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Sample records for vasectomy

  1. Vasectomy

    MedlinePlus

    ... takes no more than 30 minutes. Almost all men go home the same day. In most cases, ... against sexually transmitted diseases, such as HIV/AIDS. Men who have had vasectomy should still practice safe ...

  2. Vasectomy reversal.

    PubMed

    Belker, A M

    1987-02-01

    A vasovasostomy may be performed on an outpatient basis with local anesthesia, but also may be performed on an outpatient basis with epidural or general anesthesia. Local anesthesia is preferred by most of my patients, the majority of whom choose this technique. With proper preoperative and intraoperative sedation, patients sleep lightly through most of the procedure. Because of the length of time often required for bilateral microsurgical vasoepididymostomy, epidural or general anesthesia and overnight hospitalization are usually necessary. Factors influencing the preoperative choice for vasovasostomy or vasoepididymostomy in patients undergoing vasectomy reversal are considered. The preoperative planned choice of vasovasostomy or vasoepididymostomy for patients having vasectomy reversal described herein does not have the support of all urologists who regularly perform these procedures. My present approach has evolved as the data reported in Tables 1 and 2 have become available, but it may change as new information is evaluated. However, it offers a logical method for planning choices of anesthesia and inpatient or outpatient status for patients undergoing vasectomy reversal procedures. PMID:3811050

  3. Vasectomy reversal in humans.

    PubMed

    Bernie, Aaron M; Osterberg, E Charles; Stahl, Peter J; Ramasamy, Ranjith; Goldstein, Marc

    2012-10-01

    Vasectomy is the most common urological procedure in the United States with 18% of men having a vasectomy before age 45. A significant proportion of vasectomized men ultimately request vasectomy reversal, usually due to divorce and/or remarriage. Vasectomy reversal is a commonly practiced but technically demanding microsurgical procedure that restores patency of the male excurrent ductal system in 80-99.5% of cases and enables unassisted pregnancy in 40-80% of couples. The discrepancy between the anastomotic patency rates and clinical pregnancy rates following vasectomy reversal suggests that some of the biological consequences of vasectomy may not be entirely reversible in all men. Herein we review what is known about the biological sequelae of vasectomy and vasectomy reversal in humans, and provide a succinct overview of the evaluation and surgical management of men desiring vasectomy reversal. PMID:23248768

  4. Vasectomy and vasectomy reversal: An update

    PubMed Central

    Ramasamy, Ranjith; Schlegel, Peter N.

    2011-01-01

    Vasectomy is an elective surgical sterilization procedure for men that is intended to obstruct or remove a portion of both vas deferens, thereby preventing sperm from moving from the testes to the ejaculatory ducts. Although intended for permanent sterilization, vasectomy can be reversed in most men seeking to restore their fertility due to a change in marital status or reproductive goals. The purpose of this document is to provided a synopsis of the latest techniques used in vasectomy and reversal. PMID:21716894

  5. Vasectomy - series (image)

    MedlinePlus

    ... who are certain that they wish to prevent future pregnancies (permanent sterilization). Vasectomy is not recommended as a temporary or reversible procedure. Vasectomy is usually done in the surgeon's office while the patient is awake but pain-free ( ...

  6. Making vasectomy attractive.

    PubMed

    Herndon, N

    1992-08-01

    In 1989, Pro-Pater, a private, nonprofit family planning organization in Brazil, used attractive ads with the message Vasectomy, An Act of Love to promote vasectomy. The number of vasectomies performed/day at Pro-Pater clinics increased from 11 to 20 during the publicity campaign and fell after the ads stopped but continued at higher levels. Word of mouth communication among friends, neighbors, and relatives who had vasectomies maintained these high levels. This type of communication reduced the fear that often involves vasectomies because men hear from men they know and trust that vasectomies are harmless and do not deprive them of potency. In Sao Paulo, the percentage of men familiar with vasectomies and how they are performed increased after the campaign, but in Salvador, knowledge did not increase even though the number of vasectomies in Pro-Pater clinics increased. Organizations in Colombia and Guatemala have also been effective in educating men about vasectomies. These successes were especially relevant in Latin American where machismo has been an obstacle of family planning programs. The no-scalpel technique 1st introduced in China in 1974 reduces the fear of vasectomy and has fewer complications than the conventional technique. Further trained physicians can perform the no-scalpel technique in about 10 minutes compared with 15 minutes for the conventional technique. In 1987 during a 1-day festival in Thailand, physicians averaged 57 no-scalpel vasectomies/day compared with only 33 for conventional vasectomies. This technique has not spread to Guatemala, Brazil, Colombia, the US, and some countries in Asia and Africa. Extensive research does not indicate that vasectomy has an increased risk of testicular cancer, prostate cancer, and myocardial infarction. Physicians are working on ways to improve vasectomy. PMID:12317726

  7. Vasectomy and vasectomy reversal the Thai way.

    PubMed

    Gojaseni, P

    1982-12-01

    In 1972 the ratio of female sterilization acceptors to vasectomy acceptors in Thailand was 24.5:1; in 1978 the ratio was 2.8:1. Several factors are responsible for this change. First, a national family planning program to support voluntary family planning started in 1970 and lowered the population growth rate from 3.2% in 1973 to 2.1% in 1982. Second, the desired family size in Thailand is 3 and it is generally agreed that the solution is voluntary sterilization as a more cost effective fertility control method. Thirdly, misunderstandings about vasectomy were cleared up through media campaigns which cleared the way for greater acceptance. Fourth, in 1975 special clinics at big hospitals and a mobile unit were set up to perform vasectomies. Lastly, a group of nongovernment organizations has been set up, such as the Thai Association for Voluntary Sterilization, to provide the infrastructure for vasectomy campaigns. Requests for vasectomy reversals have, expectedly, increased as well, usually caused by marriage, child's death, improved finances, and psychosexual health. In a recent study of 32 cases, positive sperm reappearance after vas reanastomosis was found in 71.4% and the pregnancy rate was 52.3%. PMID:12265673

  8. Vasectomy offers many advantages.

    PubMed

    Finger, W R

    1997-01-01

    Vasectomy, surgical sterilization for men, is very safe, has few side effects, and results in reported annual pregnancy rates of less than 1%. However, men in only a few countries widely adopt vasectomy as their contraceptive method of choice even though it is safer and easier to perform than female sterilization. Approximately 45 million men worldwide have been vasectomized, largely in China, Thailand, India, Korea, the UK, Canada, and the US. Vasectomy is not available in many developing countries, and even if it is available and men have heard of it, many have the misconception that vasectomy causes weakness and adversely affects male sexual function. When trying to increase the access, acceptability, and uptake of vasectomy, enough providers must be trained so that their services are readily available, sustained promotional campaigns should encourage method use, and male clinics and services should be available to help men feel comfortable. Competent counseling is essential to success. The myths and facts of vasectomy, the no-scalpel approach, and promotional campaigns are discussed. PMID:12321061

  9. Vasectomy: A simple snip?

    PubMed Central

    Dhar, Nivedita Bhatta; Jones, J. Stephen

    2007-01-01

    Vasectomy is one of the most common forms of permanent sterilization methods currently in use and has a failure rate of <1% in most reported series. Since failure of vasectomy may result in pregnancy, adequate counseling is essential. Couples are advised that an analysis of a semen specimen after vasectomy is required to confirm success before the use of alternative contraception is abandoned. However, measuring the success of vasectomy is complicated by a lack of consistency with regards to both the number and timing of tests and the end points accepted. Materials and Methods: A Medline search was used to identify manuscripts dealing with vasectomy, with specific attempts to identify protocols designed to confirm sterility. Results and Conclusion: Vasectomy is one of the most reliable permanent methods of contraception. However, despite its popularity, certain issues pertaining to the procedure remain unresolved. Debate continues over the relative merits of the various techniques of isolating and sealing the vasal ends. Postoperative complication rates remain minimal regardless of the technique used, and no single strategy attempting to maximize patient compliance with postoperative semen analysis has enjoyed unmitigated success. Long-term consequences, other than regret, are rare. PMID:19675750

  10. Counselling for vasectomy.

    PubMed

    Spencer, B; Robertson, D

    In the United Kingdom the provision of vasectomy service differs according to the geographical locations within the country. Regarding the interview that occurs prior to the vasectomy operation, 3 areas of concern must be covered: information regarding the nature of the operation and its effects must be conveyed to the client; the doctor must feel confident that he/she can recommend the couple to the surgeon performing the operation; and helping the couple to explore personel feelings and experiences about birth control and providing information on all possible choices. Although the latter aspect -- counseling -- is probably the most important, it is usually the least explored. The reason for this is inherent to the procedure through which a vasectomy is currently obtained. The couple regard the interview as a situation where the doctor will either allow or refuse the operation. Conflicts may arise if the family planning doctor simultaneously tries to play both medical and counseling roles. Further confusion arises between the screening and counseling aspects of the prevasectomy interview. Vasectomy clinics have less rigid criteria than individual surgeons. A step that must be taken if vasectomy counseling is to be improved is to increase general awareness and acknowledgment of the combined goals of the preoperative interview. PMID:10248150

  11. How couples choose vasectomy.

    PubMed

    Schehl, M

    1997-01-01

    A study conducted by AVSC International between 1992 and 1995 found that couples around the world go through a highly similar decision-making process when they choose vasectomy as their family planning methods. Study findings are based upon in-depth, qualitative interviews with couples using vasectomy in Bangladesh, Mexico, Kenya, and Rwanda, where the prevalence of vasectomy is relatively low, and Sri Lanka and the US, where it is relatively high. 218 separate interviews were conducted with male and female partners. Concerns about the woman's health were cited by respondents in each country as reasons to cease childbearing and to opt for vasectomy as the means to achieving that end. Also, almost all respondents mentioned varying degrees of financial hardship as contributing to their decision to end childbearing. These findings highlight the concept of partnership in relationships and family planning decision-making, and demonstrate the importance of going beyond traditional stereotypes about gender roles in decision-making. Social influences and the potential risks of using other forms of contraception also contributed to the choice of using vasectomy. The decision-making process and lessons learned are discussed. PMID:12349014

  12. [Immunological aspects of vasectomy].

    TOXLINE Toxicology Bibliographic Information

    Schill WB

    1977-12-16

    A literature review of immunological effects of vasectomy is presented. Antibodies can be divided into sperm agglutinating, sperm immobilizing, and spermatotoxic types. Sperm agglutinating antibodies occur in ca 50% of vasectomy patients and are almost never found in unvasectomized men. Sperm immobilzing antibodies occur in ca 25% of vasectomized men and are seldom found in unvasectomized men. Spermatotoxins occur in ca 2% of vasectomized men, ca 1% of unvasectomized men, and ca 11% of men with gonadal disorders. Hemagglutination and immunofluorescence techniques can also be used to determine certain types of sperm antibodies. No studies on cellular immune reactions to sperm have been undertaken. No unequivocal evidence has been reported concerning possible immunological cross-reactions or organ specificity of sperm antibodies. Clinical-serological studies have shown a very slight increase of the serum levels of IgI and IgM after vasectomy.

  13. Noninvasive laser vasectomy

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher Michael

    Development of a noninvasive vasectomy technique may eliminate male fear of complications (incision, bleeding, infection, and scrotal pain) and result in a more popular procedure. These studies build off previous studies that report the ability to thermally target tissue substructures with near infrared laser radiation while maintaining a healthy superficial layer of tissue through active surface cooling. Initial studies showed the ability to increase the working depth compared to that of common dermatological procedures and the translation into an ex vivo canine model targeting the vas deferens in a noninvasive laser vasectomy. Laser and cooling parameter optimization was required to determine the best possible wavelength for a safe transition to an in vivo canine model. Optical clearing agents were investigated as a mechanism to decrease tissue scattering during in vivo procedures to increase optical penetration depth and reduce the overall power required. Optical and thermal computer models were developed to determine the efficacy for a successful transition into a human model. Common clinical imaging modalities (ultrasound, high frequency ultrasound, and optical coherence tomography) were tested as possible candidates for real-time imaging feedback to determine surgical success. Finally, a noninvasive laser vasectomy prototype clamp incorporating laser, cooling, and control in a single package was designed and tested in vivo. Occlusion of the canine vas deferens able to withstand physiological burst pressures measured postoperative was shown during acute and chronic studies. This procedure is ready for azoospermia and recanalization studies in a clinical setting.

  14. Pulmonary Embolism Following Outpatient Vasectomy

    PubMed Central

    Mott, Frank E.; Farooqi, Bilal; Moore, Harry

    2016-01-01

    Venous thromboembolic events have several known major risk factors such as prolonged immobilization or major surgery. Pulmonary embolism has rarely been reported after an outpatient vasectomy was completed. We present the rare case of a healthy 32-year-old Caucasian male with no known risk factors who presented with pleuritic chest pain 26 days after his outpatient vasectomy was performed. Subsequently, he was found to have a pulmonary embolism as per radiological imaging. We explore the association between outpatient vasectomies and venous thromboembolic events. A review of the literature is also included. PMID:26989373

  15. [Male contraception and vasectomy].

    PubMed

    Emperaire, J C; Audebert, A; Mattei, A

    1977-01-01

    This review summarized the regulation of testicular function and the theoretical aspects subject to male contraception, lists and tabulates steroids effective in inhibiting spermatogenesis, and evaluates vasectomy in the light of the fact that no method is entirely effective, acceptable, and reversible. Possible male contraceptive techniques include hypothalamic agents such as MAO inhibitors, biogenic amines that inhibit releasing hormones, hydrazines, reserpine, analogs of luteinizing hormone-releasing hormone, drugs acting on the testis such as ethylenimine, colchicine, chlormmphenicol, prednisolone; and substances acting on sperm maturation, e.g., heavy metals, alpha-chlorohydrins. Most of these are toxic or teratologic. Testosterone in low doses inhibits spermatogenesis and testicular volume, at high doses maintains testicular volume, produces azoospermia, but has several unacceptable side effects like increasing beta-lipoporteins. Other androgens must be combined with testosterone. Estrogens cause loss of libido. Progestagens are effective, and some are metabolized into androgens. Ethinyl testerone (Danazol) and Cyproterone acetate both depress libido so they must be combined with testosterone. The most inconvenient drawback of these drugs is that several sperm counts must be done to ensure azoospermia. Vasectomy as the advantage of being simple, effective, and without any great risk, although it should be considered irreversible, and is not popular in France. PMID:12260083

  16. Vasectomy reversal: a clinical update.

    PubMed

    Patel, Abhishek P; Smith, Ryan P

    2016-01-01

    Vasectomy is a safe and effective method of contraception used by 42-60 million men worldwide. Approximately 3%-6% of men opt for a vasectomy reversal due to the death of a child or divorce and remarriage, change in financial situation, desire for more children within the same marriage, or to alleviate the dreaded postvasectomy pain syndrome. Unlike vasectomy, vasectomy reversal is a much more technically challenging procedure that is performed only by a minority of urologists and places a larger financial strain on the patient since it is usually not covered by insurance. Interest in this procedure has increased since the operating microscope became available in the 1970s, which consequently led to improved patency and pregnancy rates following the procedure. In this clinical update, we discuss patient evaluation, variables that may influence reversal success rates, factors to consider in choosing to perform vasovasostomy versus vasoepididymostomy, and the usefulness of vasectomy reversal to alleviate postvasectomy pain syndrome. We also review the use of robotics for vasectomy reversal and other novel techniques and instrumentation that have emerged in recent years to aid in the success of this surgery. PMID:26975488

  17. Vasectomy reversal: a clinical update

    PubMed Central

    Patel, Abhishek P; Smith, Ryan P

    2016-01-01

    Vasectomy is a safe and effective method of contraception used by 42–60 million men worldwide. Approximately 3%–6% of men opt for a vasectomy reversal due to the death of a child or divorce and remarriage, change in financial situation, desire for more children within the same marriage, or to alleviate the dreaded postvasectomy pain syndrome. Unlike vasectomy, vasectomy reversal is a much more technically challenging procedure that is performed only by a minority of urologists and places a larger financial strain on the patient since it is usually not covered by insurance. Interest in this procedure has increased since the operating microscope became available in the 1970s, which consequently led to improved patency and pregnancy rates following the procedure. In this clinical update, we discuss patient evaluation, variables that may influence reversal success rates, factors to consider in choosing to perform vasovasostomy versus vasoepididymostomy, and the usefulness of vasectomy reversal to alleviate postvasectomy pain syndrome. We also review the use of robotics for vasectomy reversal and other novel techniques and instrumentation that have emerged in recent years to aid in the success of this surgery. PMID:26975488

  18. Impact of the 2012 American Urological Association Vasectomy Guidelines on Post-Vasectomy Outcomes

    PubMed Central

    Coward, Robert M.; Badhiwala, Niraj G.; Kovac, Jason R.; Smith, Ryan P.; Lamb, Dolores J.; Lipshultz, Larry I.

    2016-01-01

    Purpose The 2012 American Urological Association (AUA) vasectomy guidelines recommend the finding of rare nonmotile sperm, representing 100,000 or fewer nonmotile sperm per ml, as a metric of post-vasectomy success. At our institution success was previously defined as 2 sequential azoospermic centrifuged semen pellets. The criteria change of including rare nonmotile sperm as a success end point may simplify post-vasectomy followup and decrease the number of post-vasectomy semen analyses required to assure occlusive success. Materials and Methods In the context of the new 2012 guidelines we retrospectively reviewed and analyzed the records of 972 of the 1,740 vasectomies (55.9%) performed between January 2000 and June 2012 after which at least 1 post-vasectomy semen analysis was done. Results A total of 1,919 post-vasectomy semen analyses were obtained from 972 patients with a mean ± SE age of 39.7 ± 0.2 years. Occlusive success was evident in 337 azoospermic men (36.4%), while 514 (52.9%) underwent 2 or more post-vasectomy semen analyses and 458 (47.1%) returned for a single post-vasectomy semen analysis but were lost to followup. Of these noncompliant patients 76.0% were azoospermic, 19.7% had rare nonmotile sperm, 1.5% had greater than 100,000 nonmotile sperm per ml and 2.8% had motile sperm. Three patients underwent repeat vasectomy for persistent rare nonmotile sperm. If the criteria defined by the 2012 guidelines had been used to monitor these men, the occlusive success rate would have improved to 97.6% (949 patients) (p <0.05). Repeat vasectomies as well as 896 subsequent post-vasectomy semen analyses would have been avoided. Conclusions The AUA vasectomy guidelines provide clear, evidence-based criteria for vasectomy success. The guidelines simplify followup protocols, improve patient compliance and help avoid unnecessary post-vasectomy semen analyses and repeat vasectomies. PMID:23917167

  19. Semen characteristics after vasectomy in the ram.

    PubMed

    Janett, F; Hüssy, D; Lischer, C; Hässig, M; Thun, R

    2001-08-01

    The objective of this study was to monitor the changes in semen characteristics in vasectomized rams and to determine if infertility was present 14 days after vasectomy. Experiments were performed using five cross-breed rams, aged between 18 and 30 months. Semen was collected weekly by artificial vagina from 2 months before to 5 months after vasectomy. After sexual rest for 10 days, vasectomy was performed by the cranial midscrotal approach. In all ejaculates the volume, concentration, total sperm number, motility and morphology (normal spermatozoa, loose heads) were determined and sperm viability (SYBR-14/PI) was evaluated in all semen samples collected after vasectomy. In the first ejaculate obtained 14 days post vasectomy all rams showed a significant (P < 0.05) drop in mean volume (from 1.2 to 0.5 mL), total sperm count (from 5176.8 to 51.1 x 10(6)) and morphologically normal sperm (from 84.1 to 15.7%), when compared to the last prevasectomy collection. We could also demonstrate a positive correlation (r = 0.89) between the individual cumulative total number of spermatozoa after vasectomy and the scrotal circumference measured before vasectomy. Sperm motility and viability could never be demonstrated after vasectomy and normal spermatozoa continuously decreased concomitant with an increase in loose heads. On post mortem examination 5 months after surgery, spermatocele formation and multiple sperm granulomas were present in all five rams. Our results show that in the first ejaculate collected by artificial vagina 14 days after vasectomy, no motile and viable spermatozoa could be detected. Despite weekly collections during a 5-month period after sterilization, azoospermia could never be achieved. PMID:11516127

  20. Vasectomy effectiveness in Nepal: a retrospective study.

    PubMed

    Nazerali, Hanif; Thapa, Shyam; Hays, Melissa; Pathak, Laxmi R; Pandey, Kalyan R; Sokal, David C

    2003-05-01

    The main purpose of this retrospective, cross-sectional study was to evaluate the effectiveness of vasectomy in an ongoing public sector program in Nepal. We evaluated semen samples from men who had previously had a vasectomy, and asked about the occurrence of pregnancies in the men's partners. In addition, the surgeons who performed the vasectomies completed a questionnaire about their techniques. A two-stage stratified sampling procedure was used to select 1263 men from among over 30,000 men, who had previously undergone a no-scalpel vasectomy, mostly by ligation and excision, in 32 districts between July 1996 and June 1999. Semen samples were preserved and analyzed at a central laboratory. A US andrology laboratory validated the lab results. Twenty-three men (2.3%, 95% confidence interval [CI] 1.1-3.6) had >/=500,000 sperm/mL in their semen. Fifteen of those men reported pregnancies conceived after their vasectomy. In addition, six men with azoospermia reported pregnancies for which conception occurred within 3 months after vasectomy. Eleven men with azoospermia reported pregnancies for which conception occurred more than 3 months after vasectomy. Reported pregnancy was more likely in younger partners. The life table pregnancy rates for all men interviewed were 0.7 (95% CI 0.2-1.1), 1.7 (95% CI 1.4-2.1) and 4.2% (95% CI 3.2-5.2) at 3, 12 and 36 months, respectively. In low-resource, programmatic settings, vasectomy failure rates may be higher than commonly cited rates, especially in younger populations. Additional research is needed to determine if other occlusion techniques could reduce failure rates. Counseling on vasectomy should always convey the possibility of failure and partner pregnancy. PMID:12742564

  1. Vasectomy

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  2. Vasectomy

    MedlinePlus Videos and Cool Tools

    ... transport of sperm out of the testes. A small incision is made in the scrotum and each ... sperm from being released within the ejaculate. The small skin incision is stitched closed and the surgery ...

  3. Vasectomy

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    ... Fund Annual Fund Alliances & Partner Organizations Cause-Related Marketing Planned Giving Charitable Gift Planning is a powerful ... CareBlog Make a Difference Planned Giving Cause-Related Marketing Research Quick Links Urologic Conditions Financials & Annual Report ...

  4. Prostatic cancer, coital rates, vasectomy and testosterone.

    PubMed

    James, W H

    1994-04-01

    It is usually supposed that androgens play a major role in the aetiology of prostatic cancer. This note suggests that the association of the disease with low (as well as high) coital rates and its apparent association with vasectomy can both be reconciled with the hypothesised androgenic involvement. PMID:8014182

  5. Vasectomies performed by private physicians, United States, 1980 to 1984.

    PubMed

    Kendrick, J S; Rubin, G L

    1986-09-01

    This study used data from the National Disease and Therapeutic Index to estimate the number of vasectomies performed by private physicians in the US in 1980-84. This survey collects data from about 1500 physicians per quarter on patients seen during 12,000 practice days/year. From 55-103 sampled physicians each year reported performing vasectomies. An estimated 1.9 x 10,000,000 vasectomies were performed in this 5-year period. 48% of the procedures were performed by urologists, 35% by general surgeons, and 15% by general or family practitioners. 29% were performed in the West, 27% in the North Central US, 26% in the South, and 18% in the Northeast. Age-specific vasectomy rates were consistently highest among men 30-39 years of age and lowest among men over age 50 years. White men were significantly more likely than black men to undergo vasectomy. Most procedures were performed in private offices. The number of vasectomies declined from 1980-82 and then rose again in 1983. The estimates obtained from this analysis are considerably lower than those reported by the Associated for Voluntary Surgical Contraception, perhaps because the latter estimates include procedures performed in military facilities and clinics. It is recommended that future cycles of the National Survey of Family Growth should include data on male partners when female respondents reports use of vasectomy as the couple's contraceptive method. PMID:12340956

  6. An inexpensive yet realistic model for teaching vasectomy

    PubMed Central

    Coe, Taylor M.; Curington, John

    2015-01-01

    Purpose Teaching the no-scalpel vasectomy is important, since vasectomy is a safe, simple, and cost-effective method of contraception. This minimally invasive vasectomy technique involves delivering the vas through the skin with specialized tools. This technique is associated with fewer complications than the traditional incisional vasectomy (1). One of the most challenging steps is the delivery of the vas through a small puncture in the scrotal skin, and there is a need for a realistic and inexpensive scrotal model for beginning learners to practice this step. Materials and Methods After careful observation using several scrotal models while teaching residents and senior trainees, we developed a simplified scrotal model that uses only three components–bicycle inner tube, latex tubing, and a Penrose drain. Results This model is remarkably realistic and allows learners to practice a challenging step in the no-scalpel vasectomy. The low cost and simple construction of the model allows wide dissemination of training in this important technique. Conclusions We propose a simple, inexpensive model that will enable learners to master the hand movements involved in delivering the vas through the skin while mitigating the risks of learning on patients. PMID:26005982

  7. Post-vasectomy depression: a case report and literature review.

    PubMed

    Shaik, Subahani; Rajkumar, Ravi Philip

    2014-09-01

    Vasectomy is a commonly performed and relatively safe procedure, with low reported rates of psychological morbidity, though there is some variability across studies. Depression following a vasectomy is relatively infrequent. A married man aged 30 developed a chronic depressive episode, lasting four years and resistant to an adequate trial of fluoxetine, following a vasectomy. His depression was heralded by a post-operative panic attack, and was accompanied by medically unexplained symptoms and the attribution of all his symptoms to the procedure - a belief that was shared by his family. Psychological complications of vasectomy have generally been studied under four heads: sexual dysfunction, effects on marital relationships, chronic post-operative pain, and other complications including anxiety and depression. These complications have generally been reported at higher rates in developing countries, and are linked to poor knowledge about the procedure and inadequate pre-operative counseling. The implications of the existing literature for the patient's current complaints, and the mechanisms and risk factors involved, are discussed in the light of existing research. Suggestions for the prevention and treatment of post-vasectomy depression are also outlined. PMID:25553234

  8. Post-Vasectomy Depression: A Case Report and Literature Review

    PubMed Central

    Shaik, Subahani

    2014-01-01

    Vasectomy is a commonly performed and relatively safe procedure, with low reported rates of psychological morbidity, though there is some variability across studies. Depression following a vasectomy is relatively infrequent. A married man aged 30 developed a chronic depressive episode, lasting four years and resistant to an adequate trial of fluoxetine, following a vasectomy. His depression was heralded by a post-operative panic attack, and was accompanied by medically unexplained symptoms and the attribution of all his symptoms to the procedure – a belief that was shared by his family. Psychological complications of vasectomy have generally been studied under four heads: sexual dysfunction, effects on marital relationships, chronic post-operative pain, and other complications including anxiety and depression. These complications have generally been reported at higher rates in developing countries, and are linked to poor knowledge about the procedure and inadequate pre-operative counseling. The implications of the existing literature for the patient’s current complaints, and the mechanisms and risk factors involved, are discussed in the light of existing research. Suggestions for the prevention and treatment of post-vasectomy depression are also outlined. PMID:25553234

  9. Vasectomies: Motivations and Attitude of Physicians-as-Patients

    PubMed Central

    Alderman, Philip M.

    1988-01-01

    Vasectomies have not been as widely favoured as have techniques of sterilization in Canada for some years, in spite of having a better morbidity and mortality record than tubal sterilizations. Physicians or others who themselves have had the procedure seem to be in an especially favourable position to describe accurately the advantages and risks of this surgery, as well as its alternatives. Questionnaires inquiring about reasons for choosing vasectomy were sent to 42 medical doctors who had undergone the procedure. Counsellors can usefully proffer to inquiring patients the same advantages that reportedly motivated the medical doctors: convenience, economy, and safety. PMID:21253074

  10. Immunologic effects of vasectomy in men and experimental animals.

    PubMed

    Bigazzi, P

    1981-01-01

    Vasectomy is a widely accepted surgical procedure for male sterilization, with the unique characteristic of eliciting immune responses to self-antigens. Persistent humoral autoimmune responses to spermatozoa and transient responses to other antigens have been demonstrated in vasectomized men. Little information is available on delayed hypersensitivity reactions to spermatozoa, as well as histopathology and immunohistopathology of the testes and other organs in vasectomized individuals. Overall, the data obtained in men do not point to any immediate cause for concern and seem to justify the optimistic view that vasectomy is a safe procedure. A review of the studies performed in experimental animals similarly shows that vasectomy is followed by humoral and/or cell-mediated immune responses to spermatozoal antigens. In some species, such as rabbits and guinea pigs, it is also followed by testicular lesions, mediated by in situ immune complexes and/or delayed hypersensitivity reactions. Other sequelae may be glomerulonephritis and an increased severity of atherosclerotic lesions. Therefore, the rather encouraging picture emerging from the human studies is to a certain extent offset by the findings in experimental animals. Additional research on the effects of vasectomy is obviously necessary, as well as caution in advising this procedure to individuals who may be genetically predisposed to autoimmune disease. PMID:7031702

  11. Trends in vasectomy. Analysis of one teaching practice.

    PubMed Central

    Reynolds, J. L.

