): unilateral--41 cases, bilateral--9 cases. Tubal permeabilization was performed by tubal catheterization or by removing polyps, adhesion and was verified by chromo-tubation at the end of hysteroscopy and by sono-hysterosalpingography, 2 months after the intervention. When proximal tubal obstruction is suspected, hysteroscopy offers a solution by confirming the diagnosis and by efficiently treating the lesions, leading to an increased average of pregnancies. PMID:19292093
Lupa?cu, Ivona; Veghe?, Simina; David, Cristina; Vi?an, Valeria; Vasiliu, Veronica
Introduction Microarray gene?expression profiling is a powerful tool for global analysis of the transcriptional consequences of disease phenotypes. Understanding the genetic correlates of particular pathological states is important for more accurate diagnosis and screening of patients, and thus for suggesting appropriate avenues of treatment. As yet, there has been little research describing gene?expression profiling of infertile and subfertile men, and thus the underlying transcriptional events involved in loss of spermatogenesis remain unclear. Here we present the results of an initial screen of 33 patients with differing spermatogenic phenotypes. Methods Oligonucleotide array expression profiling was performed on testis biopsies for 33 patients presenting for testicular sperm extraction. Significantly regulated genes were selected using a mixed model analysis of variance. Principle components analysis and hierarchical clustering were used to interpret the resulting dataset with reference to the patient history, clinical findings and histological composition of the biopsies. Results Striking patterns of coordinated gene expression were found. The most significant contains multiple germ cell?specific genes and corresponds to the degree of successful spermatogenesis in each patient, whereas a second pattern corresponds to inflammatory activity within the testis. Smaller?scale patterns were also observed, relating to unique features of the individual biopsies.
Ellis, Peter J I; Furlong, Robert A; Conner, Sarah J; Kirkman-Brown, Jackson; Afnan, Masoud; Barratt, Christopher; Griffin, Darren K; Affara, Nabeel A
Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperitoneal surgery, diabetes, congenital spinal abnormalities, multiple sclerosis and spinal cord injury. Erectile dysfunction can be managed by an increasingly invasive range of treatments including medications, injection therapy and the surgical insertion of a penile implant. Retrograde ejaculation is managed by medications to reverse the condition in mild cases and in bladder harvest of semen after ejaculation in more severe cases. Anejaculation might also be managed by medication in mild cases while assisted ejaculatory techniques including penile vibratory stimulation and electroejaculation are used in more severe cases. If these measures fail, surgical sperm retrieval can be attempted. Ejaculation with penile vibratory stimulation can be done by some spinal cord injured men and their partners at home, followed by in-home insemination if circumstances and sperm quality are adequate. The other options always require assisted reproductive techniques including intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection. The method of choice depends largely on the number of motile sperm in the ejaculate.
Fode, Mikkel; Krogh-Jespersen, Sheila; Brackett, Nancy L; Ohl, Dana A; Lynne, Charles M; S?nksen, Jens
Centrins are calmodulin-like Ca(2+)-binding proteins that can be found in all ciliated eukaryotic cells from yeast to mammals. Expressed in male germ cells and photoreceptors, centrin 1 (CETN1) resides in the photoreceptor transition zone and connecting cilium. To identify its function in mammals, we deleted Cetn1 by homologous recombination. Cetn1(-/-) mice were viable and showed no sign of retina degeneration suggesting that CETN1 is nonessential for photoreceptor ciliogenesis or structural maintenance. Phototransduction components localized normally to the Cetn1(-/-) photoreceptor outer segments, and loss of CETN1 had no effect on light-induced translocation of transducin to the inner segment. Although Cetn1(-/-) females and Cetn1(+/-) males had normal fertility, Cetn1(-/-) males were infertile. The Cetn1(-/-) testes size was normal, and spermatogonia as well as spermatocytes developed normally. However, spermatids lacked tails suggesting severe defects at the late maturation phase of spermiogenesis. Viable sperm cells were absent and the few surviving spermatozoa were malformed. Light and electron microscopy analyses of Cetn1(-/-) spermatids revealed failures in centriole rearrangement during basal body maturation and in the basal-body-nucleus connection. These results confirm an essential role for CETN1 in late steps of spermiogenesis and spermatid maturation. PMID:23641067
Avasthi, Prachee; Scheel, Jan Frederik; Ying, Guoxin; Frederick, Jeanne M; Baehr, Wolfgang; Wolfrum, Uwe
The gene for DNA methyltransferase 3-like protein (DNMT3L) is essential for normal spermatogenesis and may be involved with spermatogenetic impairment and male infertility. To explore the possible association between the DNMT3L gene and male infertility, this study investigated allele, genotype and haplotype frequencies of three single nucleotide polymorphism (SNP) loci, rs2070565, rs2276248 and rs7354779, of DNMT3L in 233 infertile patients
Jian-Xi Huang; Matthew B. Scott; Xiao-ying Pu; Zhou-cun A
Objective: To assess a “stage-of-change” oriented smoking cessation intervention for infertile and pregnant women, compared with standard of care.Design: Randomized controlled trial.Setting: Three university teaching hospitals in Hamilton, Ontario, Canada.Patient(s): Infertile women at their first visit to a tertiary referral infertility clinic (n = 94) and new patients seeking pre-natal care (n = 110) who had smoked ? 3 cigarettes
Edward G Hughes; David A Lamont; Mary Louise Beecroft; Douglas M. C Wilson; Barbara G Brennan; Sarah C Rice
Objective: To determine whether reactive oxygen species in peritoneal fluid might be a factor in infertility.Design: Prospective study.Setting: Andrology laboratory and gynecology clinic at a tertiary care facility.Patient(s): Women with endometriosis (n = 15) or idiopathic infertility (n = 11) who under-went laparoscopy for infertility. Patients undergoing tubal ligation served as controls (n = 13).Intervention(s): Aspiration of peritoneal fluid.Main Outcome
Yongjin Wang; Rakesh K. Sharma; Tommaso Falcone; Jeffrey Goldberg; Ashok Agarwal
Objective. To determine to what degree the number of triple Cytosine\\/Guanine\\/Guanine (CGG) repeats on the FMR1 (fragile X) gene correlate with specific ovarian reserve parameters, and potentially facilitate infertility diagnosis. Design. Retrospective cohort study. Setting. Academically affiliated, private infertility center in New York City. Population. One hundred fifty-eight consecutive women, presenting to an infertility center. Methods. Triple CGG repeat counts
Norbert Gleicher; Andrea Weghofer; Kutluk Oktay; David H. Barad
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
Akinloye, Oluyemi; Truter, Ernest J
Infertility is an extraordinary public health problem in the Arab world, as it affects about 15% of couples seeking children. The male partner is responsible for infertility in approximately half of these cases. Classic microdeletions of the Y-chromosome involving the azoospermia factor (AZF) regions are known to be associated with spermatogenic impairment, and non-obstructive azoospermia must be differentiated on the basis of endocrine evaluation and testicular biopsy. Partial AZFc deletions remain controversial because there is no clear agreement regarding their role in spermatogenic failure. In the current study, 50 fertile males (controls) and 125 patients with primary idiopathic male infertility were studied in order to describe the frequency of Y-chromosome mirodeletions among male infertility patients in the Gaza Strip-Palestine area. No Y chromosome classical microdeletions could be detected in any of the 125 infertile men, suggesting that ethnic factors, genetic background, and Y chromosome haplogroups are key factors in such deletions. On the other hand, six gr/gr and one b1/b3 AZFc partial deletions were detected in the infertile population. The gr/gr deletion was also noted in relatives of four of the six patients with this deletion, and in one of the fertile controls. In conclusion, our study shows that the incidence of Y-chromosome microdeletions in our population is rare; these data suggest that other genetic, epigenetic, nutritional and/or local factors are responsible for impairments in semen parameters observed in this Gazan population. We further hypothesise that the gr/gr deletion is not associated with male infertility, at least in this sub-group.
Shaqalaih, Ashraf J.; Abu Halima, Masood S.; Ashour, Mohammed J.; Sharif, Fadel A.
AIM: This study aimed to evaluate the efficacy of ketotifen on sperm motility of asthenospermic infertile men. SETTING AND DESIGN: It is a prospective study designed in vivo. MATERIALS AND METHODS: In this interventional experimental study, a total of 40 infertile couples with asthenospermic infertility factor undergoing assisted reproductive technology (ART) cycles were enrolled. The couples were randomly assigned to one of two groups at the starting of the cycle. In control group (n = 20), the men did not receive Ketotifen, while in experiment group (n = 20), the men received oraly ketotifen (1 mg Bid) for 2 months. Semen analysis, under optimal circumferences, was obtained prior to initiation of treatment. The second semen analysis was done 2-3 weeks after stopped ketotifen treatment and sperm motility was defined. Clinical pregnancy was identified as the presence of a fetal sac by vaginal ultrasound examination. STATISTICAL ANALYSIS USED: All data are expressed as the mean ± standard error of mean (SEM). t test was used for comparing the data of the control and treated groups. RESULTS: The mean sperm motility increased significantly (from 16.7% to 21.4%) after ketotifen treatment (P < 0.001). This sperm motility improvement was more pronounced in the primary infertility cases (P < 0.003). The rate of pregnancy was 12.5% in infertile couples that their men receiving 1 mg/twice a day ketotifen. In 52% of infertile men's semen, the percentage of sperm motility was increased from 5% to 35% and this sperm motility improvement was also observed in 33% of necrospermia (0% motility) cases. CONCLUSION: These results suggest that ketotifen may represent as a novel therapeutic approach to improve sperm motility in the infertile men with cause of asthenospermia or necrospermia.
Saharkhiz, Nasrin; Nikbakht, Roshan; Hemadi, Masoud
Background Methylenetetrahydrofolate reductase (MTHFR) converts 5,10-methylene tetrahydrofolate to 5-methyl tetrahydrofolate and affects the activity of cellular cycles participating in nucleotide synthesis, DNA repair, genome stability, maintenance of methyl pool, and gene regulation. Genetically compromised MTHFR activity has been suggested to affect male fertility. The objective of the present study was to find the impact on infertility risk of c.203G>A, c.1298A>C, and c.1793G>A polymorphisms in the MTHFR gene. Methods PCR-RFLP and DNA sequencing were used to genotype the common SNPs in the MTHFR gene in 630 infertile and 250 fertile males. Chi-square test was applied for statistical comparison of genotype data. Linkage disequilibrium between the SNPs and the frequency of common haplotypes were assessed using Haploview software. Biochemical levels of total homocysteine (tHcy) and folic acid were measured. Meta-analysis on c.1298A>C polymorphism was performed using data from ten studies, comprising 2734 cases and 2737 controls. Results c.203G>A and c.1298A>C were found to be unrelated to infertility risk. c.1793G>A was protective against infertility (P?=?0.0008). c.677C>T and c.1793G>A were in significant LD (D’?=?0.9). Folic acid and tHcy level did not correlate with male infertility. Pooled estimate on c.1298A>C data from all published studies including our data showed no association of this polymorphism with male infertility (Odds ratio?=?1.035, P?=?0.56), azoospermia (Odds ratio?=?0.97, P?=?0.74), or oligoasthenoteratozoospermia (Odds ratio?=?0.92, p?=?0.29). Eight haplotypes with more than 1% frequency were detected, of which CCGA was protective against infertility (p?=?0.02), but the significance of the latter was not seen after applying Bonferroni correction. Conclusion Among MTHFR polymorphisms, c.203G>A and c.1298A>C do not affect infertility risk and c.1793G>A is protective against infertility. Haplotype analysis suggested that risk factors on the MTHFR locus do not extend too long on the DNA string.
Gupta, Nishi; Sarkar, Saumya; David, Archana; Gangwar, Pravin Kumar; Gupta, Richa; Khanna, Gita; Sankhwar, Satya Narayan; Khanna, Anil; Rajender, Singh
Male infertility, a common barrier that prevents successful conception, is a reproductive difficulty affecting 15% of couples. Heritable forms of nonsyndromic male infertility can arise from single-gene defects as well as chromosomal abnormalities. Although no CATSPER gene has been identified as causative for human male infertility, male mice deficient for members of the CatSper gene family are infertile. In this study, we used routine semen analysis to identify two consanguineous Iranian families segregating autosomal-recessive male infertility. Autozygosity by descent was demonstrated in both families for a ?11 cM region on chromosome 11q13.1, flanked by markers D11S1765 and D11S4139. This region contains the human CATSPER1 gene. Denaturing high-performance liquid chromatography (DHPLC) and bidirectional sequence analysis of CATSPER1 in affected family members revealed two separate insertion mutations (c.539-540insT and c.948-949insATGGC) that are predicted to lead to frameshifts and premature stop codons (p.Lys180LysfsX8 and p.Asp317MetfsX18). CATSPER1 is one of four members of the sperm-specific CATSPER voltage-gated calcium channel family known to be essential for normal male fertility in mice. These results suggest that CATSPER1 is also essential for normal male fertility in humans.
Avenarius, Matthew R.; Hildebrand, Michael S.; Zhang, Yuzhou; Meyer, Nicole C.; Smith, Luke L.H.; Kahrizi, Kimia; Najmabadi, Hossein; Smith, Richard J.H.
This study was designed to determine any correlation between infertility and semen quality with concentrations of total carnitine in human seminal plasma. Seminal plasma total carnitine concentrations were determined in 79 men. The seminal plasma of 65 infertile men and 14 men as a control group with proved fertility were investigated. The concentrations of total carnitine were reduced significantly in the infertile group compared to the control group (31.52 +/- 20.77 vs. 45.52 +/- 10.73 mg/l, P<0.05). The 65 infertile men were divided into five groups according to their sperm analysis: normospermia (n=42), oligospermia (n=23), asthenospermia (n=40), teratospermia (n=44) and oligoasthenospermia (n=10). Total seminal plasma carnitine concentration differed significantly between controls and the patient groups (P<0.05). There was a statistically significant positive correlation between seminal plasma total carnitine concentration with total sperm count and the percentage of normal forms (P<0.05 and P<0.01, respectively). Total carnitine concentration was found to be low in the asthenospermia group when compared with the group of patients, whose total motile sperm percentage was 51 (P<0.05). These findings suggest that the determination of seminal carnitine levels may be a useful test in evaluation of male infertility. PMID:14617472
Gürbüz, B; Yalti, S; Fiçicio?lu, C; Zehir, K
The present investigation was undertaken to assess the role of Mucuna pruriens in infertile men who were under psychological stress. Study included 60 subjects who were undergoing infertility screening and were found to be suffering from psychological stress, assessed on the basis of a questionnaire and elevated serum cortisol levels. Age-matched 60 healthy men having normal semen parameters and who had previously initiated at least one pregnancy were included as controls. Infertile subjects were administered with M. pruriens seed powder (5 g day?1) orally. For carrying out morphological and biochemical analysis, semen samples were collected twice, first before starting treatment and second after 3 months of treatment. The results demonstrated decreased sperm count and motility in subjects who were under psychological stress. Moreover, serum cortisol and seminal plasma lipid peroxide levels were also found elevated along with decreased seminal plasma glutathione (GSH) and ascorbic acid contents and reduced superoxide dismutase (SOD) and catalase activity. Treatment with M. pruriens significantly ameliorated psychological stress and seminal plasma lipid peroxide levels along with improved sperm count and motility. Treatment also restored the levels of SOD, catalase, GSH and ascorbic acid in seminal plasma of infertile men. On the basis of results of the present study, it may be concluded that M. pruriens not only reactivates the anti-oxidant defense system of infertile men but it also helps in the management of stress and improves semen quality.
Shukla, Kamla Kant; Ahmad, Mohammad Kaleem; Jaiswar, Shyam Pyari; Shankwar, Satya Narain; Tiwari, Sarvada Chandra
Based on published, 'grey' and anecdotal information, this paper explores some aspects of infertility, its medical treatment and their burden in poor countries. Many cases of infertility result from sexually transmitted infections (STI) and unsafe abortion and there is no doubt that their prevention and adequate treatment are of utmost importance, especially as effective infertility treatment, if any, comes at a high price for the consumer, materially as well as physically. Medical infertility interventions are apt to fail a free market of provision because of major information asymmetry. This renders patients in low-resource countries prone to exploitation, potentially damaging practices and waste of their savings. The authors argue that in countries struggling with limited funds and a range of pressing public health problems, public investment in infertility treatment should not have priority. But governments should take an active role in quality control and regulation of treatment practice, as well as invest in counseling skills for lower-level reproductive health staff to achieve rational referral of patients. PMID:11469951
van Zandvoort, H; de Koning, K; Gerrits, T
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.
Belsey, Mark A.
