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  1. The comparison between Intrauterine Insemination and Fallopian Tube Sperm Perfusion Using FAST®System in Patients with Unexplained Infertility

    PubMed Central

    Peivandi, Sepideh; Ebadi, Aghdas; Modanlu, Shila

    2015-01-01

    Background Controlled ovarian stimulation (COH) with intrauterine insemination (IUI) is commonly offered to infertile couples with patent fallopian tubes because it is simple, non-invasive and cost-effective technique. Another non-invasive method is fallopian tube sperm perfusion (FSP). This study was performed to compare the relative efficacy between FSP using fallopian sperm transfer (FAST) system and standard IUI in patients with unexplained infertility. Materials and Methods This prospective randomized study was conducted at the IVF Unit, Department of Gynecology and Obstetrics, Mazandaran University of Medical Sciences, Sari, Iran, from March 2011 to February 2012. A total of ninety patients with unexplained infertility underwent ovarian stimulation with clomiphene citrate and human menopausal gonadotropin (HMG). Patients were then randomly assigned into either group I (n=45) to undergo standard IUI or group II (n=45) to undergo FSP using FAST system. Results The patients’ basic characteristics, including age, primary infertility and duration of infertility, were not significantly different between two study groups. In the group I, there were 9 pregnancies (a pregnancy rate per cycle of 20%), whereas in the group II, 8 pregnancies occurred (a pregnancy rate per cycle of 17.8%, p>0.05). Conclusion FSP using FAST system offers no advantage over the standard IUI in order to increase pregnancy rate in patients with unexplained infertility. PMID:25780519

  2. Infertility Patients' Mental Health Problems Often Unaddressed

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_160382.html Infertility Patients' Mental Health Problems Often Unaddressed 'We're ... California, San Francisco. Many studies have found that infertility patients often feel distressed. And, Pasch said, professional ...

  3. Leukocytospermia in male infertility patients in China.

    PubMed

    Wang, A W; Politch, J; Anderson, D

    1994-01-01

    Recent studies have revealed a high prevalence of leukocytospermia (> 1 x 10(6) white blood cells ml-1 semen) in male infertility patients in the USA and certain European countries, and have implicated white blood cells as a cause of infertility. Since leukocytospermia may often be attributed to male genital-tract infections, its prevalence could vary widely in different populations depending on factors such as sexual practices and the prevalence of sexually transmitted pathogens. In the study described here the incidence of leukocytospermia was determined in a group of 101 male infertility patients and a small reference group of normal fertile men in Beijing, China. Seminal white blood cells (WBC) and WBC sub-populations were enumerated by peroxidase staining and immunohistological assay. Eight out of 101 (7.9%) samples from infertility patients and 0/10 samples from fertile donors were leukocytospermic. The incidence of leukocytospermia in the Chinese infertility patients was considerably lower than the 23% incidence observed in a recent study of infertility patients in the USA using a similar technique. All but one of the patients with leukocytospermia had a poor sperm count and/or poor sperm motility. However, due to the low incidence of leukocytospermia and the small number of patients in this group, a statistically significant association between leukocytospermia and poor semen quality was not attained. The simple peroxidase test correlated well with the more expensive and technically demanding immunohistological assay for detection of white blood cells in semen.

  4. Infertility

    MedlinePlus

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

  5. Prevalence of Infertility Problems among Iranian Infertile Patients Referred to Royan Institute

    PubMed Central

    Sepidarkish, Mahdi; Almasi-Hashiani, Amir; Shokri, Fatemeh; Vesali, Samira; Karimi, Elaheh; Omani Samani, Reza

    2016-01-01

    Background: Few studies have been conducted on the infertility problems in Iran. This study aimed to investigate the prevalence of infertility problems and related factors in Iranian infertile patients. Materials and Methods: In this cross sectional study, 405 infertile patients referred to Royan Institute, Tehran, Iran, between 2014 and 2015, were selected by simple random sampling. Participants completed the Fertility Problem Inventory (FPI) including 46 questions in five domains (social concern, sexual concern, relationship concern, rejection of parenthood, and need for parenthood). Mean difference between male and female was verified using independent-samples Student’s t test. A generalized linear model (GLM) was also used for testing the effect of variables on the fertility problems. Data was analyzed using Stata software version 13. Results: The mean age (SD) of participants was 31.28 (5.42). Our results showed that 160 infertile men (95.23%) were classified as very high prevalence of infertility problems. Among infertile women, 83 patients (35.02%) were as very high prevalence of infertility problems, and 154 patients (64.98%) were as high prevalence. Age (P<0.001), sex (P<0.001), a history of abortion (P=0.009), failure of previous treatment (P<0.001), and education (P=0.014) had a significant relationship with FPI scores. Conclusion: Bases on the results of current study, an younger male with lower education level, history of abortion and history of previous treatments failure experienced more infertility problems. PMID:27695609

  6. Prevalence of Infertility Problems among Iranian Infertile Patients Referred to Royan Institute

    PubMed Central

    Sepidarkish, Mahdi; Almasi-Hashiani, Amir; Shokri, Fatemeh; Vesali, Samira; Karimi, Elaheh; Omani Samani, Reza

    2016-01-01

    Background: Few studies have been conducted on the infertility problems in Iran. This study aimed to investigate the prevalence of infertility problems and related factors in Iranian infertile patients. Materials and Methods: In this cross sectional study, 405 infertile patients referred to Royan Institute, Tehran, Iran, between 2014 and 2015, were selected by simple random sampling. Participants completed the Fertility Problem Inventory (FPI) including 46 questions in five domains (social concern, sexual concern, relationship concern, rejection of parenthood, and need for parenthood). Mean difference between male and female was verified using independent-samples Student’s t test. A generalized linear model (GLM) was also used for testing the effect of variables on the fertility problems. Data was analyzed using Stata software version 13. Results: The mean age (SD) of participants was 31.28 (5.42). Our results showed that 160 infertile men (95.23%) were classified as very high prevalence of infertility problems. Among infertile women, 83 patients (35.02%) were as very high prevalence of infertility problems, and 154 patients (64.98%) were as high prevalence. Age (P<0.001), sex (P<0.001), a history of abortion (P=0.009), failure of previous treatment (P<0.001), and education (P=0.014) had a significant relationship with FPI scores. Conclusion: Bases on the results of current study, an younger male with lower education level, history of abortion and history of previous treatments failure experienced more infertility problems.

  7. [Genetic variants associated to male infertility in Mexican patients].

    PubMed

    Piña-Aguilar, Raúl Eduardo; Chima-Galán, María del Carmen; Yerena-de-vega, María de la Concepción A; Regalado-Hernández, Miguel Angel; Sánchez-Guerrero, Cecilia; García-Ortiz, Liliana; Santillán-Hernández, Yuritzi; Moreno-García, Jesús Daniel

    2013-05-01

    Recently Mexican Federation of Obstetrics and Gynecology Colleges (Federación Mexicana de Colegios de Obstetricia y Ginecologia, FEMECOG) published the Mexican guideline forthe management of male infertility, which suggests performing genetic laboratory tests as part of diagnosis and management of infertile patients and states that these should receive genetic counseling. This paper reviews the genetic approach proposed by Mexican guideline. A systematic review of medical literature was performed in Pubmed and Web of Knowledge from 1980 to 2012 in order to find reports of genetic variants associated to male infertility in Mexican patients. Also it is discussed the current knowledge of these variants, their clinical implications and finally the guidelines and recommendations for their molecular diagnosis. Most genetic variants in Mexican infertile patients are chromosome abnormalities. In relation to other variants there is only a report of Y chromosome microdeletions, repeated CAG in androgen receptor and more common mutations in CFTR, and other article reporting mutations in CFTR in patients with congenital absence of vas deferens. Little is known about the genetics of Mexican infertile patients apart from chromosome abnormalities. However, the contribution of genetics as etiology of male infertility is taking more relevance and currently the consensual management of infertile male should include the screening of genetic background. This review pretends to be a quick guide for clinicians who want to know about reports of genetic variants related to male infertility in Mexican population and how to approach their diagnosis.

  8. Predictors of Psychological Distress among Infertility Clinic Patients.

    ERIC Educational Resources Information Center

    Morrow, Kelly A.; And Others

    1995-01-01

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

  9. Protective emotional regulation processes towards adjustment in infertile patients.

    PubMed

    Pinto-Gouveia, José; Galhardo, Ana; Cunha, Marina; Matos, Marcela

    2012-03-01

    Little is known about emotional regulation processes of psychological flexibility/acceptance, self-compassion, and coping styles in infertility and the way they may exert a protective function towards depression. The aim of the current study was to explore how these emotion regulation processes are related to depression and to the sense of self-efficacy to deal with infertility in infertile patients. Gender differences were also considered. One hundred couples without known fertility problems and 100 couples with an infertility diagnosis completed the instruments: Beck Depression Inventory, Coping Styles Questionnaire, Acceptance and Action Questionnaire, Self-Compassion Scale and Infertility Self-efficacy Scale. Infertile couples presented statistically significantly higher scores on depression and lower scores in psychological flexibility/acceptance and self-compassion than the control group. This pattern was particularly identified in women who also tended to use less an emotional/detached coping style and to perceive themselves as less confident to deal with infertility than men. Multiple regression analysis showed that psychological flexibility/acceptance was a significant predictor of depressive symptoms in men and women with infertility. Emotional regulation processes, such as psychological flexibility/acceptance and self-compassion, seem to be relevant to the understanding of depressive symptoms and psychological adjustment to infertility, suggesting that these issues should be addressed in a therapeutic context with these couples.

  10. Laparascopic ventrosuspension in infertile patients. A new technique.

    PubMed

    Serour, G I; Hefnawi, F

    1981-01-01

    This paper describes the application of the Falope-Ring via laparascopy to the round ligaments in 86 infertile patients, for correction of retroversion of the uterus. Diagnostic laparascopy was performed on 2600 cases of infertility at Al-Azhar University Teaching Hospitals during a 3-year period. Laparascopy was performed as a primary mehtod of investigation of infertility, after clinical examination and semen analysis in 866 patients. These included long term cases of infertility, late marriage and cases where pelvic pathology was suspected on clinical grounds. Laparascopy was used as a final line of investigation of infertility in 1734 patients. In 86 patients with retroverted uterus as the only abnormality deteched, ventrosuspension was performed via the laparascope, by applying Falope-Rings to the round ligaments. These patients were followed up for periods varying from 6 months to 2 years. Pregnancy occurred in 24 patients and improvement of backache, deep dysparunea, congestive dysmenorrhea and leukorrhea occurred in 88.37%, 83.72%, 72.05% and 68.76%, respectively. The technique described in this paper is simple, easy to learn, can be performed under general or local anesthesia and is performed during the laparascopic investigation of the infertile cases and thus does not add an extra risk of operation or cost to the patient.

  11. Causes of infertility among 1000 patients in Ghana.

    PubMed

    Fiander, A

    1990-07-01

    Infertility is a serious problem in Africa; affecting large number of women and causing much suffering. To address this problem an infertility clinic was opened in an isolated District General Hospital in Ghana. Statistics were kept over an 18-month period to identify the numbers of patients involved and the main cause of infertility. 1000 patients were registered during the course of twice-weekly clinics over 18 months. 118 patients (11.8%) became pregnant during this time and in 482 (48.2%) others a definite diagnosis was reached. The remaining patients were still under investigation or lost to follow-up at the end of the study period. Of the 118 pregnancies 40% had suffered from primary and 60% from secondary infertility. The duration of infertility ranged from 1 to 10 years. As expected the "successful" patients tended to be young (65% under 25 years) and to have had subfertility of limited duration (77% 4 years). 113 patients had evidence of tubal damage (43% primary and 57% secondary infertility), 63% had a history of pelvic inflammatory disease and 37% had a history of abdominal or pelvic surgery. 219 male partners were subfertile: 38% were azoospermic; 33% severely oligospermic ( 5 x 10 to the 6th power/ml); 29% moderately oligospermic (20 x 10 tot he 6th power/ml); and 40% had never fathered a child. 61 patients were anovulatory as judged by amenorrhea or an irregular menstrual cycle. 10 of them were thought to be perimenopausal. 37 patients had uterine factors (27% primary and 73% secondary). 33 women had fibroids, 2 congenital abnormalities and 2 previous subtotal hysterectomies. 52 patients had unexplained infertility, although there were associated factors in 5; 3 men refused to have seminal analysis, 1 woman had unilateral tubal block on hysterosalpingogram and 1 required dilatation of a stenosed cervix early in the study. That infertility is a serious problem in Africa is shown by the large numbers of patients registering at the clinic during the

  12. Use of progestogens in pregnant and infertile patients.

    PubMed

    Ozlü, Tülay; Güngör, Ayşenur Cakır; Dönmez, Melahat Emine; Duran, Bülent

    2012-08-01

    Progesterone is an essential hormone in the occurence and maintenance of pregnancy. Natural or synthetic progestogens are commonly used in pregnant patients or patients undergoing infertility treatments for various indications. Most frequently put indications for the use of progestogens in these patient populations are the prevention of spontaneous preterm birth, the prevention of pregnancy loss in pregnancies with an unexplained recurrent pregnancy loss and in patients with threatened abortion. It is also used in pregnant women undergoing nonobstetric surgery, for infertility or recurrent pregnancy loss that is thought to be due to luteal phase defect or as a luteal support in stimulated IVF cycles. We aimed to review the current evidence for the use of progestogens in each of these settings.