    1998-01-01

    PROBLEM BEING ADDRESSED: How can a teaching practice develop a referral service and incorporate educational opportunities for family medicine residents, clinical clerks, and community family physicians? OBJECTIVE OF PROGRAM: To develop a high-quality vasectomy service within a teaching practice to change the surgical procedure to the no-scalpel vasectomy (NSV) technique; to educate family medicine residents, clinical clerks, and community family physicians about vasectomy and the NSV technique; and to monitor outcomes and compare them with published results. MAIN COMPONENTS OF PROGRAM: The program took place in an urban family medicine residency program. Data on number of procedures, types of patients choosing vasectomy, and outcomes are presented, along with information on number of learners who viewed, assisted with, or became competent to perform NSV. CONCLUSIONS: A few family medicine residents and some interested community physicians could be trained to perform NSV competently. Involving learners in the procedure does not seem to change the rate of complications. Images Figure 1 PMID:9559195

  12. Pre-operative risk factors associated with need for vasoepididymostomy at the time of vasectomy reversal.

    PubMed

    Fuchs, M E; Anderson, R E; Ostrowski, K A; Brant, W O; Fuchs, E F

    2016-01-01

    The absence of sperm in the ejaculate after vasectomy reversal is commonly caused by failure to recognize and subsequently bypass epididymal or proximal vasal obstruction at the time of vasectomy reversal. If intra-operative proximal obstruction is suspected, vasoepididymostomy (VE) is recommended rather than vasovasostomy (VV). We sought to calculate the associated risk of needing VE, rather than VV with time from original vasectomy (obstructive interval) using a large cohort of vasectomy reversal patients. We reviewed the electronic and paper vasectomy reversal database by a single surgeon from 1978 through 2012. We performed univariate analysis to identify variables that predicted the need for VE rather than VV, and then combined only significant univariates into our multi-variable analysis. 2697 total men underwent vasectomy reversal, and 239 were repeat procedures. Of the 5296 individual testes operated on, 1029 were VE. Significant variables that predicted the need for VE on univariate analysis included: age, obstructive time interval, vasectomy reversal after previous VV (repeat vasectomy reversal), and year the procedure was performed. On multi-variable analysis significant risk factors for VE were age above 50 (OR 1.36), repeat vasectomy reversal (OR 5.78), and greater obstructive time interval (OR 1.56). For every 3 years since original vasectomy, the risk of needing VE increases by 56%. There is a linear relationship between obstructive interval and need for VE. Men undergoing repeat vasectomy reversal have five times greater risk of requiring VE and men greater than 50 years of age are also at higher risk. Using these pre-operative predictors is helpful in identifying patients who will benefit from referral to an experienced surgeon who can perform VE. PMID:26663812

  13. Acute effect of vasectomy on the function of the rat epididymal epithelium and vas deferens.

    PubMed

    Lavers, Ann E; Swanlund, David J; Hunter, Brian A; Tran, Michael L; Pryor, Jon L; Roberts, Kenneth P

    2006-01-01

    Persistent infertility after apparently successful vasectomy reversal is common. One possible etiology is epididymal epithelial dysfunction resulting in improper sperm maturation after vasectomy reversal. The epididymal epithelium secretes a number of proteins that are thought to be required for the maturation of sperm. Ligation of the vas deferens during vasectomy may affect the synthesis of some of these proteins. In the present study, the function of the epididymal epithelium was assessed at early times after vasectomy (1, 4, and 7 days) by measuring the level of mRNA of 4 secreted proteins: Crisp-1, clusterin, osteopontin, and transferrin. In addition, the site of synthesis of these proteins was determined by immunocytochemistry. The results demonstrated that the expression of Crisp-1 and clusterin, representative epididymal secretory proteins, was largely unaffected by vasectomy. However, osteopontin mRNA increased in the vas deferens in response to vasectomy. Immunocytochemical localization of osteopontin suggested that both infiltrating immune cells and deferential luminal epithelium were responsible for this up-regulation. Transferrin expression was viewed as a marker for immune cells at the site of injury. However, both the caput epididymis and deferential epithelia were found to express transferrin, in addition to immune cells. In conclusion, there appear to be only minor changes in expression of genes encoding epididymal secretory proteins acutely after vasectomy, but, not surprisingly, there was evidence of an inflammatory response after vasectomy. PMID:16837732

  14. Prospective comparison of ligation and bipolar cautery technique in non-scalpel vasectomy

    PubMed Central

    Altok, Muammer; Şahin, Ali Feyzullah; Divrik, Rauf Taner; Yildirim, Ümit; Zorlu, Ferruh

    2015-01-01

    ABSTRACT Objectives: There is no trial comparing bipolar cautery and ligation for occlusion of vas in non-scalpel vasectomy. This study aimed to compare the effectiveness of these vasectomy occlusion techniques. Materials and Methods: Between January 2002-June 2009, patients were allocated in alternate order. We recruited 100 cases in cautery group and 100 cases in ligation group. Non-scalpel approach was performed during vasectomy and fascial interposition was performed in all cases. First semen analysis was done 3 months after vasectomy. Vasectomy success was defined as azoospermia or non-motile sperm lower than 100.000/mL. Results: Four patients from the cautery group were switched to the ligation group due to technical problem of cautery device. Thus, data of 96 patients as cautery group and 104 patients as ligation group were evaluated. After vasectomy, semen analyses were obtained from 59 of 96 (61.5%) patients in cautery group and to 66 of 104 (63.5%) patients in ligation group. There was no statistical significant difference between the two groups in terms of the success of vasectomy (p=0.863). Conclusion: Although bipolar cautery technique is safe, effective and feasible in non-scalpel vasectomy, it has no superiority to ligation. There was no statistically significant difference in terms of the success and complications between the two groups. PMID:26742977

  15. He's a real man: a qualitative study of the social context of couples' vasectomy decisions among a racially diverse population.

    PubMed

    Shih, Grace; Dub, Kate; Sheinbein, Miriam; Borrero, Sonya; Dehlendorf, Christine

    2013-05-01

    Vasectomy has advantages with respect to safety and cost when compared with female sterilization. The reasons underlying the overall low use of vasectomy, particularly among Black and Latinos, have not been adequately explored. The goals of this study were to (a) explore the social context of vasectomy decisions and (b) generate hypotheses about the social factors contributing to differences in vasectomy use by race/ethnicity. Fourteen group and nine couples interviews were conducted. Participants were 37 heterosexual couples aged 25 to 55 years who had reached their desired family size and self-identified as Black, Latino, or White. Participants discussed reasons that men and women would or would not select male sterilization. Reasons to select vasectomy included a desire to care for their current family, sharing contraceptive responsibility, and infidelity. Reasons not to select vasectomy included negative associations with the term sterilization, loss of manhood, and permanence. Misconceptions about vasectomy included misunderstandings about the vasectomy procedure and adverse postvasectomy sexual function. In addition, Black and Latino participants cited perceived ease of reversibility of female sterilization and lack of support around vasectomy as reasons not to choose it. Improving communication and social support for vasectomy, particularly among Black and Latino communities, may improve vasectomy utilization. Misconceptions regarding female and male sterilization should be targeted in counseling sessions to ensure men, women, and couples are making informed contraceptive decisions. PMID:23144022

  16. [Vasectomy: legal recognition in Italy, opposition to change in France].

    PubMed

    Dourlen-rollier, A M

    1988-03-01

    Voluntary sterilization exclusively for contraceptive purposes is now legal in many countries of Asia, North America, and Europe. Since 1972 most European countries have taken action through statutes, codes of medical ethics, decrees, or court decisions to establish the legality of contraceptive sterilization. France and Italy, neighboring countries with Catholic majorities and a tradition of Roman law, have had great difficulties in recognizing the legality of vasectomy. Italy was 1 of the few countries of the world with a law specifically prohibiting voluntary sterilization. The 1930 law was abrogated by Parliament in 1978, but in 1982 a physician was prosecuted for performing 50 vasectomies on men who had sought the procedure and consented to it. Prosecution argued that sterilization was not decriminalized despite abrogation of the 1930 law, and that voluntary sterilization was prohibited by the article of the penal code dealing with voluntary assault and battery. The interpretation surprised experts in population law, since the physician had received permission from the regional government of Tuscany to perform the vasectomies. The physician won the case, lost it in the Court of Appeals in Florence, and was finally acquitted in the Court of Cassation after a 5-year legal struggle. The court declared explicitly that voluntary sterilization did not constitute a penal infraction, but it recommended legislation to establish a minimum age, assure informed consent, and protect the interests of the spouse. In France, the legality of sterilization for purely contraceptive purposes has not always been explicitly recognized by the courts. Some recent verdicts have held that sterilization without therapeutic motivations is illicit, and some local committees of medical ethics continue to argue that vasectomy is an illicit practice that should only be considered in the presence of precise medical indications. The position is contrary to a resolution of the Committee of Ministers of the Council of Europe which France voted for in 1975, and a resolution of the National Council of the Order of Physicians in 1983. The resolution of the Order relaxed its earlier opposition to sterilization on the grounds that operative techniques had improved and that the chances for successful reversal had improved. It argued that sterilization should only be performed for very serious nonmedical reasons and required informed consent, spousal notification, and a waiting period of 2 months. The resolution has however been largely ignored. Although vasectomies are performed in numerous hospitals in France, their legal status remains ambiguous. PMID:12282190

  17. [Unique incision vasectomy: review of 1,800 cases].

    PubMed

    Castillo Jimeno, J M; Santiago González, A; Rodríguez Pérez, M J; Quel Alzueta, N; Ruiz Rubio, J L; Antón López, M J; Martínez Morillas, M

    1992-01-01

    We reviewed 1,800 vasectomy procedures using the double lateral scrotal incision and single incision of the raphe that had been performed at the Family Planning Center. The number of complications were minimal for both techniques: 6.5% for the patients submitted to the double incision and 5.5% for those submitted to the single incision procedure. The advantages of the single incision procedure are: it is easy to perform, less anesthesia is required, there are less complications, and the operating time is reduced. PMID:1586219

  18. An overview of the management of post-vasectomy pain syndrome

    PubMed Central

    Tan, Wei Phin; Levine, Laurence A

    2016-01-01

    Post-vasectomy pain syndrome remains one of the more challenging urological problems to manage. This can be a frustrating process for both the patient and clinician as there is no well-recognized diagnostic regimen or reliable effective treatment. Many of these patients will end up seeing physicians across many disciplines, further frustrating them. The etiology of post-vasectomy pain syndrome is not clearly delineated. Postulations include damage to the scrotal and spermatic cord nerve structures via inflammatory effects of the immune system, back pressure effects in the obstructed vas and epididymis, vascular stasis, nerve impingement, or perineural fibrosis. Post-vasectomy pain syndrome is defined as at least 3 months of chronic or intermittent scrotal content pain. This article reviews the current understanding of post-vasectomy pain syndrome, theories behind its pathophysiology, evaluation pathways, and treatment options. PMID:26952956

  19. An overview of the management of post-vasectomy pain syndrome.

    PubMed

    Tan, Wei Phin; Levine, Laurence A

    2016-01-01

    Post-vasectomy pain syndrome remains one of the more challenging urological problems to manage. This can be a frustrating process for both the patient and clinician as there is no well-recognized diagnostic regimen or reliable effective treatment. Many of these patients will end up seeing physicians across many disciplines, further frustrating them. The etiology of post-vasectomy pain syndrome is not clearly delineated. Postulations include damage to the scrotal and spermatic cord nerve structures via inflammatory effects of the immune system, back pressure effects in the obstructed vas and epididymis, vascular stasis, nerve impingement, or perineural fibrosis. Post-vasectomy pain syndrome is defined as at least 3 months of chronic or intermittent scrotal content pain. This article reviews the current understanding of post-vasectomy pain syndrome, theories behind its pathophysiology, evaluation pathways, and treatment options. PMID:26952956

  20. Vasectomy and the risk of prostate cancer: a meta-analysis of cohort studies

    PubMed Central

    Zhang, Xiao-Long; Yan, Jia-Jun; Pan, Shou-Hua; Pan, Jian-Gang; Ying, Xiang-Rong; Zhang, Guan-Fu

    2015-01-01

    Background: The relationship of vasectomy to prostate cancer has great public health significance. However, the results of observational studies were conflicting. To determine whether vasectomy is associated with the risk of prostate cancer, we performed a meta-analysis of cohort studies. Methods: A literature search was carried out using Pubmed, Embase, Cochrane Libraryl, and China National Knowledge Infrastructure (CNKI) between January 1966 and July 2013. Before meta-analysis, between-study heterogeneity and publication bias were assessed using adequate statistical tests. Fixed-effect and random-effect models were used to estimate summary relative risks (RR) and the corresponding 95% confidence intervals (CIs). Potential sources of heterogeneity were detected by meta-regression. Subgroup analyses and sensitivity analysis were also performed. Results: A total of nine cohort studies contributed to the analysis. There was heterogeneity among the studies but no publication bias. Pooled results indicated that vasectomy was not associated with a significant increase of total prostate cancer risk (RR = 1.07, 95% CI [0.79, 1.46]). When stratified the various studies by geographic location, we found a significant association between vasectomy and increased PCa risk among studies conducted in the USA (RR = 1.54, 95% CI [1.23, 1.93]), however, there was no significant association between vasectomy and PCa risk among studies conducted in non-USA countries (RR = 0.74, 95% CI [0.50, 1.09]). Furthermore, sensitivity analysis confirmed the stability of the results. Conclusions: In conclusion, the present meta-analysis of cohort studies suggested that vasectomy was not associated with increased risk of prostate cancer. More in-depth studies are warranted to report more detailed results, including stratified results by age at vasectomy, tumor grade, and tumor stage. PMID:26770392

  1. The influence of a vasectomy on the marital relationship and sexual satisfaction of the married man.

    PubMed

    Hofmeyr, Doreen G; Greeff, Abraham P

    2002-01-01

    The purpose of this study was to determine whether a vasectomy had any effect on important aspects of a marriage, such as sexual satisfaction, marital satisfaction, communication, and frequency of sexual intercourse. An experimental research design was used. We collected data by means of a biographical questionnaire, the Enriching & Nurturing Relationship Issues, Communications & Happiness questionnaire (Olson et al., 1985), and the Index of Sexual Satisfaction (Fischer & Corcoran, 1990), which were applied prior to and 5 months after the vasectomy. Results indicated no significant difference between the before and after measurements regarding sexual satisfaction, marital satisfaction, communication, and frequency of sexual intercourse. PMID:12082672

  2. Embolic Stroke Caused by Staphylococcus lugdunensis Endocarditis Complicating Vasectomy in a 36-Year-Old Man

    PubMed Central

    Loftsgaarden, Megan; Chukwudelunzu, Felix

    2015-01-01

    Staphylococcus lugdunensis is part of the native flora in the inguinal region of the body. Inguinal surgeries, such as vasectomy, place carriers of this aggressive pathogen at risk for contamination. Native-valve endocarditis caused by coagulase-negative S. lugdunensis has a rapid and complicated clinical course. The pathogenicity of this organism is not limited to cardiac valvular destruction. We report the case of a 36-year-old man who presented with S. lugdunensis endocarditis, dysarthria, and hemiparesis 5 weeks after a vasectomy. To our knowledge, this is the first report of embolic stroke caused by S. lugdunensis endocarditis. In addition, we discuss the relevant medical literature. PMID:26664319

  3. "Suddenly, bang, one day there's commitment with a woman..." men, vasectomy and the life course.

    PubMed

    Terry, Gareth

    2014-09-01

    Research that investigates and theorises the male reproductive life course is extremely limited, and often reduced to examining problems, such as infertility. As a consequence, what we know about men's reproductive decision making is often extrapolated from theorisation of the female reproductive life course, or simplistic assumptions about masculine identity. This article analyses interview data from 34 men talking about their vasectomy decision-making processes in order to provide a lens through which to understand men making sense of their reproductive life course. Men who had children spoke of their vasectomy as resolving their lay understandings of the 'normal' life course, men who did not want their children to speak of resisting the normal life course, and men who had experienced or considered relationship dissolution spoke of resetting the life course. PMID:25116431

  4. Optimizing outcomes in vasectomy: how to ensure sterility and prevent complications

    PubMed Central

    2016-01-01

    Vasectomy provides a long-term effective sterilization for men and is performed on nearly 500,000 men annually in the United States. Improvements in technique have led to a decreased failure rate and fewer complications, although significant variations in technique exist. Use of cautery occlusion with or without fascial interposition appears to have the least failures. A no-scalpel approach lowers risk of hematoma formation, infection and bleeding post-operatively. A patient can be considered sterile when azoospermia is achieved or the semen analysis shows less than 100,000 non-motile sperm per milliliter. Incorporating these principles may allow the physician to optimize outcomes in vasectomy. PMID:27141443

  5. Robotic intra-abdominal vasectomy reversal: A new approach to a difficult problem

    PubMed Central

    Barazani, Yagil; Kaouk, Jihad; Sabanegh, Edmund S.

    2014-01-01

    The management of obstructive azoospermia resulting from intra-abdominal vasal obstruction poses a formidable surgical challenge. A number of surgical methods have been described to address this problem, including both open and laparoscopic approaches to mobilize and sometimes even re-route the abdominal vas deferens prior to performing a re-anastamosis. We present the first report, to our knowledge, of robotic intra-abdominal vasectomy reversal used to repair obstructive azoospermia resulting from prior laparoscopic vasectomy. In doing so, we summarize the techniques described previously in the literature and build upon this body of surgical experience by combining robotic-assisted laparoscopic mobilization of the vas with robotic vasovasostomy. We believe this novel approach for repairing intra-abdominal vasal defects minimizes morbidity, while at the same time obviating the need for the operating microscope, and thus represents a practical alternative to existing techniques. PMID:25024801

  6. Laparoscopic vasectomy in African savannah elephant (Loxodonta africana); surgical technique and results.

    PubMed

    Marais, Hendrik J; Hendrickson, Dean A; Stetter, Mark; Zuba, Jeffery R; Penning, Mark; Siegal-Willott, Jess; Hardy, Christine

    2013-12-01

    Several small, enclosed reserves in southern Africa are experiencing significant elephant population growth, which has resulted in associated environmental damage and changes in biodiversity. Although several techniques exist to control elephant populations, e.g., culling, relocation, and immunocontraception, the technique of laparoscopic vasectomy of free-ranging bull elephants was investigated. Bilateral vasectomies were performed in 45 elephants. Of these elephants, one died within 24 hr of recovery and two had complications during surgery but recovered uneventfully. Histologic examination confirmed the resected tissue as ductus deferens in all the bulls. Most animals recovered uneventfully and showed no abnormal behavior after surgery. Complications recorded included incisional dehiscence, 1 full-thickness and 2 partial-thickness lacerations of the large intestine, and initial sling-associated complications, for example, deep radial nerve paresis. One bull was found dead 6 weeks after surgery without showing any prior abnormal signs. Vasectomy in free-ranging African bull elephants may be effectively performed in their normal environment. The surgical procedure can be used as a realistic population management tool in free-ranging elephants without major anesthetic, surgical, or postoperative complications. PMID:24437080

  7. COMPARISON OF CHEMICAL AND SURGICAL VASECTOMY ON TESTICULAR ACTIVITY IN FREE-ROAMING HORSES (EQUUS CABALLUS).

    PubMed

    Scully, Clare M; Lee, Rebecca L; Pielstick, Leon; Medlock, Jan; Patton, Kristin M; Collins, Gail H; Kutzler, Michelle A

    2015-12-01

    Free-roaming horse (Equus caballus) management is a complex issue incorporating social, economic, emotional, political, and environmental factors. Currently, few proven field techniques exist for managing free-roaming horse population growth, which can reach 20-25% annually. Although there are several strategies available for sterilizing mares when managing free-roaming horse populations, surgical vasectomy is the only method used in the field for stallions. Some managers believe that surgically vasectomizing dominant stallions would have significant effects on reducing horse populations. However, sterilizing only dominant harem stallions results in a relatively modest reduction in population growth as substantial reproduction may occur even when 100% of the dominant harem stallions are sterilized if other males perform as little as 10% of the breeding. The overall goal of the current project was to evaluate the efficacy of a novel nonsurgical method for sterilizing free-roaming horses (chemical vasectomy). In September of 2013, stallions that had been previously surgically vasectomized (SURG, n = 25), previously chemically vasectomized (CHEM, n = 16), or untreated (CONT, n = 32) were captured and surgically castrated in preparation for adoption. When comparing both sterilization methods to CONT, serum testosterone and estrone sulfate concentrations did not differ (P > 0.05), suggesting that these methods for sterilizing free-roaming stallions would not disrupt herd social hierarchy. However, similar to the CONT, all CHEM stallions had sperm present within the vas deferens seminal fluid samples. CHEM stallions had more morphologically abnormal sperm than did CONT stallions but it is not known if this affected the actual fertility. Additional research is needed using alternative sclerosing agents for chemical vasectomy in free-roaming horse populations. PMID:26667538

  8. Application of optical coherence tomography and high-frequency ultrasound imaging during noninvasive laser vasectomy.

    PubMed

    Cilip, Christopher M; Allaf, Mohamad E; Fried, Nathaniel M

    2012-04-01

    A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. Optical coherence tomography (OCT) and high-frequency ultrasound (HFUS) are compared for monitoring laser thermal coagulation of the vas in an acute canine model. Bilateral noninvasive laser coagulation of the vas was performed in six dogs (n=12 vasa) using a Ytterbium fiber laser wavelength of 1075 nm, incident power of 9.0 W, pulse duration of 500 ms, pulse rate of 1 Hz, and 3-mm-diameter spot. Cryogen spray cooling was used to prevent skin burns during the procedure. An OCT system with endoscopic probe and a HFUS system with 20-MHz transducer were used to image the vas immediately before and after the procedure. Vasa were then excised and processed for gross and histologic analysis for comparison with OCT and HFUS images. OCT provided high-resolution, superficial imaging of the compressed vas within the vas ring clamp, while HFUS provided deeper imaging of the vas held manually in the scrotal fold. Both OCT and high HFUS are promising imaging modalities for real-time confirmation of vas occlusion during noninvasive laser vasectomy. PMID:22559684

  9. Application of optical coherence tomography and high-frequency ultrasound imaging during noninvasive laser vasectomy

    PubMed Central

    Cilip, Christopher M.; Allaf, Mohamad E.

    2012-01-01

    Abstract. A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. Optical coherence tomography (OCT) and high-frequency ultrasound (HFUS) are compared for monitoring laser thermal coagulation of the vas in an acute canine model. Bilateral noninvasive laser coagulation of the vas was performed in six dogs (n=12 vasa) using a Ytterbium fiber laser wavelength of 1075 nm, incident power of 9.0 W, pulse duration of 500 ms, pulse rate of 1 Hz, and 3-mm-diameter spot. Cryogen spray cooling was used to prevent skin burns during the procedure. An OCT system with endoscopic probe and a HFUS system with 20-MHz transducer were used to image the vas immediately before and after the procedure. Vasa were then excised and processed for gross and histologic analysis for comparison with OCT and HFUS images. OCT provided high-resolution, superficial imaging of the compressed vas within the vas ring clamp, while HFUS provided deeper imaging of the vas held manually in the scrotal fold. Both OCT and high HFUS are promising imaging modalities for real-time confirmation of vas occlusion during noninvasive laser vasectomy. PMID:22559684

  10. Endoscopic Vasectomy of Male Feral Pigeons (Columba livia) as a Possible Method of Population Control.

    PubMed

    Heiderich, Elisabeth; Schildger, Bernd; Lierz, Michael

    2015-03-01

    To evaluate whether single-entry endoscopic vasectomy of male feral pigeons (Columba livia) significantly reduced fertility and would potentially be valuable for control of feral pigeon populations, 252 male feral pigeons were caught in the city of Berne and endoscopically vasectomized. In this procedure, approximately 1 cm of the deferent duct was removed bilaterally. Rapid, uneventful recoveries occurred in 94% (237/252) of the pigeons, whereas 6% (15/252) died because of complications associated with the procedure, consisting of perforation of the ureter (9/15), major hemorrhage (5/15), and respiratory arrest (1/15). Mean anesthesia time was 23±6 minutes. The vasectomized males were habituated to 2 pigeon houses together with fertile females. Another pigeon house with fertile pairs acted as control. All eggs laid were candled weekly to assess fertility. In the 2 pigeon houses with vasectomized males, the mean fertilization rate was 0.9% (5/563), while in the control pigeon house, the rate was 100% (39/39). The results indicate that endoscopic vasectomy of male feral pigeons may be a promising tool for field control of feral pigeon populations, especially in combination with other methods such as pigeon houses. PMID:25867661

  11. Application of optical coherence tomography and high-frequency ultrasound imaging during noninvasive laser vasectomy

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Allaf, Mohamad E.; Fried, Nathaniel M.

    2012-04-01

    A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. Optical coherence tomography (OCT) and high-frequency ultrasound (HFUS) are compared for monitoring laser thermal coagulation of the vas in an acute canine model. Bilateral noninvasive laser coagulation of the vas was performed in six dogs (n=12 vasa) using a Ytterbium fiber laser wavelength of 1075 nm, incident power of 9.0 W, pulse duration of 500 ms, pulse rate of 1 Hz, and 3-mm-diameter spot. Cryogen spray cooling was used to prevent skin burns during the procedure. An OCT system with endoscopic probe and a HFUS system with 20-MHz transducer were used to image the vas immediately before and after the procedure. Vasa were then excised and processed for gross and histologic analysis for comparison with OCT and HFUS images. OCT provided high-resolution, superficial imaging of the compressed vas within the vas ring clamp, while HFUS provided deeper imaging of the vas held manually in the scrotal fold. Both OCT and high HFUS are promising imaging modalities for real-time confirmation of vas occlusion during noninvasive laser vasectomy.

  12. Vasectomy Reversal

    MedlinePlus

    ... Fund Annual Fund Alliances & Partner Organizations Cause-Related Marketing Planned Giving Charitable Gift Planning is a powerful ... CareBlog Make a Difference Planned Giving Cause-Related Marketing Research Quick Links Urologic Conditions Financials & Annual Report ...

  13. Vasectomy Reversal

    MedlinePlus

    ... using electrocautery, shortly we'll change only to bipolar forceps to make sure that there’s no inadvertent ... Again, as I mentioned earlier, we're using bipolar forceps. This prevents inadvertent thermal injury to healthy ...

  14. Utero-tubal Embryo Transfer and Vasectomy in the Mouse Model

    PubMed Central

    Bermejo-Alvarez, Pablo; Park, Ki-Eun; Telugu, Bhanu P.

    2014-01-01

    The transfer of preimplantation embryos to a surrogate female is a required step for the production of genetically modified mice or to study the effects of epigenetic alterations originated during preimplantation development on subsequent fetal development and adult health. The use of an effective and consistent embryo transfer technique is crucial to enhance the generation of genetically modified animals and to determine the effect of different treatments on implantation rates and survival to term. Embryos at the blastocyst stage are usually transferred by uterine transfer, performing a puncture in the uterine wall to introduce the embryo manipulation pipette. The orifice performed in the uterus does not close after the pipette has been withdrawn, and the embryos can outflow to the abdominal cavity due to the positive pressure of the uterus. The puncture can also produce a hemorrhage that impairs implantation, blocks the transfer pipette and may affect embryo development, especially when embryos without zona are transferred. Consequently, this technique often results in very variable and overall low embryo survival rates. Avoiding these negative effects, utero-tubal embryo transfer take advantage of the utero-tubal junction as a natural barrier that impedes embryo outflow and avoid the puncture of the uterine wall. Vasectomized males are required for obtaining pseudopregnant recipients. A technique to perform vasectomy is described as a complement to the utero-tubal embryo transfer. PMID:24637845

  15. No-scalpel vasectomy: review of the first 1,000 cases in a family medicine unit.

    PubMed

    Arellano Lara, S; Gonzalez Barrera, J L; Hernandez Ono, A; Moreno Alcazar, O; Espinosa Perez, J

    1997-01-01

    In Mexico, the Mexican Institute of Social Security (IMSS) had adopted the no-scalpel vasectomy technique by the end of 1989. The technique was described by Dr. Li Shunquiang in 1974, and more than 60 million no-scalpel vasectomies have been performed in 26 countries. Among the advantages with no-scalpel vasectomy is that it has fewer complications (0.4%) compared to the traditional technique (3.1%). We studied 1,000 clinical charts of the subjects operated on between January, 1990 and January, 1993, with the objective of reporting our experiences as well as analyzing whether there existed a correlation between the subject's social and demographic characteristics and the number of control spermatic counts he attended postoperatively. In 97.9% of the cases, subjects had no postoperative hemorrhage or hematoma. None of the subjects had a surgical wound infection. In addition, 54.4% of the subjects came to the first control spermatic count, 39.7% came to the second, and only 18.4% came to all three controls. In an attempt to find a characteristic which defined the subject who attends his postoperative control spermatic counts, we found an association using chi2 between the attendance at two controls with the subjects who had been married from 6 - 10 years (p = 0.059), and with the subjects who had an income of three minimum wages. Regarding the attendance at all three controls, we found an association with subjects who had an income of two minimum wages (p = 0.037). We also found a weak correlation between the attendance at all three controls and the reason reported for not having more children (the couple did not want more children) (r = 0.07; p = 0.025) and with the manner in which the subjects were referred to the clinic (came on their own initiative) (r = 0.09; p = 0.006). Finally, we consider that no-scalpel vasectomy can be implemented as an adequate family planning method in Mexico's primary care centers. The lack of adequate attendance at postoperative control spermatic counts does not seem to have an important association with the subject's demographic characteristics, so it appears warranted that this issue be studied from a psychological point of view. PMID:9428576

  16. The Assessment of Post-Vasectomy Pain in Mice Using Behaviour and the Mouse Grimace Scale

    PubMed Central

    Leach, Matthew C.; Klaus, Kristel; Miller, Amy L.; Scotto di Perrotolo, Maud; Sotocinal, Susana G.; Flecknell, Paul A.