Involuntary infertility and induced abortion exist on opposite sides of the spectrum: the first being the unwanted loss of childbearing potential while the second is the intentional termination of pregnancy. However, this paper proposes that these two poles of pregnancy loss are in fact related in Yoruba society, Nigeria. This argument is supported by qualitative and quantitative data drawn from an applied research project in communities and health institutions of Lagos State, from 1996 to 1999, where a total of 693 women recounted 1114 personal abortion experiences, and 233 women shared their experiences of fertility problems. Study statistics show that 37% of secondary infertility was most probably the result of induced abortion and that half of women with abortion complications interviewed in a referral hospital will have fertility problems. This paper provides insight into the reasons why single and married women decide to abort, and use unsafe methods, despite awareness of the serious health risks, including infertility. This is paradoxical given that fear of infertility is a major reason why women do not use modern contraceptives when trying to prevent unwanted pregnancy. By analysing the relations between infertility and abortion within the socio-cultural, economic, and services-related structures that influence women's decisions, this paper suggests ways of addressing the problems related to both types of pregnancy loss. PMID:20719423
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
Teskereci, Gamze; Oncel, Selma
The present investigation was undertaken to assess the role of Mucuna pruriens in infertile men who were under psychological stress. Study included 60 subjects who were undergoing infertility screening and were found to be suffering from psychological stress, assessed on the basis of a questionnaire and elevated serum cortisol levels. Age-matched 60 healthy men having normal semen parameters and who had previously initiated at least one pregnancy were included as controls. Infertile subjects were administered with M. pruriens seed powder (5 g day(-1)) orally. For carrying out morphological and biochemical analysis, semen samples were collected twice, first before starting treatment and second after 3 months of treatment. The results demonstrated decreased sperm count and motility in subjects who were under psychological stress. Moreover, serum cortisol and seminal plasma lipid peroxide levels were also found elevated along with decreased seminal plasma glutathione (GSH) and ascorbic acid contents and reduced superoxide dismutase (SOD) and catalase activity. Treatment with M. pruriens significantly ameliorated psychological stress and seminal plasma lipid peroxide levels along with improved sperm count and motility. Treatment also restored the levels of SOD, catalase, GSH and ascorbic acid in seminal plasma of infertile men. On the basis of results of the present study, it may be concluded that M. pruriens not only reactivates the anti-oxidant defense system of infertile men but it also helps in the management of stress and improves semen quality. PMID:18955292
Shukla, Kamla Kant; Mahdi, Abbas Ali; Ahmad, Mohammad Kaleem; Jaiswar, Shyam Pyari; Shankwar, Satya Narain; Tiwari, Sarvada Chandra
Chlamydia trachomatis has currently emerged as the most common sexually transmitted pathogen. It is usually asymptomatic and is difficult to diagnose clinically. It is one of the causes for bad Obstetric History (BOH) and infertility. Women at highest risk often have the least access to health care facilities. Therefore there is a need for a rapid, simple, inexpensive and non-invasive test to detect C. trachomatis infection. Serological testing forms the mainstay of diagnosing the disease and to treat BOH and infertility. Hence the present study was conducted. Enzyme linked immunosorbent Assay (ELISA) was used for detection of IgG antibodies against C. trachomatis. Out of 260 cases, 130 had history of BOH, 80 had history of infertility and 50 healthy pregnant women (HPW) were used as controls. The seropositivity of C. trachomatis in the study was 25.4% (66). Out of 130 cases of BOH, seropositivity was 27.7% (36). Out of 80 cases of infertility, seropositivity was 35% (28) and out of 50 cases of HPW seropositivity was 4% (2). In BOH cases, women with history of two abortions showed seropositivity of 7.3% and women with history of three or more abortions showed seropositivity of 62.5%. Hence, seropositivity of C. trachomatis infection was found to be significant among women with BOH and infertility as compared to HPW. PMID:23781640
Salmani, Manjunath P; Mindolli, Preeti B; Vishwanath, G
Objectives: to present our first experience in scheme development based on CPC philosophy in Iran. Hypothesis: One of the most important reasons of an obvious gap between medical education and professional expectations (outcomes) encountered by recent medical graduates is due to applying conventional curricula, which rely on hypothetical-deductive reasoning model. The University of Calgary has implemented a new curriculum which is organized according to 125 ways in which patients may present to a physician. In this study we will present our first experience in scheme development based on CPC philosophy in Iran. Methods: In 2007, research and clinical center for infertility (Yazd University of medical sciences, IRAN), began developing a full module for infertility (lesson plan) with fourteen components based on the new curricular philosophy. We recruited a scheme of infertility according to a specific way. Results: Thus, at the first step of the module creation, a scheme was made as the most important mainstay of presentation module, i.e. a structured scheme that includes all causative diseases of infertility. Conclusions: Any effort in the organization of knowledge around schemes including in the domain of infertility would be valuable to meet some of the standards of WFME. Also, development of modules, by the teams composed of experts and students, can improve the quality of medical education.
Aflatoonian, A; Baghianimoghadam, B; Abdoli, A; Partovi, P; Hemmati, P; Tabibnejad, N; Harasym, P
Recently, intracytoplasmic sperm injection (ICSI) has been extremely successful for the treatment of male infertility. However, transmission of cytogenetic defects to offspring is a great concern. There are two types of cytogenetic problems in patients seeking ICSI; one is the transmission of genetic defects from patients with constitutional chromosomal abnormalities and the second is the generation of de novo defects in infertile men. Generally about 5.1% of infertile men have chromosomal abnormalities. Among such infertile men, men with severe spermatogenesis defects, including oligozoospermia and azoospermia, are subjects for ICSI. Therefore it is very important to obtain cytogenetic information in these infertile patients. Furthermore, oligozoospermic men with a normal somatic karyotype also have increased frequencies of sperm chromosome abnormalities. Oligozoospermia is usually associated with other sperm alterations, for example oligoasthenozoospermia, oligoteratozoospemia and oligoasthenoteratozoospermia. In this review, the relationship between sperm concentration and sperm aneuploidy frequencies has been analyzed. The inverse correlation between the frequency of sperm aneuploidy and concentration has been reported in extensive studies. Especially in severe oligozoospermia, a significantly higher frequency of sex chromosome aneuploidy has been observed and this has been corroborated in recent clinical outcome data of ICSI. PMID:16192714
Fluorescence in situ hybridization (FISH) with single-color chromosome-specific probes was used to study the rates of disomy for chromosome 1, 16, X, and Y in sperm of fertile and infertile subjects. Diploidy rates were studied using a two-color cocktail of probes for chromosomes 17 and 18 in the same sperm samples. Two-color methodology was not available at the outset of the study. A total of 450,580 spermatozoa were studied from 21 subjects (9 fertile, 12 infertile). Significant differences were observed in the disomy rates between chromosomes with the highest frequency observed for chromosome 16 (0.17%) and the lowest for the Y chromosome (0.10%). No differences were observed between fertile and infertile subjects for either diploidy or disomy. Total disomy rates for chromosomes 1, 16, X and Y ranged from 0.34% to 0.84% among infertile subjects, and 0.32% to 0.61% among fertile subjects. Our data suggest that generalized aneuploidy in sperm is not a major contributor to unexplained infertility. PMID:8168824
Miharu, N; Best, R G; Young, S R
Background To date the IMSI procedure represents the only real-time and unstained method available to discard spermatozoa with ultrastructural defects. Several studies demonstrated that IMSI provides positive results in couples with severe male factor infertility or repeated ICSI failures. Aim of this pilot study is to evaluate the differences between IMSI and ICSI in terms of IVF outcomes in an unselected infertile patient population. Methods Three hundred and thirty-two couples were analyzed: 281 couples underwent conventional ICSI procedure and 51 underwent IMSI technique. Results No statistically significant differences were found between implantation rate (ICSI: 16,83%; IMSI: 16,67%), fertilization rate (ICSI: 77,27%; IMSI: 80,00%) and pregnancy rate (ICSI: 25,30%; IMSI: 23,50%). Both groups were comparable when considering live birth rate (ICSI: 11,39%; IMSI:13,72%), ongoing pregnancy rate (ICSI: 7,47%; IMSI: 5,88%) and miscarriage rate (ICSI: 17,78; IMSI: 5,26%). The subgroup analyses did not show a statistical difference between ICSI and IMSI neither in male factor infertility subgroup nor in patients with more than one previous ICSI attempt. A trend towards better laboratory and clinical outcomes was detected in the male factor infertility subgroup when IMSI was applied. Conclusions Our preliminary results show that the IMSI technique does not significantly improve IVF outcomes in an unselected infertile population.
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
Bolúmar, F; Olsen, J; Rebagliato, M; Bisanti, L
Background: There is enough evidence in the literature to support that removal of septum improves pregnancy rates in women with bad obstetric history. However, its role in patients with otherwise unexplained infertility is still not clear due to paucity of enough evidence. Objective: To assess reproductive performance in women with septate uterus and otherwise unexplained infertility after hysteroscopic metroplasty. Materials and Methods: 72 women with septate uterus and otherwise unexplained primary infertility were included in the study. All these women underwent hysteroscopic septal resection. Reproductive performance of these women within one year of surgery was studied and analysed. Result: 33 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 the reproductive performance.
Pai, Hrishikesh D; Kundnani, Manisha T; Palshetkar, Nandita P; Pai, Rishma D; Saxena, Nidhi
Current management options for infertility, including hormone therapy, intrauterine insemination, and in vitro fertilization, tend to be expensive, are not necessarily covered by insurance, and carry different levels of short-term and long-term health risks. Many of the issues that contribute to infertility can be traced to scar tissue, fascial restriction, and lymphatic congestion in the pelvic region. Manual therapy techniques exist to release fascial restrictions, to mobilize tight ligaments, and to drain congested lymphatics, all of which can be applied to the reproductive system. In this case series, 10 infertile women were treated with 1 to 6 sessions of manual therapy applied to the pelvic region. Techniques included muscle energy, lymphatic drainage, and visceral manipulation. Six of the 10 women conceived within 3 months of the last treatment session, and all 6 of those women delivered at full term. PMID:23055467
Kramp, Mary Ellen
We examined male partners’ influence on the decision to seek medical help for infertility using from the National Survey of Fertility Barriers. Building upon an existing help-seeking framework, we incorporated characteristics of both partners from 219 heterosexual couples who had ever perceived a fertility problem. In logistic regression analyses, we found an association between couple-level attitudes and medical help-seeking even when other predisposing and enabling conditions existed. Overall, the findings highlight that both partners contribute to the infertility help-seeking process, and that different factors may play a role in different stages of help-seeking. Studies of infertility help-seeking need to be more inclusive of the context that these decisions are embedded within to better understand service use.
Johnson, Katherine M.; Johnson, David R.
Male factor infertility elucidated about half the couple of infertility and in around 50% of cases, its etiology remains unknown. The aim of this study was to investigate a predisposing genetic background for Yq deletions and male infertility and effectiveness of molecular genetic approaches have uncovered several etiopathogenetic factors, such as microdeletions of Yq chromosome. The Y chromosome microdeletions removing the azoospermia factor (AZF) regions, which are most common molecular genetic causes of oligospermia or azoospermia. However, with the analysis of Yq deletions, we are able to obtain a better understanding of the clinical significance of genetic anomaly and to the identifying of fertility candidate genes in the AZF regions. Molecular genetic approaches, becomes a routine diagnostic test, that provides an etiology for spermatogenic disturbances, and prognosis for testicular sperm retrieval according to the type of deletion. PMID:22575722
Seminal plasma is a potential source of biomarkers for many disorders of the male reproductive system including male infertility. Knowledge of the peptide and protein components of seminal fluid is accumulating especially with the appearance of high-throughput MS-based techniques. Of special interest in the field of male infertility biomarkers, is the identification and characterization of differentially expressed proteins in seminal plasma of men with normal and impaired spermatogenesis. However, the data obtained until now is still quite heterogeneous and with small percentage of overlap between independent studies. Extensive comparative analysis of seminal plasma proteome is still needed in order to establish a potential link between seminal plasma proteins and male infertility.
Davalieva, K; Kiprijanovska, S; Noveski, P; Plaseski, T; Kocevska, B; Plaseska-Karanfilska, D
Seminal plasma is a potential source of biomarkers for many disorders of the male reproductive system including male infertility. Knowledge of the peptide and protein components of seminal fluid is accumulating especially with the appearance of high-throughput MS-based techniques. Of special interest in the field of male infertility biomarkers, is the identification and characterization of differentially expressed proteins in seminal plasma of men with normal and impaired spermatogenesis. However, the data obtained until now is still quite heterogeneous and with small percentage of overlap between independent studies. Extensive comparative analysis of seminal plasma proteome is still needed in order to establish a potential link between seminal plasma proteins and male infertility. PMID:24052741
Davalieva, K; Kiprijanovska, S; Noveski, P; Plaseski, T; Kocevska, B; Plaseska-Karanfilska, D
Infertile men have poorer sperm DNA integrity than do fertile men, and this damage may contribute to reducing male reproductive potential. However, the etiology of this damage has not been fully characterized. We sought to examine the relationship, if any, between anti-sperm antibodies and sperm DNA damage in a consecutive series of non-azoospermic, infertile men in order to determine whether
Armand Zini; Simon Phillips; Josee Lefebvre; Abdulaziz Baazeem; Francois Bissonnette; Isaac Jacques Kadoch; Maria San Gabriel
Previous findings on relationships between infertility, infertility therapies, and autism spectrum disorders (ASD) have been inconsistent. The goals of this study are first, to briefly review this evidence and second, to examine infertility and its treatments in association with having a child with ASD in newly analyzed data. In review, we identified 14 studies published as of May 2013 investigating infertility and/or its treatments and ASD. Overall, prior results showed little support for a strong association, though some increases in risk with specific treatments were found; many limitations were noted. In new analyses of the CHildhood Autism Risk from Genetics and the Environment (CHARGE) population-based study, cases with autism spectrum disorder (ASD, n = 513) and controls confirmed to have typical development (n = 388) were compared with regard to frequencies of infertility diagnoses and treatments overall and by type. Infertility diagnoses and treatments were also grouped to explore potential underlying pathways. Logistic regression was used to obtain crude and adjusted odds ratios overall and, in secondary analyses, stratified by maternal age (?35 years) and diagnostic subgroups. No differences in infertility, infertility treatments, or hypothesized underlying pathways were found between cases and controls in crude or adjusted analyses. Numbers were small for rarer therapies and in subgroup analyses; thus the potential for modest associations in specific subsets cannot be ruled out. However, converging evidence from this and other studies suggests that assisted reproductive technology is not a strong independent risk factor for ASD. Recommendations for future studies of this topic are provided.
Lyall, Kristen; Baker, Alice; Hertz-Picciotto, Irva; Walker, Cheryl K.
Molecular studies on the role of the androgen receptor in male infertility have thus far concentrated solely on exonic regions of the androgen receptor gene. We have therefore screened for the first time the androgen receptor gene 59 untranslated region (nucleotides -153 to F237 ) in 240 males with idiopathic infertility for lesions which could potentially impair spermatogenesis. This region
F. J. Ghadessy; S. L. Liow; E. L. Yong
Previous findings on relationships between infertility, infertility therapies, and autism spectrum disorders (ASD) have been inconsistent. The goals of this study are first, to briefly review this evidence and second, to examine infertility and its treatments in association with having a child with ASD in newly analyzed data. In review, we identified 14 studies published as of May 2013 investigating infertility and/or its treatments and ASD. Overall, prior results showed little support for a strong association, though some increases in risk with specific treatments were found; many limitations were noted. In new analyses of the CHildhood Autism Risk from Genetics and the Environment (CHARGE) population-based study, cases with autism spectrum disorder (ASD, n = 513) and controls confirmed to have typical development (n = 388) were compared with regard to frequencies of infertility diagnoses and treatments overall and by type. Infertility diagnoses and treatments were also grouped to explore potential underlying pathways. Logistic regression was used to obtain crude and adjusted odds ratios overall and, in secondary analyses, stratified by maternal age (?35 years) and diagnostic subgroups. No differences in infertility, infertility treatments, or hypothesized underlying pathways were found between cases and controls in crude or adjusted analyses. Numbers were small for rarer therapies and in subgroup analyses; thus the potential for modest associations in specific subsets cannot be ruled out. However, converging evidence from this and other studies suggests that assisted reproductive technology is not a strong independent risk factor for ASD. Recommendations for future studies of this topic are provided. PMID:23965925
Lyall, Kristen; Baker, Alice; Hertz-Picciotto, Irva; Walker, Cheryl K
This study was undertaken in order to gain insight into the morphology of the first polar body (PB1) and the two pronuclei (2PN) in ICSI patients, specifically the nucleolar precursor bodies (NPB). Whether early abnormalities in these structures are related to the ovarian reserve of infertile women was also studied. Eighty consecutive infertile women were prospectively investigated throughout their first
Johnny S Younis; Orit Radin; Nitsa Mirsky; Ido Izhaki; Tatyana Majara; Shalom Bar-ami; Moshe Ben-ami
Infertility is a social onus for women in Iran, who are expected to produce children early within marriage. With its estimated 1.5 million infertile couples, Iran is the only Muslim country in which assisted reproductive technologies (ARTs) using donor gametes and embryos have been legitimized by religious authorities and passed into law. This has placed Iran, a Shia-dominant country, in
Marcia C. Inhorn; Ghasem Toloo
Infertility is a neglected area of public health in India despite the significant implications it has for the health of poor women. It is also less prominent in social science research due to its characterization as a biomedical problem. On the contrary, as suggested in this article, a focus on infertility provides important insights into the gendering of reproductive identity
BACKGROUND: The unfulfilled desire of millions of infertile couples worldwide to have their own biological children results in emotional distress. This study evaluated the emotional reactions of couples attending a combined infertility clinic in Kuwait and successful clients' perception of nurses. METHODS: Quantitative and qualitative methods were used. The first phase was by structured interview using two standardized psychological scales:
Florence E Omu; Alexander E Omu
The goal of this study was to examine the effect of palmitoylethanolamide (PEA) on the capacitation process and hy- peractivated motility (HA) in idiopathic infertile men. Our data show the effect of PEA on the kinematic parameters of sperm cells from idiopathic infertile men during the capacitation of spermatozoa in vitro, both in the presence and absence of 2.5 nM
ANNARINA AMBROSINI; GIOVANNA ZOLESE; SIMONA AMBROSI; ENRICO BERTOLI; FRANCO MANTERO; MARCO BOSCARO; GIANCARLO BALERCIA
Male infertility is a major cause of problems for many couples in conceiving a child. Recently, lifestyle pastimes such as alcohol, tobacco and marijuana have been shown to have further negative effects on male reproduction. The endocannabinoid system (ECS), mainly through the action of anandamide (AEA) and 2-arachidonoylglycerol (2-AG) at cannabinoid (CB1, CB2) and vanilloid (TRPV1) receptors, plays a crucial role in controlling functionality of sperm, with a clear impact on male reproductive potential. Here, sperm from fertile and infertile men were used to investigate content (through LC-ESI-MS), mRNA (through quantitative RT-PCR), protein (through Western Blotting and ELISA) expression, and functionality (through activity and binding assays) of the main metabolic enzymes of AEA and 2-AG (NAPE-PLD and FAAH, for AEA; DAGL and MAGL for 2-AG), as well as of their binding receptors CB1, CB2 and TRPV1. Our findings show a marked reduction of AEA and 2-AG content in infertile seminal plasma, paralleled by increased degradation: biosynthesis ratios of both substances in sperm from infertile versus fertile men. In addition, TRPV1 binding was detected in fertile sperm but was undetectable in infertile sperm, whereas that of CB1 and CB2 receptors was not statistically different in the two groups. In conclusion, this study identified unprecedented alterations of the ECS in infertile sperm, that might impact on capacitation and acrosome reaction, and hence fertilization outcomes. These alterations might also point to new biomarkers to determine male reproductive defects, and identify distinct ECS elements as novel targets for therapeutic exploitation of ECS-oriented drugs to treat male fertility problems.