  13. Use of progestogens in pregnant and infertile patients.

    PubMed

    Ozlü, Tülay; Güngör, Ayşenur Cakır; Dönmez, Melahat Emine; Duran, Bülent

    2012-08-01

    Progesterone is an essential hormone in the occurence and maintenance of pregnancy. Natural or synthetic progestogens are commonly used in pregnant patients or patients undergoing infertility treatments for various indications. Most frequently put indications for the use of progestogens in these patient populations are the prevention of spontaneous preterm birth, the prevention of pregnancy loss in pregnancies with an unexplained recurrent pregnancy loss and in patients with threatened abortion. It is also used in pregnant women undergoing nonobstetric surgery, for infertility or recurrent pregnancy loss that is thought to be due to luteal phase defect or as a luteal support in stimulated IVF cycles. We aimed to review the current evidence for the use of progestogens in each of these settings. PMID:22543698

  14. Aneuploidies level in sperm nuclei in patients with infertility.

    PubMed

    Alchinbayev, Mirzakarim Karimovich; Aralbayeva, Araylyim Nugmanovna; Tuleyeva, Lazzat Namatullaevna; Duysenbayeva, Svetlana Melsovna; Makazhanov, Marat Abzalovich

    2016-09-01

    Male infertility is a relevant social and medical problem. Male infertility is mostly caused by genetic disorders. The purpose of the study was to analyze the correlation of chromosome aberrations, as well as DNA fragmentation and various manifestations of spermatogenesis disorder. Sperm samples of 58 males with infertility and 23 conditionally healthy males were studied. All patients diagnosed with asthenozoospermia, teratozoospermia, oligoasthenozoospermia and oligoteratozoospermia underwent subsequent analysis of sperm DNA fragmentation. Sperm DNA fragmentation was examined with sperm chromatin dispersion test (sperm chromatin dispersion, Spermprocessor, India) with an Axioscope 40 fluorescent microscope. Fluorescence in situ hybridization with fluorescent probes (Vysis Multi Vysion PGT, Abbot Molecular) was used to study chromosome abnormalities in sperm nuclei with regard to X and Y chromosomes, as well as to chromosomes 18 and 21. It was found that the development of pathospermia was characterized by genetic discontinuity, which manifests as DNA fragmentation and disjunction of chromosomes in meiosis with spermatogenesis. It was also found that the prevailing type of pathospermia in men with infertility was oligozoospermia. In addition, this group also had the highest rate of numerical chromosome abnormalities. This was caused by the degeneration of spermatozoids with aneuploidies in chromosomes. PMID:27269280

  15. A Nutrition Screening Form for Female Infertility Patients.

    PubMed

    Langley, Susie

    2014-12-01

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

  16. A Nutrition Screening Form for Female Infertility Patients.

    PubMed

    Langley, Susie

    2014-12-01

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

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

    PubMed

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

    2015-11-01

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

  18. [Ultrastructure of immotile spermatozoa obtained from infertile male patients].

    PubMed

    Okada, H; Hayashi, A; Tanaka, H; Fujisawa, M; Matsumoto, O; Kamidono, S; Ohya, K

    1993-10-01

    We sometimes experienced infertile patients whose sperms had no motility but were not stained by Eosin Y. In this paper we report five cases of so-called "immotile spermatozoa". The ultrastructure of sperm tails was examined by transmission electrone microscope (TEM). These cases were selected from the out-patient population who attended infertility clinic of our department. The semen analyses showed that all the cases had sperm motility below 1% and more than 90% of the spermatozoa were proven alive. Family history revealed that one case had an infertile sibling. None of them had situs inversus, bronchiectasis and chronic sinusitis which are classic trias of Kartagener's syndrome. They had no symptoms of upper respiratory tract infection which was caused by the abnormality in the flagella of the respiratory tract. The TEM pictures of sperm tails showed partial deletion of inner dynein arms in two cases, lack of central microtubular doublets (so-called 9 + 0) in two cases and disarrangement of microtubular doublets in one case. For the treatment of these cases there is no effective means but AID. However, the rapid progress of IVF-ET techniques and a report that the spermatozoa from Kartagener's syndrome had showed penetration into eggs encouraged us to think the micromanipulation of spermatozoa with IVF-ET as a hopeful option of the treatment in the near future.

  19. The Impact of Letrozole Versus Clomiphene Citrate on Uterine Blood Flow in Patients with Unexplained Infertility

    PubMed Central

    Sakhavar, Nahid; Sadegi, Kambiz

    2014-01-01

    Objective To compare the effectiveness of letrozole and clomiphene citrate (CC) on uterine blood flow rate in patients with unexplained infertility. Materials and methods In this randomized clinical trial 90 women with unexplained infertility referred to a university clinic from January 2011- December 2013 were enrolled. Thirty patients were randomized for letrozole, 30 patients for CC and 3o patients for control group. On the day 3 of cycle the patients were given letrozole 2.5mg/day or CC 100 mg /day orally or did not receive any treatment. Resistance index (RI) and pulsatility index (PI) of uterine artery were calculated and chemical pregnancy rate was evaluated. Results Mean age was 26.4±3.2 (20-33) and mean BMI was 26.3± 3.2. After treatment using ultrasonography the Resistance index (RI) and Pulsatility index (PI) showed no significant difference among three groups (P > 0.05). Pregnancy rate in letrozole group (58%) was more in comparison to CC (53.6%) and control groups (46%) but the difference was not significant (P > 0.05). Conclusion Our study showed that letrozole and clomiphene citrate have comparable impact on uterine blood flow and pregnancy rate in women with unexplained infertility. PMID:24971126

  20. A Prospective Study of Depression and Anxiety in Female Fertility Preservation and Infertility Patients

    PubMed Central

    Lawson, Angela K.; Klock, Susan C.; Pavone, Mary Ellen; Hirshfeld-Cytron, Jennifer; Smith, Kristin N.; Kazer, Ralph R.

    2014-01-01

    Objective To prospectively assess anxiety, depression, coping, and appraisal in female fertility preservation patients compared to infertile patients. Design Prospective pre- and post-treatment survey. Setting Academic medical center. Patients 47 women with cancer (FP) and 91 age-matched infertile patients. Interventions None. Main Outcome Measures Depression, anxiety, coping, infertility–related stress, appraisal of treatment, and medical outcomes. Results FP patients reported more symptoms of anxiety and depression than infertile patients, but infertile patients’ symptoms worsened over time. 44% of FP and 14% of infertile patients’ scores exceeded the clinical cut-off for depression at pre-treatment. The interval between surveys and medical treatment data did not predict changes in mood symptoms. Coping strategies and infertility-related stress did not differ between groups and avoidant coping predicted higher depression and anxiety scores. Conclusion FP patients reported more anxiety and depression than infertile patients at enrollment in treatment, with more than one third of FP patients reporting clinically significant depressive symptoms. However, infertile patients’ anxiety and depressive symptoms increased across treatment. This increase was not related to time between registration for IVF and oocyte retrieval or the medical aspects of treatment. FP and infertile patients should be provided psychological consultation prior to treatment to identify mood and anxiety symptoms and to refer patients for counseling as needed to prevent worsening of symptoms. PMID:25154674

  1. Patient evaluation of infertility management in an ISO 9001:2008-certified centre for reproductive medicine.

    PubMed

    Van den Broeck, Uschi; Spiessens, Carl; Dancet, Eline; Bakelants, Els; Vrancken, Annelies; Demyttenaere, Koen; Enzlin, Paul; D'Hooghe, Thomas

    2012-03-01

    Quality management according to ISO 9001:2008 guidelines includes infertility care quality assessment and improvement. This study aimed to describe the development process of a questionnaire for infertility management. A literature review, qualitative interviews with experts and patients resulted in a content-valid and face-valid questionnaire. Three cross-sectional surveys were performed in 2004, 2007 and 2008 in a tertiary university infertility centre. First (2004), the questionnaire – measuring eight a-priori dimensions of infertility management – was tested. Second (2007), improvement projects for infertility management were evaluated. Third (2008), factor analysis was performed and internal consistency was documented. The developed patient questionnaire to evaluate infertility management and pre-set desired levels of agreement served to set targets for and assess quality improvement projects. The final patient questionnaire to evaluate infertility management within an ISO framework was valid and reliable and contained 14 items covering four dimensions of infertility management: Telephone Access, Reception, Information and Patient-centeredness. ISO 9001:2008-certified infertility centres can evaluate infertility management with this 14-item questionnaire. This top-down approach to evaluate the patients’ perspective on quality aspects selected by health professionals can be complementary to the bottom-up approach evaluating the patients’ complete experiences of quality of care.

  2. Does varicocelectomy affect DNA fragmentation in infertile patients?

    PubMed Central

    Telli, Onur; Sarici, Hasmet; Kabar, Mucahit; Ozgur, Berat Cem; Resorlu, Berkan; Bozkurt, Selen

    2015-01-01

    Introduction: The aims of this study were to investigate the effect of varicocelectomy on DNA fragmentation index and semen parameters in infertile patients before and after surgical repair of varicocele. Materials and Methods: In this prospective study, 72 men with at least 1-year history of infertility, varicocele and oligospermia were examined. Varicocele sperm samples were classified as normal or pathological according to the 2010 World Health Organization guidelines. The acridine orange test was used to assess the DNA fragmentation index (DFI) preoperatively and postoperatively. Results: DFI decreased significantly after varicocelectomy from 34.5% to 28.2% (P = 0.024). In addition all sperm parameters such as mean sperm count, sperm concentration, progressive motility and sperm morphology significantly increased from 19.5 × 106 to 30.7 × 106, 5.4 × 106/ml to 14.3 × 106/ml, and 19.9% to 31.2% (P < 0.001) and 2.6% to 3.1% (P = 0.017). The study was limited by the loss to follow-up of some patients and unrecorded pregnancy outcome due to short follow-up. Conclusion: Varicocele causes DNA-damage in spermatozoa. We suggest that varicocelectomy improves sperm parameters and decreases DFI. PMID:25878412

  3. Comparison of sexual dysfunction in women with infertility and without infertility referred to Al-Zahra Hospital in 2013-2014

    PubMed Central

    Mirblouk, Fariba; Asgharnia, Dr.Maryam; Solimani, Robabeh; Fakor, Fereshteh; Salamat, Fatemeh; Mansoori, Samaneh

    2016-01-01

    Background: One of the affected aspects in infertile women that have not been given sufficient attention is sexual function. Sexual function is a key factor in physical and marital health, and sexual dysfunction could significantly lower the quality of life. Aim of this study was to assess the comparison sexual dysfunction in women with infertility and without infertility, admitted to Al- Zahra Hospital. Objective: We decided to assess the prevalence of women sexual disorders in fertile and infertile subjects, admitted to Al-Zahra Hospital. Materials and Methods: 149 fertile and 147 infertile women who referred to infertility clinic of Al-Zahra Hospital during 2013-2014 were entered this cross-sectional study and Female Sexual Function Index questionnaire (FSFI) had been filled by all the cases. Most of women were married for 6-10 years (35.5%) and mean marriage time in participants was 9.55±6.07 years. Data were analyzed using SPSS software Ver. 18 and 2 test and logistic regression model has been used for analysis. Results: Results showed significant differences between desire (p=0.004), arousal (p=0.001), satisfaction (p=0.022) and total sexual dysfunction (p=0.011) in both groups but in lubrication (p=0.266), orgasm (p=0.61) and pain (p=0.793) difference were not significant. Conclusion: Some of sexual dysfunction indices are high in all infertile women. Our findings suggest that infertility impacts on women’s sexual function in desire, arousal, satisfaction and total sexual dysfunction. Health care professional should be sensitive to impact that diagnosis of infertility can have on women’s sexuality. PMID:27200426

  4. Psychosocial and sociocultural aspects of infertility--a comparison between Austrian women and immigrant women.

    PubMed

    Schmid, Julia; Kirchengast, Sylvia; Vytiska-Binstorfer, Elisabeth; Huber, Johannes

    2004-09-01

    The polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting female fertility. In this study we examined psychosocial parameters caused by infertility in PCOS women with different socio-cultural background. Symptomatology of PCOS, body composition characteristics as well as psychosocial parameters were examined in 49 PCOS infertility patients of the University Clinic for Gynecology and Obstetrics in Vienna, who originated from two different socio-cultural subgroups--Austrian women and Moslem immigrant women. In the appearance of the symptoms the typical heterogeneity of PCOS could be found in both subgroups with no differences. However, differences in the psychosocial aspects were impressive. Women from Islamic background do have a very high reproductive pressure. The Moslem immigrant PCOS women suffer more from infertility than Austrian women do. PMID:15509089

  5. Association of infertile patients having polycystic ovarian syndrome with recurrent miscarriage.

    PubMed

    Banu, J; Fatima, P; Sultana, P; Chowdhury, M A; Begum, N; Anwary, S A; Ishrat, S; Deeba, F; Begum, S A

    2014-10-01

    Polycystic ovarian syndrome (PCOS) has a pivotal role in the development of various complications during pregnancy. Polycystic ovarian syndrome women having elevated LH and hyper insulineuia may be at increased risk of miscarriage. The study was done to find out the recurrent pregnancy loss among the PCOS patient. This was a cross sectional case control study in total 100 infertile patients between age 20-40 years attending BSMMU out patient Department from July 2011 to June 2012, among them 50 infertile patients with PCOS regarding as a case and 50 infertile patients without PCOS selected as a control. Regarding case (infertile patients with PCOS) shows 20(40%) recurrent miscarriage and among control (infertile patients without PCOS) shows recurrent miscarriage 6(12%). And also among case group shows insulin resistance 8(16%) and control group insulin resistance 1(2%). Six (75%) abortion occur among PCOS with insulin resistance and 5(62.5%) abortion occur among PCOS with raised testosterone level. It is observed that recurrent miscarriage is higher in PCOS group. And also concluded that insulin resistance and raised testosterone level is responsible for this condition. So, further large scale study would be needed to reduce the chance of recurrent pregnancy loss by treatment with insulin sensitizer in case of obese PCOS with insulin resistance patient.