    2012-01-01

    Background Current behaviour-based pain assessments for laboratory rodents have significant limitations. Assessment of facial expression changes, as a novel means of pain scoring, may overcome some of these limitations. The Mouse Grimace Scale appears to offer a means of assessing post-operative pain in mice that is as effective as manual behavioural-based scoring, without the limitations of such schemes. Effective assessment of post-operative pain is not only critical for animal welfare, but also the validity of science using animal models. Methodology/Principal Findings This study compared changes in behaviour assessed using both an automated system (“HomeCageScan”) and using manual analysis with changes in facial expressions assessed using the Mouse Grimace Scale (MGS). Mice (n = 6/group) were assessed before and after surgery (scrotal approach vasectomy) and either received saline, meloxicam or bupivacaine. Both the MGS and manual scoring of pain behaviours identified clear differences between the pre and post surgery periods and between those animals receiving analgesia (20 mg/kg meloxicam or 5 mg/kg bupivacaine) or saline post-operatively. Both of these assessments were highly correlated with those showing high MGS scores also exhibiting high frequencies of pain behaviours. Automated behavioural analysis in contrast was only able to detect differences between the pre and post surgery periods. Conclusions In conclusion, both the Mouse Grimace Scale and manual scoring of pain behaviours are assessing the presence of post-surgical pain, whereas automated behavioural analysis could be detecting surgical stress and/or post-surgical pain. This study suggests that the Mouse Grimace Scale could prove to be a quick and easy means of assessing post-surgical pain, and the efficacy of analgesic treatment in mice that overcomes some of the limitations of behaviour-based assessment schemes. PMID:22558191

  17. Intraluminal occlusion of the seminal duct by laser and Histoacryl: Two non-invasive alternatives for vasectomy

    NASA Astrophysics Data System (ADS)

    Freitag, B.; Sroka, R.; Koelle, S.; Becker, A. J.; Khoder, W.; Pongratz, T.; Stief, C. G.; Trottmann, M.

    2014-03-01

    Introduction and objective: Vasectomy is a well-established method in family control. Even though it is a safe and low risk operation, this surgery is invasive and difficult to reverse. Therefore the aim of this study was to investigate new non-invasive methods for occlusion of the seminal duct. Material and Methods: Seminal duct tissue was obtained from patients (n=30) suffering from prostate cancer and therefore undergoing prostatectomy. In a first set of experiments, the seminal duct was occluded by intraluminal application of Histoacryl® (Braun Aesculap AG, Tuttlingen, Germany). In a 2nd set of experiments, endoluminal laser induced occlusion was performed. Four different laser wavelengths (1940nm, 1470nm, 1064nm, 940nm) and different sets of laser parameters (e.g. power, exposure duration, fibre diameter, energy applied) were compared. Effectiveness of occlusion of the seminal duct was proven by post-treatment irrigation flow measurement, as well as by morphological analyses. To evaluate a potential damage of the surrounding tissue, external temperature was measured using a thermometer during laser application. Results: Intraluminal application of Histoacryl® induced an immediate and complete occlusion of the seminal duct. The underlying connective tissue maintained its functional integrity after this treatment. By laser light application to a Histoacryl® block, a hole could be created into the block thus indicating the possibility of recanalization. Treatment with laser energy resulted in shrinkage of the ductal lumen. The laser application generally caused necrosis in the epithelium and induced formation of vacuoles in the underlying connective tissue. As described for endoluminal varicose treatment, this distinct local reaction might result in an intense inflammation leading to a functional occlusion of the vas deferens. Conclusions: Both laser-induced occlusion and application of Histoacryl® are fast and simple techniques which may be able to achieve a functional occlusion of the seminal duct. The application of Histoacryl® additionally may be easily reversible by laser treatment.

  18. How Is a Vasectomy Done?

    MedlinePlus

    ... affect my sex life? Other FAQs ... is usually performed in the office of urologist, a doctor who specializes in the male urinary tract and reproductive system. In some cases, the urologist may decide to ...

  19. What Are the Risks of Vasectomy?

    MedlinePlus

    ... Clinical Trials Resources and Publications For Patients and Consumers For Researchers and Health Care Providers Grants & Funding About Research Grants & Contracts, Types of Funding Announcements Grants Process Grant Policies & Funding Strategies Funding Opportunities & Mechanisms Peer ...

  20. Key Statistics from the National Survey of Family Growth: Vasectomy

    MedlinePlus

    ... Birth Data NCHS Key Statistics from the National Survey of Family Growth - V Listing Recommend on Facebook ... What's this? Submit Button Related Sites NCHS Listservs Surveys and Data Collection Systems Vital Statistics: Birth Data ...

  1. Staphylococcus lugdunensis endocarditis following vasectomy--report of a case history and review of the literature.

    PubMed

    Schandiz, Hossein; Olav Hermansen, Nils; Jørgensen, Trond; Roald, Borghild

    2015-08-01

    Staphylococcus lugdunensis is a coagulase-negative Staphylococcus (CoNS), and part of the normal skin flora. The bacterium is an emerging pathogen that, unlike other CoNS, resembles coagulase-positive Staphylococcus aureus infections in virulence, tissue destruction, and clinical course. We report a fatal case following minor surgery. The frequency of S. lugdunensis infections has probably been underestimated and under-reported in the past as few clinical laboratories routinely identify coagulase-negative Staphylococci. PMID:26058423

  2. How Effective Is Male Contraception?

    MedlinePlus

    ... men, methods of contraception include male condoms and sterilization (vasectomy). Male condoms. This condom is a thin ... it is not always possible. Vasectomy, like other sterilization procedures, is considered a permanent form of birth ...

  3. Studies in Family Planning, Volume 3, Number 8.

    ERIC Educational Resources Information Center

    Population Council, New York, NY.

    "Kerala's Pioneering Experiment in Massive Vasectomy Camps," the principal article in this monthly publication of the Population Council, is a detailed research report on the success of a massive vasectomy camp conducted at Cochin, the capital city of the Ernakulam District of Kerala State, India. The second article, "The Gujarat State Massive…

  4. Postvasectomy semen analysis: why patients don't follow-up.

    PubMed

    Smucker, D R; Mayhew, H E; Nordlund, D J; Hahn, W K; Palmer, K E

    1991-01-01

    Semen analysis following elective vasectomy is necessary to confirm that the procedure was successful. However, many patients fail to follow postoperative instructions to obtain semen analysis. One hundred forty-one patients who had undergone vasectomy at the Family Practice Center of the Medical College of Ohio were surveyed to assess reasons for a poor rate of follow-up after vasectomy. Only 26 percent of respondents had returned two or more semen samples following surgery. Forty-five percent had not returned any samples. The inconvenience and embarrassment of having to bring semen specimens to the laboratory were identified as factors that can affect patient adherence to instructions. Respondents who had not returned any semen specimens were more likely to answer that their spouse would not be very upset if the vasectomy failed and pregnancy resulted. Our survey results identify issues for improving patient care following vasectomy. These include patient education and postoperative protocols. PMID:1847562

  5. Physicians' attitudes, recommendations and practice of male and female sterilization in São Paulo.

    PubMed

    Bailey, P E; de Castro, M P; Araujo, M D; de Castro, B M; Janowitz, B

    1991-08-01

    While prevalence of vasectomy is low in Brazil, female sterilization is very high. The potential for growth of vasectomy services may be related to attitudes and practices of physicians. In 1984, 660 physicians at seven major hospitals in São Paulo were randomly selected from a total population of 2207 physicians in these hospitals. They were interviewed about their attitudes towards family planning in general, and specifically towards voluntary sterilization. A high degree of vasectomy among this medical community is indicated by its relatively high prevalence among married physicians and their spouses; about one in ten reported that either they or their spouse had had a vasectomy. Half of the physicians who perform sterilizations perform vasectomies: 22% of obstetricians and gynecologists, 85% of surgeons, and all urologists. In general, physicians would recommend vasectomy and tubal ligation equally often to their clients. Depending on the circumstances, up to 85% of all physicians recommend some sterilization procedure. Recommendation was modified by the type of procedure a physician performed, and by the patient's characteristics. Physician's recommendations of sterilization increased with age and parity of patient and was related to the health conditions and socioeconomic circumstances of the couple. PMID:1893711

  6. PubMed Central

    Labrecque, Michel

    1987-01-01

    Vasectomy is done by a family physician at the family planning clinic of le Centre Hospitalier de l'Universit Laval. The technique used combines an occlusion with metal clips and an excision of one to two centimetres of the vas deferens. The post-operative complications encountered with 304 vasectomies were hematomas (4%), infections of the scotal skin (1%), orchi-epididymitis (1%) and granulomas (1%). All these problems were treated on an out-patient basis, and no consultation with specialists was required. Of 151 patients who came back for a post-vasectomy semen examination, one had a test result showing motile spermatozoa. These figures are comparable to other results published. The family physician can easily incorporate this simple and safe procedure into his practice. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6 PMID:21263976

  7. The Censorship of "Maude": A Case Study in the Social Construction of Reality.

    ERIC Educational Resources Information Center

    Mihevc, Nancy T.; And Others

    The concept of reality held by individuals and societies can be explored by examining reactions to the censorship of the two-part television show in the "Maude" series that dealt with abortion and vasectomy. The station managements of WMBD in Peoria, Illinois, and of WCIA in Champaign-Urbana, Illinois, chose not to broadcast the two "Maude"…

  8. Microsurgical vasovasostomy

    PubMed Central

    Herrel, Lindsey; Hsiao, Wayland

    2013-01-01

    Up to 6% of men who have undergone vasectomy will ultimately elect for reversal in the form of vasovasostomy or vasoepididymostomy for various reasons. Vasovasostomy performed to regain fertility is a technique that has undergone numerous advances during the last century, including the use of microsurgical equipment and principles to construct a meticulous anastomosis. It is important during vasovasostomy to ensure good blood supply to the anastomosis as well as to build as a tension-free anastomosis. Visual inspection to ensure healthy mucosa and inner muscularis as well as atraumatic handling of tissues is helpful. With vasovasostomy, it is essential to create a watertight anastomosis to prevent secondary scar formation. The microdot technique of vasovasostomy allows for markedly discrepant lumens to be brought together more precisely. Thereby, the planning is separated from suture placement, which prevents dog-ears and avoids subsequent leaks. In the age of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), it becomes even more important to clarify outcomes after vasectomy reversals, as patients now have a choice between surgical sperm retrieval coupled with IVF/ICSI versus vasectomy reversal. Little data on long-term outcomes for vasectomy reversals exist. Therefore, further research in this field needs to evaluate the rate of late failures and the predictors of late failures. PMID:23147468

  9. Presterilization Interviewing: An Evaluation

    ERIC Educational Resources Information Center

    Carey, Raymond G.

    1976-01-01

    The role of interviewing in diffusing possible harmful side effects of sterilization operations was evaluated in an acute general hospital. Two simultaneous field experiments were conducted with 50 vasectomy couples and 50 tubal-ligation couples. There were no significant differences between the interview and control groups. (Author)

  10. Field Experiments of Family Planning Incentives.

    ERIC Educational Resources Information Center

    Rogers, Everett M.

    A review of four quasi-experiments on family planning incentives in three Asian nations is presented, and a multi-national comparative field experiment on family planning incentives is proposed. Experiments include: (1) The Ernakulam vasectomy campaigns, (2) Indian Tea Estates retirement bond incentive program, (3) Taiwan educational bond…

  11. [On the development of desire for refertilization among vasectomized men].

    PubMed

    Goebel, P

    1988-11-01

    All men undergoing reversal after vasectomy between 1984 and 1986 at the Steglitz clinic at the Free University of Berlin were given a deep psychological examination consisting of a history and interview and administration of the Giessen self image and partner image tests and the Giessen worry questionnaire. In 30 of the 40 cases 1 or more of the following factors was present at the time of vasectomy: status as a student, no relationship or a bad one, current or planned psychotherapy of one partner, a generalized rejection of children on ideological grounds or subjection to vasectomy in order to deliberately alienate parents. Of the 40 men treated, 25 had been married and living with their wives at the time of vasectomy, of which 22 had natural children, 2 adopted children and 1 with neither natural nor adopted children. 7 of the men were in a fixed relationship, all without either natural or adopted children. 8 of the men were not partners in a relationship; of these, 5 had natural children and 3 had neither natural nor adopted children. At the time of reversal the 29 new relationships averaged 13 months old, of which 15 were 24 months and 4 6 years. Of the 10 men living in an unchanged relationship, 3 were reacting to the death of a natural child, 3 experienced a wish for more children when their youngest child entered school and with 4 couples, previously childless, which resulted from psychotherapy of either the man or the wife. PMID:12283881

  12. Applying clinically proven human techniques for contraception and fertility to endangered species and zoo animals: a review.

    PubMed

    Silber, Sherman J; Barbey, Natalie; Lenahan, Kathy; Silber, David Z

    2013-12-01

    Reversible contraception that does not alter natural behavior is a critical need for managing zoo populations. In addition to reversible contraception, other fertility techniques perfected in humans may be useful, such as in vitro fertilization (IVF) or oocyte and embryo banking for endangered species like amphibians and Mexican wolves (Canis lupus baileyi). Furthermore, the genetics of human fertility can give a better understanding of fertility in more exotic species. Collaborations were established to apply human fertility techniques to the captive population. Reversible vasectomy might be one solution for reversible contraception that does not alter behavior. Reversible approaches to vasectomy, avoiding secondary epididymal disruption, were attempted in South American bush dogs (Speothos venaticus), chimpanzees (Pan troglodytes), gorillas (Gorilla gorilla), Przewalski's horse (Equus przewalski poliakov), and Sika deer (Cervus nippon) in a variety of zoos around the world. These techniques were first perfected in > 4,000 humans before attempting them in zoo animals. In vitro fertilization with gestational surrogacy was used to attempt to break the vicious cycle of hand rearing of purebred orangutans, and egg and ovary vitrification in humans have led to successful gamete banking for Mexican wolves and disappearing amphibians. The study of the human Y chromosome has even explained a mechanism of extinction related to global climate change. The best results with vasectomy reversal (normal sperm counts, pregnancy, and live offspring) were obtained when the original vasectomy was performed "open-ended," so as to avoid pressure-induced epididymal disruption. The attempt at gestational surrogacy for orangutans failed because of severe male infertility and the lack of success with human ovarian hyperstimulation protocols. Vitrification of oocytes is already being employed for the Amphibian Ark Project and for Mexican wolves. Vasectomy can be a reversible contraception option in zoo animals, even in endangered species. Ongoing use of gamete and embryo freezing may salvage vanishing species. PMID:24437091

  13. Family planning performance at a major hospital in Sri Lanka.

    PubMed

    Tennakoon, S

    1983-12-01

    862 men attending the family health clinic, General Hospital, Kurunegala, Sri Lanka for sterilization over the October 1, 1982-March 1983 period were interviewed to study the characteristics of the men attending the clinic and to assess the popularity of vasectomy over other methods of family planning. For the study to be more comprehensive, the figures of the family planning activities of the hospital from 1977-82 also were examined. 438 (55.5%) of the study subjects were paddy cultivators. 71 of the men were in the 16-25 age group, 422 in the 26-35 age group, 272 in the 36-45 age group, and 97 in the 46 and older age group. 725 (85%) of the men were literate. Middle income groups comprised the major segment of men in this series. In 544 (63.1%) the vasectomy was motivated by friends and relatives; only 15 (2.0%) were motivated by health staff. 821 of the men (95.3%) belonged to the 16-39 age group. A table summarizes the relationship between age of the last living child and vasectomy performance. For 279 of the men, the age of their last living child was less than 1 year; it was 1-2 years for 218 men, 2-3 years for 180 men, and 3 or more years for 185 men. Study observations indicate that a consensus is becoming established about the role played by the male partner in family planning. The incentive scheme, acceptability and safety of the method, and a change in life styles should be considered. In the 862 vasectomies performed, there were no major complications or failures in contraception. Some pertinent factors for the favorable trend in vasectomy at this clinic are: health education talks delivered by a trained staff nurse at this clinic, outpatient department, and wards of the hospital; motivation activities of the community development social workers in the field; this clinic being the leading clinic of the limited number of institutions in Kurunegala conducting regular male sterilization clinics, and personality characteristics of the medical officer, staff, and the facilities available at the clinic. The middle months and the latter part of the year were the most popular periods at this clinic. These months represent the nonharvesting season. The study shows that the small family norm has been preferred by the majority; only 111 had more than 3 living children. Better education, better communication, and better approach methods may improve vasectomy acceptance rates. PMID:6680335

  14. Changing trends in conception control.

    PubMed

    El-tonsi, H; Gable, H; Arias, E; Behr, H Z

    1989-01-01

    Individual methods of conception control lend themselves to further description and detailed breakdown regarding their unique possibilities. Surgical contraception branches into tubal ligation and vasectomy. Tubal ligation methods involve a variety of means such as electro-coagulation, rings, or clips to terminate the oviducts. Vasectomy has various possibilities for its desired effects. Contraceptive barrier devices include such commonly known items as the cervical cap/diaphragm, and IUD. Consent from the user of these devices should be designed with the patient in mind, including detailed medical history and information regarding the possible hazards of the device itself. Various areas of conception control and population control have been explored and are continuing to be explored not only in the large hemispheres of the world, but in those smaller countries where population control has previously been ignored and has gotten out of control. PMID:12315699

  15. [Vasovasostomies performed in 60 cases from June 1990 to January 1994].

    PubMed

    Alvarado, A A; García de Paredes, R; Monterrey, J A

    1994-09-01

    60 vasovasostomies were performed between june 1990 and january 1994, following the modified one layer technique, under microscopic magnification. All the patients who requested the surgical procedure were included in the present study despite their age or time after vasectomy, in order to have a non selected group. Follow up was given with sperm counts processed under similar standards and performed at 2, 4 and 6 months after the surgical procedure. Our overall experience seems to confirm that strong correlation does not exist between the surgical technique used (one layer vs two layer), but the lapse of time passed between the vasectomy and the reversal is critical. In our series a pregnancy rate of 56.6% was achieved, with a patency rate of 86.7%. PMID:7746902

  16. Petrunic and Anor. v. Barnes, 1 February 1988.

    PubMed

    1988-01-01

    The defendant physician was charged with negligence and breach of contract in the performance of a tubal ligation on the plaintiff. After the plaintiff became pregnant and gave birth to twins, she and her husband sought damages for pecuniary losses resulting from the birth of twins, claiming that the defendant should have warned them of the risk of failure of the operation or mentioned the alternative of performance of a vasectomy on the husband. The Supreme Court of Victoria, Australia, held that the defendant had no duty to inform the plaintiffs of the risk of failure or the alternative of a vasectomy since his actions accorded with accepted practice within the profession. It also concluded that, even if he had warned the plaintiffs, they would not have withheld their consent to the operation. PMID:12289437

  17. Verification of Male Infertility Biomarkers in Seminal Plasma by Multiplex Selected Reaction Monitoring Assay*

    PubMed Central

    Drabovich, Andrei P.; Jarvi, Keith; Diamandis, Eleftherios P.

    2011-01-01

    Seminal plasma is a promising biological fluid to use for noninvasive clinical diagnostics of male reproductive system disorders. To verify a list of prospective male infertility biomarkers, we developed a multiplex selected reaction monitoring assay and measured the relative abundance of 31 proteins in 30 seminal plasma samples from normal, nonobstructive azoospermia and post-vasectomy individuals. Median levels of some proteins were decreased by more than 100-fold in nonobstructive azoospermia or post-vasectomy samples, in comparison with normal samples. To follow up the most promising candidates and measure their concentrations in seminal plasma, heavy isotope-labeled internal standards were synthesized and used to reanalyze 20 proteins in the same set of samples. Concentrations of candidate proteins in normal seminal plasma were found in the range 0.1–1000 μg/ml but were significantly decreased in nonobstructive azoospermia and post-vasectomy. These data allowed us to select, for the first time, biomarkers to discriminate between normal, nonobstructive azoospermia, and post-vasectomy (simulated obstructive azoospermia) seminal plasma samples. Some testis-specific proteins (LDHC, TEX101, and SPAG11B) performed with absolute or nearly absolute specificities and sensitivities. Cell-specific classification of protein expression indicated that Sertoli or germ cell dysfunction, but not Leydig cell dysfunction, was observed in nonobstructive azoospermia seminal plasma. The proposed panel of biomarkers, pending further validation, could lead to a clinical assay that can eliminate the need for testicular biopsy to diagnose the category of male infertility, thus providing significant benefits to patients as well as decreased costs associated with the differential diagnosis of azoospermia. PMID:21933954

  18. Why Bolivians are talking about gender roles.

    PubMed

    Eschen, A

    1998-01-01

    The first hospital to offer no-scalpel vasectomy services in La Paz, Bolivia, introduced its program in 1996. However, over the course of 2 years, only 1 vasectomy was performed. Vasectomy services in La Paz are underutilized due to inadequate counseling, outreach, and use of educational materials. While the national health and population policy mandates the provision of comprehensive reproductive health care for both men and women, Bolivian men rarely seek health care services of any kind because most services are designed mainly for women and children. The only services offered to men are urology related, which focus upon screening for STDs, and workplace-related services, such as for factory workers and miners. Nongovernmental organizations (NGO) are exploring how to increase men's involvement in health care and family planning services. Men need to be made aware of gender issues related to reproductive and sexual health. The Centro de Investigacion Social Tecnologia Apropriada y Capacitacion (CISTAC), a Bolivian NGO which focuses upon research and training in health and social issues, plans to use research, training, and information dissemination to broaden the male role and identity in Bolivia, which will also affect men's access to and receipt of health care services. Toward that end, CISTAC and AVSC co-sponsored a workshop to teach health care program managers about the relationship between gender issues and men's involvement in reproductive health care. PMID:12321882

  19. Use of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens, ex vivo and in vivo

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Ross, Ashley E.; Jarow, Jonathan P.; Fried, Nathaniel M.

    2010-02-01

    Development of a noninvasive vasectomy technique may eliminate male fear of complications and result in a more popular procedure. This study explores application of an optical clearing agent (OCA) to the scrotal skin to reduce both the laser power necessary for successful noninvasive laser vasectomy and the probability of scrotal skin burns. A mixture of DMSO/glycerol was noninvasively delivered into the scrotal skin using a Madajet. Near-infrared laser radiation with a range of average powers (7.0-11.7 W) was delivered in conjunction with a range of cryogen spray cooling rates (0.20-0.33 Hz) to the skin surface in a canine model, ex vivo and in vivo. Burst pressure (BP) measurements were conducted to quantify the strength of vas closure. A 30-min application of the OCA improved skin transparency by 26 +/- 5 %, reducing the average power necessary for successful noninvasive laser vasectomy from 9.2 W without OCA (BP = 291 +/- 31 mmHg) to 7.0 W with OCA (BP = 292 +/- 19 mmHg). Control studies without OCA at 7.0 W failed to coagulate the vas with burst pressures (82 +/- 28 mmHg) significantly below typical ejaculation pressures (136 +/- 29 mmHg). Application of an optical clearing agent reduced the laser power necessary for successful noninvasive thermal coagulation of the vas by approximately 25%. This technique may result in the use of a less expensive laser system and eliminate the formation of scrotal skin burns during the procedure.

  20. Noninvasive laser coagulation of the canine vas deferens, ex vivo

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Jarow, Jonathan P.; Fried, Nathaniel M.

    2009-02-01

    Male sterilization (vasectomy) is more successful, safer, less expensive, and easier to perform than female sterilization (tubal ligation). However, female sterilization is more popular, due to male fear of vasectomy complications (e.g. incision, bleeding, infection, and scrotal pain). The development of a completely noninvasive vasectomy technique may allay some of these concerns. Ytterbium fiber laser radiation with a wavelength of 1075 nm, average power of 11.7 W, 1-s pulse duration, 0.5 Hz pulse rate, and 3-mm-diameter spot was synchronized with cryogen cooling of the scrotal skin surface in canine tissue for a treatment time of 60 s. Vas thermal lesion dimensions measured 2.0 +/- 0.3 mm diameter by 3.0 +/- 0.9 mm length, without skin damage. The coagulated vas bursting pressure measured 295 +/- 72 mm Hg, significantly higher than typical vas ejaculation pressures of 136 + 29 mm Hg. Noninvasive thermal coagulation and occlusion of the vas is feasible.

  1. Application of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Ross, Ashley E.; Jarow, Jonathan P.; Fried, Nathaniel M.

    2010-07-01

    Development of a noninvasive vasectomy technique may eliminate male fear of complications and result in a more popular procedure. This study explores application of an optical clearing agent (OCA) to scrotal skin to reduce laser power necessary for successful noninvasive laser vasectomy and eliminate scrotal skin burns. A mixture of dimethyl sulfoxide and glycerol was noninvasively delivered into scrotal skin using a pneumatic jet device. Near-infrared laser radiation was delivered in conjunction with cryogen spray cooling to the skin surface in a canine model, ex vivo and in vivo. Burst pressure (BP) measurements were conducted to quantify strength of vas closure. A 30-min application of OCA improved skin transparency by 26+/-3%, reducing average power necessary for successful noninvasive laser vasectomy from 9.2 W without OCA (BP=291+/-31 mmHg) to 7.0 W with OCA (BP=292+/-19 mmHg). Control studies without OCA at 7.0 W failed to coagulate the vas with burst pressures (82+/-28 mmHg) significantly below typical ejaculation pressures (136+/-29 mmHg). Application of an OCA reduced the laser power necessary for successful noninvasive thermal coagulation of the vas by ~25%. This technique may result in use of a less expensive laser and eliminate the formation of scrotal skin burns during the procedure.

  2. Application of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens.

    PubMed

    Cilip, Christopher M; Ross, Ashley E; Jarow, Jonathan P; Fried, Nathaniel M

    2010-01-01

    Development of a noninvasive vasectomy technique may eliminate male fear of complications and result in a more popular procedure. This study explores application of an optical clearing agent (OCA) to scrotal skin to reduce laser power necessary for successful noninvasive laser vasectomy and eliminate scrotal skin burns. A mixture of dimethyl sulfoxide and glycerol was noninvasively delivered into scrotal skin using a pneumatic jet device. Near-infrared laser radiation was delivered in conjunction with cryogen spray cooling to the skin surface in a canine model, ex vivo and in vivo. Burst pressure (BP) measurements were conducted to quantify strength of vas closure. A 30-min application of OCA improved skin transparency by 26+/-3%, reducing average power necessary for successful noninvasive laser vasectomy from 9.2 W without OCA (BP=291+/-31 mmHg) to 7.0 W with OCA (BP=292+/-19 mmHg). Control studies without OCA at 7.0 W failed to coagulate the vas with burst pressures (82+/-28 mmHg) significantly below typical ejaculation pressures (136+/-29 mmHg). Application of an OCA reduced the laser power necessary for successful noninvasive thermal coagulation of the vas by approximately 25%. This technique may result in use of a less expensive laser and eliminate the formation of scrotal skin burns during the procedure. PMID:20799844

  3. Postsurgical Food and Water Consumption, Fecal Corticosterone Metabolites, and Behavior Assessment as Noninvasive Measures of Pain in Vasectomized BALB/c Mice

    PubMed Central

    Jacobsen, Kirsten R; Kalliokoski, Otto; Teilmann, Anne C; Hau, Jann; Abelson, Klas SP

    2012-01-01

    Recognition of pain and stress is a common challenge when working with laboratory mice. The aim of the current study was to identify noninvasive parameters to assess the severity and duration of possible pain and stress after vasectomy in BALB/c mice. Mice underwent isoflurane anesthesia with or without vasectomy. Body weight, food and water intake, and fecal corticosterone metabolites (FCM) were measured 3 d before and 3 d after the procedure. Behavior was recorded 1, 2, 4, and 8 h after the procedure. Food and water consumption and defecation were reduced postoperatively in the vasectomized group compared with mice given anesthesia only. FCM were elevated the first day after anesthesia in the control mice but not in the vasectomized group. Vasectomy resulted in behavioral changes that were not seen in the group that was anesthetized only. In conclusion, food and water consumption and pain-related behaviors, but not FCM, may be useful as noninvasive parameters to assess postoperative pain and stress in vasectomized mice. PMID:22330871

  4. Infertility, impotence, and emasculation - psychosocial contexts for abandoning reproduction.

    PubMed

    Wibowo, Erik; Johnson, Thomas W; Wassersug, Richard J

    2016-01-01

    From a Darwinian perspective we live to reproduce, but in various situations genetic males elect not to reproduce by choosing medical treatments leading to infertility, impotence, and, in the extreme, emasculation. For many men, infertility can be psychologically distressing. However, for certain genetic males, being infertile may improve their quality of life. Examples include (1) men who seek vasectomy, (2) individuals with Gender Dysphoria (e.g., transwomen, and modern day voluntary eunuchs), (3) most gay men, and (4) men treated for testicular and prostate cancer. Men who desire vasectomy typically have a Darwinian fitness W >1 at the time of their vasectomies; i.e., after they have their desired number of offspring or consider themselves past an age for parenting newborns. In contrast, prostate and testicular cancer patients, along with individuals with extreme Gender Dysphoria, do not necessarily seek to be sterile, but accept it as an unavoidable consequence of the treatment for their condition undertaken for survival (in case of cancer patients) or to achieve a better quality of life (for those with Gender Dysphoria). Most gay men do not father children, but they may play an avuncular role, providing for their siblings' offspring's welfare, thus improving their inclusive fitness through kin selection. In a strictly Darwinian model, the primary motivation for all individuals is to reproduce, but there are many situations for men to remove themselves from the breeding populations because they have achieved a fitness W ≥1, or have stronger medical or psychological needs that preclude remaining fertile. PMID:26924280

  5. Application of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens

    PubMed Central

    Cilip, Christopher M.; Ross, Ashley E.; Jarow, Jonathan P.; Fried, Nathaniel M.