Di Tommaso, Monia; Pucci, Mariangela; Battista, Natalia; Paro, Rita; Simon, Luke; Lutton, Deborah; Maccarrone, Mauro
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. While much has been written about the psychological and social consequences of infertility and infertility treatment, most of this has focused on the experiences of women, with relatively little research with men as users of assisted reproduction technology. This paper discusses some of the reasons why this is the case. It comments on psychological and social research which has been carried out with men and discusses some of the limitations of the methods by which this research has been conducted. An argument is made for research to pay more attention to the ways in which men as well as women experience infertility and assisted reproduction, and the paper suggests using methods from both quantitative and qualitative traditions to more fully explore a range of issues relevant to men and to improving patient care. Further research with men is needed in all areas including: perception of fertility 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. PMID:23871364
Culley, Lorraine; Hudson, Nicky; Lohan, Maria
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
Ardalan, Ali; Vahidi, Serajeldin; Mohammad, Kazem; Russel, Mehdi
Objective To investigate psychological distress, serum levels of monoamine neurotransmitters and their metabolites, as well as their\\u000a correlation with polycystic ovarian syndrome (PCOS).\\u000a \\u000a \\u000a \\u000a \\u000a Methods Thirty infertility patients with PCOS were assigned as the experimental group and 30 infertility patients without PCOS were\\u000a assigned as the control group. Psychological distress was self-evaluated in all patients with Symptom Checklist 90 (SCL-90).\\u000a Serum concentrations of
Xiaobo Shi; Lingyan Zhang; Shuxin Fu; Na Li
Infertility is a condition loaded with meaning spanning across biomedical, psychological, social, economic, cultural and religious spheres. Given its disruptive power over women's lives, it provides a unique lens through which issues of kinship, gender, sexuality, cosmology and religion can be examined. The paper presents the results of an ethnographic study of infertility in Central Nigeria. Explanatory models of infertility were variegated, encompassing biomedical, folk and religious elements. Like other ethnographic studies of help seeking for infertility in Nigeria, among this group resort was made to biomedical treatments, traditional healers and religious healing with no one system being hegemonic. The findings of this study accord with studies of infertility in other cultural groups indicating the disruptive influence of missing motherhood. PMID:24069756
Dimka, Ritgak A; Dein, Simon L
Psychological morbidity concurrent with fertility problems has been the focus of substantial scientific inquiry. However, researchers have largely overlooked psychological resilience within this population. This study explored the associations between resilience, infertility-related and general distress, and coping behaviors in forty women from nine fertility clinics throughout the United States. Participants completed the Connor-Davidson Resilience Scale (CD-RISC), Symptom Checklist-90 (SCL-90), Beck-Depression Inventory-II (BDI-II), Fertility Problem Inventory (FPI), and Ways of Coping Questionnaire (WCQ). Women with fertility problems evidenced significantly lower resilience scores than published norms. This study established evidence for the reliability and convergent validity of the CD-RISC with infertile populations. However, similar to other studies using this instrument, the factor structure reported by Connor and Davidson [Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC). Depression and Anxiety 2003;18:76-82] was not well supported. Resilience was negatively associated with infertility-specific and general distress. Engagement in action-focused coping skills was positively correlated with resilience. Implications for enhancing resilience with this population as are discussed. PMID:19665730
Sexton, Minden B; Byrd, Michelle R; von Kluge, Silvia
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
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
|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…
Lahey, Joanna N.
A 33-month longitudinal study was conducted with 38 infertile couples making the transition to biological childlessness after unsuccessful fertility treatments. Changes in their levels of psychological distress; marital, sexual, and life satisfaction; and self-esteem were examined. Increased self-esteem and decreased sexual satisfaction were…
Daniluk, Judith C.; Tench, Elizabeth
This study uses an institutional design theoretical framework and a cross-case analysis qualitative research methodology to consider the National Cooperative Program in Infertility Research (NCPIR) centers as an effort to enhance scientific and technical knowledge by designing institutions (in this case the NCPIR centers) to promote the growth of knowledge by promoting collaboration, building collaborative networks and promoting “scientific and
Jan Youtie; Dirk Libaers; Barry Bozeman
The program for in vitro fertilization at Bourn Hall began in October 1980. Various types of infertility have been treated during this time using the natural menstrual cycle or stimulation of follicular growth with antiestrogens and gonadotrophins. Follicular growth and maturation are assayed by urinary estrogens and LH, monitored regularly during the later follicular stage. Many patients had an endogenous
R. G. Edwards; S. B. Fishel; J. Cohen; C. B. Fehilly; J. M. Purdy; J. M. Slater; P. C. Steptoe; J. M. Webster
This study explores how lesbian and heterosexual pre-adoptive couples experience and construct the transition from infertil- ity to adoption as a means to becoming parents. Thirty lesbian couples and 30 heterosexual couples were interviewed about the challenges and benefits they perceived in attempting con- ception and then later choosing adoption. Although similarities in perspectives emerged between heterosexual and lesbian participants
Abbie E. Goldberg; Jordan B. Downing; Hannah B. Richardson
Human seminal plasma is a natural reservoir of antioxidants that protect spermatozoa from oxidative damages. There is evidence in literature supports the fact that impairments in seminal antioxidant and lipid per-oxidation status play important roles in the physiopathology of male infertility. Our present study forms the first one which was carried out in Tunisia. We evaluated the antioxidant status in the seminal plasma of 120 infertile men programmed to In Vitro Fertilization (IVF) for the first tentative. Patients were characterized by an idiopathic infertility. They were divided into three groups: normozoospermics who were considered as controls (n=40), asthenozoospermics (Astheno; n=45) and oligoasthenoteratozoospermics (OAT; n=35). Seminal activities of superoxide dismutase (SOD) and glutathione peroxidase (GPX) and the levels of glutathione (GSH), zinc (Zn) and malondialdehyde (MDA) were measured. With the significant increase of the seminal activities of SOD and GPX in normozoospermics group, there were positive correlations observed between this enzymes and sperm quality. Also, significant elevated rates of seminal zinc and GSH were observed in control group, but there was contradictory associations reflecting the effects of these antioxidants on semen parameters. However, we noted significant increase of MDA levels in groups with abnormal seminogram. We showed negative associations between this per-oxidative marker and sperm parameters. These results obviously suggested that impairment on seminal antioxidants is an important risk factor for low sperm quality associated to idiopathic infertility and as a result can lead to poor IVF outcome.
Atig, Fatma; Raffa, Monia; Ali, Habib Ben; Abdelhamid, Kerkeni; Saad, Ali; Ajina, Mounir
As a good number of couples are coming to infertility clinics to have children at advanced ages, it is essential to know whether advanced paternal age is associated with diminished semen quality and a higher risk of infertility. This retrospective study was done to see the effects of age on semen quality, a well-known indicator of fertility status. Semen parameters of smokers and non-smokers in the study population were also analyzed. A sample of 1121 male partners of infertile couples (aged 25-55 years) who came to an infertility clinic for treatment were included into the study. In addition to clinical history including lifestyle, medical and occupational details and physical examination, their semen samples were examined. Semen volume (ml), sperm concentration (x 10(6)/ml), motility (%), rapidly progressing (%), slowly progressing (%), non-progressive (%) motility and morphology (%) were measured. Semen volume showed IQR 1.5-3.0 ml, and significant decreasing trend with increasing age (r = -0.070, p<0.05). Sperm motility and rapidly progressing motility showed significant decrease (IQR 40.0-70.0, r = -0.115, p<0.01 and IQR 20.0-50.0, r = -0.107, p<0.01 respectively) with increasing age. There was no significant difference between semen parameters of smokers and non-smokers in the study population. This study shown that semen volume, sperm motility and rapidly progressing motility were significantly decreased with increasing age. PMID:22561776
Hossain, M M; Fatima, P; Rahman, D; Hossain, H B
BACKGROUND: The aim of the study was to identify differences in psychological characteristics between couples with fertility disorders, especially idiopathic infertility, and a representative sample. MATERIAL AND METHODS: A total of 564 couples was examined using psychological questionnaires pertaining to sociodemographic factors, motives for wanting a child, dimensions of life satisfaction and couple relationships, physical and psychic complaints, and a
T. Wischmann; H. Stammer; H. Scherg; I. Gerhard; R. Verres
Seminal plasma motility inhibitors (SPMIs) are proteinase-resistant fragments of semenogelin I and II (Sgs), which are the major proteins of semen coagulum. SPMIs inhibit the motility of spermatozoa, and Sgs are thought to be natural regulators of human sperm function. The mechanism underlying sperm motility regulation and its association with defective motility in infertile men remain unclear. The purpose of
K. Terai; K. Yoshida; M. Yoshiike; M. Fujime; T. Iwamoto
Medical treatments such as Intra-Uterine Insemination (IUI) and Assisted Reproduction Technology (ART) that help otherwise infertile couples to get pregnant are highly successful and widely used these days. While highly successful, there have been concerns regarding the safety of these procedures and their effect on maternal and neonatal outcomes. Specifically, it has been observed that these treatments significantly increase the
Pooja G. Mookim; Randall P. Ellis; Ariella Kahn-Lang
Background. Azoospermia due to obstruction of the vaso- epididymal junction is one of the few surgically correctable causes of male infertility. In patients where all clinical and laboratory parameters suggest a vaso-epididymal junction block amenable to surgery, failure to find normal spermatogenesis on fine-needle aspiration cytology (FNAC) of the testis may necessitate a change in treatment modality to the more
RAJEEV KUMAR; GAGAN GAUTAM; N. P. GUPTA; MANJU ARON; RIMA DADA; KIRAN KUCHERIA; SATISH KUMAR GUPTA; ANURAG MITRA
Objective The use of donor sperm or ova becomes an option for some infertile couples. We sought to determine the views towards donor sperm and eggs of both men and women. Design Prospective cohort of infertile couples Setting Eight California reproductive endocrinology practices Patients Infertile couples (n=377) were recruited after initial infertility clinic visit. Main Outcome Measures From questionnaires administered at recruitment, ratings concerning the impact of the use of donor gametes were assessed. Differences between men and women in attitudes toward donor gametes were compared with ANOVA. Linear regression was used to identify independent predictors of attitudes towards gametes. Results Female's attitudes towards donor sperm were significantly more negative than their attitudes towards donor eggs (5.1±1.4 vs 4.7±1.6*). Similarly, male donor gamete attitude scores were higher for donor sperm compared to donor eggs (4.9±1.6 vs 4.1±1.6*). Both men and women agreed that the use of donor sperm was more likely to have negative effects on their relationship and negative societal ramifications. Female donor gamete attitude scores were predicted by marital status, race, and education while men's scores were independent of all measured factors.* p<0.0001 Conclusions Both men and women view the use of donor sperm with more skepticism compared to the use of donor eggs suggesting a unique underlying perception regarding the use of male donor gametes.
Eisenberg, Michael L.; Smith, James F.; Millstein, Susan G.; Walsh, Thomas J.; Breyer, Benjamin N.; Katz, Patricia P.
Phospholipid hydroperoxide glutathione peroxidase (GPx4) is an intracellular antioxidant enzyme that directly reduces peroxidized phospholipids. GPx4 is strongly expressed in the mitochondria of testis and spermatozoa. We previously found a significant decrease in the expression of GPx4 in spermatozoa from 30% of infertile human males diagnosed with oligoasthenozoospermia (Imai, H., Suzuki, K., Ishizaka, K., Ichinose, S., Oshima, H., Okayasu, I., Emoto, K., Umeda, M., and Nakagawa, Y. (2001) Biol. Reprod. 64, 674-683). To clarify whether defective GPx4 in spermatocytes causes male infertility, we established spermatocyte-specific GPx4 knock-out mice using a Cre-loxP system. All the spermatocyte-specific GPx4 knock-out male mice were found to be infertile despite normal plug formation after mating and displayed a significant decrease in the number of spermatozoa. Isolated epididymal GPx4-null spermatozoa could not fertilize oocytes in vitro. These spermatozoa showed significant reductions of forward motility and the mitochondrial membrane potential. These impairments were accompanied by the structural abnormality, such as a hairpin-like flagella bend at the midpiece and swelling of mitochondria in the spermatozoa. These results demonstrate that the depletion of GPx4 in spermatocytes causes severe abnormalities in spermatozoa. This may be one of the causes of male infertility in mice and humans. PMID:19783653
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
Endothelial nitric oxide synthase (eNOS) has diverse roles in the female reproductive system including a role in blastocyst implantation. Aberrant expression of eNOS could therefore be significant in the pathogenesis of disorders of implantation. In this study, eNOS protein and mRNA levels in the endometrium of women with recurrent miscarriages, unexplained infertility and a control group were determined by compartmental quantitative immunohistochemistry and real-time reverse-transcription PCR. eNOS was found to be immunolocalized to all layers of the endometrium and vascular endothelium. eNOS protein was higher in glandular epithelium (P = 0.004) and luminal epithelium (P = 0.002), but not vascular endothelium and stroma, in women with recurrent miscarriage. Similarly, in women with unexplained infertility, eNOS was significantly higher (P < 0.03) in luminal epithelium but not in any other compartments compared with the control group. The levels of mRNA confirmed the protein data, demonstrating higher eNOS mRNA in the endometrium of women with recurrent miscarriage and unexplained infertility compared with controls. In conclusion, increased expression of eNOS in glandular and luminal epithelium of the endometrium in women with recurrent miscarriages and unexplained infertility suggests a detrimental effect of excess nitric oxide in endometrial receptivity and implantation. PMID:22877939
Najafi, Tohid; Novin, Marefat Ghaffari; Ghazi, Reza; Khorram, Omid
In this study, I examine women’s experiences with infertility and the impact upon their conceptualizations of ‘family.’ Active interviews with 32 women revealed most women started out with conceptualizations that reflected a traditional ideology of family. Participants who conceived biological children through medical assistance expressed a broader conceptualization of family through a greater appreciation for their children and family life
Diana C. Parry
Phospholipid hydroperoxide glutathione peroxidase (GPx4) is an intracellular antioxidant enzyme that directly reduces peroxidized phospholipids. GPx4 is strongly expressed in the mitochondria of testis and spermatozoa. We previously found a significant decrease in the expression of GPx4 in spermatozoa from 30% of infertile human males diagnosed with oligoasthenozoospermia (Imai, H., Suzuki, K., Ishizaka, K., Ichinose, S., Oshima, H., Okayasu, I., Emoto, K., Umeda, M., and Nakagawa, Y. (2001) Biol. Reprod. 64, 674–683). To clarify whether defective GPx4 in spermatocytes causes male infertility, we established spermatocyte-specific GPx4 knock-out mice using a Cre-loxP system. All the spermatocyte-specific GPx4 knock-out male mice were found to be infertile despite normal plug formation after mating and displayed a significant decrease in the number of spermatozoa. Isolated epididymal GPx4-null spermatozoa could not fertilize oocytes in vitro. These spermatozoa showed significant reductions of forward motility and the mitochondrial membrane potential. These impairments were accompanied by the structural abnormality, such as a hairpin-like flagella bend at the midpiece and swelling of mitochondria in the spermatozoa. These results demonstrate that the depletion of GPx4 in spermatocytes causes severe abnormalities in spermatozoa. This may be one of the causes of male infertility in mice and humans.
Imai, Hirotaka; Hakkaku, Nao; Iwamoto, Ryo; Suzuki, Jyunko; Suzuki, Toshiyuki; Tajima, Yoko; Konishi, Kumiko; Minami, Shintaro; Ichinose, Shizuko; Ishizaka, Kazuhiro; Shioda, Seiji; Arata, Satoru; Nishimura, Masuhiro; Naito, Shinsaku; Nakagawa, Yasuhito
Background: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder which causes anovulatory infertility. Obesity is one of the factors which directly modifies the clinical, biochemical and metabolic expression of this syndrome. Recently a genetic association of PCOS with intrafamily marriages has been postulated. This study investigates the association of environmental factors such as BMI and intrafamily marriages with the
Fauzia Haq; Javed Rizvi
This month, we focus on current research in infertility. Dr. Dodson discusses five recent publications, and each is concluded with a "bottom line" that is the take-home message. The complete reference for each can be found in on this page, along with direct links to the abstracts. PMID:24104766
Dodson, William C
Background The circadian system has a major role in maintaining homeostasis and proper body functions including reproductive capacity. The aim of this study was to examine whether there is an association between genetic variability in the primary clock genes CLOCK and ARNTL and male infertility in humans. Methodology/Principal Findings We performed a case-control study, where we searched for an association between polymorphisms of CLOCK and ARNTL genes and male infertility in 961 Slovenian and Serbian Caucasian men. The study group consisted of 517 patients with idiopathic infertility and a control group of 444 fertile men. A statistically significant difference was found in genotype distribution between the two groups in the CLOCK gene: rs11932595 (p?=?6·10?5, q?=?4·10?4, OR equaled 1.9 with 95% CI 1.4–2.7), rs6811520 (p?=?2·10?3, q?=?8·10?3, OR?=?1.7 with 95% CI 1.2–2.2) and rs6850524 (p?=?0.01, q?=?0.02, OR?=?1.4 with 95% CI 1.1–1.9). Further analyses of haplotypes were consistent with genotyping results. Conclusions/Significance We provide evidence that genetic variability in the CLOCK gene might be associated with male infertility warranting further confirmation and mechanistic investigations.