  6. Comparison of Quality of Life, Sexual Satisfaction and Marital Satisfaction between Fertile and Infertile Couples

    PubMed Central

    Masoumi, Seyedeh Zahra; Garousian, Maryam; Khani, Somayeh; Oliaei, Seyedeh Reyhaneh; Shayan, Arezoo

    2016-01-01

    Background: Fertility plays an important role in sexual and psychological function in families. Infertility can result in major emotional, social, and mental disorders, including a reduction in satisfaction with marital life and quality of life. The present study aimed to compare the quality of life and marital satisfaction and sexual satisfaction between fertile and infertile couples. Materials and Methods: This analytical cross-sectional study was conducted on 250 couples at the Fatemiyeh Educational Research Center affiliated to Hamadan University of Medical Sciences, Hamadan, Iran, from May to August in 2014. The subjects were randomly selected from the patients referred to this center using a table of random numbers. They were then allocated into two groups of infertile group (n=125) and fertile group (n=125). The study participants completed World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, Linda Berg’s Sexual Satisfaction Scale, and Enrich Marital Satisfaction Scale. Then, the data were entered into the SPSS version16 for statistical analysis. The Chi-square and Mann-Whitney tests were also applied to compare the data between the groups. Results: The results revealed no significant difference between the two groups regarding demographic and general health variables. The mean scores of sexual satisfaction were 63.67 ± 13.13 and 46.37 ± 7.72 in the fertile and infertile couples, respectively. Furthermore, the mean scores of marital satisfaction were also 44.03 ± 9.36 and 36.20 ± 4.03 in the fertile and infertile groups, respectively. Our finding demonstrated that the fertile couples obtained significantly higher mean scores of quality of life as well as lower mean scores of sexual satisfaction and marital satisfaction as compared to the infertile ones (P<0.001). Conclusion: According to the results, the fertile couples obtained significantly higher quality of life and lower sexual satisfaction and marital satisfaction as

  7. Comparison of Quality of Life, Sexual Satisfaction and Marital Satisfaction between Fertile and Infertile Couples

    PubMed Central

    Masoumi, Seyedeh Zahra; Garousian, Maryam; Khani, Somayeh; Oliaei, Seyedeh Reyhaneh; Shayan, Arezoo

    2016-01-01

    Background: Fertility plays an important role in sexual and psychological function in families. Infertility can result in major emotional, social, and mental disorders, including a reduction in satisfaction with marital life and quality of life. The present study aimed to compare the quality of life and marital satisfaction and sexual satisfaction between fertile and infertile couples. Materials and Methods: This analytical cross-sectional study was conducted on 250 couples at the Fatemiyeh Educational Research Center affiliated to Hamadan University of Medical Sciences, Hamadan, Iran, from May to August in 2014. The subjects were randomly selected from the patients referred to this center using a table of random numbers. They were then allocated into two groups of infertile group (n=125) and fertile group (n=125). The study participants completed World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, Linda Berg’s Sexual Satisfaction Scale, and Enrich Marital Satisfaction Scale. Then, the data were entered into the SPSS version16 for statistical analysis. The Chi-square and Mann-Whitney tests were also applied to compare the data between the groups. Results: The results revealed no significant difference between the two groups regarding demographic and general health variables. The mean scores of sexual satisfaction were 63.67 ± 13.13 and 46.37 ± 7.72 in the fertile and infertile couples, respectively. Furthermore, the mean scores of marital satisfaction were also 44.03 ± 9.36 and 36.20 ± 4.03 in the fertile and infertile groups, respectively. Our finding demonstrated that the fertile couples obtained significantly higher mean scores of quality of life as well as lower mean scores of sexual satisfaction and marital satisfaction as compared to the infertile ones (P<0.001). Conclusion: According to the results, the fertile couples obtained significantly higher quality of life and lower sexual satisfaction and marital satisfaction as

  8. Increased Prevalence of Celiac Disease in Patients with Unexplained Infertility in the United States: A Prospective Study

    PubMed Central

    Lebwohl, Benjamin; Wang, Jeffrey; Lee, Susie K.; Murray, Joseph A.; Sauer, Mark V.; Green, Peter H. R.

    2011-01-01

    Celiac disease is an autoimmune disorder which can present with a variety of non-gastrointestinal manifestations. In women, it may manifest with an assortment of gynecologic or obstetric disorders. Some reports have linked female infertility with undiagnosed celiac disease. Though there are a number of studies from Europe and the Middle East, only two prior American studies have examined the prevalence of “silent” celiac disease in a female infertility population. We prospectively performed serologic screening for celiac disease in 188 infertile women (ages 25–39). While we did not demonstrate an increased prevalence of celiac disease in our overall infertile female population, we were able to detect a significantly increased prevalence (5.9%) of undiagnosed celiac disease among women presenting with unexplained infertility (n=51). Our findings suggest the importance of screening infertile female patients, particularly those with unexplained infertility, for celiac disease. PMID:21682114

  9. Stress and Infertility

    MedlinePlus

    ... the American Society for Reproductive Medicine Stress and infertility It is not clear how exactly stress impacts ... How can stress impact a fertility patient? Sometimes, infertility patients respond to the stress of being unable ...

  10. Prospective Changes in Infertile Patients using Nonlinear Analysis

    NASA Astrophysics Data System (ADS)

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

    2011-06-01

    We measured pulse waves in 22 infertile women from the beginning of in vitro fertilization-embryo transfer (IVF-ET) through to pregnancy testing. The largest Lyapunov exponent (LLE) and autonomic nerve balance in the pregnancy group were significantly lower than that in the non-pregnancy group. In this study, we measured plethysmograms of four women who became pregnant and 18 who did not, ten times from each. We calculated LLE and a value for the autonomic nerve balance; from this analysis, we conclude that a mental state that allows for the possibility of becoming pregnant is necessary for a successful pregnancy.

  11. Evaluation of sperm retrieval rate with bilateral testicular sperm extraction in infertile patients with azoospermia

    PubMed Central

    Moein, Mohammad Reza; Moein, Mahmoud Reza; Ghasemzadeh, Jalal; Pourmasoumi, Soheila

    2015-01-01

    Background: About 10% to 15% of infertile men have azoospermia, which could be obstructive or non-obstructive. Diagnostic biopsy from the testis and recently testicular sperm extraction (TESE) are the most precise investigations in these patients. Testicular biopsy can be done unilaterally or bilaterally. The worth of unilateral or bilateral testicular biopsy in men with azoospermia is controversial. Objective: To evaluate the necessity of bilateral diagnostic biopsy from the testis in new era of diagnosis and treatment of male infertility. Materials and Methods: In this retrospective study, we reviewed the results of testis biopsy in 419 azoospermic men, referred to Yazd Research and Clinical Center for Infertility from 2009-2013. Patients with known obstructive azoospermia were excluded from the study. Results: In totally, 254 infertile men (60.6%) were underwent unilateral TESE, which in 175 patients (88.4%) sperm were extracted from their testes successfully. Bilateral testis biopsy was done in 165 patients (39.4%) which in 37 patients (22.4%), sperm were found in their testes tissues. Conclusion: Due to the low probability of positive bilateral TESE results especially when we can’t found sperm in the first side, we recommend that physicians re-evaluate the risk and benefit of this procedure in era of newer and more precise technique of sperm retrieval like micro TESE. PMID:26730246

  12. Effect of different ultrasound contrast materials and temperatures on patient comfort during intrauterine and tubal assessment for infertility.

    PubMed

    Fenzl, Vanja

    2012-12-01

    Hysterosalpingo-contrast sonography (HyCoSy) is safe and easy to perform outpatient method in the evaluation of female infertility. During this procedure a certain level of discomfort and pain are experienced by patients. On the basis of reducing avoidable pain inductors the aim of this study was to compare pain sensation due to different warmth of applied contrasts (sterile saline and Echovist(®)). Prospective and randomized study was performed on patients requiring tubal and uterine assessment during standard infertility work up. One group of patients was examined using both contrasts at room temperature and the other group using preheated contrasts at body temperature. Pain experience of the procedure was rated by patients for each contrast by numerical scale (0-10) immediately after the procedure. There was significant statistical difference between pain scores during application of two contrasts in each group; Echovist induces significantly less pain in comparison to sterile saline at the same temperature (P=0.002, 0.001). Between two groups there is also statistically significant difference in pain during introduction of the same contrast at different temperature (P<0.001). The most tolerable for the patient is body temperature of the applied contrasts although their structure and concentrations can be another factor associated with tolerability of the procedure. PMID:22542789

  13. Clinical Factors Associated with Sperm DNA Fragmentation in Male Patients with Infertility

    PubMed Central

    Komiya, Akira; Kato, Tomonori; Kawauchi, Yoko; Watanabe, Akihiko; Fuse, Hideki

    2014-01-01

    Objective. The clinical factors associated with sperm DNA fragmentation (SDF) were investigated in male patients with infertility. Materials and Methods. Fifty-four ejaculates from infertile Japanese males were used. Thirty-three and twenty-one were from the patients with varicoceles and idiopathic causes of infertility, respectively. We performed blood tests, including the serum sex hormone levels, and conventional and computer-assisted semen analyses. The sperm nuclear vacuolization (SNV) was evaluated using a high-magnification microscope. The SDF was evaluated using the sperm chromatin dispersion test (SCDt) to determine the SDF index (SDFI). The SDFI was compared with semen parameters and other clinical variables, including lifestyle factors. Results. The SDFI was 41.3 ± 22.2% (mean ± standard deviation) and did not depend on the cause of infertility. Chronic alcohol use increased the SDFI to 49.6 ± 23.3% compared with 33.9 ± 18.0% in nondrinkers. The SDFI was related to adverse conventional semen parameters and sperm motion characteristics and correlated with the serum FSH level. The SNV showed a tendency to increase with the SDFI. The multivariate analysis revealed that the sperm progressive motility and chronic alcohol use were significant predictors of the SDF. Conclusion. The SCDt should be offered to chronic alcohol users and those with decreased sperm progressive motility. PMID:25165747

  14. Analysis of inter-examination differences in sperm nuclear vacuoles among male patients with infertility.

    PubMed

    Komiya, Akira; Watanabe, Akihiko; Kawauchi, Yoko; Fuse, Hideki

    2014-02-01

    We analyzed the inter-examination differences in sperm nuclear vacuoles among male patients with infertility. We enrolled 56 male patients with infertility who underwent multiple semen analyses and high-magnification observation of the sperm head. A total of 162 ejaculates were evaluated. The average patient age was 34.5 years. Following the conventional semen analysis, the nuclear vacuoles in motile spermatozoa were evaluated at 3700-6150 × magnification on an inverted microscope equipped with differential interference contrast optics. A large sperm nuclear vacuole (LNV) was defined as one or more vacuoles with a maximum diameter exhibiting > 50% width of the sperm head. We compared the differences in the proportion of spermatozoa with LNVs between two consecutive semen samples before treatment. Treatment-related differences in the number of LNVs were also analyzed. Student's t-test was used to perform the statistical analyses. No differences were observed in any semen parameters between the first and second ejaculates. On high-magnification microscopy, the proportion of spermatozoa with LNVs was 23.5% and 29.4% (p = 0.0220) in the first and second ejaculates, respectively in 33 patients. Among the 18 patients who underwent varicocele repair using a microsurgical subinguinal approach, the proportion of spermatozoa with LNVs at baseline, three, and six months after surgery was 27.7%, 12.0% (p = 0.0132 versus baseline), and 10.3% (p = 0.0226 versus baseline), respectively. After three months of medical treatment for male infertility in 28 patients, the proportion of spermatozoa with LNVs slightly decreased from 33.3% to 28.6% (p = 0.1276); however, it was not statistically significant. In conclusion, when multiple ejaculates were obtained, in the subset of male patients with infertility, the proportion of spermatozoa with LNVs could be different. The number of LNVs decreased following varicocele repair.