    2010-01-01

    Development of a noninvasive vasectomy technique may eliminate male fear of complications and result in a more popular procedure. This study explores application of an optical clearing agent (OCA) to scrotal skin to reduce laser power necessary for successful noninvasive laser vasectomy and eliminate scrotal skin burns. A mixture of dimethyl sulfoxide and glycerol was noninvasively delivered into scrotal skin using a pneumatic jet device. Near-infrared laser radiation was delivered in conjunction with cryogen spray cooling to the skin surface in a canine model, ex vivo and in vivo. Burst pressure (BP) measurements were conducted to quantify strength of vas closure. A 30-min application of OCA improved skin transparency by 26±3%, reducing average power necessary for successful noninvasive laser vasectomy from 9.2 W without OCA (BP=291±31 mmHg) to 7.0 W with OCA (BP=292±19 mmHg). Control studies without OCA at 7.0 W failed to coagulate the vas with burst pressures (82±28 mmHg) significantly below typical ejaculation pressures (136±29 mmHg). Application of an OCA reduced the laser power necessary for successful noninvasive thermal coagulation of the vas by ∼25%. This technique may result in use of a less expensive laser and eliminate the formation of scrotal skin burns during the procedure. PMID:20799844

  6. Infertility, impotence, and emasculation – psychosocial contexts for abandoning reproduction

    PubMed Central

    Wibowo, Erik; Johnson, Thomas W; Wassersug, Richard J

    2016-01-01

    From a Darwinian perspective we live to reproduce, but in various situations genetic males elect not to reproduce by choosing medical treatments leading to infertility, impotence, and, in the extreme, emasculation. For many men, infertility can be psychologically distressing. However, for certain genetic males, being infertile may improve their quality of life. Examples include (1) men who seek vasectomy, (2) individuals with Gender Dysphoria (e.g., transwomen, and modern day voluntary eunuchs), (3) most gay men, and (4) men treated for testicular and prostate cancer. Men who desire vasectomy typically have a Darwinian fitness W >1 at the time of their vasectomies; i.e., after they have their desired number of offspring or consider themselves past an age for parenting newborns. In contrast, prostate and testicular cancer patients, along with individuals with extreme Gender Dysphoria, do not necessarily seek to be sterile, but accept it as an unavoidable consequence of the treatment for their condition undertaken for survival (in case of cancer patients) or to achieve a better quality of life (for those with Gender Dysphoria). Most gay men do not father children, but they may play an avuncular role, providing for their siblings’ offspring's welfare, thus improving their inclusive fitness through kin selection. In a strictly Darwinian model, the primary motivation for all individuals is to reproduce, but there are many situations for men to remove themselves from the breeding populations because they have achieved a fitness W ≥1, or have stronger medical or psychological needs that preclude remaining fertile. PMID:26924280

  7. Myths and Fallacies about Male Contraceptive Methods: A Qualitative Study amongst Married Youth in Slums of Karachi, Pakistan

    PubMed Central

    Nishtar, Noureen; Sami, Neelofar; Faruqi, Anum; Khowaja, Shaneela; Farid-Ul-Hasnain

    2013-01-01

    Pakistan presently has one of the largest cohorts of young people in its history, with around 36 million people between the ages of 15 and 24 years. One of the main reasons for high population growth in Pakistan is almost stagnant contraceptive prevalence rate of 30% nationally and 17.4% amongst youth. The study was conducted to explore the perceptions regarding myths and fallacies related to male contraceptive methods among married youth aged 18-24 year in Karachi, Pakistan. Qualitative exploratory study design was adopted and a total of eight Focus Group Discussions (FGDs) were conducted. Study was conducted in two Union Councils of Korangi Town in the squatter settlement of Karachi, Pakistan from July to September 2010. Thematic analysis was done manually. General, physical, sexual, psychological, socio-cultural and religious were the common categories which lead to myths and fallacies related to condoms use and vasectomy among the married youth. The foremost myth amongst male and female youth was that use of both condoms and vasectomy cause impotence in males. Additionally, condoms were thought to cause infections, backache and headache in males. Some youth of the area think that vasectomy is meant for prisoners only. In conclusion our findings suggest that the potential reasons behind low use of male contraceptive methods among youth of squatter settlement of Karachi were myths and fallacies about male contraceptive methods. There are some important policy implications like counseling of the couple through peers and well trained family planning service providers to address these myths and misconceptions from the minds of youth. PMID:23445697

  8. Reconsidering racial/ethnic differences in sterilization in the United States

    PubMed Central

    White, Kari; Potter, Joseph E.

    2014-01-01

    Objective Cross-sectional studies have found that low-income and racial/ethnic minority women are more likely to use female sterilization and less likely to rely on a partner’s vasectomy than women with higher incomes and whites. However, studies of pregnant and postpartum women report that racial/ethnic minorities, particularly low-income minority women, face greater barriers in obtaining a sterilization than do whites and those with higher incomes. In this paper, we address this apparent contradiction by examining the likelihood a woman gets a sterilization following each delivery, which removes from the comparison any difference in the number of births she has experienced. Study Design Using the 2006–2010 National Survey of Family Growth, we fit multivariable-adjusted logistic and Cox regression models to estimate odds ratios and hazard ratios for getting a postpartum or interval sterilization, respectively, according to race/ethnicity and insurance status. Results Women’s chances of obtaining a sterilization varied by both race/ethnicity and insurance. Among women with Medicaid, whites were more likely to use female sterilization than African Americans and Latinas. Privately insured whites were more likely to rely on vasectomy than African Americans and Latinas, but among women with Medicaid-paid deliveries reliance on vasectomy was low for all racial/ethnic groups. Conclusions Low-income racial/ethnic minority women are less likely to undergo sterilization following delivery compared to low-income whites and privately insured women of similar parities. This could result from unique barriers to obtaining permanent contraception and could expose women to the risk of future unintended pregnancies. PMID:24439673

  9. Sterility: an immunologic disorder?

    PubMed

    Rümke, P; Hekman, A

    1977-09-01

    Immunologic aspects of infertility are discussed. The autoantigenic and isoantigenic nature of spermatozoa is reviewed. Sperm antibodies may form in males by extravasation of spermatozoa following vasectomy and as a result of testicular lesions. Although little is known about the formation of isoantibidies to spermatozoa in females, they may arise as a result of epithelial lesions of the genital tract. Clinical findings of sperm agglutination and immobilizing antibodies in males and sperm antibodies in females in association with infertility are discussed along with some therapeutic approaches. A rare condition, allergy to seminal plasma, is noted. PMID:891061

  10. Sterilization: A Review and Update.

    PubMed

    Moss, Chailee; Isley, Michelle M

    2015-12-01

    Sterilization is a frequently used method of contraception. Female sterilization is performed 3 times more frequently than male sterilization, and it can be performed immediately postpartum or as an interval procedure. Methods include mechanical occlusion, coagulation, or tubal excision. Female sterilization can be performed using an abdominal approach, or via laparoscopy or hysteroscopy. When an abdominal approach or laparoscopy is used, sterilization occurs immediately. When hysteroscopy is used, tubal occlusion occurs over time, and additional testing is needed to confirm tubal occlusion. Comprehensive counseling about sterilization should include discussion about male sterilization (vasectomy) and long-acting reversible contraceptive methods. PMID:26598311

  11. Postpartum Care and Contraception in Obese Women.

    PubMed

    Maclean, Courtney C; Thompson, Ivana S

    2016-03-01

    Postpartum obese women have an increased risk of breastfeeding difficulties and depression. Retaining the pregnancy weight at 6 months postpartum predicts long-term obesity. Risks for weight retention include excessive gestational weight gain, ethnicity, socioeconomic status, diet, exercise, depression, and duration of breastfeeding. Exercise and reducing total caloric intake promote postpartum weight loss. Intrauterine devices and contraceptive implants are the most effective contraceptives for obese women. Contraceptive pills, patches, and vaginal rings are effective options; however, obese women should be made aware of a potential increased risk of venous thromboembolism. Vasectomy and hysteroscopic sterilization carry the least surgical risk for obese women. PMID:26694498

  12. Human robotic assisted bilateral vasoepididymostomy and vasovasostomy procedures: initial safety and efficacy trial

    NASA Astrophysics Data System (ADS)

    Parekattil, Sijo J.; Cohen, Marc S.; Vieweg, Johannes W.

    2009-02-01

    Our goal was to develop a robotic approach for vasoepididymostomy (RAVE) and vasovasostomy (RAVV) using a 4 arm High Definition Platform (Intuitive Surgical, CA) and present our human in-vivo results. All 3 RAVV procedures were successful and one patient had 102 million motile sperm/ml of ejaculate at 1 month post-op. The RAVE procedure patient only had a few non-motile sperm at 6 month follow up in his ejaculate. The use of robotics seems to offer advantages in terms of ergonomics and suture control. Further evaluation is needed to assess the clinical potential of robotics in vasectomy reversal.

  13. The contraceptive effect of a novel filtering-type nano-copper complex/polymer composites intra-vas device on male animals.

    PubMed

    Chen, Z-L; Huang, X-B; Suo, J-P; Li, J; Sun, L

    2010-12-01

    Contraceptive techniques which target vas deferens have been paid great attention for their good efficacy, safety and reversibility. We have made a filtering-type intra-vas device (IVD) using nano-copper complex/polymer composites. Twenty male adult Beagle dogs and 40 male rabbits were randomly assigned to four groups (sham-operation, IVD, reversal and vasectomy groups). Dogs' semen parameters, concentration of ?-glucosidase, copper and zinc ions were tested pre-operation and 1, 3, 6 and 12 months post-operation. The pregnancy rates of the rabbits were evaluated by mating trials after the IVDs were implanted. The histology of testis, epididymides and vas deferens of the animals was examined using an electron microscope. Apoptosis of the cells in the testes, epididymides and vas deferens was detected by TUNEL method. There was no sperm in the semen of dogs, which had been inserted IVD and vasectomized at 1, 3, 6 and 12 months post-operation. The concentration of ?-glucosidase in the IVD group, reversal group and sham-operation group was not significantly different between pre- and post-operation. The pregnancy rates of the female rabbits in the vasectomy, IVD and reversal groups were all zero, but the pregnancy rate in the reversal group, after taking out IVD, and that of the sham-operation group was 60% and 80%, respectively. The ultrastructures of the testes, epididymides and vas deferens of the male animals in the IVD group and sham-operation group were in normal ranges compared with the vasectomy group. The apoptosis of the cells in the testes, epididymides and vas deferens in the vasectomy group of both dogs and rabbits was obvious compared with the other groups. No significant changes in the quantities of copper and zinc ions were found in semen of the male dogs both pre- and post-operation. Our studies demonstrated that the filtering-type nano-copper complex/polymer composites intra-vas device may be an efficacious, safe and reversible male contraceptive device. PMID:20236368

  14. Consequences of autoimmunity to sperm antigens in vasectomized men.

    PubMed

    Anderson, D J; Alexander, N J

    1979-12-01

    The development by a large percentage of vasectomized men of sperm autoantibodies is discussed in this monograph chapter. The production of anti-sperm antibodies is attributed to: 1) granuloma formation; 2) increased permeability of epithelial barriers in the rete testis and epididymis; and 3) transport of phagocytic cells to regional lymph nodes. Individual variation in type of antibodies and response to antibody production is documented and is thought to depend on such factors as rate of sperm production, the structure of the blood-testis barrier, surgical technique, and expression of immune response genes. Morphological changes in spermatozoa and testes occurring after vasectomy may be induced by immunological mechanisms. Tests of cell-mediated immunity to sperm antigens are described, and more accurate tests are needed. Animal studies provide evidence that chronic immune stimulation can result in formation of circulating immune complexes, resulting in deleterious systemic effects, including damage to kidneys, blood vessels, and cells of the immune system. Further studies of the autoimmune orchitis phenomenon may aid in avoidance of immunologically mediated side effects of vasectomy. PMID:92384

  15. PubMed Central

    Labrecque, Michel; Hamel, Jean-Francois; Prévost, Jean-François; Warren, Louis

    1989-01-01

    The rate of non-compliance with the post-vasectomy semen examination procedure at the Centre Hospitalier de l'Université Laval (CHUL) between October 1, 1985 and March 31, 1987 was 21%, one of the highest in the literature. The purpose of our study was to determine the causes of this situation. The socio-demographic profile obtained from the computerized files of 50 patients who did not comply with the procedure was comparable to that of the 183 patients who did comply. A telephone survey of 43 non-compliant patients was carried out. In 70% of the responses to an open question on the reasons for non-compliance, the subject cited on his own negligence. In response to the closed questions, the constraints involved in the semen examination procedure were cited most often (49%). In the responses to both open and closed questions, a lack of information was cited least often. There is not a distinctive profile among vasectomy patients at the CHUL that would make it possible to predict compliance. Despite the fact that it would be difficult to improve the factors associated with patient negligence, it might be possible to increase compliance by following up more closely and lessening the constraints. PMID:21249056

  16. Optical coherence tomography vs. high-frequency ultrasound during noninvasive laser coagulation of the canine vas deferens

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Allaf, Mohamad E.; Fried, Nathaniel M.

    2012-02-01

    A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. In this study, optical coherence tomography (OCT) and high-frequency ultrasound (HFUS) are compared for monitoring laser thermal coagulation of the vas in an acute canine model. Bilateral noninvasive laser coagulation of the vas was performed in 6 dogs (n=12 vasa) using a Ytterbium fiber laser wavelength of 1075 nm, incident power of 9.0 W, pulse duration of 500 ms, pulse rate of 1 Hz, and 3-mm-diameter spot. Cryogen spray cooling was used to prevent skin burns during the procedure. An OCT system with endoscopic probe and a HFUS system with 20-MHz transducer were used to image the vas immediately before and after the procedure. Vasa were then excised and processed for gross and histologic analysis for comparison with OCT and HFUS images. OCT provided high-resolution, superficial imaging of the compressed vas within the vas ring clamp, while HFUS provided deeper imaging of the vas held manually in the scrotal fold. Both OCT and high HFUS are promising imaging modalities for real-time confirmation of vas occlusion during noninvasive laser vasectomy.

  17. Women's contraceptive attitudes and use in 1992.

    PubMed

    Forrest, J D; Fordyce, R R

    1993-01-01

    Women aged 15-44 rate the pill, the condom, vasectomy and female sterilization most highly, according to 1992 data from an annual survey by Ortho Pharmaceutical Corporation of contraceptive attitudes and method use. The 6,955 survey respondents underrepresent women who are black or who have household annual incomes greater than $50,000, but they are similar to all American women in age, marital status and region of the country. About 74-84% of women giving an opinion view these methods favorably and 64% rate the hormonal implant favorably. The proportion of unmarried women who had had intercourse increased from 76% in 1987 to 86% in 1992. As a result, proportions of women at risk of unintended pregnancy rose from 72% to 77%. Contraceptive use also rose, from 92% to 94%. The most commonly used method is the pill (39%), followed by the condom (25%), female sterilization (19%) and vasectomy (12%). Married women exposed to the risk of unintended pregnancy are more likely to use sterilization (48%), while unmarried women are more likely to use the pill (52%) and the condom (33%). Pill use has increased since 1987, especially among married women, and condom use has increased among all women. Among unmarried women at risk of unintended pregnancy, condom use rose from 18% in 1987 to 33% in 1992. Among condom users, 40% of unmarried users and 13% of married users also use another method. PMID:8405344

  18. [Microsurgical vasovasostomy in the age of modern reproduction medicine. A cost-benefit analysis].

    PubMed

    Heidenreich, A; Altmann, P; Neubauer, S; Engelmann, U H

    2000-05-01

    WS represents the standard procedure of choice for the treatment of obstructive azoospermia following vasectomy. However, recently, ICSI has been suggested by some to represent the solution for all cases of male factor infertility regardless of its etiology based on its success rates. Therefore, we compared VVS to MESA/TESE and ICSI in terms of pregnancy, complications, and costs. Between 1/93 and 6/98 157 VVS was performed microsurgically using the 2-layer technique in 157 patients following prior vasectomy. Between 9/94 and 9/97 69 couples underwent MESA/ICSI for epididymal obstruction not amenable to micro-surgical reconstruction such as post-inflammatory obstruction and congenital absence of the vas deferens; in the same time period 42 couples underwent TESE/ICSI for azoospermia of testicular origin due to cryptorchidism, testicular atrophy, obstruction of the rete testis. In most cases MESA or TESE and ICSI were performed metachronously. Mean intervall of vasal obstruction was 7.6 (0.5-18) years; patency after VVS was 77%, pregnancy rate was 52%. Local complication rate was 4.7%, no major complications were observed. Costs per life birth after VVS were as high as 5,447,-DM or 2,800 Euro. Pregnancy rates after MESA/TESE and ICSI were 22.5% and 19.5%, respectively with 16 singletons, 3 twins and 3 abortions; local complications occurred in 3.9% of the men. Multiple birth were noticed in 15.8% following ICSI, but only in 0.7% following VVS. 5.7% and 1.4% of the female partners experienced serious complications as a mild or severe ovarian hyperstimulation-syndrome, respectively. Costs per life birth after MESA/TESE cycle were as high as 28,804,-DM or 14,100 Euro. Even in the era of ICSI microsurgical vasovasostomy represents the standard approach for obstructive azoospermia following vasectomy. Based on a cost-benefit analysis VVS is more successful in terms of pregnancy rates (52% vs. 22.5%). We conclude that MESA/ICSI should be reserved for patients not amenable for microsurgical reconstruction. PMID:10872249

  19. Voluntary and involuntary sterilization: medical, ethical, legal and religious aspects.

    PubMed

    Fasouliotis, S J; Schenker, J G

    1999-08-01

    Surgical voluntary sterilization has become one of the most widely used methods of contraception, with vasectomy and tubal sterilization being the most commonly employed techniques, associated with a low failure, morbidity, mortality, and long-term sequelae rate. As sterilization is related with the elimination of the possibility for procreation, a number of ethical, legal and religious issues have arisen, leading often to personal misjudgements, legal disputes, and failures in applying family planning. Involuntary sterilization is currently not practiced, except in cases of severely mentally retarded people, who are unable to appreciate the consequences of their acts or care for their children and who may have a high likelihood of propagating hereditary disease. PMID:10534935

  20. Robotic instrumentation: Evolution and microsurgical applications

    PubMed Central

    Parekattil, Sijo J.; Moran, Michael E.

    2010-01-01

    This article presents a review of the history and evolution of robotic instrumentation and its applications in urology. A timeline for the evolution of robotic instrumentation is presented to better facilitate an understanding of our current-day applications. Some new directions including robotic microsurgical applications (robotic assisted denervation of the spermatic cord for chronic orchialgia and robotic assisted vasectomy reversal) are presented. There is a paucity of prospective comparative effectiveness studies for a number of robotic applications. However, right or wrong, human nature has always led to our infatuation with the concept of using tools to meet our needs. This chapter is a brief tribute to where we have come from and where we may be potentially heading in the field of robotic assisted urologic surgery. PMID:21116362

  1. [East Asia 1976-1977: a general view].

    PubMed

    Keeny, S M

    1978-01-01

    Most East Asian countries have national family planning programs combined with projects to improve nutrition and jobs in rural areas. The countries which have had a rapid industrial development, such as Taiwan or Singapore, have seen their birth rate decrease sharply during the past 20 years. In most countries the government discourages large families and promotes vasectomy and minilaparotomy; abortion has been legalized almost everywhere. Information through radio and television play an important role, but not quite as important as that of fieldworkers who go from home to home in areas not reached by mass media. Cost for these programs is heavily paid by the U.S., and all programs are evaluated in the country of origin. Results are very encouraging and sometimes excellent, as in the case of South Korea, where about 45% of women practice contraception, and fertility rate has decreased from 6.0 in 1960, to 3.5 in 1975. PMID:12261365

  2. Attitudes of urban Sudanese men toward family planning.

    PubMed

    Khalifa, M A

    1988-01-01

    Using data from the Male Attitude Survey of 1985, this paper shows that Sudanese men play a major role in family planning decision-making. Attitudes regarding family planning issues are presented for 1,500 men aged 18 years and over, living in urban areas of Khartoum, the capital of Sudan. The decision not to practice family planning is found to be male-dominated, and husbands are responsible for providing contraceptives when family planning is practiced. Widespread misconceptions about vasectomy, along with a very low acceptance rate, exist among the men in the sample. It is concluded that the involvement of men in family planning programs will give these programs a better chance of success in the future. PMID:3176096

  3. Social and Logistical Barriers to the Use of Reversible Contraception among Women in a Rural Indian Village

    PubMed Central

    Hall, Mary Ann Kirkconnell; Stephenson, Rob B.; Juvekar, Sanjay

    2008-01-01

    Women in a small coastal village in western India were asked to explain their preference for female sterili-zation over modern reversible contraceptive methods. Married women aged 19+ years were interviewed in six focus groups (n=60) and individually (n=15) regarding contraceptive methods and their use and side-effects. Women publicly denied contraceptive use but privately acknowledged limited use. They obtained contraceptive information from other village women and believed that modern reversible methods and vasectomy have high physical and social risks, and fertility goals could be achieved without their use. Women felt that reversible contraception is undesirable, socially unacceptable, and usually unnecessary, although the achievement of fertility goals is likely due to the use of female sterilization with abortion as a back-up method. Economic migration of village men may also play a role. Although women with high social capital can effectively disseminate correct knowledge, the impact on the uptake of reversible method is uncertain. PMID:18686557

  4. [Urological diseases most frequently involved in medical professional liability claims].

    PubMed

    Vargas-Blasco, César; Gómez-Durán, Esperanza L; Arimany-Manso, Josep; Pera-Bajo, Francisco

    2014-03-01

    Clinical safety and medical professional liability are international major concerns, especially in surgical specialties such as urology. This article analyzes the claims filed at the Council of Medical Colleges of Catalonia between 1990 and 2012, exploring urology procedures. The review of the 173 cases identified in the database highlighted the importance of surgical procedures (74%). Higher frequencies related to scrotal-testicular pathology (34%), especially testicular torsion (7.5%) and vasectomy (19.6%), and prostate pathology (26 %), more specifically the surgical treatment of benign prostatic hyperplasia (17.9%). Although urology is not among the specialties with the higher frequency of claims, there are special areas of litigation in which it is advisable to implement improvements in clinical safety. PMID:24913755

  5. Evaluation of Canada goose sterilization for population control.

    USGS Publications Warehouse

    Converse, Kathryn A.; Kennelly, James J.

    1994-01-01

    We evaluated the vasectomy of 72 male Canada geese as a method to control growing populations of nuisance geese in Westchester County, New York. Thirty-three of the vasectomized males paired with a female and were located during ≥1 breeding seasons; 7 treated males were not seen following surgery. The remaining 32 males were never observed paired with a female during the breeding season. Of 56 nesting attempts by the 33 pairs in ≥1 breeding seasons, 84% of the nests were unsuccessful. Fidelity to nest sites during the second and third breeding seasons occurred for 17 of the 18 vasectomized males and their females that were observed for ≥2 seasons. The results suggest that male sterilization may reduce productivity of nuisance Canada geese providing one carefully selects areas and flocks suitable for this type of control.

  6. Achievements of the Iranian family planning programmes 1956-2006.

    PubMed

    Simbar, M

    2012-03-01

    Family planning programmes initiated in the Islamic Republic of Iran from 1966 met with limited success. Following the 1986 census family planning was considered a priority and was supported by the country's leaders. Appropriate strategies based on the principles of health promotion led to an increase in the contraceptive prevalence rate among married women from 49.0% in 1989 to 73.8% in 2006. This paper reviews the family planning programmes in the Islamic Republic of Iran and their achievements during the last 4 decades and discusses the principles of health promotion and theories of behaviour change which may explain these achievements. Successful strategies included: creation of a supportive environment, reorientation of family planning services, expanding of coverage of family planning services, training skilled personnel, providing free contraceptives as well as vasectomy and tubectomy services, involvement of volunteers and nongovernmental organizations and promotion of male participation. PMID:22574484

  7. AB031. Challenge of microsurgery for male infertility in China

    PubMed Central

    Yuan, Yiming; Xin, Zhongcheng

    2016-01-01

    There are more than 15% couples suffer from infertility within 1 year. One in eight couples encounters problems when attempting to conceive a first child and one in six when attempting to conceive a subsequent child. The causes of infertility both of male and female could share 50%. With the recent advances in assisted fertilization such as in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), the couples suffer from infertility would like to choose assisted fertilization and nearly 1 million cycles ICSI were carried out in China every year, even its pregnancy rate 40% and live birth rate 35%, with very costed and with risks of inherent and born defects. Among of male factors of infertility, varicoceles are highly relevant (38%) and can result in a myriad of deleterious effects on male reproduction. Varicocele repair may be effective in men with subnormal semen analysis, a clinical varicocele and otherwise unexplained infertility. Numerous therapeutic options are available for correcting varicoceles, including surgical varicocelectomy and radiographic venous embolization. However, recent studies demonstrated that microsurgery for varicocele correction, with the lowest recurrence rate and the highest pregnancy rate compared with other surgical approaches, is a more cost-effective therapeutic modality than both assisted fertility for in infertility couples and it is safe and effective compared to the others surgical approaches. Obstructive azoospermia (OA) are highly prevalent (13%) in male infertility results from obstruction of the excurrent ducts (due to many causes) at any location between the rete testis and the ejaculatory ducts. Recent advances in microsurgical approaches with reversal rate 63.8–79.2%, pregnancy rate 30.6–35.8%. According to the calculations of cost per delivery for vasectomy reversal vs. sperm retrieval/ICSI, under a wide variety of initial assumptions, it is clear that vasectomy reversal/epididymovasostomy is associated with a considerably lower cost per delivery and higher delivery rates. Sperm retrieval and ICSI must yield an 81% pregnancy rate per cycle to achieve equal costs to vasectomy reversal. For the treatment of non-obstructive azoospermia (NOA), microdissection TESE is a more effective approach than other TESE approaches for ICSI, with a patency rate 40–60%, which change the impossible to possible for NOA patients, who want their own inherent child. In our center, there are more than 4,000 cases of patients were treated by microsurgery, including microsurgical varicocelectomy/vasectomy reversal/epididymovasostomy/microdissection TESE, from 2006 to 2016. We think that microsurgical training is important for urologists and clinical. Up to now, in the recent decade, we have trained about 500 surgeons for microsurgery from 30 provinces in China. In summary, the excellent efficacies were noted by microsurgical approaches for male infertility on varicoceles and OA, with lower cost and risks of inherent and born defects compared to in assisted fertilization such as IVF and ICSI.