Hodzic, Alenka; Ristanovic, Momcilo; Zorn, Branko; Tulic, Cane; Maver, Ales; Novakovic, Ivana; Peterlin, Borut
Introduction Obesity has become a worldwide epidemic with ever increasing incidence and public health problems in both developing and developed countries. Objective The objective of the study is to investigate the incidence of obesity among patients with polycystic ovarian syndrome attending infertility clinic and the effect on treatment outcome. Methodology Two hundred and seventy women with polycystic ovarian syndrome attending
Majedah Al-Azemi; Florence E. Omu; Alexander E. Omu
The purpose of this study was to compare sexual function between women of infertile couples (AR) and women seeking tubal ligation (TL). Women who attended Setor de Infertilidade do Serviço de Ginecologia e Obstetrícia do Hospital de Clinicas de Porto Alegre (HCPA) or the Serviço de Orientaçăo e Planejamento Familiar (SERPLAN) completed the Female Sexual Function Index, a questionnaire about
Heitor Hentschel; Daniele Lima Alberton; Robert John Sawdy; Edison Capp; José Roberto Goldim; Eduardo Pandolfi Passos
This review considers some recent human rights cases in the field of assisted reproduction and explores how the UK courts are seeking to weave their way through the complex legal and ethical issues in this sensitive field to balance the competing rights of those seeking infertility treatment, gamete donors and their offspring. PMID:16192077
The objective of this case report was to identify the cause of apparent idiopathic infertility in a Red Angus (beef) bull. Semen was collected by electroejaculation and submitted to a series of assays, including evaluation of sperm motility by computer-assisted sperm analysis (CASA), sperm morphology and DNA integrity, semen cryopreservation, AI, IVF, induction of the acrosome reaction, and determination of
C. Lessard; L. G. Siqueira; O. D'Amours; R. Sullivan; P. Leclerc; C. Palmer
OBJECTIVETo determine whether men and women who are occupationally exposed to ionising radiation are at increased risk of primary infertility.METHODSA cross sectional analysis of reproductive outcome was reported in an occupational cohort of nuclear industry workers from the Atomic Energy Authority, Atomic Weapons Establishment, and British Nuclear Fuels in the United Kingdom. Data on employment and radiation monitoring supplied by
P Doyle; E Roman; N Maconochie; G Davies; P G Smith; V Beral
North Americans who suffer infertility often reach an end to treatment options at home, whether it is due to a lack of egg donors in Canada or the high cost of treatment in the USA. Patients navigate their way onto the internet, seeking support and other options. As women and couples ‘do the research’ online, they conduct endless Google searches,
Amy R. Speier
Y-chromosomal DNA haplotypes were determined in 74 infertile and 216 control Italian males using eight biallelic markers. A significant difference in haplotype frequency was found, but could be explained by the geographical origins of the samples. The Y chromosome is thus a sensitive marker for population substructuring and may be useful for determining whether two population samples come from a
Carlo Previderé; Liborio Stuppia; Valentina Gatta; Paolo Fattorini; Giandomenico Palka; Chris Tyler-Smith
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, ?(2)=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
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
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, ?2=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.
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
Summary. The Polycystic Ovary Syndrome (PSOS) is the commonest cause of anovulatory infertility. Matformin is effective in the treatment of PCOS- related anovulation. Metformin is an oral biguanide, well established for the treatment of hyperglycemia. Preliminary evidence indicates that metformin may also be effective in decreasing the risk of early spontaneous abortion in women with PCOS. The aim of the
Meiotic studies have been carried out in a series of 1100 infertile and sterile males. Of these, 599 cases have been studies in testicular biopsy, and 501, in semen samples. This is the largest meiotic series published so far. The incidence of meiotic anomalies was 4.3%. The most frequent chromosome abnormality was desynapsis (3.7%). However, the number of cases with
J. Egozcue; C. Templado; F. Vidal; J. Navarro; F. Morer-Fargas; S. Marina
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.
Umeora, OUJ; Chukwuneke, FN
The DAZ (Deleted in AZoospermia) gene family was isolated from a region of the human Y chromosome long arm that is deleted in about 10% of infertile men with idiopathic azoo- spermia. DAZ and an autosomal DAZ-like gene, DAZL1, are ex- pressed in germ cells only. They encode proteins with an RNA recognition motif and with either a single copy
Shanli Tsui; Tiane Dai; Stephen T. Warren; Eduardo C. Salido; Pauline H. Yen
The human Y chromosome harbours genes that are essential for spermatogenesis. Most of these genes lie in the male-specific region (MSY) of Y chromosome. Microdeletions of AZF within the MSY have been reported in infertile men. Widely different frequencies of such deletions (0-55%) have been reported from different populations. TSPY is another gene located in the MSY region that plays
Arvind Rup Singh; Radek Vrtel; Radek Vodicka; David Konvalinka; Jiri Santavy
The aim of this study was to assess the diagnostic value and the usefulness of sono hysterosalpingography (SHG) in the detection of uterine abnormalities and tubal patency, compared with other diagnostic methods among patient with infertility. In a prospective study, 86 patients in the initial stage of the infertility treatment were examined by SHG using saline NaCl infundibular and Echovist as contrast media. Further status of the tubes and uterine cavity was assessed by the "gold standards", laparoscopy and hysteroscopy. Sensitivity, specificity, positive predictive value and the negative predictive value of SHG using NaCl infundibular for evaluation of the uterine cavity were 98.8%, 92.5%, 91.4% and 92%, respectively. Sensitivity, specificity, positive predictive value and the negative predictive value of SHG for the assessment of the tubal status were 97.6%, 89.2%, 76.3% and 77.4%, respectively. There were no evident complications during or after the procedure. Sono hysterosalpingography is useful in making decisions regarding further procedures for the diagnosis and treatment of infertility. This method is simple, safe and cheap for early assessment of the reproductive status of uterine cavity and fallopian tubes and perspective as a routine, first-line infertility investigation. PMID:17077470
Dzotsenidze, T N; Davarashvili, D I; Nikolaishvili, T G; Peradze, D G; Datunashvili, E D
Introduction: According to the world Health organization, approximately one third of the world` population older than 15 years are smokers. Evidences indicate that both in men and in women, cigarette smoking affects reproductive health more than the consumption of caffeine or alcohol in comparable doses. The mechanisms according to which tobacco affects spermatozoa are poorly understood. Some of the studies focused on the relation between cigarette smoking and the principal semen analysis, variable such as concentration, Morphology and Motility. In this study, we compared the sperm parameters between smokers and non-smokers. Material and Methods: This case control study was done on men from infertile couples who were referred to Yazd research and clinical center for infertility but the cause of infertility was not the male factor. The semen analysis was compared between the smokers and non-smokers. Results: 151 infertile men were enrolled in the present study. 98 non-smokers and 53 smokers the mean age of patients was not significantly different between groups. There were no significant differences among groups according to sperm concentration (P-Value 0.108), Morphology (P-Value 0.138) and Motility (P-Value 0.082). Also there were no significant relationship between sperm parameters and the amount of cigarettes people had used (based on Pack/year scale). Conclusion: Semen parameters (Morphology, Motility and concentration) were lower in smokers but there were no significant differences between groups.
Davar, R; Sekhavat, L; Naserzadeh, N
Polycystic ovary syndrome (PCOS) is a common condition with both a reproductive and metabolic phenotype. Women with PCOS often seek care because of infertility or menstrual cycle irregularities that result from chronic anovulation interspersed with occasional ovulatory cycles. Initially, it is important to delineate a differential diagnosis for oligo- or amenorrhea and to evaluate for disorders that may “masquerade” as
Jennifer F. Kawwass; Tammy L. Loucks; Sarah L. Berga
|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…
XX maleness is a rare syndrome with a frequency of 1 in 20 000-25 000 males. XX males exist in different clinical categories with ambiguous genitalia or partially to fully mature male genitalia, in combination with complete or incomplete masculinization. In this study, we report a case of SRY-negative XX male with complete masculinization but infertility. The patient had fully
Singh Rajender; Vutukuri Rajani; Nalini J. Gupta; Baidyanath Chakravarty; Lalji Singh; Kumarasamy Thangaraj
BACKGROUND: The possible interference of assisted reproduction techniques (ART) with epigenetic reprogram- ming during early embryo development has recently sparked renewed interest about the reported lower birth weight among infants born as a consequence of infertility treatments. However, the latter finding so far has relied on the comparison of the birth weight of infants conceived with ART to general population
C. De Geyter; M. De Geyter; S. Steimann; H. Zhang; W. Holzgreve
Ion radiation or radiotherapy is used to treat male patients with oligozoospermia, azoospermia, temporarily infertility, or even permanent infertility. The present study aims to investigate the potential infertility mechanism of sperm in mice after carbon ion radiation (CIR). The caudal epididymal sperm of male mice whole-body irradiated with carbon ion beam (0.5Gy and 4Gy) were used 7 days after irradiation. A two-dimensional gel electrophoresis approach was employed to investigate the changes in protein expression in the caudal edididymal sperm. Spot detection and matching were performed using the PDQuest 8.0 software. The criteria used to select spots for the analysis were more than a threefold difference in protein quantities (normalized spot volume), which allowed the detection of six differentially expressed proteins. Protein identification was performed using MALDI-TOF-TOF. Six specific proteins were identified by searching the NCBI protein sequence database. Among these proteins, HSP 70-2, PLC, GPX4, ?-tubulin, and GAPDHS were associated with sperm motility, which can affect fertility. ?-tubulin is important in axoneme migration flagellar movement and regulation, and GAPDHS is related to sperm energy supply. We analyzed their expressions using immunoblotting and immunofluorescence. The changes in sperm protein expression after CIR are mainly associated with motility. These proteins are potential markers for the mechanisms of infertility in space or radiotherapy. PMID:23435181
Li, Hong Yan; Zhang, Hong
The objective of this study was to employ proton nuclear magnetic resonance ((1)H NMR) spectroscopy to evaluate the impact of Mucuna pruriens seeds on the metabolic profile of seminal plasma of infertile patients. A total of 180 infertile patients were administered M. pruriens seed powder for a period of three months. Age-matched healthy men comprised the control (n=50) group in the study. Lactate, alanine, choline, citrate, glycerophosphocholine (GPC), glutamine, tyrosine, histidine, phenylalanine, and uridine were measured in seminal plasma by (1)H NMR spectroscopy. To evaluate the degree of infertility and extent of hormonal imbalance induced by this milieu, separate sperm concentration, motility, lipid peroxide in seminal plasma and LH, FSH, T, and PRL hormone concentration in serum were measured using standard laboratory methods and RIA, respectively, in the same subjects. M. pruriens therapy rectifies the perturbed alanine, citrate, GPC, histidine and phenylalanine content in seminal plasma and improves the semen quality of post-treated infertile men with compared to pre-treated. Concomitantly, clinical variables in seminal plasma and blood serum were also improved over post therapy in infertile men. On the basis of these observations, it may be proposed that M. pruriens seed powder not only reactivates the enzymatic activity of metabolic pathways and energy metabolism but also rejuvenates the harmonic balance of male reproductive hormones in infertile men. These findings open more opportunities for infertility treatment and management by improving semen quality. PMID:21459537
Gupta, Ashish; Mahdi, Abbas Ali; Ahmad, Mohammad Kaleem; Shukla, Kamla Kant; Bansal, Navneeta; Jaiswer, Shyam Pyari; Shankhwar, Satya Narain
BACKGROUND Functional male gametes are produced through complex processes that take place within the testis, epididymis and female reproductive tract. A breakdown at any of these phases can result in male infertility. The production of mutant mouse models often yields an unexpected male infertility phenotype. It is with this in mind that the current review has been written. The review aims to act as a guide to the ‘non-reproductive biologist’ to facilitate a systematic analysis of sterile or subfertile mice and to assist in extracting the maximum amount of information from each model. METHODS This is a review of the original literature on defects in the processes that take a mouse spermatogonial stem cell through to a fully functional spermatozoon, which result in male infertility. Based on literature searches and personal experience, we have outlined a step-by-step strategy for the analysis of an infertile male mouse line. RESULTS A wide range of methods can be used to define the phenotype of an infertile male mouse. These methods range from histological methods such as electron microscopy and immunohistochemistry, to hormone analyses and methods to assess sperm maturation status and functional competence. CONCLUSION With the increased rate of genetically modified mouse production, the generation of mouse models with unexpected male infertility is increasing. This manuscript will help to ensure that the maximum amount of information is obtained from each mouse model and, by extension, will facilitate the knowledge of both normal fertility processes and the causes of human infertility.
Borg, Claire L.; Wolski, Katja M.; Gibbs, Gerard M.; O'Bryan, Moira K.
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 42 days 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
Hu, Shao-Yang; Lin, Pei-Yu; Liao, Chia-Hsuan; Gong, Hong-Yi; Lin, Gen-Hwa; Kawakami, Koichi; Wu, Jen-Leih
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.
Stone, Mary Bishop; Lyon, Joseph L.; VanDerslice, James A.; Alder, Stephen C.
Background Hysterosalpingography (HSG) is recommended as a first-line investigation for tubal assessment of infertile women. This investigation is not routinely available to GPs. Aim To explore the perceptions and attitudes of patients and health professionals to open access HSG for the initial management of infertile couples in general practice. Design of study A nested qualitative study using in-depth interviews with GPs, fertility specialists, and infertile couples. Setting Northumberland, Newcastle upon Tyne, North Tyneside, South Tyneside, and Gateshead. Method Participants were 39 interviewees: 12 GPs, five fertility specialists, and 13 infertile couples (nine interviewed with their partner). Results Four themes emerged: personal factors; will it benefit patients, GPs, and fertility specialists?; professional factors; does it fit the role of a GP?; local context; do the skills exist in general practice?; and wider context; will it benefit the NHS? GPs who had used open access HSG, felt it was appropriate for general practice and would continue to use the service. All GPs, fertility specialists, and infertile couples who had experienced open access HSG wished the service to remain in place. The main barriers to its uptake were: infrequency with which infertility presents; lack of clarity on perceived responsibilities; difficulty keeping up to date, including assimilating guidelines; low clinical priority; and lack of support in authoritative guidance. Conclusion Providing GPs with open access to HSG would allow a full initial assessment of the infertile couple and refer women with blocked tubes directly to tertiary care. While there is general support for the provision of such a facility, the majority of GPs perceive its use as being by a limited number of GPs who have a special interest in infertility. The study findings can inform future development of infertility services at the interface between primary and secondary/tertiary care.
Wilkes, Scott; Rubin, Greg; Crosland, Ann; Hall, Nicola; Murdoch, Alison
Background Secondary infertility is a common, preventable but neglected reproductive health problem in resource-poor countries. This study examines the association of past sexually transmitted infections (STIs) including HIV, bacterial vaginosis (BV) and factors in the obstetric history with secondary infertility and their relative contributions to secondary infertility. Methods Between November 2007 and May 2009 a research infertility clinic was set up at the Kigali University Teaching Hospital in Rwanda. Cases were defined as sexually-active women aged 21-45 years presenting with secondary infertility (n = 177), and controls as multiparous women in the same age groups who recently delivered (n = 219). Participants were interviewed about socio-demographic characteristics and obstetric history using structured questionnaires, and were tested for HIV and reproductive tract infections (RTIs). Results Risk factors in the obstetric history for secondary infertility were lack of prenatal care in the last pregnancy, the first pregnancy before the age of 21 years, a history of unwanted pregnancy, a pregnancy with other than current partner, an adverse pregnancy outcome, stillbirth, postpartum infection and curettage. Presence of HIV, herpes simplex virus type 2 (HSV-2), or Treponema pallidum antibodies, and bacterial vaginosis (BV), were significantly more common in women in secondary infertile relationships than those in fertile relationships. The population attributable fractions (PAF%) for obstetric events, HIV, other (STIs), and BV were 25%, 30%, 27%, and 14% respectively. Conclusions The main finding of this study is that obstetric events, HIV and other STIs contribute approximately equally to secondary infertility in Rwanda. Scaling up of HIV/STI prevention, increased access to family planning services, improvement of prenatal and obstetric care and reduction of stillbirth and infant mortality rates are all likely to decrease secondary infertility in sub-Saharan Africa.
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 20–44 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
Boerma, Ties; Vanderpoel, Sheryl; Stevens, Gretchen A.
Recent experimental animal studies suggested that the circadian locomotor output cycles kaput protein gene (CLOCK) may play an important role in male reproduction. So far, such data for humans are not available. This study used single-nucleotide polymorphisms (SNP) to examine the association between CLOCK and semen quality in a human population with idiopathic infertility. Three-variant genotyping of CLOCK and semen analysis were performed in 478 men with idiopathic infertility by SNP genotyping assays and computer-aided sperm analysis. Subjects carrying a C allele at rs3749474 (CC and TC) presented significantly lower semen volume (P=<0.001 and 0.001, respectively) compared with the TT genotype. Subjects carrying the rs3749474 CC genotype had significantly lower sperm number per ejaculate (P=0.026) and sperm motility (P=0.021) than TT genotype carriers. rs1801260 TC genotype carriers had significantly lower sperm motility compared with the TT genotype (P=0.028). For the rs3817444 genotypes, CA and AA genotype carriers presented significantly lower semen volume compared with the CC genotype (P=0.022 and 0.001, respectively). The findings suggest, as far as is known for the first time, an association between CLOCK genetic variants and altered semen quality in a human population with idiopathic infertility. The gene encoding the circadian locomotor output cycles kaput protein (CLOCK) functions as an important positive enhancer of the circadian system. The observations reported in recent experimental animal studies suggested that CLOCK may play an important role in male reproduction. So far, such data for humans are not available. In this study, single-nucleotide polymorphisms (SNP) were used to examine the association between CLOCK and semen quality in human population with idiopathic infertility. Three-variant genotyping of CLOCK and semen analysis were performed in 478 males with idiopathic infertility by SNP genotyping assays and computer-assisted semen analysis. The results showed that the subjects carrying a C allele at rs3749474 (CC and TC) presented significantly lower semen volume compared with the TT genotype. For subjects carrying the CC genotype, sperm number per ejaculate and sperm motility were significantly lower compared with TT genotype carriers. The rs1801260 TC genotype carriers also had significantly lower sperm motility compared with the TT genotype. For the rs3817444 genotypes, the CA and AA genotype carriers presented significantly lower semen volume compared with the CC genotype. The findings suggested, as far as is known for the first time, an association between CLOCK genetic variants and altered semen quality in a human population with idiopathic infertility. PMID:22999556
Zhang, Jie; Ding, Xinliang; Li, Yingchun; Xia, Yankai; Nie, Jihua; Yi, Cao; Wang, Xinru; Tong, Jian
Purpose Association of ESR1 gene PvuII, XbaI and (TA)n microsatellite polymorphisms and woman infertility was evaluated.\\u000a \\u000a \\u000a \\u000a Methods Infertile(n?=?104) and fertile(n?=?107) women were included in this study. We performed polymerase chain reaction-restriction fragment-length polymorphism\\u000a analysis for detecting ESR1 polymorphisms.\\u000a \\u000a \\u000a \\u000a Result(s) PvuII and XbaI polymorphisms confered risk for infertility in a simple dominant manner in which a significant relationship\\u000a was observed between infertile and control
Özge Üner Ayvaz; Abdullah Ekmekçi; Volkan Baltac?; Hacer ?lke Önen; Evrim Ünsal
Purpose: The aim of our study was to determine the incidence of AZF deletions and familial forms of infertility suggesting autosomal mutations among patients requiring intracytoplasmic sperm injection with ejaculated sperm.