  15. The Desire for Multiple Pregnancy among Patients with Infertility and Their Partners

    PubMed Central

    Md Latar, Ida Lilywaty; Razali, Nuguelis

    2014-01-01

    Objective. To study the predictors for desire for multiple pregnancies and the influence of providing information regarding the maternal and fetal complications associated with multiple pregnancies on their preference for multiple pregnancies. Methods. Couples attending an infertility clinic were offered to fill up a questionnaire separately. Following this, they were handed a pamphlet with information regarding the risks associated with multiple pregnancies. The patients will then be required to answer the question on the number of pregnancies desired again. Results. Two hundred fifty three out of 300 respondents completed the questionnaires adequately. A higher proportion of respondents, 60.3% of females and 57.9% of males, prefer singleton pregnancy. Patients who are younger than 35 years, with preexisting knowledge of risks associated with multiple pregnancies and previous treatment for infertility, have decreased desire for multiple pregnancies. However, for patients who are older than 35, with longer duration of infertility, and those patients who have preexisting knowledge of the increased risk, providing further information regarding the risks did not change their initial preferences. Conclusion. Providing and reinforcing knowledge on the risks to mother and fetus associated with multiple pregnancies did not decrease the preference for multiple pregnancies in patients. PMID:25763396

  16. Oral antioxidant treatment partly improves integrity of human sperm DNA in infertile grade I varicocele patients.

    PubMed

    Gual-Frau, Josep; Abad, Carlos; Amengual, María J; Hannaoui, Naim; Checa, Miguel A; Ribas-Maynou, Jordi; Lozano, Iris; Nikolaou, Alexandros; Benet, Jordi; García-Peiró, Agustín; Prats, Juan

    2015-09-01

    Infertile males with varicocele have the highest percentage of sperm cells with damaged DNA, compared to other infertile groups. Antioxidant treatment is known to enhance the integrity of sperm DNA; however, there are no data on the effects in varicocele patients. We thus investigated the potential benefits of antioxidant treatment specifically in grade I varicocele males. Twenty infertile patients with grade I varicocele were given multivitamins (1500 mg L-Carnitine, 60 mg vitamin C, 20 mg coenzyme Q10, 10 mg vitamin E, 200 μg vitamin B9, 1 μg vitamin B12, 10 mg zinc, 50 μg selenium) daily for three months. Semen parameters including total sperm count, concentration, progressive motility, vitality, and morphology were determined before and after treatment. In addition, sperm DNA fragmentation and the amount of highly degraded sperm cells were analyzed by Sperm Chromatin Dispersion. After treatment, patients showed an average relative reduction of 22.1% in sperm DNA fragmentation (p = 0.02) and had 31.3% fewer highly degraded sperm cells (p = 0.07). Total numbers of sperm cells were increased (p = 0.04), but other semen parameters were unaffected. These data suggest that sperm DNA integrity in grade I varicocele patients may be improved by oral antioxidant treatment.

  17. Comparison of dysfunctional attitudes and social adjustment among infertile employed and unemployed women in Iran.

    PubMed

    Fatemi, Azadeh S; Younesi, Seyed Jalal; Azkhosh, Manouchehr; Askari, Ali

    2010-04-01

    This study aims to compare dysfunctional attitudes and social adjustment in infertile employed and unemployed females. Due to the stresses of infertility, infertile females are faced with a variety of sexual and psychological problems, as well as dysfunctional attitudes that can lead to depression. Moreover, infertility problems provoke women into maladjustment and inadvertent corruption of relationships. In this regard, our goal is to consider the effects of employment in conjunction with education on dysfunctional attitudes and social adjustment among infertile women in Iran. In this work, we employed the survey method. We recruited 240 infertile women, utilizing the cluster random sampling method. These women filled out the Dysfunctional Attitudes Scale and the social adjustment part of the California Test of Personality. Next, multivariate analysis of variance was performed to test the relationship of employment status and education with dysfunctional attitudes and social adjustment. Our results indicated that dysfunctional attitudes were far more prevalent in infertile unemployed women than in infertile employed women. Also, social adjustment was better in infertile employed women than in infertile unemployed women. It was shown that education level alone does not have significant effect on dysfunctional attitudes and social adjustment. However, we demonstrated that the employment status of infertile women in conjunction with their education level significantly affects the two dimensions of dysfunctional attitudes (relationships, entitlements) and has insignificant effects on social adjustment. It was revealed that in employed infertile women in Iran, the higher education level, the less dysfunctional were attitudes in relationships and entitlements, whereas in unemployed infertile women, those with a college degree had the least and those with master's or higher degrees had the most dysfunctional attitudes in terms of relationships and entitlements.

  18. Defining Infertility

    MedlinePlus

    ... of the American Society for Reproductive Medicine Defining infertility What is infertility? Infertility is “the inability to conceive after 12 months ... to conceive after 6 months is generally considered infertility. How common is it? Infertility affects 10%-15% ...

  19. Comparison of age-related changes in anti-Müllerian hormone levels and other ovarian reserve tests between healthy fertile and infertile population.

    PubMed

    Bozkurt, Banu; Erdem, Mehmet; Mutlu, Mehmet Firat; Erdem, Ahmet; Guler, Ismail; Mutlu, Ilknur; Oktem, Mesut

    2016-09-01

    In this study, we aimed to determine whether anti-Müllerian hormone (AMH) levels vary between fertile and infertile populations and compare them with basal follicle-stimulating hormone (FSH) levels and antral follicle count (AFC). This was a prospective study that included 177 primarily infertile patients who underwent IVF treatment and 162 healthy fertile patients admitted to our clinic for benign diseases. FSH and AMH levels and the AFC of the infertile and fertile populations were compared between the age categories <30, 30-39 and ≥40. Correlations between AMH, basal FSH, and AFC with age were evaluated. AFC and AMH levels did not differ between the fertile and infertile groups in all age categories. AMH was inversely correlated with age in both the fertile and infertile populations. However, AFC revealed a stronger correlation with age in both the fertile and infertile populations compared with basal FSH and AMH. Age was positively correlated with basal FSH and inversely correlated with AMH and AFC. In conclusion, there was no significant difference between the fertile and infertile populations in terms of AMH or AFC. The decrease in ovarian reserve in infertile patients is directly related to age, not infertility.

  20. Combined letrozole and clomiphene versus letrozole and clomiphene alone in infertile patients with polycystic ovary syndrome

    PubMed Central

    Hajishafiha, Masomeh; Dehghan, Meisam; Kiarang, Nazila; Sadegh-Asadi, Nahideh; Shayegh, Seyed Navid; Ghasemi-Rad, Mohammad

    2013-01-01

    Background Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of childbearing age (6.8%–18%), is among the most common causes of infertility due to ovulation factors, and accounts for 55%–70% of infertility cases caused by chronic anovulation. In this study, we used a combination of letrozole and clomiphene in patients resistant to both drugs individually, and studied the effects of this combination in ovulation and pregnancy in resistant PCOS patients. Methods The study population included infertile couples diagnosed as PCOS in the wife. The women used clomiphene for at least six cycles in order to ovulate after failure to form the dominant follicle, and were then put on letrozole for four cycles. Patients who were unable to form the dominant follicle were enrolled on letrozole and clomiphene combination therapy. Results One hundred enrolled patients underwent 257 cycles of a combination of letrozole and clomiphene, in which 213 were able to form the dominant follicle (82.9%) and 44 were unable to do so (17.1%). The number of mature follicles was 2.3±1.1. The mean endometrial thickness in patients on the day of human chorionic gonadotropin administration was 8.17±1.3 mm. The pregnancy rate was 42%. Conclusion According to the results of this study, it can be proposed that in PCOS patients resistant to clomiphene and letrozole used as single agents, a combination of the two drugs can be administered before using more aggressive treatment that may have severe complications or surgery. This combination may also be used as a first-line therapy to induce ovulation in severe cases of PCOS in order to save time and expense. PMID:24348019

  1. Female Infertility

    MedlinePlus

    Infertility means not being able to get pregnant after at least one year of trying (or 6 ... woman keeps having miscarriages, it is also called infertility. Female infertility can result from age, physical problems, ...

  2. Infertility - resources

    MedlinePlus

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

  3. Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia

    PubMed Central

    Bezold, Guntram; Politch, Joseph A.; Kiviat, Nancy B.; Kuypers, Jane M.; Wolff, Hans; Anderson, Deborah J.

    2009-01-01

    Objective To determine the prevalence of pathogens that cause sexually transmitted infections (STIs) in semen from asymptomatic male infertility patients with and without leukocytospermia (LCS), and associations between STIs, inflammatory markers and other semen variables. Design Retrospective, controlled study. Setting Center for Reproductive Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Patient(s) 241 male infertility patients undergoing routine semen analysis; 132 with LCS, and 109 without LCS. Intervention(s) None Main Outcome Measure(s) DNA from STI pathogens [human papillomavirus (HPV), cytomegalovirus (CMV), herpes simplex virus (HSV), human herpes virus type 6 (HHV-6), Epstein-Barr virus (EBV), hepatitis B virus (HBV) and Chlamydia trachomatis (CT)], routine semen parameters and markers of accessory gland and epididymal function and inflammation. Results STI DNA was detected in 45/241 (18.7%) of the samples (CMV 8.7%, HPV 4.5%, HHV-6 3.7%, HSV 3.7%, CT 2.5%, EBV 0.4%, and HBV 0%), with no difference in prevalence between LCS and non-LCS groups. STI DNA in semen was associated with a decrease in sperm concentration, motile sperm concentration, total sperm count and neutral α-glucosidase concentration, whereas LCS was associated with a decrease in total sperm count, % normal forms and fructose concentration. Conclusion(s) STI pathogen DNA was detected in semen from a high percentage of asymptomatic male infertility patients and was associated with poor semen quality. Efforts to diagnose and treat subclinical genital tract infections should be intensified. PMID:17433312

  4. Infertility with Testicular Cancer.

    PubMed

    Ostrowski, Kevin A; Walsh, Thomas J

    2015-08-01

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

  5. Prevalence and determinants of complementary and alternative medicine use among infertile patients in Lebanon: a cross sectional study

    PubMed Central

    2012-01-01

    Background Complementary and alternative medicine (CAM) is widely used for the treatment of infertility. While the Middle East and North Africa region has been shown to house one of the fastest growing markets of CAM products in the world, research describing the use of CAM therapies among Middle-Eastern infertile patients is minimal. The aim of this study is to examine the prevalence, characteristics and determinants of CAM use among infertile patients in Lebanon. Methods A cross sectional survey design was used to carry out face-to-face interviews with 213 consecutive patients attending the Assisted Reproductive Unit at a major academic medical center in Beirut. The questionnaire comprised three sections: socio-demographic and lifestyle characteristics, infertility-related aspects and information on CAM use. The main outcome measure was the use of CAM modalities for infertility treatment. Determinants of CAM use were assessed through the logistic regression method. Results Overall, 41% of interviewed patients reported using a CAM modality at least once for their infertility. There was a differential by gender in the most commonly used CAM therapies; where males mostly used functional foods (e.g. honey & nuts) (82.9%) while females mostly relied on spiritual healing/prayer (56.5%). Factors associated with CAM use were higher household income (OR: 0.305, 95% CI: 0.132–0.703) and sex, with females using less CAM than males (OR: 0.12, 95% CI: 0.051–0.278). The older patients were diagnosed with infertility, the lower the odds of CAM use (p for trend <0.05). Almost half of the participants (48%) were advised on CAM use by their friends, and only 13% reported CAM use to their physician. Conclusions The considerably high use of CAM modalities among Lebanese infertile patients, added to a poor CAM use disclosure to physicians, underscore the need to integrate CAM into the education and training of health professionals, as well as enhance infertile patients' awareness

  6. Effect of Pertubation on Pregnancy Rates before Intrauterine Insemination Treatment in Patients with Unexplained Infertility

    PubMed Central

    Yildiz, Funda; Bozkurt, Nuray; Erdem, Ahmet; Erdem, Mehmet; Oktem, Mesut; Onur Karabacak, Recep

    2014-01-01

    Background: The aim of this study was to determine the relationship between marital violence and distress level among women with a diagnosis of infertility. Materials and Methods: In this prospective randomized study, a total of 180 patients were included in the study. Amongst these, pertubation of the uterine cavity was carried out in 79 patients prior to insemination. One patient in the pertubation group was later excluded because insemination could not be performed due to cycle cancellation. Results: There were no significant differences in demographic characteristics between the study and control groups. When the pregnancy rates of both groups were evaluated, 14(17.8%) patients in the study group achieved pregancy. Three (3.8%) had a biochemical pregnancy, 1(1.3%) miscarried and 10(12.7%) had live births. In the control group, a total of 24(23.8%) pregnancies were achieved, amongst which one (1%) had a biochemical pregnancy, 3(3%) miscarried and 20(19.8%) resulted in live births. There was no significant difference between groups in terms of total pregnancy and live birth rates (p>0.05). There was a 21% total pregnancy loss rate. There was no significant difference between the control and study groups in terms of pregnancy loss rates (p>0.05). Conclusion: This study on a homogenous group of unexplained infertile patients determined that the addition of pertubation to a controlled ovarian hyperstimulation plus intrauterine insemination (COH+IUI) treatment protocol did not affect pregnancy rates (Registration Number: NCT01999959). PMID:24695882

  7. Laparoscopic ovarian treatment in infertile patients with polycystic ovarian syndrome (PCOS): endocrine changes and clinical outcome.