  8. Analysis of the Pathogenetic Basis for Shedding and Transmission of Ovine Gamma Herpesvirus 2

    PubMed Central

    Hüssy, Daniela; Janett, Fredi; Albini, Sarah; Stäuber, Norbert; Thun, Rico; Ackermann, Mathias

    2002-01-01

    Ovine herpesvirus 2 (OvHV-2), a member of the viral subfamily Gammaherpesvirinae, shares numerous similarities with human herpesvirus 8 (HHV-8). Both viruses are apathogenic in their healthy original host, may cause lymphoprolipherative diseases, cannot routinely be propagated in cell culture, and may be sexually transmitted. However, the pathways of sexual transmission of these viruses, as well as the underlying pathogenetic dynamics, are not well understood. Organs from naturally OvHV-2-infected, as well as OvHV-2-free, sheep were quantitatively analyzed for OvHV-2 by the DNA amplification techniques. The dynamics of OvHV-2 multiplication and excretion were monitored after experimental infections and, most importantly, subsequent to vasectomy. The OvHV-2 DNA load in various tissues and internal organs was not merely reflecting the viral DNA load in the bloodstream, which suggested compartmentalization of OvHV-2. Moreover, OvHV-2 DNA was detected at several portals for virus shedding, i.e., the respiratory, alimentary, and urogenital tracts. Transient OvHV-2 excretion was detected in ejaculates of experimentally infected rams. Upon vasectomy, OvHV-2 DNA reappeared in the ejaculatory plasma, but the titers did not decline after reaching a peak. Spiking and fractionation experiments revealed an inhibitory activity, associated with the spermatozoa, which was able to suppress detection of viral DNA but which was no longer present in samples from vasectomized animals. Therefore, epidemiological studies on viruses that may be transmitted by the ejaculatory pathway and for whose tracing nucleic acid amplification methods are used, i.e., OvHV-2, HHV-8, and the human immunodeficiency virus, should include vasectomized males. PMID:12454175

  9. Analysis of the pathogenetic basis for shedding and transmission of ovine gamma herpesvirus 2.

    PubMed

    Hüssy, Daniela; Janett, Fredi; Albini, Sarah; Stäuber, Norbert; Thun, Rico; Ackermann, Mathias

    2002-12-01

    Ovine herpesvirus 2 (OvHV-2), a member of the viral subfamily Gammaherpesvirinae, shares numerous similarities with human herpesvirus 8 (HHV-8). Both viruses are apathogenic in their healthy original host, may cause lymphoprolipherative diseases, cannot routinely be propagated in cell culture, and may be sexually transmitted. However, the pathways of sexual transmission of these viruses, as well as the underlying pathogenetic dynamics, are not well understood. Organs from naturally OvHV-2-infected, as well as OvHV-2-free, sheep were quantitatively analyzed for OvHV-2 by the DNA amplification techniques. The dynamics of OvHV-2 multiplication and excretion were monitored after experimental infections and, most importantly, subsequent to vasectomy. The OvHV-2 DNA load in various tissues and internal organs was not merely reflecting the viral DNA load in the bloodstream, which suggested compartmentalization of OvHV-2. Moreover, OvHV-2 DNA was detected at several portals for virus shedding, i.e., the respiratory, alimentary, and urogenital tracts. Transient OvHV-2 excretion was detected in ejaculates of experimentally infected rams. Upon vasectomy, OvHV-2 DNA reappeared in the ejaculatory plasma, but the titers did not decline after reaching a peak. Spiking and fractionation experiments revealed an inhibitory activity, associated with the spermatozoa, which was able to suppress detection of viral DNA but which was no longer present in samples from vasectomized animals. Therefore, epidemiological studies on viruses that may be transmitted by the ejaculatory pathway and for whose tracing nucleic acid amplification methods are used, i.e., OvHV-2, HHV-8, and the human immunodeficiency virus, should include vasectomized males. PMID:12454175

  10. Survey of recent medical graduates' status in sterilization operation experience.

    PubMed

    1983-12-01

    The Institute for Population and Social Research of Thailand's Mahidol University and the Thai Association for Voluntary Sterilization (TAVS) conducted a survey among "recent" Medical graduates to determine the achievement of training programs on sterilization operations among reent medical graduates, who graduated from the 7 medical schools in Thailand during 1978-81; to assess whether the skills attained from the training sessions during the undergraduate years are sufficient or whether additional training programs are required; to determine the willingness of the recent medical graduates to have more training in various techniques of sterilization operations; and to estimate the rate of vasectomy and tubal ligation performed by recent medical graduates. The questionnaire was mailed to all medical graduates listed as the population under study. The response was 1358 or 64.6%. Analysis was based on 972 completed questionnaires. The following were among the major survey findings: experiences gained during the medical undergraduate training did not seem to be sufficient for only 41% of respondents had performed tubal ligation; 52% of the respondents indicated that they did not have enough training during their undergraduate training, and 72% stated that they needed additional training; 89% of the respondents who stated that they did not have sufficient skill in performing sterilization operations expressed willingness to participate ina training session if it would be organized; and regarding the rate of vasectomy and tubal sterilization performed by intership trainees, these were on the average 3 and 25 cases per year. On the basis of the findings that recent medical graudates still have insufficient skills in performing the sterilization procedure, it is recommended that an attempt be made to improve the medical undergraduate training. Training should be improved either through training method or increase in number of cases to be performed before graduation. PMID:12266146

  11. Pilot programs increase men's involvement.

    PubMed

    Finger, W R

    1992-08-01

    The UN Population Fund contends that it is the need for family planning (FP) information and services instead of lack of interest that prevents men from participating more in FP. 3 pilot projects in Pakistan, Zimbabwe, and Colombia have acted on this belief. In geographically isolated Mardan, Pakistan, the all male Urban Community Developing Council (UCDC) started a community education project to involve men in FP. 5 UCDC member form 1 community educator team of which there are 60. The teams visit families in Mardan. In 1988, 1 team reported that some men in the households wanted a women to inform their wives about FP. Eventually UCDC located enough women free to be members on 40 teams. In 4 years, contraceptive prevalence among married couples rose from 9% to 21%. Initially the methods tended to be temporary methods but are now longer lasting methods (IUDs, sterilization, injectables, and even a few vasectomies). Other community groups donate about US$541/month to the project. In 1988, the Zimbabwean National Family Planning Council (ZNFPC) began its national education/male motivation project which included sending messages via popular radio soap opera, discussions, and leaflet distribution. The program reached many rural men since they tend to have radios. In 1 year, more men were taking part in decisions about FP (25-35%). ZNFPC has learned it needs to design 2 campaigns to promote condom use: 1 for single and 1 for married men. PROFAMILIA in Colombia began its 1st male clinic in 1985 in Bogota. By 1992, it had 8 male clinics. The key to its success is attractive clinics, low cost vasectomy, individualized care, wide range of services such as condom distribution and treatment of sexually transmitted diseases, and Saturday hours. Despite the 3 projects' successes, they face many obstacles that need to be addressed. PMID:12317728

  12. Stiff upper lips.

    PubMed

    Snyder, J D

    1991-01-01

    In an interview with Family Planning World, Helen Axby of the Marie Stopes Clinics explains that the organization's growth at a time when the number of abortions in Great Britain has begun to decline is due to successful management and marketing. Although the British government provides from abortion services, the Marie Stopes Clinics performs over 25,000 abortions a year. According to Axby, the main reason for this is that government restrictions have created a cumbersome process where women often wait 3-4 weeks to receive an abortion. At the Stopes clinics, women receive prompt treatment in a comfortable setting. A consultation is scheduled within a day or two following the initial phone call, and the operation is scheduled at the woman's convenience. Axby explains that the organization conducts extensive advertisement in the Yellow Pages, local newspapers, and women's magazines. Though the clinic operates for profit, its services are far less expensive than what it would cost to obtain them at other private offices. In 1990, the organization grossed about 6.2 million pounds (profits were around 1 million pounds). The profits are used to fund overseas projects. Because of the decline in the number of abortions in Britain, Axby expects the organization to earn less this year. However, Marie Stopes clinics plans to fight to increase its market share of family planning services. Its fastest growing service is vasectomy. Relying on the noninvasive bipolar diathermy technique, the Stopes Clinics have made vasectomy a more simple and comfortable experience for men. Other services include employee screening (for pap smears, breast checks, etc.). Finally, Axby says that the organization might also increase its market share by acquiring its competitors. PMID:12284512

  13. Iran rebuilds family planning services.

    PubMed

    Butta, P

    1993-07-01

    After the revolution, the Islamic Republic of Iran instituted pronatalist policies which included lowering the minimum marriage age for girls to 9 years, abolishing some laws securing women's rights, and limiting availability of family planning (FP) services. By 1983, Iran's population growth rate was 3.9% which was among the highest worldwide. Before the revolution, Iran had 37 million people. About 2 million more people were added each year, resulting in a population size of 60 million by 1992. By the mid-1980s, economic development stood idle, there were not enough houses, children attended schools on 3 shifts, and malnutrition was spreading. In 1989, the government formed a population council and reestablished FP services. It also increased the minimum age of marriage for girls to 13 years, slightly improved women status, and eliminated fertility incentives for couples with at least 4 children. It also significantly increased funding for FP (from 560 million to 13 billion rials between 1990 and 1992). Government spending for FP will likely increase 2% annually until 2011. The government initiated a promotion of FP mass media campaign, emphasizing a 2-child family. Some posters showed a family with 2 girls. The mass media campaign promoted specific contraceptive methods (even tubal occlusion and vasectomy), a practice other Middle Eastern countries not do. 80% of sterilization acceptors claimed to learn about sterilization from the radio or newspapers. The Ministry of Health has invited the Association for Voluntary Surgical Contraception (AVSC) to help with its campaign to update sterilization techniques, including the non scalpel vasectomy technique. AVSC hopes to become even more involved in helping Iran update its national FP program. PMID:12318289

  14. A dynamic family planning and health campaign.

    PubMed

    1986-11-01

    Any successful development program that combines family planning, nutrition, and parasite control such as the integrated project, must include effective information, education, and communication (IEC) components. The Population an Community Development Association (PDA), the largest nonprofit organization in Thailand provides a network of family planning service delivery composed of volunteer distributors including midwives, school techers and shopkeepers. Reliability and accessibility are the 2 important elements. A concerted media campaign which exposes people to condoms and other contraceptives helps desensitize an otherwise "too personal" issue. The problem which confronts family planning communication is how to counteract the sensuous messages form advetisers while focusing on mundane topics such as maternal and child health, responsible parenthood, and family budgets. The PDA has tried to use the same attractions to promote family planning. It distributes promotional items such as T-shirts, pens towels and cigarette lighters bearing family planning messages. In addition to the use of television and radio, PDA also utilizes every possible channel of communication. Approaches include: the Youth-to-Youth Program; informational exhibits; video-mobile vans which visit schools and factories; and the holding of PDA's vasectomy festivals. Informational exhibits on family planning and health care use a variety of audio-visual methods. Video is an effective communication medium. The PDA video material ordinarily consists of family dramas illustrating good and bad family planning practices. By holding vasectomy festivals, PDA provides a media-attracting forum to educate the public and promote vasectomey as the most effective birth control method. Mass media campaigns must be linked with fieldwork outreach. PMID:12314464

  15. Aetiology of testicular cancer: association with congenital abnormalities, age at puberty, infertility, and exercise. United Kingdom Testicular Cancer Study Group.

    PubMed Central

    1994-01-01

    OBJECTIVE--To determine the risk of testicular cancer associated with undescended testis, inguinal hernia, age at puberty, marital status, infertility, vasectomy, and amount of exercise. DESIGN--A population based case-control study with a questionnaire administered by an interviewer and with relevant supplementary data extracted from general practitioners' notes. SETTING--Nine health regions within England and Wales. SUBJECTS--794 men, aged 15-49 years, with a testicular germ cell tumour diagnosed between 1 January 1984 and 1 January 1987; each had an age matched (within one year) control selected from the list of their general practitioner. RESULTS--There was a significant association of testicular cancer with undescended testis (odds ratio 3.82; 95% confidence interval 2.24 to 6.52) and inguinal hernia (1.91; 1.12 to 3.23). The excess risk associated with undescended testis was eliminated in men who had had an orchidopexy before the age of 10 years. There were positive associations with early age at voice breaking, early age at starting to shave, and infertility. There was a significant association with a sedentary lifestyle and a moderate protective effect of exercise. There was no association with vasectomy. CONCLUSION--This study confirms previous reports that developmental urogenital abnormalities result in an increased risk of testicular cancer. The trend to perform orchidopexy at younger ages may reduce the risk associated with undescended testis. The increased risks associated with early age at puberty and low amounts of exercise may be related to effects of exposure to endogenous hormones. Changes in both of these factors may partly contribute to the increasing rates of testicular cancer observed in the past few decades. PMID:7912596

  16. New methods, increased safety make sterilization popular choice.

    PubMed

    1985-01-01

    Family Health International (FHI), in conjuction with researchers in developing countries, tested new sterilization methods and examined the short- and longterm safety of female sterilization and vasectomy. FHI-supported projects also have studied the motivations, decision making process, and satisfaction of users and provided financial and technical assistance to help train physicians, nurses, and midwives to safely and effectively perform sterilization. FHI is involved in several studies testing surgical methods against each other and evaluating new transcervical methods. A nonsurgical method of female sterilization that can be performed safely in a primary health care center would increast the availability of sterilization for millions of women. FHI is supporting research in the US, Latin America, and Asia to develop nonsurgical sterilization methods. I method FHI has helped evaluate is the use of the anti-malarial drug quinacrine. Quinacrine scars and permanetly obstructs the fallopian tubes when inserted into the uterus without causing irreversible damage to the lining of the uterus. In conjuction with Dr. R Guzman-Serani of the University of Valdivia in Chile, FHI has begun a pilot test of FemTest, a new procedure for testing tubal patency. Women usually must undergo tests several weeks after sterilization to ensure the procedure worked. The current method for testing tubal patency is hysterosalpingography (HSG), a complex procedure that injects dye into the fallopian tubes and uses x-rays to determine if the tubes are blocked. FemTest is a simple, hand-held device that uses carbon dioxide rather than dye and x-rays to test for tubal patency. Studies involving clipping the fallopian tubes are receiving high priority at FHI. FHI is testing a new clip on the market, the Filshie clip, as against the Pomeroy techinique, the Wolf clip, and the tubal ring. Innovations in female sterilization techniques have greatly reduced many complications formerly associated with the operation. Female sterilization still presents a small risk, and FHI has helped to evaluate the safety of several techniques, including conventional laparoscopy, open laparoscopy, and the need for prophylactic antibiotics following vasectomy. Increased demand for sterilization in many developing countries is coupled with a shortage of physicians to perform the procedure, especially in rural areas. Such is the case in Thailand, and FHI and the Thai Fertility Association are supporting a study of training procedures, safety, and user satisfaction. The main project focus is the training of an additional 35 nurse-midwives to perform postpartum sterilization and an evaluation of sterilization safety, particularly longterm complications and efficacy. PMID:12340324

  17. Relative suitability of DMSO and NaHCO3 for reversal of RISUG(®) induced long-term contraception.

    PubMed

    Ansari, A S; Hussain, M; Khan, S R; Lohiya, N K

    2016-03-01

    Among the vas-based methods on trial, reversible inhibition of sperm under guidance (RISUG(®) ), a co-polymer of styrene and maleic anhydride is being projected as an effective alternative to No Scalpel Vasectomy. RISUG offers long-term contraception with safety, efficacy in human trials and can be delivered by no-scalpel injection. Currently, the procedure is under phase-III clinical trial. However, reversal of this vas-based drug-induced contraception needs to be established in animal models prior to clinical trials to ensure its claim as an effective alternative for vasectomy. In the present investigation, the relative suitability of dimethyl sulphoxide (DMSO) and NaHCO3 for RISUG induced long-term vas occlusion reversal was carried out in albino rats. Animals were allocated into four groups (n = 10), viz., sham-operated control (group-I), vas occlusion with RISUG for 360 days (group-II), vas occlusion with RISUG for 360 days and reversal with DMSO (group-III) and vas occlusion with RISUG for 360 days and reversal with NaHCO3 (group-IV). A variable response in fertility was observed in different groups. Absolute sterility in group III at all mating intervals, while, zero percent fertility in groups II and IV following 90 days of occlusion was observed. Following reversal restoration of fertility with DMSO at 45 days, whereas, reversal by NaHCO3 at 30 days was noticed. Ejaculated spermatozoa of RISUG injected and initial intervals of reversed animals exhibited various degrees of abnormalities. The testes exhibited focal degeneration in vas occluded animals. The occluded lumen of the vas deferens contained an eosinated polymer with exfoliated epithelium. Following vas occlusion reversal, a complete regeneration in the vas epithelium was seen. All other parameters remained unaltered. The reversal with NaHCO3 resulted into an early resumption of fertility when compared with DMSO and the procedure found to be successful, feasible and safe up to F1 generation. Thus, RISUG provides a hope for reversible male contraceptives. PMID:26748683

  18. A Reproductive Management Program for an Urban Population of Eastern Grey Kangaroos (Macropus giganteus)

    PubMed Central

    Tribe, Andrew; Hanger, Jon; McDonald, Ian J.; Loader, Jo; Nottidge, Ben J.; McKee, Jeff J.; Phillips, Clive J. C.

    2014-01-01

    Simple Summary We designed a programme to control free-ranging kangaroos on a Queensland golf course, using contraceptive implants in females and vasectomisation or testicle removal in males. This reduced the numbers of pouch young to about one half of pre-intervention levels and controlled the population over a 2–4 year period. However, the necessary darting caused a mortality rate of 5–10% of captured animals, mainly due to complications before and after anaesthesia. It is concluded that population control is possible but careful management of kangaroos around the time of anaesthesia induction and recovery is important in such programmes to minimise losses. Abstract Traditionally, culling has been the expedient, most common, and in many cases, the only tool used to control free-ranging kangaroo populations. We applied a reproductive control program to a population of eastern grey kangaroos confined to a golf course in South East Queensland. The program aimed to reduce fecundity sufficiently for the population to decrease over time so that overgrazing of the fairways and the frequency of human–animal conflict situations were minimised. In 2003, 92% of the female kangaroos above 5 kg bodyweight were implanted with the GnRH agonist deslorelin after darting with a dissociative anaesthetic. In 2007, 86% of the females above 5 kg were implanted with deslorelin and also 87% of the males above 5 kg were sterilised by either orchidectomy or vasectomy. In 2005, 2008 and 2009, the population was censused to assess the effect of each treatment. The 2003 deslorelin program resulted in effective zero population growth for approximately 2.5 years. The combined deslorelin–surgery program in 2007 reduced the birth rate from 0.3 to 0.06%/year for 16 months, resulting in a 27% population reduction by November 2009. The results were consistent with implants conferring contraception to 100% of implanted females for at least 12 months. The iatrogenic mortality rates for each program were 10.5% and 4.9%, respectively, with 50% of all mortalities due to darting-related injuries, exertional myopathy/hyperthermia or recovery misadventure. The short term sexual and agonistic behaviour of the males was assessed for the 2007 program: no significant changes were seen in adult males given the vasectomy procedure, while sexual behaviours’ were decreased in adult males given the orchidectomy procedure. It is concluded that female reproduction was effectively controlled by implantation with deslorrelin and male reproductive behaviour was reduced by orchidectomy, which together achieved population control. PMID:26480325

  19. A look at a successful fee-charging urban project.

    PubMed

    Traitongyoo, T

    1985-10-01

    Bangkok's fee-charging Integrated Family Planning and Parasite Control Program (FPPC) is implemented by the Population and Community Development Association (PDA) and has grown from serving 36 schools and raising about US$1500 in 1976 to serving 231 schools and 200 factories and raising over US$75,000 in 1984. In addition to promoting health, the program aims at instilling a lifetime commitment to sensible health and family practices in the community. This urban program has been implemented in conjunction with a rural FPPC program through the financial and technical support of JOICFP, since 1976. Prior to that, PDA provided only family planning services. PDA is currently Thailand's largest private, non-profit organization involved in health care, appropriate technology, refugee assistance, water supply, agricultural marketing, as well as family planning and parasite control. The FPPC program works to mobilize the community to offer its support. Community involvement begins with the management of the program. Another community involvement comes from medical professionals from the local medical university who participate in the program for a fraction of their fees. Community-based family planning volunteers distribute contraceptives throughout their areas. The community also actively supports the FPPC program financially by paying fees. To communicate the benefits that people can derive from the services it offers, Bangkok's Urban FPPC program utilizes sophisticated marketing techniques such as advertising, direct mail, and a variety of public relations efforts. Family planning is publicly promoted in vasectomy festivals held each year throughout Bangkok. Married men are offered vasectomies free of charge if they have had 2 or more children. Exhibitions on parasite control and other health-related topics are also featured together with the sale of promotional items. Many of the program's activities have become major media events. Much of the credit is due to the flexibility of the program to adopt to the changing health needs of the people. Through PDA's efforts in the urban areas, the people of Bangkok are recognizing the need for family planning and health services. PMID:12313885

  20. Sperm Recovery and IVF after Testicular Sperm Extraction (TESE): Effect of Male Diagnosis and Use of Off-Site Surgical Centers on Sperm Recovery and IVF

    PubMed Central

    Omurtag, Kenan; Cooper, Amber; Bullock, Arnold; Naughton, Cathy; Ratts, Valerie; Odem, Randall

    2013-01-01

    Objective Determine whether testicular sperm extractions and pregnancy outcomes are influenced by male and female infertility diagnoses, location of surgical center and time to cryopreservation. Patients One hundred and thirty men undergoing testicular sperm extraction and 76 couples undergoing 123 in vitro fertilization cycles with testicular sperm. Outcome Measures Successful sperm recovery defined as 1–2 sperm/0.5 mL by diagnosis including obstructive azoospermia (n = 60), non-obstructive azoospermia (n = 39), cancer (n = 14), paralysis (n = 7) and other (n = 10). Obstructive azoospermia was analyzed as congenital absence of the vas deferens (n = 22), vasectomy or failed vasectomy reversal (n = 37) and “other”(n = 1). Sperm recovery was also evaluated by surgical site including infertility clinic (n = 54), hospital operating room (n = 67) and physician’s office (n = 11). Treatment cycles were evaluated for number of oocytes, fertilization, embryo quality, implantation rate and clinical/ongoing pregnancies as related to male diagnosis, female diagnosis, and use of fresh or cryopreserved testicular sperm. Results Testicular sperm recovery from azoospermic males with all diagnoses was high (70 to 100%) except non-obstructive azoospermia (31%) and was not influenced by distance from surgical center to laboratory. Following in vitro fertilization, rate of fertilization was significantly lower with non-obstructive azoospermia (43%, p = <0.0001) compared to other male diagnoses (66%, p = <0.0001, 59% p = 0.015). No differences were noted in clinical pregnancy rate by male diagnosis; however, the delivery rate per cycle was significantly higher with obstructive azoospermia (38% p = 0.0371) compared to diagnoses of cancer, paralysis or other (16.7%). Women diagnosed with diminished ovarian reserve had a reduced clinical pregnancy rate (7.4% p = 0.007) compared to those with other diagnoses (44%). Conclusion Testicular sperm extraction is a safe and effective option regardless of the etiology of the azoospermia. The type of surgical center and/or its distance from the laboratory was not related to success. Men with non-obstructive azoospermia have a lower chance of successful sperm retrieval and fertilization. PMID:23922817

  1. Choice of contraceptive modality by women in Norway.

    PubMed

    Skjeldestad, F E

    1994-01-01

    During October 1988-August 1989, staff of the Central Bureau of Statistics in Norway interviewed 4019 women, 20-44 years old, as part of a second Norwegian fertility survey. An obstetrician-gynecologist analyzed data on 2782 of these women who were fecund, sexually active within the last 30 days, and not pregnant, to determine contraceptive use patterns. 90.8% used contraception. Nearly 70% of the 9.2% not using contraception stated positive attitudes about someday becoming pregnant. Most of the sexually active women were married or cohabiting and had 1 or more children. Most women depended on IUDs (29.9%), oral contraceptives (OCs) (20.8%), or sexual sterilization (14% for female sterilization and 4.8% for vasectomy) to prevent pregnancy. OC use decreased linearly with age (p .0001) (59.8% for 20-24 year olds, 25.5% for 25-29 year olds, 14.7% for 30-34 year olds, 4.3% for 35-39 year olds, and 1.5% for 40-44 year olds). On the other hand, IUD use tended to increase with age (6.4% for 20-24 year olds to 40.5% for 35-39 year olds). Sexual sterilization also increased with age (p .05) (female sterilization, 0.1% for 20-24 year olds to 36.4% for 40-44 year olds; vasectomy, 0.8% for 25-29 year olds to 10.1% for 40-44 year olds). Women with no children or 1 child tended to use OCs, while women with at least 2 children tended to use the IUD or had chosen sexual sterilization. Induced abortions were most common among single women (e.g., 40.5% vs. 12.3% for married/cohabiting 20-34 year old women with no children or 1 child). Single women were less likely to have given birth than married/cohabiting women (7.7% vs. 63% 20-34 year olds with 0-1 children). Modern contraceptive use patterns mirror recommendations to women who seek contraceptive counseling. That 69.5% depended on OCs, the IUD, or sexual sterilization suggested that the level of awareness and knowledge of modern contraceptives is high in Norway. PMID:8304025

  2. Men and family planning: toward a policy of male involvement.

    PubMed

    Pillai, V K; Kelley, A C

    1994-01-01

    The stated aim of this discussion is to examine the extent of male use of family planning and the nature of men's role in family planning in developing countries. Case studies are presented which are successful examples of strategies for involving men in family planning. Policies that aim to increase male involvement must be sensitive to cultural values, apply to a decentralized government approach toward information and supplies, include adequate political will, and consider the costs and benefits of changing values. A male family planning policy would not always be compatible with all fertility values in developing countries or traditional values of the older population. A policy should stress the value of male individuals contributing as much as possible for their own and others' welfare. Community participation is considered important in order to create a feeling of mutual support. A sizeable investment will be required for mass distribution of contraceptive information. Schools are viewed as an ideal place for educating youth about the problems of high fertility and about use of family planning methods, such as the condom. Religious organizations should be used to educate people about responsible parenthood and to minimize barriers to use of modern contraception. Comic books on how to use condoms are suggested as a good source. Local authorities who are trusted are useful in influencing acceptance among local populations. Local personnel may be trained as information disseminators. Adequate contraceptive information needs to be supplied to a wide audience. Lack of supply and inadequate information are given as two key reasons for insufficient use of male contraception. Condoms should be priced to be affordable to the average person and free to those with no income. Program strategies that proved successful are cited for Thailand's Mechai Viravaidya program and Bali's grass-roots program. The vasectomy program in Bangladesh is also noted for its success. Low levels of condom use are attributed to factors such as price, education, availability, accessibility, culture, religion, and economic conditions. Male sterilization levels can be enhanced with wider availability of clinics and provision of correct information for challenging beliefs that vasectomy is a form of castration. PMID:12290097

  3. Comparison of four lasers (λ = 650, 808, 980, and 1075 nm) for noninvasive creation of deep subsurface lesions in tissue

    NASA Astrophysics Data System (ADS)

    Chang, Chun-Hung; Wilson, Christopher R.; Fried, Nathaniel M.

    2015-07-01

    Lasers have been used in combination with applied cooling methods to preserve superficial skin layers (100's μm's) during cosmetic surgery. Preservation of a thicker tissue surface layer (millimeters) may also allow development of other noninvasive laser procedures. We are exploring noninvasive therapeutic laser applications in urology (e.g. laser vasectomy and laser treatment of female stress urinary incontinence), which require surface tissue preservation on the millimeter scale. In this preliminary study, four lasers were compared for noninvasive creation of deep subsurface thermal lesions. Laser energy from three diode lasers (650, 808, and 980 nm) and a Ytterbium fiber laser (1075 nm) was delivered through a custom built, side-firing, laser probe with integrated cooling. An alcohol-based solution at -5 °C was circulated through a flow cell, cooling a sapphire window, which in turn cooled the tissue surface. The probe was placed in contact with porcine liver tissue, ex vivo, kept hydrated in saline and maintained at ~ 35 °C. Incident laser power was 4.2 W, spot diameter was 5.3 mm, and treatment time was 60 s. The optimal laser wavelength tested for creation of deep subsurface thermal lesions during contact cooling of tissues was 1075 nm, which preserved a surface layer of ~ 2 mm. The Ytterbium fiber laser provides a compact, low maintenance, and high power alternative laser source to the Neodymium:YAG laser for noninvasive thermal therapy.

  4. Aspirin use is associated with lower prostate cancer risk in male carriers of BRCA mutations.

    PubMed

    Cossack, Matthew; Ghaffary, Cameron; Watson, Patrice; Snyder, Carrie; Lynch, Henry

    2014-04-01

    Previous studies have shown that male BRCA mutation carriers stand at increased risk of developing prostate cancer and have concerns about developing cancer. Genetic counseling practitioners often discuss strategies for reducing the risk of cancer for patients at high risk due to their genetic background. Addressing modifiable health habits is one such strategy. Unfortunately, modifiable risk factors for prostate cancer have only been documented in the general population and have not yet been studied in the BRCA carrier subpopulation. Therefore, this study aimed to identify modifiable risk factors for prostate cancer in BRCA carriers. We examined prostate cancer risk factors in 74 men who were part of families with a BRCA mutation. This study examined nine dichotomous variables including: exercise, history of vasectomy, smoking history, alcohol use, finasteride use, statin use, aspirin use, coffee use, and vitamin use. The survey was sent to all cases of prostate cancer in the Hereditary Cancer Center Database at Creighton University with a known BRCA status. This study confirmed the protective benefits of daily aspirin use, which have been observed in previous studies of the general population, and suggests its benefit in BRCA carriers. Protective benefits from regular vigorous exercise and daily coffee use trended towards significance, but neither factor withstood the Bonferroni Correction for multiple comparisons. PMID:23881471

  5. [Children born to Hansen's disease patients in Amami-Oshima, Kagoshima, Japan].

    PubMed

    Moriyama, Kazutaka; Kikuch, Ichiro; Ishii, Norihisa

    2009-09-01

    In the Japanese leprosaria, it was very difficult or almost impossible for leprosy patients to give birth to their children. There were various reasons for this situation. Leprosy in the women mostly worsened in pregnancy and some of the children developed leprosy. Because of the chronic nature of the disease, marriage was encouraged in Japanese leprosaria, so that vasectomy was usually enforced in men who were wed, while artificial abortion was enforced in pregnant women. The only one exception was the situation of the Amami Wako-en Leprosarium. The Wako-en Leprosarium was started in 1943, and between 1946 and 1953, it was under American rule. Later it was transferred to Japanese rule. Religions such as Buddhism, Christianity and other religions greatly helped with leprosy patients, and in the Wakoen, it was Catholicism which prevailed. Catholic believer Joan Matsubara (later the secretary of Wako-en), Father Patrick Finn, Kaoru Ohira (director) outlined how children born to Hansen's disease patients would be grown up and made the internal rules of the couples' dormitory, while this was impossible in other leprosaria. Between 1953 and 1954, children were brought up by Matsubara's family or nurses. And since November 1954, children were brought up at nurseries (firstly named "Children's House" and later at "Naze Engel House" and children between 2 and 3 years went to "White Lily House". The children could meet their parents at times and now they are full-fledged grown-up citizens. PMID:19803374

  6. Adolescents and sex.

    PubMed

    Castro, C; Palomar Castro, Y

    1992-01-01

    Adolescent health problems in the Philippines are identified as follows: adolescent unwanted pregnancy, early marriage, abortion and sometimes death, sexually transmitted disease (STD), AIDS, inadequate knowledge about sex and reproduction (population education), taboos, inadequate resources directed to youth, and personnel insufficiently trained for gender sensitive and adolescent sensitive counseling. A recent University of the Philippines Population Institute survey reported that only 10% of urban respondents and 8.1% of rural respondents considered virginity to be unimportant. 33% in urban and 29% in rural areas consent to premarital sex if the couple were "in love" and there was a promise of marriage. Premarital sex is increasing, but was lower among those who grew up with their parents. Population education is compulsory but teachers are ill equipped, unknowledgeable about the latest technology, and biased. Human reproduction is taught but family planning methods are frequently ignored. The topic is taboo between parents and children. Acquisition of knowledge is haphazard at best. Government resources are directed to adult reproductive women. Emphasis needs to be placed on the importance and proper use of pills, condoms, IUDs, and diaphragms. Vasectomy and tubal ligation should be readily available. Youth should be taught rhythm, basal body temperature, and Billings ovulation methods. Misconceptions should be debunked. Sex education, STD prevention, and counseling for adolescents are available in only 5 centers in the Philippines, as reported by the International Center on Adolescent Fertility; this is adequate to serve the almost 50% of the population 18 years. PMID:12285922

  7. Control of fertility amongst travellers.

    PubMed

    Moreton, J

    1988-08-01

    The special family planning requirements of the "Travellers," a term including the Romanies, Gypsies and Irish Tinkers of the United Kingdom, are explained. These groups share a nomadic life style, but have racial make-up and cultural traditions that easily distinguish them from other non-house dwellers. They rarely marry non-travellers, but frequently do marry cousins. While the Irish are strict Catholics, and the Romanies are not religious, these groups have taboos about sexuality that affect practice of contraception. They do not permit discussion of sexual topics between the sexes or to children, consider the woman's body unclean, will not breast-feed or touch the genitals even to use tampons, and only women practice any type of fertility regulation. Most are uneducated and illiterate. Because of television, many women are now aware of family planning, and some go to great lengths to attend clinics. Some women resort to sterilization, injectables, or IUDs. The most popular method among those who do use contraception is the pill. Abortion, vasectomy, barrier methods of any kind including condoms, withdrawal and natural family planning are never used, either because of religious beliefs, taboo about handling the body, about discussing sexuality, or about any form of male limitation. Family planning workers should make special efforts to understand the difficulties that a nomadic existence and illiteracy cause for traveller clients. PMID:3419351

  8. Robotic assisted andrological surgery

    PubMed Central

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE). PMID:23241637

  9. Family planning methods: new guidance.

    PubMed

    1996-10-01

    Presented in this report are the recommendations of two expert groups, the Technical Guidance/Competence Working Group of the US Agency for International Development's Maximizing Access and Quality Initiative and the World Health Organization's Family Planning and Population Unit, regarding currently available family planning methods. The former group addressed key biomedical questions and formulated recommendations about 11 groups of family planning methods: combined oral contraceptives, progestin-only pills during breast feeding, progestin-only injectables, combined injectable contraceptives, Norplant implants, copper-bearing IUDs, tubal occlusion, vasectomy, lactational amenorrhea method, natural family planning, and barrier methods. A table presents the relative importance, by method, of procedures such as pelvic exam, blood pressure reading, breast exam, and screening for sexually transmitted diseases and cervical cancer. The medical eligibility recommendations for each method are also presented in tabular form, with four categories for temporary methods: 1) no restrictions on use, 2) advantages generally outweigh theoretical or proven risks, 3) theoretical or proven risks usually outweigh the advantages, and 4) unacceptable health risks. Included among the 41 conditions for which eligibility criteria are specified are age, smoking, thromboembolic disorder, headaches, irregular vaginal bleeding, family history of breast cancer, obesity, drug interactions, parity, breast feeding, postpartum, and postabortion. The new guidance presented in this report enables providers to give family planning clients expanded contraceptive choices while ensuring method safety and effectiveness. PMID:9342775

  10. [Male contraception].