J. Selva; S. Kanafani; Y. Prigent; V. Poncet; M. Bergčre
We previously have shown the efficacy of recombinant (r) chlamydial protease-like activity factor (CPAF) vaccination against hydrosalpinx development following primary genital chlamydial challenge. In this study, we evaluated further the protection induced by rCPAF vaccination against infertility. Following primary challenge, fertility levels were not significantly different between the mock- and CPAF-vaccinated and Chlamydia alone challenged mice. However, following secondary genital chlamydial challenge, mock (PBS) immunized mice displayed a significant reduction of fertility compared to age-matched naďve mice, while mice vaccinated intranasally with rCPAF+CpG displayed significant prevention of infertility. These results suggest that hydrosalpinx may be a reliable indicator of impending infertility, and that rCPAF is a promising candidate to prevent infertility resulting from repeated genital chlamydial infections.
Murthy, Ashlesh K.; Li, Weidang; Guentzel, M. Neal; Zhong, Guangming; Arulanandam, Bernard P.
Objective: To evaluate two different assays of human sperm DNA integrity, DNA denaturation (DD) and DNA fragmentation (DF), and to correlate these with standard semen parameters.Design: Prospective, observational study.Setting: University infertility clinic.Patient(s): Forty consecutive semen samples from 33 nonazoospermic men presenting for infertility evaluation and 7 fertile men presenting for vasectomy.Intervention(s): Assessment of sperm concentration, motility, morphology, DD and DF.Main
Armand Zini; Ryszard Bielecki; Donna Phang; Maria Teresa Zenzes
BACKGROUND: The polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting female fertility. In this study, we examined the symptomatology of PCOS and the health-related quality of life among infertility patients suffering from PCOS with different socio-cultural and ethnic background. METHODS: Symptomatology of PCOS, body composition characteristics as well as socio-economic factors were examined in 49 PCOS infertility
Julia Schmid; Sylvia Kirchengast; Elisabeth Vytiska-Binstorfer; Johannes Huber
Environmental xenobiotics such as organophosphate pesticides are known factors involved in male infertility. Paraoxanase (PON) and glutathione transferase (GST) are involved in biotransformation of organophosphate pesticides. Interindividual genetic variations in biotransformation enzyme activities can lead to differences in the susceptibility to male infertility. This case-control study investigated associations between polymorphisms in the PON and GST genes (PON1–55\\/192, PON2–311, GSTM1\\/T1) and
Marija Volk; Helena Jakli?; Branko Zorn; Borut Peterlin
BACKGROUND: Three typical folate metabolism enzymes—i.e. methylenetetrahydrofolate reductase (MTHFR), methionine synthase (MS) and MS reductase (MTRR) in the folate cycle—play a critical role in DNA synthesis and methylation reactions. We evaluated whether polymorphisms of these three enzymes are associated with non- obstructive male infertility. METHOD: Three hundred and sixty patients with non-obstructive infertility and 325 fertile men without any chromosomal
Han-Chul Lee; Yu-Mi Jeong; Sook Hwan Lee; Kwang Yul Cha; Seung-Hun Song; Nam Keun Kim; Kyo Won Lee; Suman Lee
Purpose In view of the genetic risks for the next generation, the importance of careful evaluation of karyotypes and AZF microdeletions\\u000a in male infertility prior to assisted reproduction is evident. In the present study, it is aimed to investigate the frequency\\u000a and types of both major chromosomal abnormalities by using standard cytogenetic methods and Y chromosome microdeletions of\\u000a infertile males with
M. Balkan; S. Tekes; A. Gedik
The purpose of this article is to ascertain and appraise the ethical issues inherent to the utilisation of preimplantation genetic diagnosis for gender selection in infertile patients anticipating undergoing a medically indicated assisted reproductive technique procedure. Performance of preimplantation genetic diagnosis per request specifically for gender selection by an infertile couple undergoing medically indicated assisted reproductive technique may not breach the principles of ethics, and is unlikely to alter the population balance of sexes. PMID:18667646
Merhi, Z O; Pal, L
The levels of two proinflammatory cytokines, namely tumor necrosis factor ! (TNF-!) and interleukin 6 (IL-6), were investigated in seminal plasma (SP) of proven fertile (n=24) and infertile (n=55) men to evaluate the relationship between diagnosis and semen parameters in a prospective study. Infertile men were divided into four groups as follows: (1) varicocele (n=23), (2) 3 months after varicocelectomy
Izzet Koçak; Çigdem Yenisey; Mehmet Dündar; Pinar Okyay; Mukadder Serter
Because research on infertile women usually uses clinic-based samples of treatment seekers, it is difficult to sort out to what extent distress is the result of the condition of infertility itself and to what extent it is a consequence of the experience of infertility treatment. We use the National Survey of Fertility Barriers, a two-wave national probability sample of U.S. women, to disentangle the effects of infertility and infertility treatment on fertility-specific distress. Using a series of ANOVAs, we examine 266 infertile women who experienced infertility both at Wave 1 and at Wave 2, three years later. We compare eight groups of infertile women based on whether or not they have received treatment and on whether or not they have had a live birth. At Wave 1, infertile women who did not receive treatment and who had no live birth reported lower distress levels than women who received treatment at Wave 1 only, regardless of whether their infertility episode was followed by a live birth. At Wave 2, women who received no treatment have significantly lower fertility-specific distress than women who were treated at Wave 1 or at Waves 1 and 2, regardless of whether there was a subsequent live birth. Furthermore, fertility-specific distress did not increase over time among infertile women who did not receive treatment. The increase in fertility-specific distress was significantly higher for women who received treatment at Wave 2 that was not followed by a live birth than for women who received no treatment or for women who received treatment at Wave 1 only. These patterns suggest that infertility treatment is associated with levels of distress over and above those associated with the state of being infertile in and of itself.
Greil, Arthur L.; McQuillan, Julia; Lowry, Michele; Shreffler, Karina M.
BACKGROUND. Subfertility in general practice is a common problem. However, most treatment is initiated in hospital. There may be a role for general practitioners in the treatment of some infertile patients. AIM. The aim of this study was to investigate the prevalence and management of infertility in women in general practice and to identify a specific cohort of patients potentially suitable for management in primary care. METHOD. The general practice notes of all women patients between the ages of 16 and 42 years who presented to their general practitioner with an infertility problem in the five years preceding July 1993 were analysed retrospectively. The patients were identified from the computer database of one Durham general practice. RESULTS. Fifty four cases were identified over the five year period, giving a prevalence of infertility in women in the practice of 15 per 1000 women. Of those who had a definite diagnosis made, 27% had an ovulatory disorder. Women with an ovulatory disorder tended to have a low serum day 21 progesterone level (90%); to present with primary infertility (80%); and to receive clomiphene as first line therapy (80%). The majority of ovulation induction therapy (95%) was initiated in secondary care. CONCLUSION. Ovulation induction therapy with clomiphene appears to be uncommon in general practice at present. Women requiring ovulation induction therapy may be a cohort of patients suitable for such management in general practice. These patients tend to present with primary infertility and to have a low mid-luteal progesterone level.
Wilkes, S; Jones, K
The subject of male infertility has, to a large extent, been broached from a western perspective that often insists on the biological factor. This approach has led to a narrowed and narrowing perception of male infertility in that it often neglects other possible crucial socio-cultural dimensions pertaining to the issue. The study is purely qualitative. Focus group discussions and key informant interviews (with males and females) are used to collect qualitative data. The study notes that, unlike in western inclined discourses, male infertility is an intricate condition that transcends biology. Witchcraft and punishment either from God or angry ancestors were avowed to be the determinants of male infertility. The study notes that the Shona people in Mhondoro-Ngezi exclusively rely on socio-cultural intervention strategies to solve the problem of male infertility. The study thus recommends a holistic approach to male infertility which integrates the socio-cultural perspectives in policy and programming, if progress is to be made in unearthing the underlying causes and treatment options. PMID:24069755
Moyo, Stanzia; Muhwati, Itai
Traditional healers have been an established source of health care delivery in Africa for centuries while Christian religious healers (193 traditional healers and 99 Christian religious healers) with respect to infertility and some other fertility-related issues. The findings show that both types of healers believe that infertility is most commonly due to the past life of the woman, physical problems related to the womb or to male potency, and imcompatibity between the man and the woman. Traditional healers also believed that being bewitched or being cursed can lead to infertility. Both groups of healers threat infertility by sacrifices, prayer and fasting, and timing of intercourse to coincide with the fertile period. Also 61% of traditional healers and 87% of religious healers advice their-clients with infertility to do nothing at least initially. To those clients seeking advice on preventing pregnancy, traditional healers tend to recommend herbal concoctions, beads and rings while Christian healers tended to recommend condoms, withdrawal method and the safe period. Both groups are consulted on premarital sex, premarital conception, sex during pregnancy and influencing the sex of an unborn baby. It was concluded that both traditional healers and Christian faith healers are involved with infertility and other fertility-related issues in their practices. There is an overlap in beliefs about causes and treatment of such conditions among both groups although areas of differences in beliefs and practices are clearly identifiable. PMID:10456130
Obisesan, K A; Adeyemo, A A
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
Infertility is a major health problem which affects approximately 22% of married couples in reproductive age. Chromosomal defects are the most common genetic abnormalities in infertile men, with an incidence of cytogenetic abnormalities ranging from 2.1% to 15.5%. We describe here the clinical and cytogenetic studies carried out in a couple with repeated abortions. Cytogenetic analysis of the couple showed a de novo chromosomal translocation t (2;11)(p14;q21) in the male partner and a normal 46, XX karyotype in the female counterpart. Such an autosomal translocation may lead to the disruption of genes responsible for spermatogenesis or impaired synaptic complex pairing during meiosis resulting in reproductive failure. PMID:23738880
Ananthapur, V; Avvari, S; Veena, K; Sujatha, M; Jyothy, A
Introduction Unwanted contraception through prolonged retention of fetal bone is a rare cause of secondary infertility. It is usually associated with a history of abortion, either spontaneous or induced. Case presentation We describe a case of intrauterine retention of fetal bone diagnosed 8 years after the termination of a pregnancy. The patient had no complaints of pain, irregular vaginal bleeding or discharge. A hysteroscopy was performed and irregular structures were removed. These fragments were fetal bones, which probably functioned as an intrauterine contraceptive device. After removal of the fetal bone fragments the patient conceived spontaneously within 6 months. Conclusion This case report stresses the importance of taking a thorough history and evaluation of the endometrium by transvaginal ultrasound or hysteroscopy in women with secondary infertility.
Kramer, Hannah MC; Rhemrev, Johann PT
Varicocele in infertile males is associated with Leydig cell dysfunction and hypogonadism. The effect of varicocelectomy on serum testosterone level is not yet established. We analysed 200 heterosexual infertile men diagnosed to have clinical varicocele they were divided into two groups: group 1 (100 men) had microsurgical varicocelectomy, and group 2 (100 patients) underwent assisted reproduction procedures. All participants had semen analysis, serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and total testosterone (TT), measured both at recruitment time and 6 months later. In group 1, the mean TT level increased significantly after varicocelectomy (1.644 ± 0.029 to 2.461 ± 0.0198?ng/dL, P < 0.0001) and testicular size correlated with the mean change in TT (P = 0.001). No similar change was found in group 2. Out of the 100 patients in group 1, 78 had postoperative normalization of TT unlike only 16 men in group 2.
Sathya Srini, Vasan; Belur Veerachari, Srinivas
Sulphasalazine treatment for inflammatory bowel disease in man causes oligospermia, reduced sperm motility and an increased proportion of abnormal forms. On withdrawal of sulphasalazine these effects are found to be reversible and 15 pregnancies occurred at a median of 2.5 months after stopping sulphasalazine therapy. Seminal plasma concentrations of acid phosphatase fructose and PGE2 as well as the hormone profiles of patients on sulphasalazine for three months were found to be within normal limits. Sulphasalazine fed to male Sprague Dawley rats caused a dose dependent and reversible infertility with a significant reduction in litter size. Rats fed the metabolite sulphapyridine also had a reduced litter size when mated, while those fed the metabolite 5'aminosalicylic acid and a polymer of 5'aminosalicylic acid did not. It seems likely that the sulphapyridine moiety of sulphasalazine is responsible for the infertility seen, the effect being mediated at a late stage in sperm maturation.
O'Morain, C; Smethurst, P; Dore, C J; Levi, A J
Recently we demonstrated an ectopic expression of the human herpesvirus 1 thymidine kinase (HHV1-TK) gene by functioning of an intrinsic endogenous promoter in the transgenic rat (TG-rat), suggesting that HHV1 infection in humans induces expression of the TK gene with the ectopic promoter in the testis and results in accumulation of HHV1-TK protein, triggering male infertility similar to that in the TG-rat. Hence, in this study, we started to investigate a relationship between infection of herpesvirus and human male infertility. Semen was donated by Chinese male infertile patients (153 men, aged 21-49 years) with informed consent, followed by DNA preparation and analysis by PCR and DNA sequencing. Semen volume, sperm number and density, and sperm mortality were examined. DNAs of HHV1, HHV3, HHV5 and HHV6 were confirmed by PCR, electrophoresis and DNA sequencing. Finally, virus DNA was identified in 59 patients (39%). The number of carriers was 39 (25%) for HHV1, 6 (4%) for HHV4, 33 (22%) for HHV5 and 3 (2%) for HHV6, respectively. Moreover, double-infection was found in 22 out of 59 specimens (37%), most of which were double-infection of HHV1 and HHV5 (15 out of 22 carriers). Though slight severity was present in some of the carriers, the relationship between virus infection and sperm impairment was not conclusive. Accordingly, it is essential to examine whether the viral HHV1-TK gene is expressed in the testis of the infertile human HHV carrier. PMID:23748714
Chen, Mo; Cai, Li-Yi; Kanno, Naoko; Kato, Takako; Lu, Jinxing; Jin, Fan; Wang, Honghua; Sekita, Masayo; Higuchi, Masashi; Yoshida, Saishu; Yako, Hideji; Ueharu, Hiroki; Izumi, Shun-Ichiro; Kato, Yukio
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, 10-15 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
Mendeluk, Gabriela Ruth; Costa, Sergio López; Scigliano, Sergio; Menga, Guillermo; Demiceu, Sergio; Palaoro, Luis Alberto
Objective: To determine the efficacy of two different group psychological interventions on viable pregnancy rates in women experiencing infertility of less than 2 years’ duration.Design: Prospective, controlled, single-blind, randomized study.Setting: Large tertiary-care teaching hospital.Patient(s): One hundred eighty-four women who had been trying to get pregnant for 1 to 2 years.Intervention(s): Participants were randomized into a 10-session cognitive-behavioral group, a standard
Alice D Domar; Diane Clapp; Ellen A Slawsby; Jeffery Dusek; Bruce Kessel; Melissa Freizinger
Investigations on the effects of acid soil infertility factors on legumes are often focussed on growth, nodulation, and N2?fixation, while very little emphasis has been given to the mineral composition of plants. In the present investigation, effects of varying solution pH [4.5, 5.0 and 5.5], concentrations of Ca [0.05, 0.5 and 2.5 mM] and activities of Al [0 ? 33
A. K. Alva; D. G. Edwards; C. J. Asher
Objectives: High levels of follicle stimulating hormone (FSH) in infertile males received a significant attention and exploration. Studies investigating the isolated deficiency of FSH in males are few, and its real prevalence is still unknown. Therefore, the objectives of the current study was to report the prevalence of isolated low FSH in infertile males and highlight their demographics and standard sperm parameters. Methods: Records of 3335 infertile men were retrospectively checked. Patients with isolated low FSH were retrieved. FSH levels were categorized into 3 groups based on the number of affected sperm parameter (s). Study variables were also arranged into 2 groups in relation to smoking history. A control group was included to document the changes in sperm morphology. Results: Isolated low FSH (1.146 ± 0.219 mIU/mL) was found in 29 (0.87%) patients. All patients showed at least one abnormal sperm parameter. The abnormal parameters were present in different combinations within the same patient but with no significant correlations with the FSH levels. The FSH levels got lower as the number of the affected sperm parameters increased although the decline was insignificant. The most frequent abnormal parameter presented was sperm morphology (86.2%). Anomalous sperm morphology was highly and significantly demonstrated in the head; specifically in acrosome. Abnormal sperm parameters were present in both smoking and nonsmoking groups but with no significant differences in between. Conclusions: Isolated low FSH among infertile males has a low prevalence. This may be associated with abnormality in semen parameters; particularly sperm morphology. These patients are suggested to be found as a primary entity. However, an additional work-up is highly recommended to validate this hypothesis. PMID:24085232
Salama, Nader; El-Sawy, Mohamed
This paper aims to complement existing clinical guidelines charges rather than the true cost of treatment. Insurance-based by providing evidence of the relative cost-effectiveness of charges rely on a top-down approach to costing and are treatments for infertility in the UK. A series of decision- presented at an aggregate level. Furthermore, they cannot be analytical models have been developed to
Z. Philips; M. Barraza-Llorens; J. Posnett
The methylenetetrahydrofolate reductase (MTHFR) gene is one of the main regulatory enzymes involved in folate metabolism, DNA synthesis and remethylation reactions. The influence of MTHFR variants on male infertility is not completely understood. The objective of this study was to analyze the distribution of the MTHFR C677T and A1298C variants using PCR-Restriction Fragment Length Polymorphism (RFLP) in a case group
Abdelmajid Eloualid; Omar Abidi; Majida Charif; Brahim El houate; Houda Benrahma; Noureddine Louanjli; Elbakkay Chadli; Maria Ajjemami; Abdelhamid Barakat; Anu Bashamboo; Ken McElreavey; Houria Rhaissi; Hassan Rouba
Objective: To compare transvaginal sonography with hysteroscopy for the evaluation of intrauterine disorders.Design: Clinical study.Setting: Academic research environment.Patient(s): Patients who were undergoing initial evaluation for primary or secondary infertility or investigation after three failed IVF attempts.Intervention(s): Transvaginal sonography was performed, followed by hysteroscopy, between January 1998 and April 1999. The endometrial findings at sonography were compared with those at hysteroscopy,
Josef Shalev; Israel Meizner; Itay Bar-Hava; Dov Dicker; Reuben Mashiach; Zion Ben-Rafael
s Androgen and the androgen receptor (AR) have been shown to play critical roles in male fertility. Our previous data demonstrated\\u000a that mice lacking AR (AR?\\/y) revealed incomplete germ cell development and lowered serum testosterone levels, which resulted in azoospermia and infertility.\\u000a However, the consequences of AR loss in Leydig cells remain largely unknown. Using a Cre-LoxP conditional knockout strategy,\\u000a we
Qingquan Xu; Hung-Yun Lin; Shauh-Der Yeh; I-Chen Yu; Ruey-Shen Wang; Yen-Ta Chen; Caixia Zhang; Saleh Altuwaijri; Lu-Min Chen; Kuang-Hsiang Chuang; Han-Sun Chiang; Shuyuan Yeh; Chawnshang Chang
The roles of E-cadherin and ?-catenin were evaluated in the development of varicocele-induced infertility. Analysis of the association between the expression of E-cadherin\\/?-catenin and clinical\\/pathological parameters was performed. Thirty 10-week-old male rats (experimental group) were used for the experiments; the left renal vein was ligated to form a varicocele. The abdomen was incised in 30 rats (control group) and no
Hong Koo Ha; Hyun Jun Park; Nam Cheol Park
BackgroundTreatment of patients according to individual pattern diagnoses is an important feature of acupuncture rooted in traditional Chinese medicine (TCM). Little is known about the reliability of TCM pattern diagnoses.ObjectiveTo examine in a cross-sectional study the inter-rater reliability of TCM diagnoses and acupuncture point selection.Methods30 infertile and 24 previously pregnant women were examined for TCM patterns by two acupuncturists. An
Oddveig Birkeflet; Petter Laake; Nina Vřllestad
BACKGROUND: This study analyses the prevalence of karyotype changes and Yq11 microdeletions among couples referred for assisted reproduction techniques. METHODS: Prior to receiving either IVF or ICSI treat- ment, each partner of 2078 infertile couples was screened for karyotype changes by GTG-banding technique on peripheral lymphocytes. No subject presented with obvious phenotype of chromosomal rearrangement. All the oligo\\/azoospermic men with
E. Clementini; C. Palka; I. Iezzi; L. Stuppia; P. Guanciali-Franchi; G. M. Tiboni
We present a case of an XX male with carcinoma of the breast and primary infertility. He was admitted to hospital with recurrent chest pains, but a history of surgery for breast carcinoma, gynaecomastia and the finding of bilaterally atrophied testes, coupled with the fact that he had never fathered children, necessitated further investigations. Chromosomal analysis showed a 46, XX male genotype with a normal X chromosome and an abnormal X chromosome formed by translocation between the short arm of one X chromosome and the Y chromosome. By using fluorescence in situ hybridisation, the patient proved to be SRY positive, the sex-determining region of the Y chromosome. In this rare genetic abnormality, males retain normal phenotype but they are generally of short stature, have gynaecomastia, and may have genital anomalies. They are infertile and at increased risk of developing carcinoma of the breast. This seems to be the first documented case of carcinoma of the breast in an SRY positive XX male. This particular case illustrates the need for all cases of male breast cancer to undergo full endocrinological assessment, especially in the presence of genital anomaly or infertility. PMID:14686579
Hado, H S H; Helmy, S W; Klemm, K; Miller, P; Elhadd, T A
Objective To determine the effect of infertility-linked sperm phospholipase C? (PLC?) mutations on their ability to trigger oocyte Ca2+ oscillations and development, and also to evaluate the potential therapeutic utility of wild-type, recombinant PLC? protein for rescuing failed oocyte activation and embryo development. Design Test of a novel therapeutic approach to male factor infertility. Setting University medical school research laboratory. Patient(s) Donated unfertilized human oocytes from follicle reduction. Intervention(s) Microinjection of oocytes with recombinant human PLC? protein or PLC? cRNA and a Ca2+-sensitive fluorescent dye. Main Outcome Measure(s) Measurement of the efficacy of mutant and wild-type PLC?-mediated enzyme activity, oocyte Ca2+ oscillations, activation, and early embryo development. Result(s) In contrast to the wild-type protein, mutant forms of human sperm PLC? display aberrant enzyme activity and a total failure to activate unfertilized oocytes. Subsequent microinjection of recombinant human PLC? protein reliably triggers the characteristic pattern of cytoplasmic Ca2+ oscillations at fertilization, which are required for normal oocyte activation and successful embryo development to the blastocyst stage. Conclusion(s) Dysfunctional sperm PLC? cannot trigger oocyte activation and results in male factor infertility, so a potential therapeutic approach is oocyte microinjection of active, wild-type PLC? protein. We have demonstrated that recombinant human PLC? can phenotypically rescue failed activation in oocytes that express dysfunctional PLC?, and that this intervention culminates in efficient blastocyst formation.