    PubMed

    Liguori, G; Tolino, A; Moccia, G; Scognamiglio, G; Nappi, C

    1996-08-01

    During the years 1991-1994, 97 anovulatory infertile women with polycystic ovarian syndrome (PCOS) were treated with laparoscopic electrocautery of the ovarian surface after they had failed to ovulate under ovarian stimulation. To assess the endocrinological and clinical outcome and in an attempt to determine the mechanism of action, the serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), androstenedione, testosterone and dehydroepiandrosterone sulfate (DHEAS) were determined before and after laparoscopic ovarian cautery. Fifty regularly cycling women undergoing laparoscopy for investigation of infertility or tubal ligation served as controls. In patients with PCOS but not in controls, the reduction of androgen levels and normalization of cycle length were highly significant. In contrast, LH and FSH levels rose during the first 2 days after the operation. These results resemble those reported after ovarian wedge resection. Ovulation was obtained in 90% (81 of 90) and pregnancy in 81.1% (73 of 90) of the patients; that increased to 84.4%, including the non-responders (nine patients) treated with clomiphene citrate (CC), after electrocautery. The response to ovarian electrocautery was influenced by body weight, with an ovulation rate of 95-96% in the slim and moderately obese women, decreasing to 81-82% in the really obese ones. When ovulation was established, the pregnancy rate was independent of body weight. However, a striking relationship was detected between smoking habits and pregnancy rate subsequent to ovarian electrocautery, ranging from 24% in smokers to 92% in non-smoking couples. In 30 second-look operations, de novo adhesions were found in 23.3% of the patients (7 of 30). Therefore, ovarian electrocautery is an effective procedure to improve the intraovarian mechanism of selecting a dominant follicle for patients with PCOS in whom initial medical management fails, and it appears to be one of the possible treatments for this

  8. Investigating the Relationships among Stressors, Stress Level, and Mental Symptoms for Infertile Patients: A Structural Equation Modeling Approach

    PubMed Central

    Wang, Jong-Yi; Liang, Wen-Miin; Yang, Tung-Chuan; Lee, Young-Chang; Wang, Chia-Woei

    2015-01-01

    Objective Patients with infertility are a high risk group in depression and anxiety. However, an existing theoretically and empirically validated model of stressors, stress, and mental symptoms specific for infertile patients is still a void. This study aimed to determine the related factors and their relational structures that affect the level of depressive and anxiety symptoms among infertile patients. Methods A cross-sectional sample of 400 infertility outpatients seeking reproduction treatments in three teaching hospitals across Taiwan participated in the structured questionnaire survey in 2011. The hypothesized model comprising 10 latent variables was tested by Structural Equation Modeling using AMOS 17. Results Goodness-of-fit indexes, including χ2/DF = 1.871, PGFI = 0.746, PNFI = 0.764, and others, confirmed the modified model fit the data well. Marital stressor, importance of children, guilt-and-blame, and social stressor showed a direct effect on perceived stress. Instead of being a factor of stress, social support was directly and positively related to self-esteem. Perceived stress and self-esteem were the two major mediators for the relationships between stressors and mental symptoms. Increase in social support and self-esteem led to decrease in mental symptoms among the infertile patients. Conclusions The relational structures were identified and named as the Stressors Stress Symptoms Model, clinically applied to predict anxiety and depression from various stressors. Assessing sources and level of infertility-related stress and implementing culturally-sensitive counseling with an emphasis on positive personal value may assist in preventing the severity of depression and anxiety. PMID:26484531

  9. Ulipristal Acetate in Myomectomy Optimization in an Infertile Patient with Giant Myomas.

    PubMed

    de la Fuente, Elena; Borrás, María Dolores; Rubio, Miriam; Abril, Nuria

    2016-01-01

    The use of ulipristal acetate (UPA) has been recently introduced in the treatment of uterine leiomyomas. This drug has proven useful to control menometrorrhagia and to reduce myoma size. In the case presented here, we show the benefits of UPA treatment in facilitating surgical removal of giant myomas in an infertile patient. In addition to myoma reduction and a better control of preoperative bleeding, the treatment with UPA reduced the duration and complexity of the surgery, as well as the area of uterine wall involved and the resulting scar. No side effects were observed and the patient became pregnant 6 months after the surgery and had a normal pregnancy and delivery. This case report shows the beneficial effects of UPA in the preoperative treatment of myomas which affect uterus function. PMID:27594886

  10. Ulipristal Acetate in Myomectomy Optimization in an Infertile Patient with Giant Myomas

    PubMed Central

    Borrás, María Dolores; Rubio, Miriam; Abril, Nuria

    2016-01-01

    The use of ulipristal acetate (UPA) has been recently introduced in the treatment of uterine leiomyomas. This drug has proven useful to control menometrorrhagia and to reduce myoma size. In the case presented here, we show the benefits of UPA treatment in facilitating surgical removal of giant myomas in an infertile patient. In addition to myoma reduction and a better control of preoperative bleeding, the treatment with UPA reduced the duration and complexity of the surgery, as well as the area of uterine wall involved and the resulting scar. No side effects were observed and the patient became pregnant 6 months after the surgery and had a normal pregnancy and delivery. This case report shows the beneficial effects of UPA in the preoperative treatment of myomas which affect uterus function.

  11. Ulipristal Acetate in Myomectomy Optimization in an Infertile Patient with Giant Myomas

    PubMed Central

    Borrás, María Dolores; Rubio, Miriam; Abril, Nuria

    2016-01-01

    The use of ulipristal acetate (UPA) has been recently introduced in the treatment of uterine leiomyomas. This drug has proven useful to control menometrorrhagia and to reduce myoma size. In the case presented here, we show the benefits of UPA treatment in facilitating surgical removal of giant myomas in an infertile patient. In addition to myoma reduction and a better control of preoperative bleeding, the treatment with UPA reduced the duration and complexity of the surgery, as well as the area of uterine wall involved and the resulting scar. No side effects were observed and the patient became pregnant 6 months after the surgery and had a normal pregnancy and delivery. This case report shows the beneficial effects of UPA in the preoperative treatment of myomas which affect uterus function. PMID:27594886

  12. The role of impairment of adrenal mineraloglucocorticoid function in the development of infertility in varicocele patients.

    PubMed

    Mazo, E B; Koryakin, M V; Kudryavtsev JuV; Evseev, L P; Akopyan, A S

    1989-01-01

    The study was aimed at the understanding of pathophysiological mechanisms of the impairment of spermatogenesis in varicocele patients. The crucial role of tension increase in the venous plexus of the spermatic cord in spermatogenesis damage in the testis on the varicocele side and absence of any effect of haemodynamic abnormalities on spermatogenesis in the complementary testis has been determined. Retrograde blood flow through the central vein of the left adrenal gland in varicocele has been evidenced by X-ray examination. The role of this phenomenon in the changes of functional activity of the adrenal gland is discussed. Results of the study of functional status of adrenal glands revealed their tendency to provide hyperactivity in synthesis of mineraloglucocorticoids. Correlation between cortisol level in peripheral blood and percentage of abnormal sperm in ejaculate was shown. This fact supported the idea about the existence of a causal interrelationship between abnormalities in the functional status of adrenal glands and development of infertility in varicocele patients.

  13. Multiple Determinations of Sperm DNA Fragmentation Show That Varicocelectomy Is Not Indicated for Infertile Patients with Subclinical Varicocele

    PubMed Central

    García-Peiró, Agustín; Ribas-Maynou, Jordi; Oliver-Bonet, María; Navarro, Joaquima; Checa, Miguel A.; Nikolaou, Alexandros; Amengual, María J.; Abad, Carlos; Benet, Jordi

    2014-01-01

    Varicocele is one of the most common causes of low semen quality, which is reflected in high percentages of sperm cells with fragmented DNA. While varicocelectomy is usually performed to ameliorate a patient's fertility, its impact on sperm DNA integrity in the case of subclinical varicocele is poorly documented. In this study, multiple DNA fragmentation analyses (TUNEL, SCD, and SCSA) were performed on semen samples from sixty infertile patients with varicocele (15 clinical varicoceles, 19 clinical varicoceles after surgical treatment, 16 subclinical varicoceles, and 10 subclinical varicoceles after surgical treatment). TUNEL, SCD, and SCSA assays all showed substantial sperm DNA fragmentation levels that were comparable between subclinical and clinical varicocele patients. Importantly, varicocelectomy did improve sperm quality in patients with clinical varicocele; however, this was not the case in patients with subclinical varicocele. In summary, although infertile patients with clinical and subclinical varicocele have similar sperm DNA quality, varicocelectomy should only be advised for patients with clinical varicocele. PMID:24967335

  14. Uterine factors and infertility.

    PubMed

    Sanders, Barry

    2006-03-01

    A literature review was performed to explore the available information regarding the association of uterine factors--intrauterine adhesions, uterine septa, uterine myomas and endometrial polyps--with infertility and reproductive loss. The literature was reviewed also to ascertain evidence that treatment of these abnormalities improves fertility. A MEDLINE search was performed to identify the relevant publications in the English-language literature. There is minimal published evidence to demonstrate that intrauterine adhesions lead to infertility or pregnancy loss, but the literature does contain several observational series that demonstrate successful fertility, with term pregnancy rates ranging from 32% to 87% following hysteroscopic division of intrauterine adhesions. The evidence supporting a direct link between a septate uterus and reproductive loss/infertility is derived from the results of metroplasty. Several case series demonstrated a reduction in the spontaneous abortion rate, from 91% to 17%, on average, after hysteroscopic metroplasty. Furthermore, following metroplasty, the mean pregnancy rate in previously infertile patients is 47%. Little has been written regarding the association of endometrial polyps and infertility. One study did demonstrate a pregnancy rate of 78% after hysteroscopic polypectomy as compared to 42% in infertile patients with normal endometrial cavities. The literature that associates myomas with infertility/reproductive loss is more extensive but quite controversial. Evidence from the in vitro fertilization literature suggests that only those myomas that distort the endometrial cavity impair fertility. Pregnancy rates approximating 50% are achieved with myomectomy by laparotomy, laparoscopy or hysteroscopy.

  15. Detection of structural and numerical chomosomal abnormalities by ACM-FISH analysis in sperm of oligozoospermic infertility patients

    SciTech Connect

    Schmid, T E; Brinkworth, M H; Hill, F; Sloter, E; Kamischke, A; Marchetti, F; Nieschlag, E; Wyrobek, A J

    2003-11-10

    Modern reproductive technologies are enabling the treatment of infertile men with severe disturbances of spermatogenesis. The possibility of elevated frequencies of genetically and chromosomally defective sperm has become an issue of concern with the increased usage of intracytoplasmic sperm injection (ICSI), which can enable men with severely impaired sperm production to father children. Several papers have been published about aneuploidy in oligozoospermic patients, but relatively little is known about chromosome structural aberrations in the sperm of these patients. We examined sperm from infertile, oligozoospermic individuals for structural and numerical chromosomal abnormalities using a multicolor ACM FISH assay that utilizes DNA probes specific for three regions of chromosome 1 to detect human sperm that carry numerical chromosomal abnormalities plus two categories of structural aberrations: duplications and deletions of 1pter and 1cen, and chromosomal breaks within the 1cen-1q12 region. There was a significant increase in the average frequencies of sperm with duplications and deletions in the infertility patients compared with the healthy concurrent controls. There was also a significantly elevated level of breaks within the 1cen-1q12 region. There was no evidence for an increase in chromosome-1 disomy, or in diploidy. Our data reveal that oligozoospermia is associated with chromosomal structural abnormalities suggesting that, oligozoospermic men carry a higher burden of transmissible, chromosome damage. The findings raise the possibility of elevated levels of transmissible chromosomal defects following ICSI treatment.