    PubMed

    Khomasuridze, A G; Marshaniia, Z S

    1991-01-01

    Various methods of contraception in men are reviewed. One of the methods of contraception is the use of hormonal agents (estrogens, androgens, antiandrogens, progestins, or their combinations), which block spermatogenesis. More advantageous is the use of nonhormonal agents (alpha-chlorhydrine, 6-chloro-6-deoxyglucose, salsosulfapyridine), which act on the process of sperm maturation in the epididymis. Plant extracts show marked contraceptive activity in men. The preparation gossypol isolated from cotton seeds and roots was found to inhibit male fertility. Various isomers of gossypol decreased sperm mobility by inhibiting the mitochondrial respiratory chain. Major side-effect of gossypol was hepatotoxicity. Glycosides isolated from the herb Tripterigium Wilfordii (TW) were found to have the antifertility activity. The antifertility effect of TW glycosides was dose- dependent: large doses were shown to inhibit spermatogenesis, while small doses were found to decrease sperm motility and viability. TW glycosides were free of toxic side-effects. Another approach to regulation of male fertility is the use of surgical methods of contraception including vasectomy. Development of less invasive and reversible surgical methods showed effectiveness of subcutaneous occlusion of vas deferens with various chemical substances (calcium chloride, p-butyl-2-cyanoacrylate). The best results were achieved with high molecular weight medical polyurethane. PMID:2042728

  11. Effects of Mass Media and Cultural Drift in a Model for Social Influence

    NASA Astrophysics Data System (ADS)

    Mazzitello, Karina I.; Candia, Julián; Dossetti, Víctor

    In the context of an extension of Axelrod's model for social influence, we study the interplay and competition between the cultural drift, represented as random perturbations, and mass media, introduced by means of an external homogeneous field. Unlike previous studies [J. C. González-Avella et al., Phys. Rev. E 72, 065102(R) (2005)], the mass media coupling proposed here is capable of affecting the cultural traits of any individual in the society, including those who do not share any features with the external message. A noise-driven transition is found: for large noise rates, both the ordered (culturally polarized) phase and the disordered (culturally fragmented) phase are observed, while, for lower noise rates, the ordered phase prevails. In the former case, the external field is found to induce cultural ordering, a behavior opposite to that reported in previous studies using a different prescription for the mass media interaction. We compare the predictions of this model to statistical data measuring the impact of a mass media vasectomy promotion campaign in Brazil.

  12. Genome-wide promoter methylation profile of human testis and epididymis: identified from cell-free seminal DNA

    PubMed Central

    2013-01-01

    Background DNA methylation analysis is useful for investigation of male fertility in mammals, whereas the reliance on tissues limits the research on human. We have previously found the presence of high concentration of cell-free seminal DNA (cfsDNA) in human semen. We proposed that some testis and epididymis-specific methylated promoters could be detected in human cfsDNA, and thus hold promise as noninvasive epigenetic biomarkers for male infertility, of which most cases are caused by defects in testicular sperm production or epididymal sperm maturation. Results The ejaculate of successfully vasectomized men does not contain any secretion from testis and epididymis. Here we compared genome-wide promoter methylation profiles in cfsDNA between health donors and post-vasectomy men. Promoters of 367 testis and epididymis-specific hypomethylated genes and 134 hypermethylated genes were identified. Subsequent validation by Methyl-DNA immunoprecipitation and MethyLight analysis confirmed the result of promoter microarray. Gene Ontology analysis revealed many genes involved in male reproduction. Conclusion We detected the testis and epididymis-specific methylated promoters in human cfsDNA, which may be used for noninvasive epigenetic biomarkers for the study and diagnosis of male infertility. PMID:23622456

  13. Hot issues in female and male hormonal contraception.

    PubMed

    Gava, Giulia; Lantadilla, Claudia; Martelli, Valentina; Fattorini, Anna; Seracchioli, Renato; Meriggiola, Maria C

    2016-02-01

    In recent years a number of significant developments in the field of female hormonal contraception have been made which have produced new formulations and delivery systems providing high efficacy, safety and important non-contraceptive benefits. In particular long-acting reversible contraception (LARC) formulations have been demonstrated to ensure extremely high efficacy in typical use, minimal contraindications, optimal safety in all women thereby representing the best option for most women of all ages. Their effectiveness is not reliant upon user adherence and their ability to reduce unintended pregnancies and abortions has been proven. Unfortunately the same considerations cannot be made for male hormonal contraception. Although a large number of men are interested and would welcome the opportunity to use male contraceptive methods, no safe, effective and reversible methods are available on the market. Current methods available for men are limited to condoms and vasectomy. Highly effective prototype regimens have been developed but the pharmaceutical industry is unwilling to pursue further development and market these products. Of all new approaches to male contraception, hormonal methods are the closest to clinical application. These are based on the reversible suppression of luteinizing hormone and follicle stimulating hormone with subsequent reversible inhibition of spermatogenesis and consequent replacement to maintain androgen dependent physiological functions. Most approaches tested combination regimens such as testosterone and a progestin or testosterone and a GnRH analog. PMID:26633041

  14. Reduced meiotic recombination on the XY bivalent is correlated with an increased incidence of sex chromosome aneuploidy in men with non-obstructive azoospermia

    PubMed Central

    Sun, F.; Mikhaail-Philips, M.; Oliver-Bonet, M.; Ko, E.; Rademaker, A.; Turek, P.; Martin, R.H.

    2008-01-01

    Both aberrant meiotic recombination and an increased frequency of sperm aneuploidy have been observed in infertile men. However, this association has not been demonstrated within individual men. The purpose of this study was to determine the association between the frequency of recombination observed in pachytene spermatocytes and the frequency of aneuploidy in sperm from the same infertile men. Testicular tissue from seven men with non-obstructive azoospermia (NOA) and six men undergoing vasectomy reversal (controls) underwent meiotic analysis. Recombination sites were recorded for individual chromosomes. Testicular and ejaculated sperm from NOA patients and controls, respectively, were tested for aneuploidy frequencies for chromosomes 9, 21, X and Y. There was a significant increase in the frequency of pachytene cells with at least one achiasmate bivalent in infertile men (12.4%) compared with controls (4.2%, P = 0.02). Infertile men also had a significantly higher frequency of sperm disomy than controls for chromosomes 21 (1.0% versus 0.24%, P = 0.001), XX (0.16% versus 0.03%, P = 0.004) and YY (0.12% versus 0.03%, P = 0.04). There was a significant correlation between meiotic cells with zero MLH1 foci in the sex body and total sex chromosome disomy (XX + YY + XY) in sperm from men with NOA (r = 0.79, P = 0.036). PMID:18583429

  15. Navajo Nation expands family planning services.

    PubMed

    Haws, J; Crawford, G

    1996-01-01

    An AVSC training program, conducted in cooperation with the Navajo Nation Family Planning Corporation (NNFPC), has the potential to profoundly affect sterilization provision and acceptability on the Navajo Nation reservation. AVSC trained a family physician from the Northern Navajo Medical Center (New Mexico) in the no-scalpel vasectomy technique. This physician expects to provide 30 such sterilizations in the one-year period following the training and is preparing to teach reservation physicians from other health centers to perform the procedure. In addition, a joint AVSC-NNFPC course on sterilization counseling was presented to 30 nursing staff from the New Mexico Center. Central to this training was consideration of the obstacles to sterilization acceptance posed by Navajo cultural beliefs. Sensitivity to some women's desire to keep the procedure private, due to concerns their husbands will abandon them if they can no longer bear children, and to the potential need to include mothers and grandmothers in counseling sessions, is required. Also salient for female counselors and nurses are cultural taboos against a woman discussing sexual matters with a man with whom she is not intimate. In late 1996, AVSC will provide a sterilization counseling update for all NNFPC counselors working at centers throughout the four-state reservation. PMID:12347635

  16. Use of a domestic Korean black goat (Capra hircus coreanae) with its chest crayon-harnessed in detecting estrus of Himalayan tahrs (Hemitragus jemlahicus)

    PubMed Central

    Yong, Hwanyul

    2014-01-01

    The reliability of a Korean black goat (Capra hircus coreanae) to detect estrus in Himalayan tahrs (Hemitragus jemlahicus) for an artificial breeding program was investigated. Estrus in six female Himalayan tahrs was synchronized using fluorogestone acetate (FGA) sponges. Thirteen days later, 200 IU of PMSG and 100 IU of hCG were injected before removing the sponges and simultaneously injecting 5 mg of PGF2α the next day. Penetration of the cervical canal and the thickness and location of red crayon marks were examined 40~43 h later. Two females treated with sponges containing 60 or 45 mg of FGA had estrogen levels of 8.7 and 11.1 pg/mL, respectively. No red marks were found on the backs of these two tahrs. The remaining females had higher levels of estradiol, and the red crayon marks were clearly shown. The cervical folds of these tahrs were readily penetrated and the insemination gun was smoothly inserted into the uterine body. In conclusion, a Korean domestic goat with its chest crayon-harnessed was successfully used to detect estrus of Himalayan tahrs. This technique might be utilized as a part of breeding programs for wild goats and avoid the need for a vasectomy of conspecific males. PMID:24690603

  17. Wolf management in the 21st century: From public input to sterilization

    USGS Publications Warehouse

    Mech, L.D.; Fritts, S.H.; Nelson, M.E.

    1996-01-01

    Human-population increase and land development portend increasing conflict with large predators. Concurrently, changes and diversification of human attitudes are bringing increased disagreement about wildlife management. Animal-rights advocacy resulting from urbanization of human populations conflicts with traditional wildlife management. These forces focus more on wolves than on other wildlife because of strong public and media interest in wolves. Thus wolf management in the future will come under even greater public scrutiny, involve more public input, and may have greater restrictions imposed on it. This will lead to increased complexity in wolf management including more zoning, more experimentation with lethal and non-lethal capture techniques and alternate methods of alleviating damage to pets, livestock, and large ungulate herds, and greater public and private subsidy of wolf damage. One form of non-lethal control of wolf populations that may hold some promise is direct sterilization of males to reduce the biotic potential of the wolf population. Experimental vasectomy of five wild male wolves from four packs in Minnesota indicates that sterile males will continue to hold mates and territories, which would be necessary if sterilization is to be a viable technique for assisting with population control. If sterile males held territories but failed to produce pups, such territories might contain only about a third the number of wolves as fertile pack territories. Because wolves are long-lived in unexploited populations and their territories are large, direct sterilization of relatively few animals each year might significantly reduce populations.

  18. The etiology of prostate cancer: what does the epidemiology suggest

    SciTech Connect

    Ross, R.K.; Paganini-Hill, A.; Henderson, B.E.

    1983-01-01

    The two most important demographic characteristics of prostate cancer in Los Angeles are the high rates among blacks, which are two times those among whites and four times those among Asians, and the rapid increase in rates with age after age 40. Despite the high rates among blacks, a birth cohort analysis indicates that mortality rates among black men born after 1900 have decreased. In this report, epidemiologic and experimental evidence supporting each of three etiologic hypotheses--industrial exposure to cadmium, sexual transmission by an infectious agent, and endocrine factors--are reviewed. Evidence from descriptive data in Los Angeles suggests that only a small portion of cases might be attributable to industrial exposures. In a cohort study of Catholic priests, we found no deficit of prostate cancer mortality, strong evidence against sexual transmission of the disease. Experimental evidence and a limited amount of human data support an endocrine hypothesis. Preliminary results of a case-control study of prostate cancer are presented, but these results are unable to distinguish among these hypotheses further. This study finds a substantial protective effect of vasectomy, an event that is accompanied by reduced prostatic function and size, but this result is thus far statistically insignificant.

  19. IMA to conduct training courses in family planning.

    PubMed

    1993-11-15

    For the last six and a half decades, the Indian Medical Association (IMA) has been actively engaged in Public Health issues, ranging from immunization, ORT, maternal and child health care, and has been cooperating with the Government of India in various National Health Programs. Recently, IMA organized a new and exciting program on India's most significantly health issue--family planning. The training is to be competency based and participatory, with the main emphasis on knowledge, attitude and skills required to provide comprehensive child spacing. IMA has developed this multilevel program to train personnel in all methods of family planning, like: participation in basic oral contraceptive training; supplementary training in other methods; clinical practice for providing information on how to select and manage non-clinical family planning services; simulated practice in IUCD; and clinical practice in IUCD training. Training can also be arranged for vasectomy practicum and minilaparotomy. The main purpose of the training program is to realize the Government's goal of 60% contraceptive prevalence usage by the year 2000. In India, less than 2% of the 132.5 million reproductives, couples use oral contraceptives, because of widespread misconceptions regarding the pill among the general populace and the medical community. This program has been designed to counter these misgivings and thus encourage the "use of modern family planning methods" to take on the menace of the population explosion. PMID:12179169

  20. Robotic assisted andrological surgery.

    PubMed

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE). PMID:23241637

  1. Men's Perspectives on Their Role in Family Planning in Nyanza Province, Kenya.

    PubMed

    Withers, Mellissa; Dworkin, Shari L; Onono, Maricianah; Oyier, Beryl; Cohen, Craig R; Bukusi, Elizabeth A; Newmann, Sara J

    2015-06-01

    Research has indicated that gender dynamics-and in particular men's disapproval of family planning-have had an influence on the low levels of contraceptive use in sub-Saharan Africa. Limited evidence exists, however, on effective strategies to increase male approval. We conducted 12 focus group discussions with married men aged 20-66 (N = 106) in Kenya to explore FP perceptions. Men's disapproval of FP was associated with anxieties regarding male identity and gender roles. Men often distrusted FP information provided by their wives because they suspected infidelity or feared being viewed as "herded." Men also feared that providers might pressure them into vasectomies or into disclosing extramarital sexual activity or HIV diagnoses to their wives. Suggested strategies include programs targeting couples jointly and FP education for men provided by male outreach workers. To encourage men's acceptance, community-based programs directly targeting men are needed to reduce stigma and misconceptions and to increase awareness of the benefits of FP. PMID:26059990

  2. Leaving machismo behind.

    PubMed

    Eschen, A; Castano, F

    1999-01-01

    A study, which was conducted in Colombia's five largest cities, determined men's, women's, and health care provider's knowledge, attitudes, and needs regarding sexual and reproductive health services for men. Data were collected through 60 focus groups, 720 surveys of service users and nonusers, 45 interviews with health care staff, and 5 couple's life histories. The study found that, due to the inadequate service facilities offered to men, it was difficult for men to achieve the goal of being responsible about their own and their partner's sexual and reproductive health. Only 9 of the 14 health care facilities surveyed rendered services such as vasectomy, health care promotion or prevention, and educational programs aimed at men. According to providers, one reason for lack of services is the low utilization rate even if such services are available. In addition, existing services focus on disease management rather than preventive protocols. The AVSC will work with health care facilities, the Ministry of Health, and health insurance companies in establishing sexual and reproductive health services for men in Bogota, Cali, and Medellin. PMID:12295275

  3. Onsite Provision of Specialized Contraceptive Services: Does Title X Funding Enhance Access?

    PubMed Central

    Riedel, Julie Cross; Menz, Mary; Darney, Philip D.; Brindis, Claire D.

    2014-01-01

    Abstract Background: This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Methods: Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. Results: A significantly greater proportion of Title X–funded providers compared to non–Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non–Title X, 38% private); contraceptive implants (58% Title X, 19% public non–Title X, 7% private); vasectomy (8% Title X, 4% public non–Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non–Title X, 49% private) (all p<0.0001). The association between onsite provision and Title X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Conclusions: Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training. PMID:24405313

  4. Advances in male contraception.

    PubMed

    Page, Stephanie T; Amory, John K; Bremner, William J

    2008-06-01

    Despite significant advances in contraceptive options for women over the last 50 yr, world population continues to grow rapidly. Scientists and activists alike point to the devastating environmental impacts that population pressures have caused, including global warming from the developed world and hunger and disease in less developed areas. Moreover, almost half of all pregnancies are still unwanted or unplanned. Clearly, there is a need for expanded, reversible, contraceptive options. Multicultural surveys demonstrate the willingness of men to participate in contraception and their female partners to trust them to do so. Notwithstanding their paucity of options, male methods including vasectomy and condoms account for almost one third of contraceptive use in the United States and other countries. Recent international clinical research efforts have demonstrated high efficacy rates (90-95%) for hormonally based male contraceptives. Current barriers to expanded use include limited delivery methods and perceived regulatory obstacles, which stymie introduction to the marketplace. However, advances in oral and injectable androgen delivery are cause for optimism that these hurdles may be overcome. Nonhormonal methods, such as compounds that target sperm motility, are attractive in their theoretical promise of specificity for the reproductive tract. Gene and protein array technologies continue to identify potential targets for this approach. Such nonhormonal agents will likely reach clinical trials in the near future. Great strides have been made in understanding male reproductive physiology; the combined efforts of scientists, clinicians, industry and governmental funding agencies could make an effective, reversible, male contraceptive an option for family planning over the next decade. PMID:18436704

  5. Cryopreservation of testicular and epididymal sperm: techniques and clinical outcomes of assisted conception.

    PubMed

    Gangrade, Bhushan K

    2013-01-01

    The introduction of the technique of intracytoplasmic sperm injection to achieve fertilization, especially using surgically retrieved testicular or epididymal sperm from men with obstructive or non-obstructive azoospermia, has revolutionized the field of assisted reproduction. The techniques for the retrieval of spermatozoa vary from relatively simple percutaneous sperm aspiration to open excision (testicular biopsy) and the more invasive Micro-TESE. The probability of retrieving spermatozoa can be as high as 100% in men with obstructive azoospermia (congenital bilateral absence of the vas deferens, status post-vasectomy). However, in nonobstructive azoospermia, successful sperm retrieval has been reported in 10-100% of cases by various investigators. The surgical retrieval and cryopreservation of sperm, especially in men with non-obstructive azoospermia, to some extent ensures the availability of sperm at the time of intracytoplasmic sperm injection. In addition, this strategy can avoid unnecessary ovarian stimulation in those patients intending to undergo in vitro fertilization-intracytoplasmic sperm injection with freshly retrieved testicular sperm when an absolute absence of sperm in the testis is identified. Several different methods for the cryopreservation of testicular and epididymal sperm are available. The choice of the container or carrier may be an important consideration and should take into account the number or concentration of the sperm in the final preparation. When the number of sperm in a testicular biopsy sample is extremely low (e.g., 1-20 total sperm available), the use of an evacuated zona pellucida to store the cryopreserved sperm has been shown to be an effective approach. PMID:23503963

  6. Comparison of 808, 980, and 1075nm lasers for noninvasive thermal coagulation of the canine vas deferens, ex vivo

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Schweinsberger, Gino R.; Fried, Nathaniel M.

    2011-03-01

    Successful noninvasive laser coagulation of the canine vas deferens, in vivo, has been previously reported. However, the therapeutic window for treatment is relatively narrow. This study determines the dependence of vas thermal coagulation on laser wavelength for development of a noninvasive laser vasectomy procedure. Noninvasive laser coagulation of canine vas tissue, ex vivo, was performed using three commonly available near-infrared laser wavelengths: 808, 980, and 1075 nm. Each laser delivered an average power of 9.2 W, 500-ms pulse duration, pulse rate of 1.0-Hz, and 3.2-mm diameter laser spot, synchronized with cryogen spray cooling of the scrotal skin surface for a total treatment time of 60 s. Vas burst pressures were measured to determine strength of vas closure and compared to previously reported ejaculation pressures. Gross inspection of vas and scrotal skin was also performed immediately after the procedure as an indicator of thermal coagulation and skin burns. The 1075 nm laser produced the highest vas burst pressures (288 +/- 28 mmHg), significantly greater than previously reported ejaculation pressures (136 +/- 29 mmHg). The 808 nm wavelength produced insufficient vas burst pressures of 141 +/- 61 mmHg, and minor scrotal skin burns were observed in at least one case. The 980 nm wavelength was unable to produce thermal coagulation of the vas, with low burst pressures (89 +/- 58 mmHg) and severe scrotal skin burns. The 1075 nm wavelength was the only near-IR wavelength that consistently thermally coagulated the vas with a strong degree of closure and without any scrotal skin burns.

  7. Review and appraisal of the World Population Plan of Action [WPPA].

    PubMed

    1984-01-01

    This article summarizes the major points covered in the document, "Review and Appraisal of the World Population Plan of Action," with special emphasis on demographic factors pertaining to Asia and the Pacific. This document, which will be a focus for deliberations at the International Conference on Population, includes 6 major chapters: 1) socioeconomic development and population; 2) development of population policies; 3) population trends, prospects, goals, and policies; 4) promotion of knowledge; 5) role of national governments and the international community; and 6) monitoring, review, and appraisal of the World Population Plan of Action. Each chapter synthesizes major trend over the 1974-84 decade and projects possible future trends. The variation in fertility levels within the developing world are now as large as those previously found between developed and developing regions. For example, kfertility declined by 44% in East Asia but only by 14% in South Asia in the 1970-75 to 1980-85 period. Recent increases in contraceptive practice have primarily involved methods employed by women. Despite the relative safety and cost-effectiveness of vasectomy, many more women than men have been voluntarily sterilized. a common feature in most developing countries over the past decade has been rising female labor force participation andequalization of the school enrollment of males and females. Governments are increasingly aware of the link between demographic goals and implementation of population and development programs has been recognized. In general, family planning has become integrated with other development programs. Effective service approaches have included integration of family planning with maternal and child health services, community centered primary health care, community based distribution and marketing of contraceptives, and use of paraprofessional personnel. The rapid increase in the school age population is projected to be among the most important demograhic trends for the remainder of this century, and the aging of the population will have important implications for the current world population structure. PMID:12313214

  8. Noninvasive laser coagulation of the canine vas deferens, in vivo

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Ross, Ashley E.; Jarow, Jonathan P.; Fried, Nathaniel M.

    2010-02-01

    Development of a noninvasive vasectomy technique may eliminate male fear of complications (incision, bleeding, infection, and scrotal pain) and result in a more popular procedure. This study builds upon previously reported ex vivo tissue studies by exploring acute and short-term chronic in vivo canine studies. Isolation of the canine vas was achieved using a conventional vas ring clamp method. No perforation of the scrotal skin was necessary to occlude the vas. Laser radiation with a wavelength of 1075 nm, average power of 11.2 W, 500-ms pulse duration, 0.5 Hz pulse rate, and 3-mm-diameter spot was synchronized with cryogen spray cooling of the scrotal skin surface in a total of 8 dogs (n = 16 vasa) for a treatment time of 60 s. Burst pressure measurements were conducted at Days 0 and 21 (n = 8 vasa each day) to quantify the strength of vas closure. The vas was successfully thermally occluded in 15/16 (94%) procedures with 14/15 (93%) vas recording burst pressures above ejaculation pressure. One vas was not present, and another vas recorded a bursting pressure below ejaculation pressure. The coagulated vas bursting pressure averaged 283 +/- 34 mm Hg at Day 0 and 260 +/- 77 mm Hg at Day 21, significantly higher than reported vas ejaculation pressures of 136 +/- 29 mm Hg. Minor scrotal skin burns were observed during the recovery period. Noninvasive thermal occlusion of the vas is feasible in an in vivo canine model. Elimination of minor skin burns and longer term chronic in vivo canine studies are needed to confirm azospermia after vas occlusion without recanalization.