Nomikos, Michail; Yu, Yuansong; Elgmati, Khalil; Theodoridou, Maria; Campbell, Karen; Vassilakopoulou, Vyronia; Zikos, Christos; Livaniou, Evangelia; Amso, Nazar; Nounesis, George; Swann, Karl; Lai, F. Anthony
Objective To investigate the influence of laparoscopic surgery on the natural conception rate in infertile women with endometriosis during the first year after the operation. Methods We retrospectively studied 43 infertile women with surgically proven endometriosis. The natural conception rate was investigated for the 12 months after the laparoscopy. Results The overall pregnancy rate was 41.9% (18/43). 66.7% (12/18) and 94.4% (17/18) of the patients conceived within postoperative 3 months and 6 months, respectively. The spontaneous pregnancy rate was not associated with the severity of endometriosis or laparoscopic findings or the type of surgery. The pregnancy rate for stage IV was relatively low (20.0%) compared to stage I, II, and III (35.7%, 44.4%, and 53.3%, respectively), although it did not reach statistical significance. Conclusion Conservative surgical treatment with laparoscopy and a prompt attempt at natural conception may be effective for infertile patients with endometriosis.
Lee, Hye Jun; Lee, Jae Eun; Ku, Seung-Yup; Kim, Seok Hyun; Kim, Jung Gu; Moon, Shin Yong
The aim of the investigations was to study the efficiency of demedullation of both ovaries in the case of polycystic ovary syndrome (POS), determination of infertility structure in patients in case of ineffective operation of POS and determination of additional treatment tactics in these patients. In all 245 patients tests of functional diagnostics were carried out as well as the ultrasound investigation of pelvic organs and adrenal glands, X-ray of skull and sella turcica, hysterosalpingography were performed. In blood serum the basal levels of prolactin, LH, FSH, estradiol, progesterone and cortisol were investigated by RIA. In twenty four-hours urine 17 KS, DHA and 17 OKS levels were determined. In all patients laparoscopy, hysteroscopy, chromopertubation with diagnostic curettage of uterus cavity were performed. According to the data in operated patients without a positive effect the most frequent cause of infertility was anovulation. Therefore, even successful surgical intervention and recovery of ovarian function do not guarantee post operational adhesions, which can cause infertility of tuboperitoneal genesis. Treatment tactics of patients operated due to POS without effect can't be standard and depend on revealed pathology discovered in post operational period. PMID:17077476
Bablidze, N I
Context: The pseudoautosomal regions (PARs) of the Y-chromosome undergo meiotic recombination with the X-chromosome. PAR mutations are associated with infertility and mental and stature disorders. Objective: The aim of the study was to determine whether men with Y-chromosome microdeletions have structural defects in PARs. Design and Participants: Eighty-seven infertile men with Y-chromosome microdeletions and 35 controls were evaluated for chromosomal rearrangements using commercial or custom (X- and Y-chromosome) array comparative genomic hybridization or by quantitative PCR of selected PAR genes. Multisoftware-defined chromosomal gains or losses were validated by quantitative PCR and FISH. Results: Array comparative genomic hybridization confirmed the AZF deletions identified by multiplex PCR. All men with Y-chromosome microdeletions and an abnormal karyotype displayed PAR abnormalities, as did 10% of men with Y-chromosome microdeletions and a normal karyotype. None of the control subjects or infertile men without Y-chromosome microdeletions had PAR duplications or deletions. SHOX aberrations occurred in 14 men (nine gains and five losses); four were short in stature (<10th percentile), and one was tall (>95th percentile). In contrast, the height of 23 men with Y-chromosome microdeletions and normal PARs was average at 176.8 cm (50th percentile). Conclusions: Y-chromosome microdeletions can include PAR defects causing genomic disorders such as SHOX, which may be transmitted to offspring. Previously unrecognized PAR gains and losses in men with Y-chromosome microdeletions may have consequences for offspring.
Weedin, John W.; Sahin, Aysegul; Tannour-Louet, Mounia; Han, Shuo; Bournat, Juan C.; Mielnik, Anna; Cheung, Sau Wai; Nangia, Ajay K.; Schlegel, Peter N.; Lipshultz, Larry I.
Objective To evaluate the effect of the addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles for infertile patients undergoing IVF/ICSI. Methods One hundred and ten infertile patients, aged 28 to 39 years, were recruited for this prospective randomized study. They were randomly assigned to receive vaginal progesterone gel (Crinone) along with 4 mg estradiol valerate (group 1, n=55) or only Crinone (group 2, n=55) for luteal support. A GnRH antagonist multiple dose protocol using recombinant human FSH was used for controlled ovarian stimulation (COS) in all of the subjects. The COS results and pregnancy outcomes of the two groups were compared. Results Group 1 and 2 were comparable with respect to the patient characteristics. The COS and IVF results were also comparable between the two groups. There were no differences in the clinical pregnancy rate (PR) and multiple PR between the two groups. However, the embryo implantation rate were significantly higher in group 1 than that in group 2 (22.2% vs. 13.3%, p=0.035). The incidence of luteal vaginal bleeding (LVB) was significantly lower in group 1 (7.4% vs. 27.8%, p=0.010). Conclusion The addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles reduces the incidence of LVB and increases the embryo implantation rate in infertile patients undergoing IVF/ICSI.
Kwon, Su-Kyoung; Lee, Kyung-Hee; Jeon, Il Kyung; Ahn, Jun-Woo; Kim, Sung-Hoon; Chae, Hee-Dong; Kang, Byung-Moon
One in seven couples worldwide are infertile, and male factor infertility accounts for approximately 30%–50% of these cases. Although many genes are known to be essential for gametogenesis, there are surprisingly few monogenic mutations that have been conclusively demonstrated to cause human spermatogenic failure. A nuclear receptor, NR5A1 (also called steroidogenic factor 1), is a key transcriptional regulator of genes involved in the hypothalamic-pituitary-steroidogenic axis, and it is expressed in the steroidogenic tissue of the developing and adult human gonad. Mutations of NR5A1 have been reported in 46,XY disorders of sex development and in 46,XX primary ovarian insufficiency. To test the hypothesis that mutations in NR5A1 cause male infertility, we sequenced NR5A1 in 315 men with idiopathic spermatogenic failure. We identified seven men with severe spermatogenic failure who carried missense mutations in NR5A1. Functional studies indicated that these mutations impaired NR5A1 transactivational activity. We did not observe these mutations in more than 4000 control alleles, including the entire coding sequence of 359 normospermic men and 370 fertile male controls. NR5A1 mutations are found in approximately 4% of men with otherwise unexplained severe spermatogenic failure.
Bashamboo, Anu; Ferraz-de-Souza, Bruno; Lourenco, Diana; Lin, Lin; Sebire, Neil J.; Montjean, Debbie; Bignon-Topalovic, Joelle; Mandelbaum, Jacqueline; Siffroi, Jean-Pierre; Christin-Maitre, Sophie; Radhakrishna, Uppala; Rouba, Hassan; Ravel, Celia; Seeler, Jacob; Achermann, John C.; McElreavey, Ken
This article investigates how doctors configured infertile men and sperm donors in the development of donor insemination (DI) in Taiwan. In the initial stage (1950s-1970s) doctors adjusted clinical procedures to repair the deformed gender identities of infertile men. To expand DI in the late 1970s and early 1980s, doctors stressed the positive eugenics of DI by spotlighting the high intelligence of donors, playing down biological patrilineage and re-emphasising the contribution of men of higher rank in society. In the mid-1980s, when donors came to be seen as potential carriers of fatal diseases like acquired immune deficiency syndrome, doctors managed to associate risky donors with socially stigmatised men, and therefore perpetuate the conventional hierarchy of masculinities. As the intracytoplasmic sperm injection emerged in the early 1990s doctors quickly presented infertile men as universally longing for biological fatherhood and hence devalued DI in an attempt to augment paternal masculinity. These diverse configuration activities come together to create a socio-technical network of DI that most of the time perpetuates the reigning gender order, rather than destabilising it. I argue the importance of incorporating various types of participants in analysis to understand the changing dynamics of multiple masculinities along with the development of DI. PMID:20937052
Mitochondrial genomes are usually inherited maternally and therefore there is no direct selection against mutations that have deleterious effects in males only (mother's curse). This is true in particular for mitochondrial mutations that reduce the fertility of their male carriers, as has been reported in a number of species. Using both analytical methods and computer simulations, we demonstrate that spatial population structure can induce strong selection against such male infertility mutations. This is because (1) infertile males may reduce the fecundity of the females they mate with and (2) population structure induces increased levels of inbreeding, so that the fitness of females carrying the mutation is more strongly reduced than the fitness of wild-type females. Selection against mitochondrial male infertility mutations increases with decreasing deme size and migration rates, and in particular with female migration rates. On the other hand, the migration model (e.g., island or stepping stone model) has generally only minor effects on the fate of the mitochondrial mutations. PMID:23025607
Zhang, Hui; Guillaume, Frédéric; Engelstädter, Jan
Assisted reproductive technology is an evolving area, and several adjuvant procedures have been created to increase a couple's chance of conceiving. For male infertility, the current challenges are to properly accommodate old and new techniques that are both cost-effective and evidence-based. In this context, urologists are expected to diagnose, counsel, provide medical or surgical treatment whenever possible and/or correctly refer male patients for assisted conception. Urologists are sometimes part of a multiprofessional team in an assisted reproduction unit and are responsible for the above-cited tasks as well as the surgical retrieval of sperm from either the epididymides or testicles. We present a comprehensive review of the surgical treatment options for infertile males, including the perioperative planning and prognostic aspects, with an emphasis on the role of microsurgery in the optimization of treatment results. This review also discusses current techniques for sperm retrieval that are used in association with assisted reproductive technology and includes sperm retrieval success rates according to the technique and the type of azoospermia. New insights are provided with regard to each surgical treatment option in view of the availability of assisted conception to overcome male infertility.
Esteves, Sandro C.; Miyaoka, Ricardo; Agarwal, Ashok
Background Chlamydia trachomatis is the most reported bacterial sexually transmitted disease, especially among young women worldwide. The aim of this study was comparison the prevalence of Chlamydia trachomatis infection in woman with tubal infertility by means of PCR and cell culture techniques. Methods Fifty-one women with confirmed TFI were enrolled in this study in (avicenna infertility Clinic) between January 2010 and January 2011. Cervical swab and cytobrush specimens were collected from each patient by gynecologists and sent to laboratory in transport media. Detection of Chlamydia trachomatis in samples was performed using PCR and bacteria culture in MacCoy cell line. The data were analyzed by Fisher's exact test and independent t-test. Statistical significance was established at a p-value <0.05. Results A significant relation was observed between increased the age of first intercourse and chlamydial infection. Six (11.7%) samples had positive PCR result, whereas cell culture results were positive in only 2 (3.9%) samples. A significant relation was also identified between the duration of infertility and infection (p < 0.05) by PCR versus cell culture method. Conclusion The results showed that PCR is a rapid method, compared to cell culture for detecting Chlamydial organism. It also became clear that the age at first intercourse is important to predict the likelihood of Chlamydia trachomatis.
Hajikhani, Bahareh; Motallebi, Tayebeh; Norouzi, Jamileh; Bahador, Abbas; Bagheri, Rezvan; Asgari, Soheila; Chamani-Tabriz, Leili
Background We here report the first investigation of exclusively elective in vitro fertilization (IVF) cycles in women with no apparent history of infertility. Since IVF outcome in women with infertility are always influenced by underlying causes of infertility, a study on non-infertile women may offer new insights. Methods We investigated 88 females without history of infertility in 109 consecutive elective IVF cycles, almost exclusively performed for purposes of preimplantation genetic screening (PGS; i.e., elective gender selection). The following questions were addressed: (i) impact of PGS on IVF pregnancy chances; (ii) impact of transfer of 1 vs. ?2 embryos on IVF pregnancy chances; (iii) correlation of anti-Müllerian hormone (AMH) levels to embryo ploidy (iv) effect of gonadotropin dosage used in stimulation on available embryos for transfer; and (v) in form of a 1:1 case control study, compared 33 elective PGS cycles with matched control cycles without PGS, performed in couples with either prior tubal ligations and/or severe male factor infertility as indication of IVF. Results The overall clinical pregnancy rate for the group was 36.7%; pregnancy was associated with number of euploid (P?=?0.009) and number of embryos transferred (P?=?0.001). Odds of pregnancy were 3.4-times higher if ?4 euploid embryos were produced in comparison to <4 (95% CI 1.2 to 9.2; P?=?0.019), and odds of pregnancy were 6.6-times higher if greater than or equal to 2 rather than <1 euploid embryos were transferred (95% CI 2.0 to 21.7; P?=?0.002). Increasing AMH (P?=?0.001) and gonadotropin dosage used in ovarian stimulation (P?=?0.024), was, independently, associated with number of available euploid embryos. Increasing AMH, but not follicle stimulating hormone (FSH), was associated with number of embryos available for biopsy and PGS (P?=?0.0001). Implantation rates were 26.4% with PGS and 9.5% without (P?=?0.008). Women undergoing PGS, demonstrated 4.58-times higher odds of pregnancy than matched controls (95% CI 1.102 to 19.060, Exp 4.584, P?=?0.036). Conclusions This study suggests that outcomes of elective IVF cycles may significantly deviate from infertility-associated cycles. Affirming proof of concept for PGS, utilizing day-3 embryo biopsy and fluorescence in-situ hybridization (FISH), both widely held responsible for earlier failures to establish such proof, suggests that the principal cause of prior failures were likely not insufficient laboratory techniques but poor patient selection for PGS. Such a conclusion questions the current reintroduction of PGS with improved techniques and technologies in absence of prior determination of suited patient populations.