  16. Extended letrozole regimen versus clomiphene citrate for superovulation in patients with unexplained infertility undergoing intrauterine insemination: A randomized controlled trial

    PubMed Central

    2011-01-01

    Background The aim of this randomized controlled trial was to compare the efficacy of extended letrozole regimen with clomiphene citrate in women with unexplained infertility undergoing superovulation and intrauterine insemination (IUI). Methods Two hundred and fourteen patients with unexplained infertility were randomized into two equal groups using computer generated list and were treated by either letrozole 2.5 mg/day from cycle day 1 to 9 (extended letrozole group, 211 cycles) or clomiphene citrate 100 mg/day from cycle day 3 to 7 (clomiphene citrate group,210 cycles). Intrauterine insemination was performed 36 to 40 hours after HCG administration. Results Both groups were comparable with regard to number of mature follicles (2.24 +/- 0.80 Vs 2.13 +/- 0.76) and the day of HCG administration. Serum estradiol was significantly greater in clomiphene citrate group (356 +/- 151 Vs 822 +/- 302 pg/ml, P = < 0.001) and the endometrial thickness was significantly greater in extended letrozole group (9.10 +/- 1.84 Vs 8.18 +/- 1.93 mm, P = < 0.001).The pregnancy rate per cycle and cumulative pregnancy rate were significantly greater in extended letrozole group (18.96% Vs 11.43% and 37.73% Vs 22.86%, respectively). Conclusion The extended letrozole regimen had a superior efficacy as compared with clomiphene citrate in patients of unexplained infertility undergoing superovulation and IUI. Trial registration ClinicalTrials.gov, NCT01232075 PMID:21693030

  17. Diagnostic Testing for Male Factor Infertility

    MedlinePlus

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

  18. Comparison of the Effects of Varicocelectomy and Oral L-carnitine on Sperm Parameters in Infertile Men with Varicocele

    PubMed Central

    Ghaderi, Ebrahim; Ganji, Omid

    2016-01-01

    Background Varicocele is defined as dilated and twisted veins of the pampiniform plexus in the spermatic cord. It is the most common cause of male infertility. There are various medical and surgical procedures for the treatment of this disease. Aim This study was aimed to compare the effects of oral administration of L-Carnitine and varicocelectomy on spermogram parameters. Materials and Methods This study was conducted as a double blind clinical trial without randomization. Inclusion criteria were, all married infertile men with varicocele. Patients chose their treatment personally and spermogram was carried out for all patients before and after the third and sixth months of treatment. Then, the sperm parameters of the two groups were compared using repeated measures ANOVA. Results In our study, trend of sperm count in the surgery group changed from 22 to 28.61 million (vs 34.6 to 45.37 in L-Carnitine group), motility changed from 21.74 to 35.38 percent (vs 33.9 to 47.48 in L-Carnitine group), normal sperm morphology changed from 46.25 to 60 percent (vs 56.61 to 69.7 in L-Carnitine group) and volume of semen changed from 3.5 to 4.17 cc (vs 2.95 to 4.33 in L-Carnitine group). These values were not statistically different between the two groups. Conclusion Based on the results of this study, we can say that medicinal treatment by administration of oral L-Carnitine is as effective as varicocelectomy in improving semen parameters and can be used as an alternative to surgery for varicocele grade II. PMID:27190879

  19. Male Infertility

    MedlinePlus

    ... treatments may include medicines, surgery, or assisted reproductive technology. Happily, many couples treated for infertility are able to have babies. NIH: National Institute of Child Health and Human Development

  20. Human sperm and other seminal constituents in male infertile patients from arsenic and cadmium rich areas of Southern Assam.

    PubMed

    Sengupta, Mahuya; Deb, Ishita; Sharma, Gauri Dutta; Kar, Kushal Kumar

    2013-08-01

    In the present study the occurrence of two heavy metals, arsenic and cadmium, have been reported in the drinking water and seminal plasma of infertile male patients as compared to a control group. The study originated from a survey of geogenic groundwater contamination with the heavy metals arsenic and cadmium in Southern Assam, India as an increase in the incidence of male infertility was being reported from these areas. According to WHO protocol, patients with sperm concentration < 20 x 10(6)/ml were selected as cases (oligozoospermic and azoospermic), and those with > 20 x 10(6)/ml, without any extreme pathological disorders and having fathered a child within 1-2 years of marriage were the control (normozoospermic) group. The study reports an inverse relationship between total sperm count and heavy metal content in drinking water as well as seminal plasma of the subjects. Moreover, a high correlation between altered semenological parameters and lower expression of accessory sex gland markers like fructose, acid phosphatase, and neutral α-glucosidase in the seminal plasma of patients is reported. The study also highlights significant differences of the sperm function parameters like hypo-osmotic swelling, acrosome reaction, and nuclear chromatin decondensation in the patient group as compared to controls. These findings are significant as they address a likely association between heavy metal stress and altered sperm function as well as seminal enzyme inhibition.

  1. Seminal insulin-like growth factor-I may be involved in the pathophysiology of infertility among patients with clinical varicocele.

    PubMed

    Naderi, GholamHossein; Mohseni Rad, Hamed; Tabassomi, Firouzeh; Latif, AmirHossein

    2015-06-01

    Varicocele, the most common cause of male infertility, is defined as abnormal dilation of the pampiniform plexus. Although different mechanisms have been proposed to explain the pathophysiology of infertility caused by varicocele, it is still open to debate. Previous studies have demonstrated the effect of insulin-like growth factor-I (IGF-I) on semen quality in animals and humans, but there are no studies on the probable role of seminal IGF-I in the pathophysiology of infertility among patients with clinical varicocele. We therefore aimed to examine the seminal IGF-I concentration in 49 patients with varicocele and primary infertility before and after varicocelectomy and compare the results with those of 50 healthy fertile men (in the control group). Mean seminal IGF-I level of patients before varicocelectomy (93.7 ± 67.2 ng/mL) was significantly different (P < 0.001) from that following varicocelectomy (58 ± 35.1 ng/mL) and from that of the controls (57.6 ± 22.1 ng/mL). However, mean seminal IGF-I levels of patients after varicocelectomy and the controls were not significantly different. Seminal IGF-I level was not correlated with grade and side of varicocele, and semen quality. We conclude that locally secreted IGF-I in the semen may be involved in the pathophysiology of infertility in patients with varicocele or semen.

  2. Comparison of hysterosalpingograms with laparoscopy in the diagnostic of tubal factor of female infertility at the Yaoundé General Hospital, Cameroon

    PubMed Central

    Ngowa, Jean Dupont Kemfang; Kasia, Jean Marie; Georges, NGuefack-Tsague; Nkongo, Victorine; Sone, Charles; Fongang, Emmanuel

    2015-01-01

    Introduction The objectives were to assess the diagnostic value of hysterosalpingography (HSG) with laparoscopy as gold standard in the evaluation of tubal patency and pelvic adhesions in women suffering from infertility. Methods We conducted a comparative cross sectional study on 208 medical files of infertile women followed up at the Yaoundé General Hospital during a period of five years (December 2007 to December 2012). Tubal patency, hydrosalpinx and pelvic adhesions detected at HSG were compared with laparoscopic findings as the gold standard. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of HSG were calculated with 95% confidence interval (CI). Results Mean age of the patients was 31.4± 6.45 years. Secondary infertility was the most frequent type of infertility (66.82%). HSG had a moderate sensitivity (51.0%; 95% IC. 37.5-64.4), high specificity (90.0%; 95% IC.74.4-96.5), high PPV (89.3%; 95% IC. 72.8-96.3) and a moderate NPV (52.9%; 95% IC. 39.5-65.9) in the diagnosis of bilateral proximal tubal occlusion. Concerning, distal tubal patency, HSG had a high sensitivity (86.8%; 95% IC. 76.7-92.9), low specificity (42.2%; 95% CI. 29.0-56.7), moderate PPV (69.4%; 95% IC. 58.9-78.2) and a moderate NPV (67.9%; 95% IC. 49.3-82.0) in the diagnosis of bilateral or unilateral distal tubal occlusion. However, HSG had a low diagnostic value (27.8%; 95%IC.18.8-39.0) in the pelvic adhesions. Conclusion HSG is of limited diagnostic value in tubal factor infertility and is of low diagnostic value for pelvic adhesions. PMID:26958127

  3. Use of recombinant luteinizing hormone for controlled ovarian hyperstimulation in infertile patients.

    PubMed

    Maia, Mônica C S; Approbato, Mário S; da Silva, Tatiana M; Fleury, Eliamar A B; Sanchez, Eliane G M; Sasaki, Reinaldo S A

    2016-01-01

    Controlled ovarian stimulation has become an integral part of a high complexity infertility treatment. Treatment options with recombinant gonadotrophins add more to knowledge on folliculogenesis and ovarian steroidogenesis. Therefore, a literature search was conducted in the following data bases: Medline, Scielo and PubMed. The descriptors/ key words used were ovarian stimulation, in vitro fertilization, recombinant luteinizing hormone, supplementation LH. The aim of this study was to review the available literature and to assess the benefits of using recombinant luteinizing hormone associated with recombinant follicle stimulating hormone in different populations who have undergone assisted reproduction procedures. PMID:27244766

  4. The Production of Interleukin-11 and Decidualization Are Compromised in Endometrial Stromal Cells Derived from Patients with Infertility

    PubMed Central

    Karpovich, Natalia; Klemmt, Petra; McVeigh, J. Enda; Barlow, David H.; Mardon, Helen J.; Hwang, Jung Hye; Heath, John K.

    2006-01-01

    IL-11 signaling is critical for decidualization of the endometrial stroma in early pregnancy in the mouse. In this study, we investigate the function of IL-11 signaling in cAMP-induced decidualization of human endometrial stromal cells. We show that treatment of endometrial stromal cells with 8-bromo-cAMP (8-Br-cAMP) results in an increase in the levels of secreted IL-11, whereas levels of cell surface IL-11 receptor α are similar with or without 8-Br-cAMP treatment. The production of IL-11 correlates with the production of molecular markers of decidualization, prolactin and IGF-binding protein-1. The expression of these markers is inhibited when IL-11 signaling is specifically blocked in decidualizing endometrial stromal cells by the IL-11 antagonist W147A. We demonstrate that 8-Br-cAMP-induced endometrial stromal cells derived from patients with primary infertility produce lower levels of prolactin, IGF-binding protein-1, and IL-11 than cells derived from fertile women. Our results suggest that IL-11 expression is critically important during decidualization in the human endometrium, and that aberrant regulation of endometrial IL-11 production may be associated with some types of infertility. PMID:15613426

  5. The relationship between methylenetetrahydrofolate reductase c.677TT genotype and oligozoospermia in infertile male patients living in the Trakya region of Turkey.

    PubMed

    Gurkan, H; Tozkır, H; Göncü, E; Ulusal, S; Yazar, M

    2015-11-01

    Methylenetetrahydrofolate reductase (MTHFR), the key enzyme of the folate metabolic pathway, has been reported to be five times more active in the testicles compared to other organs in adult mice. The aim of this study was to investigate the relationship between MTHFR c.677C>T and c.1298A>C polymorphisms and infertility in nonobstructive azoospermic and oligozoospermic male patients living in the Trakya region of Turkey. The study population included 75 nonobstructive azoospermic and 62 oligozoospermic, nonconsanguineous patients who were referred to the Department of Medical Genetics of Trakya University between 01.03.2012 and 01.06.2013 due to infertility and who had been diagnosed based on clinical examinations and spermiograms. All of the patients had a normal karyotype without a Y chromosome microdeletion. Melting curve analysis with labelled probes and primers that were designed by the manufacturers and the real-time polymerase chain reaction method were used. The MTHFR c.677TT genotype frequency in the oligozoospermic infertile male patient group was greater than that of the fertile control group [odds ratio (OR) = 2.675 (95% CI: 0.979-7.305), (P < 0.048)]. The MTHFR c.677TT genotype may be a genetic risk factor for oligozoospermic infertile male patients who live in the Trakya region of Turkey.

  6. Pregnancy established in an infertile patient after transfer of a donated embryo fertilised in vitro.

    PubMed Central

    Trounson, A; Leeton, J; Besanko, M; Wood, C; Conti, A

    1983-01-01

    In vitro fertilisation after stimulation of the ovulatory cycle has led to successful pregnancy. If more oocytes are recovered than are needed they may be left unfertilised, preserved, or donated to a recipient couple from whom oocytes cannot be obtained. A case of human pregnancy initiated by transfer of a donated embryo fertilised in vitro is reported. The donor was a 42 year old woman with primary infertility from whom six follicles were aspirated after stimulation of the ovulatory cycle. The recipient was a 38 year old infertile woman who had undergone several unsuccessful attempts for artificial insemination from a donor. Five oocytes were recovered from the donor's six follicles, four of which were inseminated with spermatozoa of the donor's husband and the fifth with a frozen sample of semen. Three of the four embryos fertilised by her husband were returned to the donor and the fifth was transferred to the recipient. No pregnancy was recorded in the donor, but pregnancy was confirmed in the recipient, though spontaneous abortion occurred after 10 weeks. This case will give useful information for further study of in vitro fertilisation, but also raises many ethical issues. PMID:6403104

  7. Obesity leads to higher risk of sperm DNA damage in infertile patients

    PubMed Central

    Dupont, Charlotte; Faure, Céline; Sermondade, Nathalie; Boubaya, Marouane; Eustache, Florence; Clément, Patrice; Briot, Pascal; Berthaut, Isabelle; Levy, Vincent; Cedrin-Durnerin, Isabelle; Benzacken, Brigitte; Chavatte-Palmer, Pascale; Levy, Rachel

    2013-01-01

    There has been a growing interest over the past few years in the impact of male nutrition on fertility. Infertility has been linked to male overweight or obesity, and conventional semen parameter values seem to be altered in case of high body mass index (BMI). A few studies assessing the impact of BMI on sperm DNA integrity have been published, but they did not lead to a strong consensus. Our objective was to explore further the relationship between sperm DNA integrity and BMI, through a 3-year multicentre study. Three hundred and thirty male partners in subfertile couples were included. Using the terminal uridine nick-end labelling (TUNEL) assay, we observed an increased rate of sperm DNA damage in obese men (odds ratio (95% confidence interval): 2.5 (1.2–5.1)). PMID:23792341