  9. Male contraception: a clinically-oriented review.

    PubMed

    Kanakis, George A; Goulis, Dimitrios G

    2015-10-01

    Despite the variety of available female contraceptive methods, many pregnancies (~50%) are still undesired. Many men (>60%) want to participate equally with their partner in family planning; however, male contraceptive methods (MCMs) account for only 14% of those used worldwide and no pharmaceutical MCM is available so far. The only two MCMs currently available are condoms, which despite protecting against sexually transmitted diseases have high failure rates (~19%), and vasectomy, which though very efficient (99%) is poorly reversible (<50%). Among MCMs under investigation, male hormonal contraceptives (MHCs) are those that have come closest to commercialization. The action of MHCs relies on the disruption of spermatogenesis that exogenous androgen administration evokes by suppressing the hypophyseal-gonadal axis. Various regimens of androgens as monotherapy or in combination with progestins have been tested in clinical trials achieving a Pearl Index <1.0 (equal to that of the female oral contraceptive pill); however, concerns regarding the variable response rates observed (non-responders: 5-20%), the impracticality of parenteral administration and long-term prostate-associated or cardiovascular morbidity have deflected the interest of the pharmaceutical industry from further research. Non-hormonal contraception methods may be, at least theoretically, more specific by selectively disrupting spermatogenesis and sperm transport or fertilizing ability. Nevertheless, only a few have been tested in clinical trials (Reversible Inhibition of Sperm Under Guidance, RISUG, and Intra Vas Plugs); most of them are still in pre-clinical development or have been abandoned due to toxicity (gossypol). Consequently, until a reliable, safe and practical MCM is developed, women will continue to bear most of the contraception burden. PMID:26732151

  10. A recipe for success: ingredients for a successful family planning program.

    PubMed

    Merrill, J

    1992-09-01

    The basic elements of a successful family planning (FP) program are variable between countries. Providing better access to modern contraceptives, access to general and reproductive health care, and increasing economic and educational opportunities contribute to reducing fertility rates. Effective distribution is constrained by rural, isolated populations and cultural attitudes. Indonesia has used floating clinics located on boats to reach inaccessible areas; Norplant and hormonal injection availability also contribute to the 53% contraceptive prevalence rate. The Japanese Organization for International Cooperation in Family Planning has shipped bicycles to developing countries. The result has been improved status among peers and greater program success. Contraceptive social marketing programs (CSM) have been successful in some countries to distribute contraceptives through local channels such as shops and stalls; people seem willing to pay also. CSM has been successful in Egypt in increasing condom sales. IUD use increased from 11% to 42% between 1975-88 with CSM. Multimedia promotion that is carefully researched and targeted is another way to increase contraceptive prevalence (CP) rates. A Brazilian multimedia vasectomy campaign led to an 80% monthly increase in Pro-Pater male health clinics. 240,000 women in Turkey were encouraged through multimedia efforts to switch to modern methods. In Zimbabwe, men have been the target of efforts to educate them about the advantages of small families. Women are recruited to implement FP services in INdia and in poor neighborhoods; an increase from 12% to 61% was achieved. Highly motivated workers with a respect for the community's values is essential to any successful FP program as is government support. China's policy has drawn criticism; China has welcomed a UN program which provides financial motivation. Thailand has been successful due to the commitment between public and private sectors; in 17 years CP rose from 10% to 68%. Family life education is prevalent; female literacy is high at 96%. PMID:12317713

  11. Acquired von Willebrand syndrome with a type 2B phenotype: diagnostic and therapeutic dilemmas.

    PubMed

    Scepansky, Ellen; Othman, Maha; Smith, Hedy

    2014-01-01

    In this report, we provide evidence of an acquired von Willebrand syndrome (AVWS) with a type 2B phenotype rather than the expected type 1 or 2A. The patient was referred prior to surgical removal of a fibrous mass within the maxillary sinus. His first bleeding 7 years earlier following a retinal tear had been complicated by monocular blindness. Several mucocutanous bleedings followed. Hematological investigations revealed von Willebrand factor (VWF):Ag 91 IU/ml, factor VIII 86 IU/ml, VWF:RCo 34 IU/ml and profound thrombocytopenia with platelet clumping. VWF multimer analysis showed a loss of high-molecular-weight multimers and his plasma aggregated normal platelets under low ristocetin concentration, consistent with type 2B von Willebrand disease (VWD). Sequencing of VWF exon 28 and of the platelet GP1BA gene to investigate the possibility of platelet-type VWD failed to reveal mutations. Serum protein electrophoresis showed a monoclonal IgG protein and led to the diagnosis of monoclonal gammopathy of unknown significance (MGUS), raising suspicion of an AVWS. Over 2 years, he experienced severe gingival bleedings and traumatic intracerebral hemorrhage. Following debridement of the sinus mass, the patient required 20 units of packed red blood cells, despite high-dose Humate-P, continuous Amicar and twice-daily platelet transfusions. Bleeding finally ceased following infusion of activated factor VIIa. A history of prior uncomplicated vasectomy and tendon laceration, no family history of bleeding, the inability to identify a causative mutation in either exon 28 VWF or platelet GP1BA and the MGUS led to diagnosis of AVWS with a type 2B phenotype. This case highlights the difficulties in assigning a diagnosis and the management of bleeding in a patient with an atypical presentation of AVWS. PMID:24296552

  12. Clinical aspects and perinatal outcomes after cryopreservation of embryos and gametes.

    PubMed

    Rodriguez-Wallberg, K A

    2015-04-01

    Cryopreservation techniques play today a central role in assisted reproduction, as they enhance the overall efficacy of in vitro fertilization (IVF) treatments by allowing the banking of supernumerary embryos obtained in these treatments, and their later use. The transfer of frozen/thawed embryos was established nearly 30 years ago, and although it has been clinical routine for a long time, the importance of freezing embryos has been newly emphasized. As recognized downsides of IVF treatment include the high prevalence of perinatal complications due to multiple births, the recommended practice of transferring fewer embryos in the fresh IVF treatment cycle, with the goal of performing single embryo transfer and the cryostorage of remaining embryos for their later use in frozen-thawed cycles, one at a time, is currently the trend. Also of great importance, cryopreservation techniques for spermatozoa and oocytes have additionally permitted gamete storage for long-term and the implementation of several new treatment modalities for assisted reproduction. Most of these methods are applied today in clinical programs of fertility preservation and third-part reproduction, such as sperm- and egg donor programs. Use of frozen thawed sperm has been in clinical use for over 50 years and banking sperm has been routinely offered to men, usually before gonadotoxic treatments, but also in many cases, practised as a "safety policy" previously to a vasectomy. Freezing methods for women's egg have required a much longer time to achieve a comparable effective clinical standard. Only recently, with the development of vitrification of oocytes, the clinical standard was recognized and since 2013 when the label "experimental" was removed, the freezing of oocytes could be regarded as an established method, and its use extended into clinical practice for fertility preservation but also performed after personal requirements, so called, "social freezing". PMID:25714875

  13. Statistics.

    PubMed

    1993-02-01

    In 1984, 99% of abortions conducted in Bombay, India, were of female fetuses. In 1986-87, 30,000-50,000 female fetuses were aborted in India. In 1987-88, 7 Delhi clinics conducted 13,000 sex determination tests. Thus, discrimination against females begins before birth in India. Some states (Maharashtra, Goa, and Gujarat) have drafted legislation to prevent the use of prenatal diagnostic tests (e.g., ultrasonography) for sex determination purposes. Families make decisions about an infant's nutrition based on the infant's sex so it is not surprising to see a higher incidence of morbidity among girls than boys (e.g., for respiratory infections in 1985, 55.5% vs. 27.3%). Consequently, they are more likely to die than boys. Even though vasectomy is simpler and safer than tubectomy, the government promotes female sterilizations. The percentage of all sexual sterilizations being tubectomy has increased steadily from 84% to 94% (1986-90). Family planning programs focus on female contraceptive methods, despite the higher incidence of adverse health effects from female methods (e.g., IUD causes pain and heavy bleeding). Some women advocates believe the effects to be so great that India should ban contraceptives and injectable contraceptives. The maternal mortality rate is quite high (460/100,000 live births), equaling a lifetime risk of 1:18 of a pregnancy-related death. 70% of these maternal deaths are preventable. Leading causes of maternal deaths in India are anemia, hemorrhage, eclampsia, sepsis, and abortion. Most pregnant women do not receive prenatal care. Untrained personnel attend about 70% of deliveries in rural areas and 29% in urban areas. Appropriate health services and other interventions would prevent the higher age specific death rates for females between 0 and 35 years old. Even though the government does provide maternal and child health services, it needs to stop decreasing resource allocate for health and start increasing it. PMID:12286355

  14. Meeting health and family planning needs in Latin America and the Caribbean.

    PubMed

    1995-06-01

    The operations research and technical assistance (OR/TA) project in The Population Council has concentrated on fertility and infant mortality issues in Latin American and the Caribbean for more than a decade through INOPAL. INOPAL is an acronym for Investigacion Operacional en Planificacion Familiar y Atencion Materno-Infantil para America Latina y el Caribe (Operations Research in Family Planning and Maternal-Child Health in Latin America and the Caribbean). In March 1995, the project entered its third phase, INOPAL III, with the renewal of its contract from the United States Agency for International Development (USAID). To facilitate communication between INOPAL, collaborating agencies, and USAID, INOPAL Director James Foreit moved from Peru to a Council office in Washington, D.C. INOPAL has six objectives: 1) to test the integration of family planning and reproductive health services; 2) to increase access to family planning; 3) to develop strategies to reach special populations; 4) to improve the sustainability of family planning programs; 5) to improve service quality; and 6) to institutionalize operations research capability in the region. INOPAL II conducted 61 subprojects in 12 countries in collaboration with 24 USAID cooperating agencies and other international organizations. The project established new services for postpartum women, adolescents, and rural women; improved program quality and financial sustainability; increased vasectomy promotion and the range of available contraceptives; and developed new modes of service delivery. A key finding of INOPAL II operations research was the importance of increasing cost-effectiveness to ensure program sustainability. INOPAL III will work toward all six objectives, with an emphasis on integrating reproductive health and family planning services. Operations research and technical assistance (OR/TA) subprojects will focus on the prevention and treatment of sexually transmitted diseases, perinatal and postpartum care, and postabortion care. PMID:12319543

  15. Thai family planner uses humor, good sense.

    PubMed

    Cantlay, C

    1984-01-01

    This article is a proflie of Khun Mechai, a leader in the Thai family planning field who was instrumental in creating the community-based contraceptive distribution program which began in 1973 with the 1st in a series of grants from the International Planned Parenthood Federation (IPPF). The community-based distribution program is active in some 16,000 villages and neighborhoods throughout Thailand. The Community-Based Family Planning Service (CBFPS) was established in 1974 with Khun Mechai as secretary general to coordinate the efforts of the nationwide network. The CBFPS has been linked with a massive, humorous, and creative campaign of "desensitization": Khun Mechai passes out condoms at official dinners, and honors the king's birthday with an annual free vasectomy marathon. As a result of his efforts, family planning is no longer a taboo topic and no longer the exclusive province of government bureaucrats and medical professionals. Khun Mechai's basic concern is in improving access to family planning services by overcoming physical and sociocultural distance and by providing an acceptable method of service delivery. All family planning activities of the Population and Community Development Association, the CBFPS parent organization, are voluntary. Links have been created between family planning and personal and community betterment to help motivate acceptance. Khun Mechai became acquainted with the country' development needs as a young economist with the National Economic and Social Development Board. His family planning activities grew out of his conviction that rapid, unplanned population growth is Thailand's and the world's single most serious problem. An incremental approcah with insistence on individual and local responsibility for development is essential to his philosphy and personality. PMID:12266279

  16. Ethical issues in male sterilization in developing countries.

    PubMed

    Rizvi, S A; Naqvi, S A; Hussain, Z

    1995-11-01

    The history of sterilization dates back to the time of Hippocrates, when female sterilization was recommended for preventing hereditary mental diseases. James Blundell introduced surgical sterilization in 1823 for the prevention of high risk pregnancies. Vasectomy was first performed in the US at the end of the 19th century, mainly to prevent hereditary disorders. Male sterilization was a means of genocide during Nazi rule in Germany. Religious beliefs have the most powerful impact on the practice or nonpractice of family planning. In the teachings of Islam, Christianity, and Judaism, only sporadic references explicitly prohibit contraception, yet various religious edicts have interpreted these references too broadly by advocating prohibition of most contraceptive methods. Recently, the world community endorsed the basic right of couples to decide the number of children they want and the right to family planning with free informed choice. An integral part of a successful family planning program is voluntarism. In Europe and North America sterilization is legal, except in Italy, France, and Turkey. In Latin America sterilization is illegal in a number of countries; in Burma and Vietnam restrictions are in place; and in Africa fertility regulation is illegal in one-third of the countries. Informed consent before sterilization during counseling by a skilled, unbiased counselor is indispensable. All family planning services should be part of the national health care system including the voluntary contraception services. Incentives may compromise voluntarism. Most programs require a minimum age and a minimum number of children, marital status, and spousal consent. For sterilization, a waiting period of 1-30 days has been recommended. The exclusion of childless and single individuals has been challenged as a violation of human rights. For mentally retarded people parents or guardians provide consent. Major ethical issues in the future could emerge concerning novel fertility techniques: cryopreservation of sperm and intracytoplasmic sperm injection. PMID:8535748

  17. Advocacy in the Western Hemisphere Region: some FPA success stories.

    PubMed

    Andrews, D J

    1996-01-01

    The International Planned Parenthood Federation's Vision 2000 Strategic Plan has emphasized advocacy and the training of family planning associations (FPAs) in the Western Hemisphere region. During the summer of 1995 training programs in advocacy leadership management were sponsored for six FPAs in the Bahamas, Suriname, Belize, Colombia, Honduras, and Brazil. At the Western Hemisphere Regional Council Meeting in September 1995 awards were presented to FPAs for media outstanding projects. These FPAs used outreach to the community to promote the goals of Vision 2000. The Bahamas FPA won the Rosa Cisneros Award for articles published in a magazine that is distributed in primary and secondary schools and deals with the activities, achievements, and opinions of students. Issues include: love, relationships, responsibility, and teen pregnancy. A weekly television talk show also addresses the issues facing youth including education, music, community work, sexuality, pregnancy, and the relationship between teenagers and adults. The Family Planning Association of Honduras was also nominated for the award for a radio show on the health of mothers and children, the problems of adolescents, and FP. The newspaper Tiempo received the award for feature articles on social issues and FP. In 1994 the Association distributed thousands of booklets on contraceptives as well as fliers on vasectomy, female sterilization, oral contraceptives, IUDs, condoms, responsible parenthood, high-risk pregnancy, vaginal cytology, and cervical cancer. Similar posters were placed in hospitals and health centers, in 1997 FP posts, and 400 commercial outlets. The Family Planning Association of Suriname also carried out an impressive advocacy program during the period of 1968-93 with the goals of establishing a balance between population growth and the available resources to achieve well-being with regard to education, health care, nutrition, and housing. PMID:12291093

  18. Testicular obstruction: clinicopathological studies.

    PubMed Central

    Hendry, W. F.; Levison, D. A.; Parkinson, M. C.; Parslow, J. M.; Royle, M. G.

    1990-01-01

    Genital tract reconstruction has been attempted in subfertile men with obstructive azoospermia (370 patients) or unilateral testicular obstruction (80 patients), and in vasectomised men undergoing reversal for the first (130 patients) or subsequent (32 patients) time. Histopathological changes in the obstructed testes and epididymes, and immunological responses to the sequestered spermatozoa have been studied to gain insight into possible causes of failure of surgical treatment. The results of surgery have been assessed by follow-up sperm counts and occurrence of pregnancies in the female partners. The best results were obtained with vasectomy reversal (patency 90%, pregnancy 45%), even after failed previous attempts (patency 87%, pregnancy 37%). Epididymovasostomy gave good results with postinfective caudal blocks (patency 52%, pregnancy 38%), while postinfective vasal blocks were better corrected by total anatomical reconstruction (patency 73%, pregnancy 27%) than by transvasovasostomy (patency 9%, no pregnancies). Poor results were obtained with capital blocks (patency 12%, pregnancy 3%), in which substantial lipid accumulation was demonstrated in the ductuli efferentes; three-quarters of these patients had sinusitis, bronchitis or bronchiectasis (Young's syndrome). There is circumstantial evidence to suggest that this syndrome may be a late complication of mercury intoxication in childhood. After successful reconstruction, fertility was relatively reduced in those men who had antibodies to spermatozoa, particularly amongst the postinfective cases. Similarly, impaired fertility was found in men with unilateral testicular obstruction and antibodies to spermatozoa. Mononuclear cell infiltration of seminiferous tubules and rete testis was noted occasionally, supporting a diagnosis of autoimmune orchitis; although rare, this was an important observation as the sperm output became normal with adjuvant prednisolone therapy. Images Figure 4 Figure 6 Figure 7 Figure 10 Figure 11 Figure 12 Figure 14 PMID:2241062

  19. Men in Bangladesh play a role in family planning.

    PubMed

    Ahsan, S B

    1992-08-01

    More and more men are convincing their wives to use family planning in Bangladesh. In this conservative, Moslem country, women are not allowed to leave the homes so husbands must go to buy methods especially rural areas. 70% of women who use oral contraceptives (OCs), IUDs, or condoms report that their husbands obtain these method for them. many couples are poor peasants. Contraceptive prevalence is not 23.2%. Female sterilization and OCs are the 2 most popular methods (9% each) followed by condoms (2%), IUD (1.7%), and vasectomy (1.5%). The total fertility rate is 4.8 which is higher than the goal of 3.5 Bangladesh hoped to reach by 1995. In 1975, 30% of women believed fate determines family size but now only 8% think that. Attitude changes about family size have occurred despite illiteracy and poverty. Traditional religious beliefs are still prevalent in rural areas making it difficult for wives to speak to their husbands about family planning. Husband-wife communication is more open among urban, middle class couples. The long lasting hormonal implant, Norplant, holds promise as a means for Bangladesh to reach its goal. About 4500 women now have Norplant and government and nongovernment clinics plan to insert it into around 20,000 more women. A study of 2586 potential acceptors of Norplant at family clinics in Bangladesh 3 other developing countries shows that counseling diminishes the anxiety women and their husbands experience about Norplant and its side effects. A study in Bangladesh reveals higher continuation rates of Norplant for women whose husbands underwent counseling than for those whose husbands did not undergo counseling. Family planning advertisements on the radio, TV, and in newspapers have convinced couples to use family planning, but the advertisements tend to not explaining how to use family planning. Men are key to the changes in attitude about family planning in Bangladesh. PMID:12317723

  20. Abnormal Accumulation of Collagen Type I Due to the Loss of Discoidin Domain Receptor 2 (Ddr2) Promotes Testicular Interstitial Dysfunction

    PubMed Central

    Zhao, Hu; Bu, Xin; Li, Zhen; Zhao, Jie; Gong, Wei-dong; Wu, Zhi-qun; Yao, Li-bo; Li, Wei; Zhang, Yuan-qiang

    2015-01-01

    Background Loss of functional allele for discoidin domain receptor 2 (Ddr2) results in impaired Leydig cell response to luteinizing hormone (LH), low testosterone production and arrested spermatogenesis in older male Ddr2slie/slie mice. However, the underlying mechanism responsible for this phenotype remains unknown. Herein, we reported for the first time that the deregulated expression of Ddr2 cognate ligand, namely collagen type I (COL1), may account for the disruption of the testicular steroidogenesis in Ddr2slie/slie mutant testes. Methodology/Principal Findings Expression of Ddr2 increased gradually along postnatal development, whereas COL1 expression became negligible from adulthood onwards. In Ddr2slie/slie mutant testis, however, in contrast to the undetectable staining of Ddr2, COL1 expression was constantly detected, with the highest values detected during adulthood. In the experimental vasectomy model, Ddr2slie/slie mutant mice exhibited an early androgen deficiency than wild-type mice, along with the accumulation of fibrotic tissue in the interstitium. Functionally, ablation of endogenous Ddr2 resulted in a significant decrease of testosterone (T) level in TM3 cells in the presence of higher concentration of COL1 treatment. Conversely, overexpression of Ddr2 could help TM3 cells to maintain a normal testicular steroidogenesis even in the presence of high concentration of COL1. Additionally, attenuated expression of Ddr2 correlates to the deregulated level of serum T levels in human pathological testes. Conclusions Abnormal accumulation of interstitial COL1 may be responsible for the steroidogenic dysfunction in Ddr2slie/slie mutant testes. PMID:26158267

  1. Brdt Bromodomains Inhibitors and Other Modern Means of Male Contraception.

    PubMed

    Zdrojewicz, Zygmunt; Konieczny, Radosław; Papier, Paulina; Szten, Filip

    2015-01-01

    Compared to efficient and secure female contraception, a vasectomy and condoms are the only options for men. The choice of male contraceptive methods is limited, so contraception mainly rests on the shoulders of women. Several concepts are considered: testosterone administration--inhibiting pituitary secretion of lutropin (LH) and follicle stimulating hormone (FSH), progestogen--affecting the secretion of gonadotropin and gonadoliberin (GnRH) antagonists. New potential targets for non-hormonal male contraception were discovered: glyceraldehyde-3-phosphate-dehydrogenase (GAPDHS)--specific to male germ cells and voltage-gated cation channel (CatSper). Both are responsible for sperm motility. Drugs such as thioridazine used in schizophrenia treatment and phenoxybenzamine (antihypertensive activity) exhibit a contraceptive effect. Similar action exhibits an analogue of lonidamine--adjudin and an antagonist of retinoic acid receptors (BMS-189453). Researchers are working on a contraceptive vaccine, whose active ingredient is epididymal protease inhibitor (Eppin). Another promising method acts by blocking Bromodomain testis-specific proteins (Brdt) involved in the process of spermatogenesis. JQ1-the Brdt inhibitor causes reversible infertility without affecting the endocrine signaling pathways. A recent discovery of Juno as the binding partner for Izumo1 identifies these proteins as the cell-surface receptor pair, essential for gamete recognition and this interaction can be inhibited by an anti-Juno monoclonal antibody. Our review shows that the situation of men can change and investigators are close to the optimal solution. In the near future men will be able to choose the best contraceptive suited to their needs. PMID:26469117

  2. Optical and thermal simulations of noninvasive laser coagulation of the human vas deferens

    NASA Astrophysics Data System (ADS)

    Schweinsberger, Gino R.; Cilip, Christopher M.; Trammell, Susan R.; Cherukuri, Harish; Fried, Nathaniel M.

    2011-03-01

    Successful noninvasive laser coagulation of the canine vas deferens, in vivo, has been previously reported. However, there is a significant difference between the optical properties of canine and human skin. In this study, Monte Carlo simulations of light transport through tissue and heat transfer simulations are performed to determine the feasibility of noninvasive laser vasectomy in humans. A laser wavelength of 1064 nm was chosen for deep optical penetration in tissue. Monte Carlo simulations determined the spatial distribution of absorbed photons inside the tissue layers (epidermis, dermis, and vas). The results were convolved with a 3-mm-diameter laser beam, and then used as the spatial heat source for the heat transfer model. A laser pulse duration of 500 ms and pulse rate of 1 Hz, and cryogen spray cooling were incident on the tissue for 60 s. Average laser power (5-9 W), cryogen pulse duration (60-100 ms), cryogen cooling rate (0.5-1.0 Hz), and increase in optical transmission due to optical clearing (0-50 %), were studied. After application of an optical clearing agent to increase skin transmission by 50%, an average laser power of 6 W, cryogen pulse duration of 60 ms, and cryogen cooling rate of 1 Hz resulted in vas temperatures of ~ 60°C, sufficient for thermal coagulation, while 1 mm of the skin surface (epidermis and dermis) remained at a safe temperature of ~ 45 °C. Monte Carlo and heat transfer simulations indicate that it is possible to noninvasively thermally coagulate the human vas without adverse effects (e.g. scrotal skin burns), if an optical clearing agent is applied to the skin prior to the procedure.

  3. Barriers to male involvement in contraceptive uptake and reproductive health services: a qualitative study of men and women’s perceptions in two rural districts in Uganda

    PubMed Central

    2014-01-01

    Background Spousal communication can improve family planning use and continuation. Yet, in countries with high fertility rates and unmet need, men have often been regarded as unsupportive of their partner’s use of family planning methods. This study examines men and women’s perceptions regarding obstacles to men’s support and uptake of modern contraceptives. Methods A qualitative study using 18 focus group discussions (FGDs) with purposively selected men aged 15–54 and women aged 15–49 as well as eight key informant interviews (KIIs) with government and community leaders was conducted in 2012 in Bugiri and Mpigi Districts, Uganda. Open-ended question guides were used to explore men and women’s perceptions regarding barriers to men’s involvement in reproductive health. All FGDs and KIIs were recorded, translated, and transcribed verbatim. Transcripts were coded and analyzed thematically using ATLAS.ti. Results Five themes were identified as rationale for men’s limited involvement: (i) perceived side effects of female contraceptive methods which disrupt sexual activity, (ii) limited choices of available male contraceptives, including fear and concerns relating to vasectomy, (iii) perceptions that reproductive health was a woman’s domain due to gender norms and traditional family planning communication geared towards women, (iv) preference for large family sizes which are uninhibited by prolonged birth spacing; and (v) concerns that women’s use of contraceptives will lead to extramarital sexual relations. In general, knowledge of effective contraceptive methods was high. However, lack of time and overall limited awareness regarding the specific role of men in reproductive health was also thought to deter men’s meaningful involvement in issues related to fertility regulation. Conclusion Decision-making on contraceptive use is the shared responsibility of men and women. Effective development and implementation of male-involvement family planning initiatives should address barriers to men’s supportive participation in reproductive health, including addressing men's negative beliefs regarding contraceptive services. PMID:24597502

  4. [Family planning in China].

    PubMed

    Suyin, H

    1972-01-01

    Family planning in People's Republic of China between 1956 to 1970 has been marked by rapid change and total interrelation with the political and social developments. Since 1949, the Communist government has taken several measures to protect the mother and child. The campaign for family planning was started in 1956 by public meetings, posters, lectures with films, and an extensive distribution of contraceptive means. However, in 1965 there were still 2 trends among women: 1, based on tradition, supported the idea that a large number of children was a source of honor, prosperity and security; the other taking hold among younger women was in favor of family planning. The rural population was the latest to start practicing family planning. In 1963 a movement of socialist education was launched together with the formation of mobile medical teams to inform and educate people all over the country and to make known the various forms available for family planning. The contraceptive methods used included: male and female sterilisation (vasectomy for men and tube ligation for women), IUD, and condom; abortion, legal for women who already had children or if it was necessary for the mother's health; and oral contraceptives, which were produced in China. Medical services were reorganized and teams of "bare-foot doctors" were sent all over China. They lectured on health measures and fertility regulation. Intellectuals were sent to live in villages and exchange their knowledge with that of the peasants and workers. The tendency has been to limit the number of children to 2 or 3. The young people are recommended to postpone their marriage, women till they are 25, men till later. Nationally produced contraceptive means are being experimented with such as herbs, or a new intrauterine plastic device called "flower". The regions with national minorities like Tibet, the Inner Mongolia and Sinkiang had been under underpopulated and therefore population growth has been encouraged mainly by trying to irradicate diseases. PMID:12306192

  5. High-Frequency Ultrasound Imaging of Noninvasive Laser Coagulation of the Canine Vas Deferens

    PubMed Central

    Cilip, Christopher M.; Pierorazio, Phillip M.; Ross, Ashley E.; Allaf, Mohamad E.; Fried, Nathaniel M.

    2011-01-01

    Background and Objectives A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery (e.g. hematoma, infection, acute and chronic pain, sterilization failure) and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. In this study, high-frequency ultrasound is used to confirm successful laser thermal coagulation and scarring of the vas in a short-term canine model. Materials and Methods Bilateral noninvasive laser coagulation of the vas was performed in a total of 9 dogs using a laser wavelength of 1075 nm, incident power of 9.0 W, pulse duration of 500 ms, pulse rate of 0.5 Hz, and 3-mm-diameter spot. Cryogen spray was used to cool the scrotal skin surface and prevent burns during the procedure. A clinical ultrasound system with a 13.2-MHz high-frequency transducer was used to image the vas before after the procedure. Burst pressure measurements were performed on excised vasa to confirm thermal occlusion. Results Day 0 and 28 burst pressures averaged 291 ± 31 mmHg and 297 ± 26 mmHg, respectively, significantly greater than ejaculation pressures of 136 ± 29 mmHg. Ultrasound showed a hyperechoic vas segment after thermal coagulation (Day 0) and scarring (Day 28). Doppler ultrasound showed normal blood flow through the testicular artery, indicating no collateral thermal damage to proximal structures. Conclusions High-frequency ultrasound may be used as a noninvasive diagnostic tool to assist in determining successful short-term laser thermal coagulation and scarring of the vas. PMID:21956632

  6. Review and follow-up of patients using a regional sperm cryopreservation service: ensuring that resources are targeted to those patients most in need.

    PubMed

    Tomlinson, M; Meadows, J; Kohut, T; Haoula, Z; Naeem, A; Pooley, K; Deb, S

    2015-07-01

    Are all patients undergoing chemotherapy for long-term sperm banking at risk of permanent sterility? Male fertility is generally lower in men with cancer and all patient groups are at risk of azoospermia. Careful management is required to ensure that samples are not stored for excessively long periods should they not be required. A retrospective analysis of 1688 patient records and prospective recall of patients for semen testing were performed. Pre-therapy fertility was compared with a group of pre-vasectomy patients as a comparator. Those who fail to bank spermatozoa, rates of disposal of samples and the utilization in assisted reproduction were also examined. Sperm quality was poorest in testicular cancer (TC) patients followed by those with Hodgkin's lymphoma (HL) prior to treatment. Post-therapy data were available in 376 patients (42%). Sperm number was lowest (and azoospermia highest at 77%) in patients with HL treated with regimens other than adriamycin, bleomycin, vinblastine and dacarbazine (ABVD). Non-HL NHL and leukaemic patients had similarly high rates of azoospermia at 46 and 55%. HL patients treated with ABVD (11%) and TC patients (9.7%) had the lowest rates of azoospermia. Azoospermia was seen in every treatment group except for TC patients receiving carboplatin. Only 45 patients used their samples in ART (4.5%) in 10 years. Little is known about the fertility status of the patients not coming forward for follow-up testing, those conceiving naturally, those with no intention of conceiving and some which may have psychological reasons for not attending. In conclusion, virtually all patients undergoing chemotherapy are potentially at risk of temporary or permanent infertility. However, as uptake and utilization of stored material remain low, sperm banks should be carefully managed to ensure that resources are targeted to the patients most in need. PMID:26084986

  7. Inhibin B in seminal plasma: testicular origin and relationship to spermatogenesis.

    PubMed

    Anderson, R A; Irvine, D S; Balfour, C; Groome, N P; Riley, S C

    1998-04-01

    In men, inhibin B is the circulating isoform involved in the regulation of follicle stimulating hormone (FSH) secretion. Within the testis, inhibin B may have a role in Sertoli and germ cell interactions, thus secretion into seminal plasma may reflect seminiferous tubule function. Using specific immunoassays, inhibin B was present in seminal plasma in fertile men (n = 105) and in unselected men attending an infertility clinic (n = 174) with a wide range in concentration from undetectable (<15 pg/ml) up to 54,100 pg/ml (geometric mean 280 pg/ml). There was a highly significant correlation between seminal plasma inhibin B concentration and sperm concentration (r = 0.46, P < 0.001), but no correlation with percentages of spermatozoa with progressive motility or normal morphology. Inhibin A and isoforms containing pro and alphaC immunoreactivity were not detectable. In post-vasectomy seminal plasma samples (18 of 20) inhibin B was undetectable, indicating that the testis is the predominant source. In unselected men attending an infertility clinic, inhibin B was undetectable in 17% (present in remainder; maximum concentration 26,200 pg/ml; mean 263 pg/ml), with a highly significant correlation between seminal plasma inhibin B and sperm concentration (r = 0.55, P < 0.0001). In men with oligo/ azoospermia (sperm concentration <20 x 10(6)/ml), seminal plasma inhibin B concentrations were lower in those with elevated plasma FSH concentrations (mean values 42 and 205 pg/ml, P < 0.05). Inhibin alpha and betaB subunits were localized predominantly in Sertoli and Leydig cells, using immunohistochemistry. We conclude that inhibin B of testicular origin is present in normal human seminal plasma, but with a very wide range in concentration, and may reflect the functional state of the seminiferous epithelium. PMID:9619549

  8. Some aspects of the sterilization program in Malaysia.

    PubMed

    Arshat, H; Ali, J; Noor Laily Abu Bakar

    1984-06-01

    Sterilization is most often indicated when the desired family size is reached and no more children are desired. Because of technical advances and societal changes surgical sterilization is increasingly becoming the most utilized method of contraception. Since female sterilization is more common, several methods have been devised to make it safe and reliable. The traditional large abdominal incision (laparotomy) is now replaced by minilaparotomy, which is a small abdominal incision. Other techniques, such as transvaginal and trancervical approaches require no incision at all. These method permit occlusion of any part of the fallopian tube. Minilapatomy is the recommended method of female sterilization for 3rd world countries. Laparoscopic sterilization appears to be more psychologically acceptable to 3rd world women who have an inherent dread of surgery. A higher incidence of hematoma formation has been reported in puerperal laparoscopic sterilizations and the failure rate is also higher than in other methods. Other complications associated with laparoscopic sterilization include wound sepsis, surgical emphysema of the parieties and uterine perforation. Laparoscopic sterilizations can be performed under local, general, spinal or epidural anesthesia. Local and general anesthesia is the commonest. Both tubal ligations and vasectomies have been available in Malaysia since the 1960s. Laparoscopy was 1st introduced in Malaysia in the early 1970s. Several laparoscopy centers have been established in Malaysia to provide specialized family planning services. Outpatient laparoscopic sterilization is a feature of the Kuala Lumpur Specialist Center. Traditonally doctors and specialists in Malaysia received their practical training in sterilization techniques during their internship or residency. Since 1980, however, a formal training program was initiated. Because laparoscopy provides interval sterilization without major abdominal surgery, this procedure has played a major role in promoting acceptance of female sterilization. The use of mass media to promote sterilization has not been fully utilized because of religious and political sensitivities. PMID:12267515

  9. Population policy forum. Men, the Church, and pleasure.

    PubMed

    Hunt, M E

    1991-01-01

    I applaud Marge Berer's initial proposal on feminist population police, demonstrating that feminists are capable of construction as well as criticism. Such creative efforts, while partial, are what keep the conversation going and us in it. Several points deserve to be highlighted as they point toward much needed changes in public policy. One is the need to shift the overwhelming burden of reproduction from women alone to society in general and men in particular. This is not to give an inch on women;s moral agency and primary decision making. To the contrary, it is to insist that male birth control be an integral part of all population policies in action as well as in regulations. Rates of tubal ligations and vasectomies in most countries show that women assume more than a fair share, men doing comparative little. Another important element is the role of religion as a shaper of social policy, the Catholic church worldwide being the prime example of how sex education, birth control, and abortion are regulated as much be theology as by law. Feminist s ignore this reality in our peril, though dealing head on with it, as some religious professions have found out, is also dangerous. The fact that the majority of women of childbearing age in the US ignore the church's pronouncements and use contraception shows that the ideological strangle hold is slipping. We can loosen it further. A related, though perhaps less politically correct, concern in such a feminist proposal is the place of sexual pleasure for its own sake. While public policy is not typically concerned with such matters, education is needed for women to feel entitled to separate sex from procreation, to enjoy the full range of sexual activities for which reproduction is but 1 possible outcome. This, after all, is a major feminist achievement that deserves to made available without delay] PMID:12178839

  10. Advances in Male Contraception

    PubMed Central

    Page, Stephanie T.; Amory, John K.; Bremner, William J.