The deletion polymorphisms of the glutathione S-transferase M1 (GSTM1) and glutathione S-transferase T1 (GSTT1) genes were considered as candidates for genetic susceptibility factors of male infertility. Previous studies concerning the relationship between the null genotype of the two genes and male infertility have been reported in recent years. However, the results remain elusive. A meta-analysis was performed to estimate the relationship between the deletion polymorphism of the GSTM1 or GSTT1 gene, and male infertility in this study. Sixteen studies concerning the GSTM1 gene, including 2174 cases and 1861 controls, and 13 case-control studies on the GSTT1 gene with a total number of 1992 cases and 1617 controls were processed. The results showed that the null genotype of the GSTM1 gene was associated with male infertility in the overall populations (P=0.003, OR=1.40, 95%CI=1.12-1.75), especially in Caucasian (P=0.012, OR=1.50, 95%CI=1.09-2.07) as well as Chinese (P=0.001, OR=1.55, 95%CI=1.19-2.03). The null genotype of the GSTT1 gene was strongly related to male infertility only in Chinese (P=0.000, OR=1.70, 95%CI=1.34-2.14). These results indicated that the null genotype of the GSTM1 gene might contribute to the susceptibility of male infertility, whereas the null genotype of the GSTT1 gene may be a genetic susceptibility factor of male infertility for the Chinese. PMID:23631429
Ying, Hou-Qun; Qi, Yue; Pu, Xiao-Ying; Liu, Shuo-Ran; A, Zhou-Cun
The Glutathione S-transferases (GSTs) polymorphisms have been implicated in susceptibility to male idiopathic infertility, but study results are still controversial. To investigate the genetic associations between GSTs polymorphisms and risk of male idiopathic infertility, a systematic review and meta-analysis were performed. Meta-analysis was performed by pooling odds ratio (OR) with its corresponding 95 % confidence interval (95 % CI) form studies in electronic databases up to March 16, 2012. Glutathione S-transferase M 1 (GSTM1) null genotype, Glutathione S-transferase T 1 (GSTT1) null genotype, and dual null genotype of GSTM1/GSTT1 were analyzed independently. 14 eligible studies with a total of 1,845 idiopathic infertility males and 1,729 controls were included. There were 13 studies on GSTM1 polymorphism, 10 ones on GSTT1 polymorphism and 5 ones on GSTM1-GSTT1 interaction analysis. Meta-analyses of total relevant studies showed GSTM1 null genotype was significantly associated with an increased risk of male idiopathic infertility (OR = 1.40, 95 % CI 1.07-1.84, P OR = 0.015). The GSTM1-GSTT1 interaction analysis showed dual null genotype of GSTM1/GSTT1 was also significantly associated with increased risk of male idiopathic infertility (OR = 1.85, 95 % CI 1.07-3.21, P OR = 0.028). Subgroup analyses by ethnicity showed the associations above were still statistically significant in Caucasians (For GSTM1, OR = 1.51, 95 % CI 1.11-2.05, P OR = 0.009; For GSTM1/GSTT1, OR = 2.10, 95 % CI 1.51-2.91, P OR < 0.001). This meta-analysis suggests GSTM1 null genotype contributes to increased risk of male idiopathic infertility in Caucasians, and males with dual null genotype of GSTM1/GSTT1 are particularly susceptible to developing idiopathic infertility. PMID:23238917
Li, Xin; Pan, Jinhong; Liu, Qigui; Xiong, Enqing; Chen, Zhiwen; Zhou, Zhansong; Su, Yongping; Lu, Gensheng
Recent work suggests that infertility treatment is associated with adverse child health outcomes. In exploring various methods of assembling a cohort of children conceived by infertility treatment, the authors conducted a validation study of the assisted reproductive technology and infertility drug use check boxes on the Massachusetts birth certificate. Using 2001 and 2002 data, the authors conducted telephone interviews with 399 women whose child's birth certificate had at least one of the boxes checked along with 185 women who were over age 42 years or who delivered twins or higher order multiples to compare the check box information with maternal report. Among the 579 women with available information, the birth certificate was fully concordant with respect to infertility treatment status for 271 (47%) women, partially concordant for 248 (43%) women, and discordant for 60 (10%) women. Agreement between the birth certificate and maternal report was good for singletons (weighted kappa = 0.66) but was found to be very poor among twins and higher order multiples (weighted kappa = 0.05). The authors concluded that birth certificates are an efficient means of locating children conceived with the help of infertility treatment but that they are not appropriate for identifying type of treatment.
Lynch, Courtney D.; Buck Louis, Germaine M.; Lahti, Maureen C.; Pekow, Penelope S.; Nasca, Philip C.; Cohen, Bruce
Recent work suggests that infertility treatment is associated with adverse child health outcomes. In exploring various methods of assembling a cohort of children conceived by infertility treatment, the authors conducted a validation study of the assisted reproductive technology and infertility drug use check boxes on the Massachusetts birth certificate. Using 2001 and 2002 data, the authors conducted telephone interviews with 399 women whose child's birth certificate had at least one of the boxes checked along with 185 women who were over age 42 years or who delivered twins or higher order multiples to compare the check box information with maternal report. Among the 579 women with available information, the birth certificate was fully concordant with respect to infertility treatment status for 271 (47%) women, partially concordant for 248 (43%) women, and discordant for 60 (10%) women. Agreement between the birth certificate and maternal report was good for singletons (weighted kappa = 0.66) but was found to be very poor among twins and higher order multiples (weighted kappa = 0.05). The authors concluded that birth certificates are an efficient means of locating children conceived with the help of infertility treatment but that they are not appropriate for identifying type of treatment. PMID:21705488
Lynch, Courtney D; Louis, Germaine M Buck; Lahti, Maureen C; Pekow, Penelope S; Nasca, Philip C; Cohen, Bruce
The human Y chromosome is essential for human sex determination and spermatogenesis. The long arm contains the azoospermia factor (AZF) region. Microdeletions in this region are responsible for male infertility. The objective of this study was to determine the frequency of Y microdeletions in Algerian infertile males with azoospermia and oligoasthenoteratozoospermia syndrome (OATS) and to compare the prevalence of these abnormalities with other countries and regions worldwide. A sample of 80 Algerian infertile males with a low sperm count (1-20 × 10(6) sperms/ml) as well as 20 fertile male controls was screened for Y chromosome microdeletions. 49 men were azoospermic and 31 men had OATS. Genomic DNA was isolated from blood and polymerase chain reaction was carried out with a set of 6 AZFa, AZFb and AZFc STS markers to detect the microdeletions as recommended by the European Academy of Andrology. Among the 80 infertile men screened for microdeletion, 1 subject was found to have microdeletions in the AZFc (sY254 and sY255) region. The deletion was found in azoospermic subjects (1/49, 2%). The overall AZF deletion frequency was low (1/80, 1.3%). AZF microdeletions were observed neither in the OATS group nor in the control group. The frequency of AZF microdeletions in infertile men from Algeria was comparable to those reported in the literature. We suggest analyzing 6 STS in the first step to detect Y microdeletions in our population. PMID:23548818
Chellat, Djalila; Rezgoune, Mohamed Larbi; McElreavey, Ken; Kherouatou, Naouel; Benbouhadja, Sebti; Douadi, Hamane; Cherifa, Benlatrčche; Abadi, Noureddine; Satta, Dalila
Objectives: This study evaluated the association between pus cells and semen parameters in infertile Pakistani males. Methods: A cross-sectional descriptive study was carried out in the Department of Reproductive Physiology/Health, National Institute of Health, Islamabad, Pakistan, from 2004 to 2009. A total of 1,521 subjects were analysed, along with 97 proven fathers as controls. Results: The mean of pus cells was 7.43 ± 0.43, 4.35 ± 0.34, and 4.26 ± 0.17 per high field in teratozoospermic, oligoasthenozoospermic, and asthenozoospermic groups, respectively, while it was 3.25 ± 0.26, 3.10 ± 0.19, and 2.98 ± 0.04 per high field in azoospermic, oligozoospermic and the proven father groups, respectively. The fewest pus cells were observed among proven fathers, which varied non-significantly (P >0.05) with all cases, except with teratozoospermic, oligozoospermic, and oligoasthenozoospermic cases. Pus cells showed an inverse relationship to sperm motility and count, except in azoospemia cases. Similarly, the fewest pus cells were observed among groups where normal forms where significantly more frequent (P <0.05). More pus cells were observed in cases where motility, and concentration or morphology was compromised. Similarly, low pus cell counts were seen in cases where sperm had the fewest head and neck defects. All kinds of sperm defects varied non-significantly (P >0.05) between proven fathers and normal concentration cases. Conclusion: High pus cell counts were observed in various subclasses of infertile patients. Ignorance of this pyospermic factor will make pyospermic patients to be misdiagnosed as normozoospermic. Therefore, the presence of pyospermia must be considered by physicians as a male infertility factor.
Khan, Mohammad S.; Mohammad, Syed H.; Deepa, Fariyal; Tahir, Fahim
Background An increasing number of women are utilizing fertility treatments, but little is known about their relation to autism spectrum disorders (ASD). Methods To determine the association between maternal fertility therapy use and risk of having a child with ASD, we conducted a nested case-control study within the Nurses’ Health Study II (n = 116,430). Maternally reported diagnoses of ASD were confirmed through a supplementary questionnaire and, in a subgroup, the Autism Diagnostic Interview-Revised. Controls were randomly selected by frequency matching to case children’s year of birth. Associations were examined by self-reported infertility and type of therapy using conditional logistic regression. Results In all, 9% of the 507 cases and 7% of 2,529 controls indicated fertility therapy use for the index pregnancy. No significant associations with self-reported fertility therapies or history of infertility were seen in primary analyses. In subgroup analyses of women with maternal age ?35 years (n = 1,020), artificial insemination was significantly associated with ASD; ovulation inducing drug (OID) use was significantly associated in crude but not adjusted analyses (odds ratio 1.81, 95% CI 0.96–3.42). Results were similar by diagnostic subgroup, though within the advanced maternal age group, OID and artificial insemination were significantly associated with Asperger syndrome and pervasive developmental disorder not-otherwise specified, but not autistic disorder. Conculsion Assisted reproductive therapy and history of infertility did not increase risk of having a child with ASD in this study. However, the associations observed with OID and artificial insemination among older mothers, for whom these exposures are more common, warrant further investigation.
Lyall, Kristen; Pauls, David L.; Spiegelman, Donna; Santangelo, Susan L.; Ascherio, Alberto
Background Mucin 4 (MUC4) plays an important role in protecting and lubricating the epithelial surface of reproductive tracts, but its role in the pathogenesis of endometriosis is largely unknown. Methods To correlate MUC4 polymorphism with the risk of endometriosis and endometriosis-related infertility, we performed a case-control study of 140 patients and 150 healthy women. Six unique single-nucleotide polymorphisms (SNPs) (rs882605, rs1104760, rs2688513, rs2246901, rs2258447 and rs2291652) were selected for this study. DNA fragments containing the target SNP sites were amplified by polymerase chain reaction using the TaqMan SNP Genotyping Assay System to evaluate allele frequency and distribution of genotype in MUC4 polymorphisms. Results Both the T/G genotype of rs882605 and the frequency of haplotype T-T (rs882605 and rs1104760) were higher in patients than in controls and were statistically significant. The frequency of the C allele at rs1104760, the C allele at rs2688513, the G allele at rs2246901 and the A allele at rs2258447 were associated with advanced stage of endometriosis. Moreover, the G allele at rs882605 was verified as a key genetic factor for infertility in patients. Protein sequence analysis indicated that amino acid substitutions by genetic variations at rs882605, rs2688513 and rs2246901 occur in the putative functional loops and the type D von Willebrand factor (VWFD) domain in the MUC4 sequence. Conclusions MUC4 polymorphisms are associated with endometriosis development and endometriosis-related infertility in the Taiwanese population.
Olfactory receptor (OR) expression is also present in the sperm cells and could mediate sperm chemotaxis. OR1D2 was the first OR expressed in the testis demonstrated to be involved in chemotaxis and to be expressed also in the nose with a similar behavior. Bourgeonal is the OR1D2 most potent known agonist. Infertility affects ~15 % of couples in western countries and sometimes it is unexplained. This pilot study compared the bourgeonal olfactory thresholds, the ability of sperm to sense the bourgeonal and the frequency of 13 single nucleotide polymorphisms (SNPs) of OR1D2 gene in nine males suffering of unexplained infertility with a control group of 15 healthy males. The mean olfactory threshold for bourgeonal was statistically different between the study group (10.5 ± 3.7; median 12.3) and the control group (14.0 ± 2.8; median 15.5) (p = 0.006). Statistical analysis showed a significantly higher percentage of spermatozoa that migrated toward the capillaries filled with bourgeonal in the control group compared to the study group (p < 0.0001). Sperm migration was equally inhibited in both groups of subjects when, together with bourgeonal, capillaries were filled with undecanal, a strong bourgeonal inhibitor (p = 0.42). The 13 SNPs of OR1D2 revealed a statistically significant difference for allele and genotype frequency of rs769423 in study group versus control group (p = 0.02). The present preliminary study seems to confirm the important role of OR1D2 both in nose and spermatozoa and may explain the idiopathic infertility of the study group. Further studies on larger series are mandatory to confirm our preliminary evidence. PMID:23525651
Ottaviano, G; Zuccarello, D; Menegazzo, M; Perilli, L; Marioni, G; Frigo, A C; Staffieri, A; Foresta, C
Intracytoplasmic sperm injection (ICSI) is an assisted fertilization technique and has been widely applied in human medicine to overcome some obstacles of infertility. However, this technology has not yet been used as a mainstream technique for animal production, including the rabbit, due to its limited success. The aim of this study was to improve ICSI techniques and establish an efficient ICSI method for rabbits. Spermatozoa used for ICSI were collected from mature New Zealand white male rabbits. They were washed two to three times with HEPES-buffered TCM199 containing 10% FBS and then mixed with 10% polyvinylpyrrolidone (PVP) prior to microinjection. Oocytes were harvested from superovulated donor rabbits after 14-15 h hCG treatment and were fertilized by microinjection of a single living spermatozoon into the ooplasm of each oocyte without additional activation treatment. A total of 317 injected oocytes resulted in the high survival rate of 86.1%. Among the surviving oocytes, 273 were placed into culture dishes for in vitro development. The fertilization, cleavage and blastocyst rates were 59.0%, 88.2% and 45.3% respectively. Furthermore, ICSI embryos were produced with spermatozoa from an infertile male rabbit, and 21 early-stage embryos (2-cell and 4-cell) were surgically transferred into the oviducts of two adult female rabbits. On day 31 after transfer, one out of the two recipients gave birth to two normal and healthy young rabbits. These results demonstrate that rabbit oocytes can be successfully activated and fertilized by the new ICSI protocol. Spermatozoa derived from infertile rabbits can successful fertilize oocytes and produce offspring by the simple ICSI technique. PMID:19079830
Li, Qiuyan; Hou, Jian; Wang, Sheng; Guan, Hong; Zhang, Nan; Chen, Yongfu; An, Xiaorong
Background: The purpose of this study was to evaluate patient-learning and nurse-teaching experiences when using a redesigned prefilled, ready-to-use follitropin alfa pen injector. Methods: Seventy-three UK women of reproductive age either administering daily treatment with self-injectable gonadotropins or about to start gonadotropin treatment for infertility (aged 24–47 years; 53 self-injection-experienced and 20 self-injection-naďve) and 28 nurses from UK infertility clinics were recruited for the study. Following instruction, patients and nurses used the redesigned follitropin alfa pen to inject water into an orange and completed questionnaires to evaluate their experiences with the pen immediately after the simulated injections. Results: Most (88%, n = 64) patients found it easy to learn how to use the pen. Among injection-experienced patients, 66% (n = 35) agreed that the redesigned pen was easier to learn to use compared with their current method and 70% (n = 37) also said they would prefer its use over current devices for all injectable fertility medications. All nurses considered the redesigned pen easy to learn and believed it would be easy to teach patients how to use. Eighty-six percent (n = 24) of the nurses thought it was easy to teach patients to determine the remaining dose to be dialed and injected in a second pen if the initial dose was incomplete. Compared with other injection devices, 96% (n = 27) thought it was “much easier” to “as easy” to teach patients to use the redesigned pen. Based on ease of teaching, 68% (n = 19) of nurses would choose to teach the pen in preference to any other injection method. Almost all (93%, n = 26) nurses considered that having the same pen format for a range of injectable gonadotropins would facilitate teaching and learning self-injection. Conclusion: In this market research study with infertile patients and infertility nurses, the redesigned follitropin alfa pen was perceived as easy to learn, easy to teach how to use, and well accepted.