  8. Cadmium Concentrations in Blood and Seminal Plasma: Correlations with Sperm Number and Motility in Three Male Populations (Infertility Patients, Artificial Insemination Donors, and Unselected Volunteers)

    PubMed Central

    Benoff, Susan; Hauser, Russ; Marmar, Joel L; Hurley, Ian R; Napolitano, Barbara; Centola, Grace M

    2009-01-01

    To investigate a possible common environmental exposure that may partially explain the observed decrease in human semen quality, we correlated seminal plasma and blood cadmium levels with sperm concentration and sperm motility. We studied three separate human populations: group 1, infertility patients (Long Island, NY, USA); group 2, artificial insemination donors (AID) (Rochester, NY, USA); and group 3, general population volunteers (Rochester, NY, USA). Information about confounding factors was collected by questionnaire. Seminal plasma cadmium did not correlate with blood cadmium (Spearman correlation, n = 91, r = −0.092, P = 0.386, NS). Both blood and seminal plasma cadmium were significantly higher among infertility patients than the other subjects studied (for example, median seminal plasma cadmium was 0.282 μg/L in infertility patients versus 0.091 μg/L in AID and 0.092 μg/L in general population volunteers; Kruskal–Wallis test, P < 0.001). The percentage of motile sperm and sperm concentration correlated inversely with seminal plasma cadmium among the infertility patients (r = −0.201, P < 0.036 and r = −0.189, P < 0.05, respectively), but not in the other two groups. Age (among infertility patients) was the only positive confounder correlating with seminal plasma cadmium. To validate our human findings in an animal model, we chronically exposed adolescent male Wistar rats to low-moderate cadmium in drinking water. Though otherwise healthy, the rats exhibited decreases in epididymal sperm count and sperm motility associated with cadmium dose and time of exposure. Our human and rat study results are consistent with the hypothesis that environmental cadmium exposures may contribute significantly to reduced human male sperm concentration and sperm motility. PMID:19593409

  9. Uterine fibroids associated with infertility.

    PubMed

    Van Heertum, Kristin; Barmat, Larry

    2014-11-01

    In recent years, there has been an increasing focus on the contributory role of uterine fibroids to infertility. The prevalence of these tumors increases with age, which becomes significant as more women are delaying childbearing. Therefore, fibroids and infertility frequently occur together. Treatment varies with fibroid location and size. The various methods of treatment include open myomectomy, laparoscopic or robot-assisted myomectomy, medical treatment, uterine artery embolization and magnetic resonance guided focused ultrasound surgery. While there is a general consensus on the treatment of submucosal fibroids, the management of intramural fibroids in the infertility patient remains controversial. This paper aims to review and summarize the current literature in regards to the approach to uterine fibroids in the infertile patient. PMID:25482490

  10. Uterine fibroids associated with infertility.

    PubMed

    Van Heertum, Kristin; Barmat, Larry

    2014-11-01

    In recent years, there has been an increasing focus on the contributory role of uterine fibroids to infertility. The prevalence of these tumors increases with age, which becomes significant as more women are delaying childbearing. Therefore, fibroids and infertility frequently occur together. Treatment varies with fibroid location and size. The various methods of treatment include open myomectomy, laparoscopic or robot-assisted myomectomy, medical treatment, uterine artery embolization and magnetic resonance guided focused ultrasound surgery. While there is a general consensus on the treatment of submucosal fibroids, the management of intramural fibroids in the infertility patient remains controversial. This paper aims to review and summarize the current literature in regards to the approach to uterine fibroids in the infertile patient.

  11. Seminal vesicles of infertile patients with male accessory gland infection: ultrasound evaluation after prolonged treatment with tadalafil, a selective phosphodiesterase-5 inhibitor.

    PubMed

    La Vignera, S

    2013-12-01

    The aim of this study was to investigate possible ultrasound seminal vesicle (SV) changes in infertile patients with 'hypertrophic-congestive' (HCUF) or 'fibro-sclerotic' (FSUF) ultrasound form of male accessory gland infection (MAGI) after prolonged administration of tadalafil (TAD), a selective phosphodiesterase-5 inhibitor. Forty infertile patients with HCUF and 40 patients with FSUF and erectile dysfunction were selected and arbitrarily divided into two groups, who were prescribed TAD 5 mg daily for 3 months, the first 20 consecutive patients with HCUF (group A1) or FSUF (group A2) or placebo, the second 20 consecutive patients with HCUF (group B1) or FSUF (group B2). All patients underwent scrotal and prostate-vesicular transrectal ultrasound evaluation and semen analysis (WHO, 2010) before and after treatment. Group A1 patients showed a significant reduction in fundus/body ratio and higher pre- and post-ejaculatory body SV antero-posterior diameter difference compared with the other three groups. These patients showed also a significant increase in SV ejection fraction and a significant improvement in the total sperm count, progressive motility, seminal levels of fructose and ejaculate volume. These results suggest that infertile patients with HCUF had an improvement in SV ultrasound features suggestive of chronic inflammation after daily treatment with low doses of TAD.

  12. AB270. Surgical sperm retrieval, micro TESE, and What do I treat for patient with male infertility

    PubMed Central

    Huang, William J.

    2016-01-01

    Objective Micro-dissection testicular sperm extraction (mTESE) nowadays has been the major sperm retrieval method for patients with non-obstructive azoospermia (NOA) in assisted reproduction technology (ART). However, there are still 40 to 50% chances that no sperm can be found after the procedure, and the ICSI cycles are then aborted. Therefore the couples need to take the significant physical, psychological and financial risks, including ovulation induction, eggs retrieval and costs for procedures. Design: we introduce the concept of diagnostic mTESE for men with NOA to determine the decision to initiate ovulation cycles. Methods From 2012 to 2014, 152 men received diagnostic mTESE procedures. This study had excluded patients with obstructive azoospermia and needle biopsy-confirmed hypospermatogenesis cases. Patients with undescended testis, Klinefelter’s syndrome, or Y microdeletion were included. The procedure was performed by Schlegel’s method, the testicular tissues were examined under operative microscope up to 24 X. The procedures were started from right testicle, if no sperm found from right side, then left side was opened consequently. The tubules larger than 300 m were sampled for immediate table side touch print smear examination and the tissues were transferred to Bouin’s fixatives for further pathological examination. The whole procedure was video-taped for future review. The location of sperm-positive areas was recorded in operation note. The testis wound at tunica albuginea was closed using intra-tunical zipper suture with 6-0 Prolene. Results Among the 152 patients, the mean sperm retrieval rate was 45.3%. If we included the patients with biopsy-confirmed hypospermatogenesis receiving only therapeutic mTESE, the overall sperm retrieval rate was about 61%. For the patients with positive results at diagnostic mTESE, the sperm retrieval rate at later therapeutic mTESE for ICSI cycle was 100%. For patients who had no sperm found at diagnostic m

  13. Infertility and Fertility

    MedlinePlus

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

  14. Causes of Male Infertility

    MedlinePlus

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

  15. Understanding Infertility - The Basics

    MedlinePlus

    ... Lobo of the American Society for Reproductive Medicine discusses the various methods to evaluate infertility. Causes of ... Lobo of the American Society for Reproductive Medicine discusses various methods of coping with infertility. Infertility Treatments ...

  16. [ANTIOXIDANT THERAPY FOR INFERTILE COUPLES].

    PubMed

    Nashivochnikova, N A; Krupin, V N; Selivanova, S A

    2015-01-01

    This study presents results of 113 infertile couples treated with supplements speroton and pregnoton containing folic acid, L-carnitine, vitamin E, zinc, and other vitamins and minerals. Infertility in couples was due to both the pathology of spermatogenesis, and female genital diseases. It has been demonstrated that intake of Speroton restores impaired motility in the ejaculate of patients with several forms of pathospermia, and Pregnoton ensure its preservation in vaginal secretions. PMID:26390564

  17. Relationship of semen hyperviscosity with IL-6, TNF-α, IL-10 and ROS production in seminal plasma of infertile patients with prostatitis and prostato-vesiculitis.

    PubMed

    Castiglione, R; Salemi, M; Vicari, L O; Vicari, E

    2014-12-01

    Changes in levels of oxidative damage products in semen and their relationship to seminal fluid viscosity (SFV) have recently received increasing research interest. We analysed whether SFV was associated with ROS generation, levels of cytokines TNF-alpha (TNF-α), IL-6 and IL-10 and seminal leucocyte concentration, and whether ROS production was related to the extent of infections/inflammations at one (prostatitis) or two (prostato-vesiculitis) male accessory glands. We studied 169 infertile patients, with chronic bacterial prostatitis (PR, n = 74) and/or bilateral prostato-vesiculitis (PV, n = 95), as diagnosed by the ultrasound (US) criteria. Healthy fertile men (n = 42) served as controls. In the PV patient group, SFV, semen characteristics and ROS production had median values that were significantly higher than those found in PR patients and controls, although other sperm variables had values significantly lower than those found in PR patients or controls. In PV infertile patients, ROS generation and pro-inflammatory cytokines levels were higher than those found in PR infertile patients and controls, although seminal IL-10 levels in PV and PR patients were lower than those found in the controls. In PR patients, the levels of SFV were positively related to TNF-α (r = 0.67; P < 0.01), fMLP-stimulated ROS production in the 45% Percoll fraction (r = 0.687, P < 0.01) and the 90% Percoll fraction in basal condition (r = 0.695, P < 0.01), and after fMLP-stimulation (r = 0.688, P < 0.01). Thus, our data indicated that seminal hyperviscosity is associated with increased oxidative stress in infertile men and increased pro-inflammatory interleukins in patients with male accessory gland infection, more when the infection was extended to the seminal vesicles.

  18. Association between endometriosis and hyperprolactinemia in infertile women

    PubMed Central

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

    2015-01-01

    Background: The association of endometriosis with hyperprolactinemia is controversial. Objective: The present study aimed to determine the frequency of endometriosis and association of prolactin with endometriosis in infertile women. Materials and Methods: 256 infertile women who underwent diagnostic laparoscopy for the evaluation of infertility, referred to Fatemezahra Infertility and Reproductive Health Research Center were included in a cross-sectional study. The presence of endometriosis was evaluated. To investigate the association of endometriosis with hyperprolactinemia, the patients whose infertility was not caused by endometriosis were included as control group. Serum prolactin (PRL) level was measured in both groups. The comparison of basal serum PRL levels between the two groups was performed, using independent t-test. One way ANOVA was used to determine PRL association with endometriosis stages. Results: The frequency of endometriosis was found to be 29%. PRL levels were significantly higher in endometriosis group compared to control group (23.02±1.25 vs. 17.22±1.22 respectively, p=0.004). Statistically significant associations were found between staging of endometriosis and prolactin levels (p=0.01). Conclusion: Hyperprolactinemia may be associated with endometriosis and its progression. PMID:26000006

  19. Impact of extensive laparoscopic venous disconnection on the recurrence rate and sperm DNA quality in infertile varicocele patients

    PubMed Central

    Abdelaziz, Alsayed Saad; Burham, Waleed Ahmed; Aboelsaad, Ahmed Yosef; Badran, Yaser Ali; Ahmed, Abul-Fotouh Abdel-Maguid

    2015-01-01

    Introduction: Although there are many literature examining the possible effects of varicocelectomy on classic semen parameters and recurrence rate, few published articles have examined the effect of conventional laparoscopic varicocelectomy on sperm DNA integrity. Objectives: The objective was to evaluate the effect of extensive laparoscopic venous disconnections on the recurrence rate and sperm DNA damage in varicocele patients. Methods: Totally, 54 patients with varicocele underwent extensive laparoscopic venous disconnections were assessed by clinical evaluation, duplex scan, semen analysis, and sperm DNA fragmentation assay before surgery and after 6 and 12 months following surgery. Results: No intra- or post-operative complications were observed and out of 54 patients preoperatively complained from varicocele 2 (3.7%) patients' have recurrence during the follow-up period for 12 months. Out of 54 patients complaining from male infertility, 14 patients success to get pregnancy after 6 months with pregnancy rates of 25.92% and 22 (40.74%) after 12 months, and 28 patients (51.85%) had a preoperative DNA fragmentation index (DFI) >30%, decreased following surgery below 30% in 19 (35.18%) patients after 6 months, and 11 (20.37%) after 12 months, and the percentage of sperm with DFI > 30% was significantly decreased after 6 and 12 months, respectively (38.4 ± 10.6 vs. 31.3 ± 12.4, [P < 0.001] at 6 months, and 22.9 ± 13.2, [P < 0.001] after 1-year). Other spermatic parameter was significantly improved. Conclusions: An extensive laparoscopic venous disconnection was significantly decreasing the recurrence rate, DFI and improving normal semen parameters and fertility. PMID:26692670

  20. Unilateral adrenal tumor, erectile dysfunction and infertility in a patient with 21-hydroxylase deficiency: effects of glucocorticoid treatment and surgery.