    2008-01-01

    Despite significant advances in contraceptive options for women over the last 50 yr, world population continues to grow rapidly. Scientists and activists alike point to the devastating environmental impacts that population pressures have caused, including global warming from the developed world and hunger and disease in less developed areas. Moreover, almost half of all pregnancies are still unwanted or unplanned. Clearly, there is a need for expanded, reversible, contraceptive options. Multicultural surveys demonstrate the willingness of men to participate in contraception and their female partners to trust them to do so. Notwithstanding their paucity of options, male methods including vasectomy and condoms account for almost one third of contraceptive use in the United States and other countries. Recent international clinical research efforts have demonstrated high efficacy rates (90–95%) for hormonally based male contraceptives. Current barriers to expanded use include limited delivery methods and perceived regulatory obstacles, which stymie introduction to the marketplace. However, advances in oral and injectable androgen delivery are cause for optimism that these hurdles may be overcome. Nonhormonal methods, such as compounds that target sperm motility, are attractive in their theoretical promise of specificity for the reproductive tract. Gene and protein array technologies continue to identify potential targets for this approach. Such nonhormonal agents will likely reach clinical trials in the near future. Great strides have been made in understanding male reproductive physiology; the combined efforts of scientists, clinicians, industry and governmental funding agencies could make an effective, reversible, male contraceptive an option for family planning over the next decade. PMID:18436704

  11. Have you heard the rumour?

    PubMed

    Nakato, L

    1994-01-01

    Rumors and misinformation about the use of contraceptives can arise from general fears about contraception, fears about specific methods, and fears based on a poor understanding of human physiology. In Uganda, general fears about contraception include the notion that usage encourages promiscuity in women, that contraception causes sickness, and that the use of contraception is not socially acceptable. Specific fears about oral contraceptives include the notions that they burn all the women's eggs, that they cause changes in weight, that they cause high blood pressure, and that they are not effective. Specific fears about the IUD are that it can move within the body and that a woman can conceive with it in place (which is true). The condom is thought to be able to disappear in the uterus or to slip off inside a woman's body and require surgical removal. Vasectomy is believed to make men impotent or mentally disturbed. Tubal ligation is thought to stop menstruation or to "overturn" the tubes. Medical personnel can be the source of some of these rumors when they lack appropriate training. Uninformed users can also start rumors. In order to combat these misconceptions and increase the practice of family planning (FP) in Uganda, the FP delivery system must be standardized, FP personnel must be adequately trained, FP providers must counsel clients, satisfied users should disseminate FP information and motivation in their communities, and IEC (information, education, and communication) programs should be increased. In addition to misconceptions, nutritional and sexual taboos affect maternal and child health in Uganda. Some prohibit women from eating high protein foods; others prohibit pregnant women from eating salt. Other practices include 1) deciding whether an infant is really a member of the clan by the behavior of its dried umbilical cord when thrown in water and 2) allowing men instead of women to decide how many children a woman should have. PMID:12318958

  12. Y-STRs in forensic medicine: DNA analysis in semen samples of azoospermic individuals.

    PubMed

    Soares-Vieira, Jos Arnaldo; Billerbeck, Ana Elisa Correia; Iwamura, Edna Sadayo Miazato; Zampieri, Ricardo Andrade; Gatts, Gilka Jorge Fgaro; Munoz, Daniel Romero; Hallak, Jorge; Mendonca, Berenice Bilharinho; Lucon, Antonio Marmo

    2007-05-01

    The incidence of rape has increased, especially in metropolitan areas, such as the city of So Paulo. In Brazil, studies about it have shown that the majority of this type of crime is committed by the relatives and persons close to the victim. This has made the crime more difficult to be denounced, as only 10% of the cases are reported to competent police authorities. Usually, cytological exams are carried out in sex crime investigations. The difficulty in showing the presence of spermatozoa is frequent, but it does not exclude the presence of male DNA. The absence of spermatozoa in material collected from rape victims can be due to several factors, including the fact that the agressor suffers from azoospermia. This condition can be the result of a successful vasectomy. As the majority of DNA in the ejaculation sample is from spermatozoa, there is much less DNA to be analyzed. This study presents the application of Y-STRs (DYS19, DYS389I, DYS389II, DYS390, DYS391, DYS392, and DYS393) in DNA analysis of sperm samples from 105 vasectomized men. The study demonstrated a great variation in DNA concentration. DNA extraction and amplification was possible in all sperm samples even in the absence of spermatozoa. The same profile was observed, for each individual, from DNA extracted from blood, pre- and postvasectomy semen samples. The use of markers specific for Y chromosome in sex crime cases, especially in the absence of spermatozoa, is very important, mainly because in most situations there is a small quantity of the agressor's DNA in the medium and a large quantity of the victim's DNA. PMID:17456093

  13. Contraceptive use in China.

    PubMed

    Perkin, G W; Genstein, J; Morrow, M

    1980-01-01

    An estimate is made of the relative use of the various contraceptive methods--IUDs, sterilization, oral contraceptives (OCs), condoms, injectable contraceptives, abortion, and other contraceptive products approved for general use but only available in limited supply--in China at this time. All of the major contraceptive methods are available without cost. The user is permitted to be absent from work with pay when he/she chooses either IUD insertion/removal, vasectomy, tubal ligation, and induced abortion. IUDs, OCs, sterilization, and condoms account for most of the contraceptive practice in China. Abortion is also available, particularly as a backup to failed contraception. A look at the family planning program in the major municipal area of Tianjin provides an indication of the impact of the national planned birth program. In Tianjin, contraceptives are distributed without cost through the union representative or in the commune. Many men and women obtain their contraceptive supplies at work. The Tianjin program of social and economic incentives and disincentives is typical of such programs throughout China, but the specific details vary from province to province. There are many advantages to having the "only-child certificates" issued by the Tianjin Municipal Revolutionary Council. Economic sanctions are recommended for couples who have a 2nd child. The IUD is the most widely used method in China and is the method most often recommended for women living in rural areas. The IUD may account for as much as 50% of national contraceptive practice. The most widely used IUD consists of a single ring of tightly coiled stainless steel wire. Male and female sterilization is available in most parts of China and accounts for about 30% of contraceptive practice. OC use may be estimated to account for about 8-10% of national contraceptive practice. The condom accounts for about 6% of national contraceptive practice and the injectable for about 1% of total contraceptive use. PMID:12311625

  14. [Family planning among lower status women in Rio de Janeiro city].

    PubMed

    Costa, S H; Martins, I R; Pinto, C S; Freitas, S R

    1991-08-14

    The National School of Public Health aided by WHO conducted a survey between 1984 and 1985 in 7 communities of Rio de Janeiro, Brazil, enlisting 1900 women aged 15-49 from 2019 households selected. 1783 were interviewed, yielding a response rate of 92%. 538 (30%) women were single, 7.2% of who had no sexual experience. 4.5% of the sample were widowed, divorced, or separated. Their familiarity with contraceptives was as follows: oral contraceptives, (OCs) 99.7%; female sterilization and the condom, 90%; coitus interruptus and vasectomy; 33%; the diaphragm, 27%; and natural methods; 22%. 83% of the women used OCs; less than 20% used the condom, coitus interruptus, or spermicides; and 5% had used the IUD. 8% of those 40 decided on tubal sterilization. 67% of the women in sexual unions used contraceptives vs. 35% of single women with sexual activity. Nonuse increased after age 35, while more than 50% of women 20 did not use contraceptives. Half of the sterilized women underwent the procedure before age 30 when they had 4 children. 66% of ligations were done during birth, and accompanied 63% Cesarean section. Only 28 of sterilizations were done by laparoscopy on another occasion. Misinformation about sterilization was rife, as 15% of sterilized women states that they wanted to bear a child in the future, and 11% thought that they could get pregnant. 42% of women aged 35 and over were sterilized by laparoscopy. In hospitals and clinics the average sterilized woman was 29.4 years old and had 3.5 children. Contraceptive prevalence was higher than the national average, it was comparable to the level in countries that have traditionally low fertility. The fact that OCs, the pill, and tubal ligation made up the predominant pattern of contraceptive use is the result of the inability of the health care system to provide an integrated family planning program with education about and provision of contraceptives. PMID:12344982

  15. Constraints in the development of contraceptives for men.

    PubMed

    Puri, C P; Gopalkrishnan, K; Iyer, K S

    2000-09-01

    Considerable efforts have been made to develop a male contraceptive and the studies have provided very useful information in this field. At least five different strategies to develop a male contraceptive have been pursued, namely: inhibition of sperm production, interference with sperm function, interruption of sperm transport, prevention of sperm deposition, and prevention of sperm-egg interaction. Of all these approaches, inhibition of sperm production by using androgens either alone or in combination with progestins have given the most encouraging results. A number of clinical trials substantiate that it is indeed possible to have a reversible, effective and safe hormonal method of contraception. A postmeiotic and epididymal approach to interfere with sperm function or the secretory and metabolic processes of the epididymis is another attractive option of male contraceptive development. A number of chemical compounds have been identified which interfere with sperm function in the epididymis without affecting sperm production, however, the compounds evaluated so far were found to be toxic. Interruption of sperm transport through the vas either by vasectomy or percutaneous intravasal injection of liquids which form cure-in-place plugs is also an attractive option. However, reversibility of the methods is of concern in their wide scale use. The major constraint in developing a long-acting male contraceptive seems to be the need for greater investment for product development. The clinical trials for evaluating the efficacy and safety of the new products and formulations stretch over several years and require enormous financial commitment. Nevertheless, the long-term gain of having a long-acting reversible contraceptive for men is far greater than the financial commitments over few years. Male attitude towards using methods of family planning is much more favourable than originally believed. The pharmaceutical industry as well as the health care providers therefore have a greater responsibility. For early development of a contraceptive for men, it is essential to increase investment and simplify the drug regulatory procedures. The advent of newer technologies coupled with the convergent efforts of scientists will certainly make it possible to have an effective, safe and reversible male contraceptive in the near future. PMID:11225976

  16. Family planning in industrial units.

    PubMed

    1970-01-01

    The Family Planning Association of Pakistan conducted a survey of existing Family Planning Services in industrial units in cooperation with the Government of Pakistan, Family Planning Division. In East Pakistan the Association in cooperation with the Family Planning Council selected 3 areas for this survey, in Khulna a Jute Mill, in Sylhet a Tea Estate, and in Naryangnaj (a suburb of Dacca), a cotton mill. The purpose of the survey was to ascertain the extent of the knowledge, attitude, and practice of family planning in an industrial sample in the context of the national family planning program. A further objective was to explore the possibilities of establishing family planning motivational centers in industrial units. This was the first study of its kind undertaken in Pakistan. Monogamy is the practice among the industrial laborers. 83.99% of the respondents married once only, and 97.4% have 1 wife currently with them. The mean number of years of married life is 12.88 years. The estimated mean age of all respondents is 37.2 years. At present the mean number of living children is 4.08, 2.13 boys and 1.95 girls. The desired number of children is 4.35, 1.76 girls and 2.59 boys. 69.98% of the respondents have knowledge of family planning, and level of education is closely associated. Vasectomy is the best known method followed by tubal ligation. Of the 1349 respondents, 735 or 55.97% were in favor of family planning. Only 54 persons or 4% are currently using family planning methods. It is clear from the survey that a great number of laborers are aware of the family planning program. They are also aware of the family planning methods, their uses, and their necessity. On the basis of the findings the establishment of motivational centers with full family planning services in 3 industrial units is recommended. Registration of the eligible couples for easy identification for giving family planning services and follow-ups is also recommended, and it is suggested that there be continual follow-up studies. PMID:12332197

  17. A study of characteristics of women seeking induced abortion.

    PubMed

    Chia Sze Foong

    1982-12-01

    A study was conducted in Malaysia of 148 women seeking induced abortion from doctors. The influence of socioeconomic, ethnic, religious, and educational factors on the practice of induced abortion in Malaysia was examined along with the relationship of induced abortion to the use of contraceptives. 135 of the women were married; 13 were unmarried. 22.3% of the women did not complete primary education, 51.4% of the women completed primary education, and 26.3% completed secondary education. 30.4% of the women were from rural areas, and the remaining 103 women lived in towns and suburbs. 62.2% of the women were housewives, 29.7% were unskilled workers, and 8.1% were skilled workers. 107 women were Buddhist, 31 were Muslims, 4 were Hindus, 2 were Catholics, 2 were Protestants, and 2 were free thinkers. There were 111 Chinese respondents, 28 Malay respondents, and 9 Indian respondents. There were 31 cases with less than 6 weeks of amenorrhea, 93 cases with 6-8 weeks of amenorrhea, 15 cases with between 8-10 weeks of amenorrhea, 7 cases of between 10-12 weeks of amenorrhea, and 2 cases with more than 12 weeks of amenorrhea. Only 53 patients (35.8%) practiced contraception of 1 kind or another. Of this group, the partners of 26 women used condoms, 9 practiced coitus interruptus, 5 used oral contraceptives (OCs), 2 used parenteral contraception, 2 used the traditional method, and the husband of 1 woman had had a vasectomy. The remaining 95 cases (64.2%) who did not use contraception gave the following reasons: side effects of contraception; fear of ill effects of contraception; ignorance of effective contraceptive methods; inconvenience; and husband's refusal for no apparent reason. 83 patients were practicing effective contraception at the time of the interview. Of these, 42 were using OCs, the partners of 24 used condoms, 10 used the IUD, 5 were getting parenteral contraceptives, and 2 had had a tubal ligation. 27 patients indicated at the interview their intention to use contraception after the induced abortion, but they did not indicate the contraceptive method. The remaining 38 patients were not willing nor did they use any effective contraception. Deferring childbirth and limiting family size were 85.8% of the reasons for abortion. There was no significant difference between women deferring childbirth and women limiting family size when comparing the racial, religious characteristics, the period of amenorrhea, occupation, and marital status. PMID:7167082

  18. The Epidemiology of Anti-Sperm Antibodies Among Couples with Unexplained Infertility in North West Bank, Palestine

    PubMed Central

    Yasin, Ahmad Lotfi; Basha, Walid Salim

    2016-01-01

    Introduction Anti sperm antibodies (ASA) can present in serum and semen and they may lead to impair the sperms function leading to infertility. The precise mechanism of generation of these antibodies is yet to be discovered. Aim This study was performed to determine the prevalence of anti-sperm antibodies (ASA) in patients with unexplained infertility. The study was initiated also to explore the possible factors that may associate with ASA formation and how ASA status is associated with pregnancy rates after going with in vitro fertilization – intracytoplasmic sperm injection (IVF-ICSI). Materials and Methods A cross-sectional study was conducted on 42 normal infertile couples consulting Razan Medical Center for Infertility & I.V.F. in Nablus, Palestine, from December 2012 – March 2013. Serum levels of immunoglobulins G (IgG) ASA were measured in participants (males and females) using enzyme-linked immunosorbent assay (ELISA). In addition, participants also filled a questionnaire about the presence of previous varicocele repair, inguinal hernia repair, orchitis, testicular trauma and vasectomy reversal among males and severe coitus bleeding and coitus during menses or puerperium among females. Couples were also asked about previous IVF-ICSI procedures and the outcome of the procedure in terms of either they got pregnant or not. Data was analysed using SPSS software. Results The prevalence of ASA was 14.3% (6/42) among all couples, 9.5% (4/42) among males and 4.8% (2/42) among females. There was no significant relationship between previous varicocele repair, previous inguinal hernia repair, or orchitis and formation of ASA (p value =0.64, 0.56, and 0.26 respectively). Previous trauma, vasovasostomy, severe coitus bleeding and coitus during menses or puerperium were not observed in any of the study sample. ASA did not seem to affect the outcome of IVF-ICSI (p-value =0.54). Conclusion Prevalence of ASA in infertile couples in the north part of Palestine is similar to that obtained worldwide. ASA formation does not relate to any of the studied risk factors and does not seem to associate with pregnancy rate after IVF-ICSI. We recommend further studies using a larger sample size and including all parts of Palestine in order to generalize the obtained results. PMID:27134944

  19. Voices of acceptors. How family planning has touched the lives of five Filipino couples.

    PubMed

    Santos, R P

    1993-03-01

    Five Filipino couples present their experience with family planning (FP). Tomasina Campuso relates that her first exposure to FP was in a high school health class. She then received advice from a health center on the rhythm method and became pregnant before her first wedding anniversary. Two months postpartum she returned to the clinic for oral pills, which caused side effects; she switched to an IUD, which had to be fitted twice before a proper fit was achieved. After the second child, she returned to IUD use. Both parents are happy to have spaced and planned their children. One is currently in preschool and the spacing will make it possible for them to send their first child to college; the second child can be helped through college by the first. Joel and Evelyn Gatdula married as teenagers. Evelyn feels that use of FP has made her look younger in spite of having produced 3 children. Their marriage became stronger because of mutual interest in using FP. Evelyn volunteered to use an IUD after her husband volunteered to use condoms. Evelyn, being a Catholic, expressed that greater guild would be felt if she had more children than she could provide or care for. She talks to friends and family about the advantages of contraception. Loida Bilaoen had a very difficult first pregnancy, was confined to her bed, and relied on intravenous fluids. She was happy to use rhythm, and condoms until the second child was born; thereafter she had a ligation, even though she had two boys. The boys attend a private school and she has returned to nursing school. Violeta was one of 13 children. Her first was born after 5 years of marriage and the second came 6 years later. Initially condoms and rhythm were used; currently she is taking oral pills, which are delivered every other month by an outreach worker. There were some initial side effects of weight loss and then a return of her original weight. She felt that without FP they could not have afforded the luxury of owning modern appliances. Gerry and Divine Cruz, after the birth of twins, chose first an IUD and then vasectomy. The decision meant following their conscience rather than Church doctrine. They hope that their girls will achieve their dreams. PMID:12286378

  20. Importance of male fertility control in family planning.

    PubMed

    Tulsiani, Daulat R P; Abou-Haila, Aida

    2014-01-01

    The world population, currently estimated to be almost seven billion, is expected to double in less than four decades. The projected population growth will cause severe competition for existing resources, not to mention the issue of overcrowding of the planet and additional greenhouse gases that will have an adverse effect on the ecological health of the planet. A recent survey conducted by the United Nations Population Control Division shows that the majority of today's young men in many countries are willing to participate in family planning by taking full control of their fertility, an important global health issue. However, the contraceptive needs of tens of millions of men/couples go unmet every single day and results in millions of unwanted pregnancies. Ever since the approval of the birth control pill by the Food and Drug Administration (FDA) in 1960, scientists have been hoping for a male equivalent. It has, however, been a difficult road, in part because of the complicated science of the male reproductive system. It is easier to control a monthly event of ovulation in women than to regulate the production of millions of fertile spermatozoa every day in men. Thus, the contraceptive options for men have not changed in decades and are still limited to the use of condoms, a timely withdrawal/pulling out (coitus interruptus) or vasectomy, a minor surgical procedure in which the vas deferens is occluded to prevent the release of spermatozoa during ejaculation. The first two approaches have a relatively higher failure rate, whereas the last approach is largely irreversible and not suitable for younger men. In this article, we will discuss various approaches currently available for men to take control of their fertility. Our intention is to discuss the details of three similar approaches that will provide safe, affordable and reversible contraception for men and are close to being approved for use by millions of men around the globe. The availability of safe, reversible and reliable male contraceptives will allow men and women to take full control of their fertility in family planning. PMID:24654689

  1. Directions and potentials of contraceptive research.

    PubMed

    Djerassi, C

    1973-01-01

    The current status of birth control methods is reviewed. No fundamentally new practical birth control agent is in sight for the immediate future which would be more effective than presently employed procedures. The present climate of hypercaution and virulent consumerism penalizes the imaginative approach and encourages minor and safe modifications of existing methods. The scientific community does not lack theoretical leads, but those theories may not be put into practice. Special emphasis is given in this review to the reversible fertility control agents that will be needed during the next decade or 2, notably in developing countries. In the area of abortion, abortifacients, and related agents, the development of chemical abortifacients, preferably administered orally or intravaginally should get very high priority. Chemical agents for abortion fall into 2 classes: 1) those which interfere with embryonic development, and 2) those which lead to expulsion of the embryo or fetus, e.g. prostaglandins. Although there are many publications and books written about ovulation inhibitors, relatively little work has been devoted to developing new steroidal ovulation inhibitors. For fertility control in developing countries, IUDs offer the singular advantage of a 1-shot administration. The development of the copper T IUD is important. Preliminary clinical studies have indicated that the addition of copper results in much lower pregnancy rate and the T shape results in a lower bleeding and expulsion rate. The Food and Drug Administration may extend the time interval between clinical studies and eventual public use of the copper T because it carries a metal. It is not likely that a male pill will be developed in the near future. For males, major advances in vasectomy techniques which would quarantee reversibility upon demand would constitute a significant forward step. For females, recent clinical studies indicate that sterilization can be produced through occlusion of their fallopian tubes by the intrauterine installation of quinacrine. A variety of methods which could interfere with the viability or passage of sperm once it enters the vagina are unlikely to result in practical fertility control agents before the end of this decade. PMID:4788233

  2. [Children and bankers in Bangladesh].

    PubMed

    Hartmann, B

    1991-06-01

    This critique of the World Bank's role in developing country population programs begins with a description of a 1987 case in which an 80-year- old Bangladeshi man was persuaded to undergo vasectomy and then robbed of his incentive payment by the health agent. For over 20 years, the World Bank has pressured 3rd World governments to implement population control programs. Although there are divergent opinions within the World Bank, the most dominant is the neomalthusian view that the poor through their high fertility help perpetuate their own poverty. This view hides the real source of poverty in the Third World: the unequal distribution of resources within these countries and between the developed and developing countries. The World Bank has always been blind to the inequalities, and has associated with the elites of developing countries who monopolize the resources of their countries and thereby impede authentic development. Furthermore, the emphasis on population control distorts social policy and hinders the implementation of safe and voluntary family planning services. In many countries the World Bank has required governments to give greater priority to population control than to basic health services. It has pressured them to relax contraceptive prescription norms and has promoted the more effective methods without regard to proper use or side effects. In Bangladesh the World Bank has sponsored sterilization programs that rely on coercion and incentives. In that country of enormous inequities, 10% of landowners control over 50% of lands, while nearly half the population is landless and chronically underemployed. Political power is concentrated in the military government, which annually receives over 1.5 billion dollars in external aid. External aid primarily benefits the wealthy. 3/4 of the population are undernourished and less than 1/3 are literate or have access to basic health care. The poor of Bangladesh, as in many other countries, feel that their only source of security is to have many children, a significant proportion of whom will not survive. In rural Bangladesh, where chronic hunger and unemployment are rife, the incentives and the pressures of family planning and health workers were sufficient to persuade many persons to undergo sterilization. Payment of commissions to workers to promote sterilization has discouraged them from supplying adequate information about sterilization for fear of losing clients. Population from other donors and wide publicity about the abuses in the sterilization program and the high rates of regret among women undergoing sterilization only for the incentives have led to some modifications, but the World Bank has continued to exert pressure on the Bangladeshi government to develop fertility-control programs. The damaging effects of World Bank population programs can also be seen in Indonesia, Nepal, and other developing countries. PMID:12284143

  3. [Survey of men provides reliable data on contraception in the Dominican Republic].

    PubMed

    1987-01-01

    Comparison of the results of 2 contraceptive prevalence surveys in the Dominican Republic, 1 of a sample of 4741 women in 1983 and the other of a sample of 4203 men in 1984, indicated that men and women have similar levels of knowledge and reported similar levels of use of contraceptives. Differences were noted in such areas as the acceptability of methods and the number of children each spouse desired. Both surveys were conducted by the National Council of Population and the Family. The women were aged 15-49 years and the men were 15-59. 2037 of the men were in union at the time of the survey and 2166 were single. The majority of respondents in both groups were under age 30. 44% of the men and 29% of the women under 30 were single. Dominican men are 5-10 years older than women on average when they enter stable unions. A comparison of age specific fertility rates of men and women showed that men have their highest level of fertility between 25-30 years and continue to reproduce beyond age 50, while women's fertility is highest between the ages of 20-29 and declines considerably thereafter. The total fertility rate was 4.2 for men aged 15-49 and 4.6 for men aged 15-59. It was 4.1 for women aged 15-49. Over 1/2 of men and 1/2 of women in union who had 2 or more children stated they wanted no more children, but at each parity men were more disposed to want another child. Women at all parities overestimated the number of children their partners wanted. The pill was the only contraceptive method that the majority of men and women who had ever been in union named spontaneously. When other methods were named, 94% of men and 97% of women ever in union knew about pills and female sterilization, 71% of men and 89% of women knew about IUDs, 71% of men and 80% of women knew about injectables, and 61% of men and 75% of women knew about vaginal methods. 92% of men and 88% of women knew about condoms. 46% of the women in union had been using a family planning method, including 27% who were sterilized and 9% who used pills. The responses of men when asked about their wives' contraceptive use were about the same. However, men reported higher use of male methods. 9% of men but only 1% of women reported using rhythm, 7% of men but 3% of women withdrawal, and 5% of men and 2% of women condoms. Among men not using a method, 61% reported they might use rhythm, condoms, withdrawal, or vasectomy in the future. 94% of men approved of at least 1 female method, but approval of specific methods varied widely. Over 80% of men in union approved of female sterilization and rhythm, but only 37% approved of pills and 41% of IUDs. The researchers concluded that men cooperate sufficiently to justify similar surveys in other Latin American countries, and that men can be reliable sources of information for programming and evaluation of family planning programs. PMID:12269052

  4. [Colombia. Prevalence, Demography and Health Survey 1990].

    PubMed

    1991-06-01

    Colombia's 1990 Survey of Prevalence, Demography, and Health (EPDS) was intended to provide data on the total population and on the status of women's and children's health for use in planning and in formulating health and family planning policy. 7412 household interviews and 8647 individual interviews with women aged 15-49 years were completed. This document provides a brief description of the questionnaire, sample design, data processing, and survey results. More detailed works on each topic are expected to follow. After weighing, 74.8% of respondents were urban and 25.2% rural. 3.2% were illiterate, 36.6% had some primary education, 50.2% had secondary educations, and 9.9% had high higher educations. Among all respondents and respondents currently in union respectively, 98.2% and 997% knew some contraceptive method, 94.1% and 97.9% knew some source of family planning, 57.6% and 86.0% had ever used a method, and 39.9% and 66.1% were currently using a method. Among all respondents and respondents currently in union respectively, 52.2% and 78.9% had ever used a modern method and 33.0% and 54.6% were currently using a modern method. Among women in union, 14.1% currently used pills, 12.4% IUDs, 2.2% injectables, 1.7% vaginal methods, 2.9% condoms, 20.9% female sterilization, .5% vasectomy, 11.5% some tradition method, 6.1% periodic abstinence, 4.8% withdrawal, and .5% others. Equal proportions of rural and urban women were sterilized. The prevalence of female sterilization declined with education and increased with family size. Modern methods were used by 57.5% of urban and 47.7% of rural women, 44.0% of illiterate women, 51.8% of women with primary and 57.8% with secondary educations. Among women in union, 10.9% wanted a child soon, 19.7% wanted 1 eventually, 3.6% were undecided, 42.6% did not want 1, 21.4% were sterilized, and 1.2% were infertile. Among women giving birth in the past 5 years, the proportion having antitetanus vaccinations increased from 39% in 1986 to 55.5% in 1990; the proportion receiving prenatal care from a physician increased from 67 to 80%; and the proportion receiving medical assistance at delivery increased from 61 to 71%. Among children under 5, 66% of urban and 61% of rural residents were completely vaccinated. The proportion completely vaccinated ranged from 59% in the Atlantic province to 69% in the Eastern province. 48% of children of illiterate mothers and 68% of children whose mothers has higher educations were completely vaccinated. The proportion of children under 5 who suffered from diarrhea within the past 24 hours declined from 9.8 in 1986 to 4.6% in 1990 and the proportion with diarrhea in the preceding 2 weeks declined from 118.7 to 12.5%. 2/3 of the women knew about Pap tests and 46% had ever had 1. Almost all respondents knew about AIDS. 20% reported ever having been struck by their husbands. PMID:12284197