Abbotts, Carole; Salgado-Braga, Cristiana; Audibert-Gros, Celine
OBJECTIVES: The attitudes towards cross-border reproductive care (CBRC) held by infertile Japanese patients have not been explored. The objective of the present study was to examine interest levels, preferred destinations, motivations, and sources of information related to CBRC. Our findings provide a general outline of CBRC and the future of reproduction and assisted reproductive technology (ART) in Japan. METHODS: The study used a cross-sectional design. Data were collected from 2,007 infertile Japanese patients from 65 accredited ART clinics in Japan (response rate, 27.4 %) via anonymous questionnaires. RESULTS: Most of the infertile Japanese patients who responded denied using CBRC. However, by group, 171 (8.5 %) patients in non-donor in vitro fertilization, 150 (7.5 %) in egg donation, 145 (7.2 %) in pre-implantation genetic diagnosis, and 129 (6.4 %) in surrogacy said that, depending on the situation, they might travel abroad in the future. Older respondents were more likely to express an intention to travel overseas for egg donation in the future. The most popular destination for CBRC was the United States. Popular reasons for interest in CBRC among those considering or planning using this approach to third-party reproduction were that egg donation or surrogacy was unavailable or that obtaining ethical approval takes too long in Japan, whereas these processes are legal and affordable overseas. However, high cost was the most common reason for hesitancy regarding CBRC. Among the participants who were considering or planning to travel abroad for this purpose, TV, medical agencies, print media, and message boards on websites were popular sources of information, whereas doctors, friends, and patient self-help groups were not. CONCLUSIONS: Although CBRC among infertile Japanese patients is not at present common, the demand for and use of this approach may increase in the future in the context of the increasingly aging population. Lack of regulation and unavailability of third-party reproduction is a major cause of CBRC among Japanese patients. Health care provider faces an urgent need for giving useful information for patients regarding CBRC. PMID:23749591
Hibino, Yuri; Shimazono, Yosuke; Kambayashi, Yasuhiro; Hitomi, Yoshiaki; Nakamura, Hiroyuki
Objectives To evaluate the outcome of hysteroscopic adhesiolysis in patients with infertility due to Asherman’s syndrome.\\u000a \\u000a \\u000a \\u000a Materials and methods This was a retrospective clinical analysis of 89 patients who underwent hysteroscopic adhesiolysis by monopolar electrode\\u000a knife. A second-look office hysteroscopy was performed in all cases after 2 months. On second-look hysteroscopy, 12 patients\\u000a showed reformation of adhesions and needed a repeat procedure.\\u000a \\u000a \\u000a \\u000a Results The
K. K. Roy; Jinee Baruah; Jai Bhagwan Sharma; Sunesh Kumar; Garima Kachawa; Neeta Singh
Aim The aim of this study was to identify the genetic effects of Y chromosome and azoospermia factor (AZF) gene variation in men\\u000a with infertility and to elucidate the molecular mechanism responsible for the identified point mutation.\\u000a \\u000a \\u000a \\u000a Methods Chromosome analysis was performed according to standard methods on lymphocyte cultured cells and genomic DNA was extracted\\u000a from the peripheral blood. Three sets of
Ozturk Ozdemir; Eylem Gul; Hakan Kilicarslan; Gökhan Gokce; Fatma Y. Beyaztas; Semih Ayan; Ihan Sezgin
Objectives To evaluate the outcome of hysteroscopic septal resection in patients with infertility and recurrent abortions.\\u000a \\u000a \\u000a \\u000a Materials and methods This was a retrospective clinical analysis of 170 patients who underwent hysteroscopic septal resection by monopolar electrode\\u000a (Collin’s) knife. A second-look office hysteroscopy was performed in all cases within 2 months. The mean follow-up period\\u000a was 28.5 months.\\u000a \\u000a \\u000a \\u000a \\u000a Results The mean age of the patients was
K. K. Roy; S. Singla; J. Baruah; S. Kumar; J. B. Sharma; D. Karmakar
Objective: To determine the efficacy of electroejaculation in combination with assisted reproductive technology (ART).Design: Case series.Setting: University fertility program.Patient(s): One hundred twenty-one consecutive couples seeking treatment of anejaculatory infertility.Intervention(s): Electroejaculation with IUI, or gamete intrafallopian transfer or IVF.Main Outcome Measure(s): Pregnancy and pregnancy outcome.Result(s): Fifty-two couples became pregnant (43%), 39 by IUI alone (32.2%). Cycle fecundity for IUI was 8.7%.
Dana A. Ohl; Lynda J. Wolf; Alan C. Menge; Gregory M. Christman; William W. Hurd; Rudi Ansbacher; Yolanda R. Smith; John F. Randolph
Infertility affects 10-15% of the population, of which approximately 40% is due to male etiology and consists primarily of low sperm count (oligozoospermia) and/or abnormal sperm motility (asthenozoospermia). Recently, it has been demonstrated that mtDNA substitutions can influence semen quality. In this study, we performed a sequence analysis of the mitochondrial cytochrome oxidase I (COXI) gene in 31 infertile men suffering from asthenozoospermia in comparison to 33 normozoospermic infertile men and 100 fertile men from the Tunisian population. A novel m.6307A>G mutation was found in sperm mitochondrial DNA (mtDNA). This mutation was found in six asthenozoospermic patients, and was absent in normozoospermic and fertile men. We also detected 21 known substitutions previously reported in the Human Mitochondrial Database. The m.6307A>G mutation substitutes a highly conserved asparagine at position 135 to serine. In addition, PolyPhen-2 analysis predicted that this variant is "probably damaging. PMID:23712756
Baklouti-Gargouri, Siwar; Ghorbel, Myriam; Ben Mahmoud, Afif; Mkaouar-Rebai, Emna; Cherif, Meriam; Chakroun, Nozha; Sellami, Afifa; Fakhfakh, Faiza; Ammar-Keskes, Leila
Background\\/Aims: The objective of the present study was to examine the possible relationship between the chlamydial heat shock proteins (cHSP) 60 and 10 expression and the damaging sequelae of a Chlamydia trachomatis infection, such as infertility. Methods: Seven fertile and 7 infertile female patients infected with C. trachomatis attending the gynecology outpatient department of Safdarjung hospital (New Delhi, India) were
Rajneesh Jha; Harsh Vardhan; Sylvette Bas; Sudha Salhan; Aruna Mittal
Introduction: Newly-weds choose to use contraception either to spend the first years of their marriage more freely, because of economic reasons or because of the increase in working career women. We studied the reasons for infertility and the rate of contraception use in the first years of marriage among couples with primary infertility and evaluated the use of a spermiogram
Hakan Kiran; Deniz Cemgil Arikan; Ayhan Coskun; Mustafa Kaplanoglu; Gurkan Kiran; Ozgur Ozdemir; M. Turan Cetin
Background: Recent attention has focused on the expression of integrin molecules within the endometrium, and their relation to infertility. Objective: The present pro- spective study was undertaken to determine whether the endometrium of women with unexplained infertility differs in the expression of very late activation antigens (VLA) from the endometrium of normal fertile women. Methods: Thirty samples of endometrial biopsies
Mehri Ghafourian Boroujerdnia; Fathemeh Ghalambor Dezfuly; Nepton Emad; Rahim Chinipardaz
Studies of delayed conception and risk of gestational diabetes (GDM) are sparse, although common underlying mechanisms are plausible, including insulin resistance and inflammation. The association between a history of infertility and GDM was assessed prospectively among 40,773 eligible pregnancies in the US Nurses' Health Study II cohort (1989-2001). Biennial questionnaires provided updated information on infertility and several lifestyle and health-related characteristics. Multivariable log-binomial models with generalized estimating equations were used to compute risk ratios and 95% confidence intervals, adjusting for age, prepregnancy body mass index (weight (kg)/height (m)(2)), and additional potential confounders. GDM occurred among 1,405 (5.2%) women. A prepregnancy history of infertility was reported by 5,497 (20.5%) participants and was significantly associated with a 39% greater risk of GDM (risk ratio (RR) = 1.39, 95% confidence interval (CI): 1.24, 1.57; P < 0.001). Underlying reasons for infertility associated with GDM included ovulation disorders (RR = 1.52, 95% CI: 1.23, 1.87; P < 0.001) and tubal blockage (RR = 1.83, 95% CI: 1.20, 2.77; P = 0.005). The association of cervical mucus disorder with GDM was of borderline significance (RR = 1.70, 95% CI: 0.88, 3.30; P = 0.11). Endometriosis (RR = 1.27, 95% CI: 0.70, 2.31; P = 0.43) and male factor infertility (RR = 1.12, 95% CI: 0.78, 1.61; P = 0.55) were not associated with GDM risk. These novel findings suggest that infertility, particularly from ovulation disorders and tubal blockage, is associated with an increased GDM risk. Further research is needed to identify mechanisms or common underlying metabolic dysfunction explaining these observations. PMID:23956097
Tobias, Deirdre K; Chavarro, Jorge E; Williams, Michelle A; Buck Louis, Germaine M; Hu, Frank B; Rich-Edwards, Janet; Missmer, Stacey A; Zhang, Cuilin
We investigated the prevalence of oxidative stress in male partners of infertile couples displaying different inflammation patterns in their genital tract and/or oligospermia. The levels of acknowledged oxidative stress markers (8-isoprostanes [8-EPI], diene conjugates, reactive oxygen species-total antioxidant capacity [ROS-TAC] score) were elevated in both leukocytospermic men and subjects whose inflammation was limited only to expressed prostatic secretion and/or post-massage urine. Oligospermic men with severe inflammation were different from oligospermic men who had no inflammation at all - the former had elevated 8-EPI, diene conjugates and ROS-TAC score when compared to the latter indicating that inflammation has substantially more significant impact on oxidative stress markers than oligospermia status. At the same time nitric oxide (NO) and hydrogen peroxide (H2 O2 ) levels were significantly increased not only in the men with severe inflammation but also in men with borderline inflammation in their genital tact and in men having non-inflammatory oligospermia. NO, H2 O2 and 8-EPI were negatively correlated with per cent of normal sperms, and NO and H2 O2 showed negative correlation also with sperm count. We can conclude that in men presenting with couple infertility the acknowledged oxidative stress markers are substantially associated with markers of inflammation in genital tract while NO and H2 O2 display high levels also in patients with mild inflammation and non-inflammatory oligospermia. PMID:24106058
Kullisaar, T; Türk, S; Kilk, K; Ausmees, K; Punab, M; Mändar, R
We identified a previously uncharacterized gene, spermatid maturation 1 (Spem1), encoding a protein exclusively expressed in the cytoplasm of steps 14–16 elongated spermatids in the mouse testis. This protein contains no known functional domains and is highly conserved across mammalian species. Male mice deficient in Spem1 were completely infertile because of deformed sperm characterized by a bent head wrapped around by the neck and the middle piece of the tail. We show that lack of Spem1 causes failure of the cytoplasm to become loose and detach from the head and the neck region of the developing spermatozoa. Retained cytoplasmic components mechanically obstruct the straightening of the sperm head and the stretching of the growing tail, leading to the bending of the head in the neck, followed by the wrapping of the head by the neck or the middle piece of the sperm tail. Our study reveals that proper cytoplasm removal is a genetically regulated process requiring the participation of Spem1 and that lack of Spem1 causes sperm deformation and male infertility.
Zheng, Huili; Stratton, Clifford J.; Morozumi, Kazuto; Jin, Jingling; Yanagimachi, Ryuzo; Yan, Wei
N-acylethanolamides are naturally occurring hydrophobic molecules usually present in a very small amount in many mammalian tissues and cells. The presence of N-acylethanolamides has also been demonstrated in human reproductive tracts and fluids, although their biological effects and molecular mechanisms of action are not yet completely elucidated. It is known that some N-acylethanolamides, such as oleoylethanolamide, have antioxidative properties. The aim of this study was to test whether oleoylethanolamide could protect sperm cells from reactive oxygen species-induced oxidative damage in cases of idiopathic infertility, because the excessive generation of these radicals was associated with this pathology. Our results show that 2.5 nM oleoylethanolamide in vitro supplementation significantly reduces DNA strand breaks both in fertile and infertile subjects. Moreover, oleoylethanolamide increases kinematic parameters, such as curvilinear velocity and amplitude of lateral head displacement and hyperactivation, both in the presence and in the absence of oxidative stress. Results of this study support the hypothesis of a possible protective action of oleoylethanolamide against reactive oxygen species, which could explain its beneficial effects on in vitro capacitated spermatozoa. PMID:16354794
Ambrosini, Annarina; Zolese, Giovanna; Ambrosi, Simona; Ragni, Letizia; Tiano, Luca; Littarru, Gianpaolo; Bertoli, Enrico; Mantero, Franco; Boscaro, Marco; Balercia, Giancarlo
In recent years, many studies have focused on the effect of oxidative stress, reactive oxygen species (ROS) and antioxidants on the male eproductive system. Under physiological conditions, sperm produces small amounts of ROS, which are needed for fertilisation, acrosome reaction and capacitation. However, if an increased production of ROS is not associated with a similar increase in scavenging systems, peroxidative damage of the sperm plasma membrane and loss of DNA integrity typically occur, which leads to cell death and reduced fertility. Furthermore, since there is no linear correlation between sperm quality and pregnancy rates, an improvement in semen parameters should not be the sole outcome considered in studies of antioxidant therapies. A definitive conclusion regarding the benefit of these therapies is difficult to obtain, as most of the previous studies lacked control groups, considered different antioxidants in different combinations and doses, or did not evaluate pregnancy rates in previously infertile couples. Even if beneficial effects were reported in a few cases of male infertility, more multicentre, double-blind studies performed with the same criteria are necessary for an increased understanding of the effects of various antioxidants on fertility.
Lombardo, Francesco; Sansone, Andrea; Romanelli, Francesco; Paoli, Donatella; Gandini, Loredana; Lenzi, Andrea
Deletions of Y chromosome AZF locus were analyzed during a large-scale andrological and genetic examination of 810 infertile men. The search for Yq microdeletions was carried out according to the standard EAA/EMQN guidelines. The breakpoints were mapped for the deletions in AZF locus. The Y chromosome macro- and microdeletions were detected in 61 (7.5%) infertile men. The frequencies of AZF deletions during azoospermia and severe oligozoospermia amounted to 12.2 and 8.1 %, respectively. On the whole, the frequencies of Yq microdeletions and the genophenotypic correlations characteristic of various AZF deletion types comply with the relevant published data. However, spermatozoids in the ejaculate sediment of men with completely deleted AZFa region or AZFb+c deletions (from solitary spermatozoids to several dozens) were detected for the first time. It was demonstrated that the breakpoints were localized between AZFa and AZFb regions proximally to AZFb+c microdeletions for the majority of cytogenetically detectable deletions in the Y chromosome long arm. This indicates that the mechanisms underlying Yq macro- and microdeletions are somewhat different. The issues related to the role of Y chromosome deletions in the origins of monosomy for X chromosome and X/XY mosaicism are discussed. PMID:17025164
Chernykh, V B; Chukhrova, A L; Beskorova?naia, T S; Grishina, E M; Sorokina, T M; Shile?ko, L V; Gogolevski?, P A; Kalugina, A S; Morina, G V; Togobetski?, A S; Tanevski?, V E; Zdanovski?, V M; Gogolevskaia, I K; Kramerov, D A; Poliakov, A V; Kurilo, L F
We have employed a proteomic approach to study the immune response to human sperm in an infertile female patient suffering from systemic lupus erythematosus (SLE). Human sperm antigenic extracts were resolved by means of two-dimensional electrophoresis and electroblotted onto nitrocellulose membranes. The membranes were incubated with serum from the SLE patient. Sperm antigens that were reactive to polyclonal antibodies were next visualized on X-ray film, using the enhanced chemiluminescence (ECL). Three spots corresponding to the positions of sperm immunoreactive antigens on a nitrocellulose membrane were localized in a silver stained gel and subjected to mass spectrometry. A database search of the sequences recognized by the analyzed SLE serum revealed its homology to the clathrin heavy chain (CHC). Further analysis revealed that anti-CHC antibody reacted with multiple sperm antigenic determinants, resolved by either one- or two-dimensional electrophoresis. When studied by immunofluorescence, we demonstrated anti-CHC antibody reactivity with the sperm tail tip (corresponding to the sperm agglutination pattern), also with the principal piece and with cytoplasmic droplets around the sperm midpiece. Live sperm clearly exhibited reactivity with the midpiece. This study demonstrates clathrin heavy chain on human sperm using serum of an infertile individual with a concomitant autoimmune disease. PMID:21470689
Domagala, Alina; Pulido, Silvia; Kamieniczna, Marzena; Kurpisz, Maciej; Herr, John C
Lead causes male reproductive impairment among painters, but information is still limited. Therefore, the effect of lead on semen quality and reproductive endocrinal function in those patients was investigated. A case series of 27 infertile painters were subjected to semen analysis, measuring of blood lead level (PbB) and serum levels of endocrinal parameters including follicle-stimulating hormone (FSH), luteinising hormone (LH), testosterone (T) and prolactin (PRL). Significantly lower sperm count and motility were found in those with duration of exposure (? 15 years), but no significant difference was found for PbB and serum levels of FSH, LH, PRL and T. A significant negative correlation between PbB and spermatic count and motility was observed, while there was no significant correlation between PbB and all endocrinal parameters. Patients with PbB ? 20 ?g dl(-1) showed a significant decrease in sperm motility and increase in testosterone alone among all measured hormones. But the observed decrease in sperm count did not reach a significant level. It is concluded that infertile painters are at risk of lead-related influence on semen quality, especially sperm motility and increased testosterone level without significant affection of other reproductive endocrinal parameters. PMID:22680063
Hosni, H; Selim, O; Abbas, M; Fathy, A
Over the 1980s in Western societies which have used new reproductive technologies, there has been intense argumentation about connected philosophical, ethical and economic issues. This research on I.V.F. donor egg (i.e. 'non-genetic') motherhood is based on qualitative data from partial life histories of twelve women having children by this technology through a Melbourne infertility programme. Methodology, interpretation, and discussion place it within both critical social and feminist personal identity theoretical frameworks. None of the respondent women but all except one of their respective partners are the biological parents of a total of ten children already born at the data collection stage, and in three well-established pregnancies. Two-thirds of the respondents used 'unknown' donor ova. 'Known' donors were typically the recipients' sisters. Many of these Australian births represent world 'firsts' in medical technical applications. In biographical accounts, the focus was on experiences of social pressure towards parenthood, of infertility and medical treatment, and attitudes of openness or secrecy about using donated ova. While socially and technologically acquired parenthood added a highly-desired dimension to their social identities, a sense of loss appeared to persist in most of the women's personal identities. Where a policy of secrecy towards relatives and friends about use of reproductive technology and gamete donation was maintained, this loss was reinforced by a feeling of social isolation. PMID:16130265
Hallebone, E L
Background Since nitric oxide (NO) has an oxidant activity, lower levels following a varicocelectomy may result in better functioning sperm, improved semen quality and consequently higher fertility rates. However, this procedure should be examined in more detail. Objectives Accordingly, this study was performed to compare the before and after varicocelectomy levels of NO in the seminal fluid of infertile men. Patients and Methods In this before and after comparative study, 20 consecutive patients attending a training hospital in Tehran, Iran were recruited. All of these men had primary or secondary infertility accompanied with a varicocele. A semen sample was collected from the men in two phases, first before their varicocelectomy and two months after their operation. Results NO levels differed significantly across the study and the mean (± standard deviation) levels of NO in the patients were 30.59 ± 10.35 µM/L and 21.48 ± 32.14 µM/L in the before and after phases of the study, respectively (P = 0.009). Conclusions According to the results obtained in this study, it may be concluded that in future, levels of NO should be taken into consideration together with other parameters for the evaluation of patients who are affected by varicoceles,