    PubMed

    Scaroni, C; Favia, G; Lumachi, F; Opocher, G; Bonanni, G; Mantero, F; Armanini, D

    2003-02-01

    In untreated congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21OHDS) the presence of adrenal and testicular tumors had been described; however little is known about the effect of the enzymatic defect on fertility in males. We studied a male adult patient affected by 21OHDS for infertility, after a long period of discontinuation of glucocorticoid therapy and then during resumption of treatment and 8 months after monoadrenalectomy. The initial spermatic count revealed azoospermia and testicular needle aspiration showed a cytological picture consistent with prepuberty. The morphofunctional study revealed a right adrenal mass with reduced uptake at radioscan. Treatment was resumed with onset of impotency, which improved after reduction of the dose of glucocorticoids. The patient was monoadrenalectomised and his spermatic count increased. The patient shows that corticosteroid therapy in 21OHDS should be continued lifelong to avoid adrenal hyperplasia with possible areas of autonomy and to allow regular fertility. Impotence during treatment is probably due to a decrease of excessive adrenal androgens while testicular androgen production is still suppressed. PMID:12605349

  1. "Now we feel like we did everything we could": A qualitative study into the experiences of Dutch patients who travelled to Belgium for infertility treatment.

    PubMed

    Van Hoof, W; De Sutter, P; Pennings, G

    2014-01-01

    Many Dutch infertility patients go to Belgium for treatment every year. This is the first qualitative interview study looking into the experiences and perspectives of Dutch patients who travel to Belgium for infertility treatment. We recruited 16 heterosexual couples and one single woman to ensure maximal diversity in age, distance to the clinic, type of treatment and number of previously failed cycles. The interview data was analysed using inductive thematic analysis. The central theme in the data was that going to Belgium was the next step. The Dutch patients believed that the quality of care was very high in Belgium and that in taking this step, they did everything they could to achieve a pregnancy. PMID:25593693

  2. Chromosomal Abnormalities in Infertile Men Referred to Iran Blood Transfusion Organization Research Center

    PubMed Central

    Mahjoubi, Frouzandeh; Soleimani, Saeideh; Mantegy, Sanaz

    2010-01-01

    Introduction The prevalence of somatic chromosomal abnormalities in infertile male individuals has been reported to vary in different literatures. The aim of this study was to investigate the frequency of chromosomal aberrations among infertile men referred to the Cytogenetic Laboratory of Iran Blood Transfusion Organization Research Centre (IBTO). Materials and Methods Chromosomal analysis was performed on phytohemag-glutinin (PHA)-stimulated peripheral lymphocyte cultures of 1052 infertile men using standard cytogenetic methods. The study took place during 1997 to 2007. Results Total chromosome alterations were revealed in 161 (15.30%) infertile men. The most prevalent chromosomal abnormality in the infertile men was 47, XXY, that was seen in 94 (58.38%) men while one of them had a mosaic karyotype: mos 47, XX[54]/47,XXY[18]/46,XY[9]. In 37 (22.98%) cases, structural aberrations were detected. There were 30 (18.63%) cases of sex reversal. Conclusion Cytogenetic studies of these patients showed increased chromosomal abnormalities in infertile men in comparison with that of the normal population, justifying the need for cytogenetic analysis of men with idiopathic infertility. PMID:23926486

  3. The conventional management of male infertility.

    PubMed

    Nieschlag, Eberhard; Lenzi, Andrea

    2013-12-01

    Although the male reproductive function is impaired in about half of infertile couples, the evaluation of male infertility is underrated or neglected even today. In addition to a physical examination and imaging techniques, semen analysis as well as endocrine and genetic analyses should be part of the routine investigation. Few disorders have become subjects of rational treatment of the infertile male, even though, as examples, hypogonadotropic hypogonadism is treatable by gonadotropins and obstructive azoospermia by reconstructive surgery. Early treatment of maldescended testes and sexually transmitted diseases can prevent infertility. Similar pregnancy rates from patients with varicocele following surgery or counseling demonstrate the important role of the physician in the treatment of infertility. In the age of evidence-based medicine, most empirical treatments have been demonstrated to be ineffective. Instead, symptomatic treatment by assisted reproductive techniques has become a central tool to overcome otherwise untreatable male infertility.

  4. Ethical and Psychosocial Impact of Female Infertility

    PubMed Central

    Leyser-Whalen, Ophra; Temple, Jeff R.

    2012-01-01

    This manuscript reviews research from the past year on the ethical and psychosocial impact of infertility on women and men. We discuss several issues surrounding ovarian stimulation, particularly high-order multiple births, egg banking (especially for research purposes), and diminished ovarian reserve. We also present recent work on distress and counseling, which includes greater attention to subgroups of infertile women. More research on issues confronting men has emerged recently, and we outline these with regard to their relationships with infertile women, or as the infertility patient. Last, we outline some ethical issues posed by newer procedures of fertility preservation and uterine transplant. PMID:23336092

  5. A private matter: how patients decide what to do with cryopreserved embryos after infertility treatment.

    PubMed

    Provoost, Veerle; Pennings, Guido; De Sutter, Petra; Dhont, Marc

    2012-12-01

    This study describes patients' satisfaction with the information they received regarding the disposition of supernumerary embryos in the context of their decision making, as well as partners' roles and the involvement of others. An anonymous mail questionnaire was sent to 412 female patients from the Department of Reproductive Medicine (Ghent University Hospital, Ghent, Belgium). The questionnaire had a response rate of 79%. The majority of patients who did not want to continue the storage of their embryos (87.9%) thought the information provided was sufficient to make a decision. Patients who were not satisfied more often failed to reach a decision compared to other patients (4/25 vs. 6/173, p = 0.0248). The majority of couples (81.7%) reached a decision jointly between partners. Nonetheless, in 15.6% of couples, one of the partners had made the decision alone, mostly after consulting their partners. Only a minority of the couples (13.2%) consulted others (mostly family members or close friends), suggesting that patients view these decisions as a private matter. Only 1.1% of all patients had talked to someone at the centre about their decision. To conclude, for most patients, the information provided was adequate in light of their disposition decision making. Overall, patients' decision making appears to be a private matter which happens out of sight from medical staff, making it hard to assist patients who face difficulties. PMID:23121255

  6. Y chromosome and male infertility.

    PubMed

    Krausz, C; McElreavey, K

    1999-01-15

    Male factor infertility accounts for about half the cases of couple infertility. In more than 60% of cases the origin of reduced testicular function is unknown but they may have an unidentified genetic anomaly. Microdeletions of the long arm of the human Y chromosome are associated with spermatogenic failure and have been used to define three regions of Yq (AZFa, AZFb and AZFc) that are recurrently deleted in infertile males. Several genes have been identified within this region and have been proposed as candidates for infertility. Many of these genes encode proteins involved in post-transcriptional gene expression and therefore could participate in the sperm maturation process. About 10-15% of azoospermic and about 5-10% of severely oligozoospermic men have Yq microdeletions. The deletions are associated with a wide range of histological pictures ranging from Sertoli Cell Only Syndrome (SCOS) to spermatogenic arrest and severe hypospermatogenesis. Assisted reproduction techniques such as in vitro fertilization (IVF) and Intra Cytoplasmic Sperm Injection (ICSI) alone, or in association with testicular sperm retrieval, represent an efficient therapy for these patients. However the potential of these techniques to transmit genetic defects causing male infertility raises the need for a systematic genetic screening and genetic counselling of these patients.

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

    PubMed Central

    Dilbaz, Berna; Çınar, Mehmet; Özkaya, Enis; Tonyalı, Nazan Vanlı; Dilbaz, Serdar

    2012-01-01

    Objective: The aim of this study was to evaluate the clinical features and health quality profile differences between infertile women with polycystic ovary syndrome (PCOS) phenotypes and women with unexplained infertility. Material and Methods: The WHOQOL-BREF were administered in a cross-sectional survey to 132 women diagnosed with PCOS (study group) and 32 women diagnosed with unexplained infertility (control group). Body mass index (BMI), duration of infertility (DOI), type of infertility (TOI) and Ferriman Gallwey scores (FG scores), were compared between the study and control groups and between different phenotype groups of PCOS: Group 1-Hyperandrogenemia (HA)-anovulation (N=34), Group 2-HA-PCO (ovulatory PCOS, (N=34), Group 3-PCO-anovulation (N=32), and Group 4-HA-PCO-anovulation (N=32) and the associations of these parameters with the health quality profile were analyzed. Results: Physical, Spiritual and Environmental scores were significantly lower (p<0.05) in Group 1 patients (HA-AO) in comparison to the other three PCOS groups and the control group, while the same difference was observed in the social scores with a near significance (p=0.05). Linear regeression analyses revealed significant associations between type of infertility (beta coefficient: −0.423, p=0.001), FG score (beta coefficient: −0.177, p=0.016), phenotype 1 (beta coefficient: −0.236, p=0.002) and physical scores. Psychological scores were associated with the type (beta coefficient: −0.641, p=0.001) and duration (beta coefficient: −0.149, p=0.009) of infertility. Scores in the social area were only associated with type of infertility (beta coefficient: −0.443, p=0.001). Scores of environmental area were significantly associated again with the type of infertility (beta coefficient: −0.499, p=0.001) and FG scores (beta coefficient: −0.195, p=0.008). Primary infertility was a risk factor for low physical (odds ratio: 8.100, 95% CI: 3.827–17.142), social (odds ratio: 9

  8. Sexual Dysfunction and Infertility

    MedlinePlus

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

  9. Smoking and Infertility

    MedlinePlus

    ... the American Society for Reproductive Medicine Smoking and infertility Can smoking affect my ability to have a ... smoke do not conceive as efficiently as nonsmokers. Infertility rates in both male and female smokers are ...

  10. Primary infertility (image)

    MedlinePlus

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

  11. Management of primary ciliary dyskinesia/Kartagener's syndrome in infertile male patients and current progress in defining the underlying genetic mechanism

    PubMed Central

    Sha, Yan-Wei; Ding, Lu; Li, Ping

    2014-01-01

    Kartagener's syndrome (KS) is an autosomal recessive genetic disease accounting for approximately 50% of the cases of primary ciliary dyskinesia (PCD). As it is accompanied by many complications, PCD/KS severely affects the patient's quality of life. Therapeutic approaches for PCD/KS aim to enhance prevention, facilitate rapid definitive diagnosis, avoid misdiagnosis, maintain active treatment, control infection and postpone the development of lesions. In male patients, sperm flagella may show impairment in or complete absence of the ability to swing, which ultimately results in male infertility. Assisted reproductive technology will certainly benefit such patients. For PCD/KS patients with completely immotile sperm, intracytoplasmic sperm injection may be very important and even indispensable. Considering the number of PCD/KS susceptibility genes and mutations that are being identified, more extensive genetic screening is indispensable in patients with these diseases. Moreover, further studies into the potential molecular mechanisms of these diseases are required. In this review, we summarize the available information on various aspects of this disease in order to delineate the therapeutic objectives more clearly, and clarify the efficacy of assisted reproductive technology as a means of treatment for patients with PCD/KS-associated infertility. PMID:24369140

  12. Endocrine causes of male infertility.

    PubMed

    Jarow, Jonathan P

    2003-02-01

    Although endocrinopathies are not often seen in infertile men, these disorders are clinically significant; they often have potentially serious medical significance, regardless of fertility issues. Correction of these disorders represents a possible way to restore normal fertility for the male partner. Male fertility is critically dependent upon a normal hormonal milieu. The hypothalamic-pituitary-gonadal axis is quite sensitive to disruption by endocrine disorders and other generalized medical disorders. Thus, male infertility is occasionally the presenting sign for significant underlying medical disease; it is important to properly evaluate these patients.

  13. History of infertility.

    PubMed

    Morice, P; Josset, P; Chapron, C; Dubuisson, J B

    1995-09-01

    Infertility has always been a constant preoccupation. The problems it raises today on medical, social, ethical, political and religious levels bear witness to this emphasis, but also to how complicated infertility is to deal with and understand. This study not only examines the history of infertility and the treatments applied but also the repercussions for infertile women socially. As we look through history, we find that the attitudes of physicians have often reflected the role of the woman and her image in society.

  14. Immune Aspects of Female Infertility

    PubMed Central

    Brazdova, Andrea; Senechal, Helene; Peltre, Gabriel; Poncet, Pascal

    2016-01-01

    Immune infertility, in terms of reproductive failure, has become a serious health issue involving approximately 1 out of 5 couples at reproductive age. Semen that is defined as a complex fluid containing sperm, cellular vesicles and other cells and components, could sensitize the female genital tract. The immune rejection of male semen in the female reproductive tract is explained as the failure of natural tolerance leading to local and/or systemic immune response. Present active immune mechanism may induce high levels of anti-seminal/sperm antibodies. It has already been proven that iso-immunization is associated with infertility. Comprehensive studies with regards to the identification of antibody-targets and the determination of specific antibody class contribute to the development of effective immuno-therapy and, on the other hand, potential immuno-contraception, and then of course to complex patient diagnosis. This review summarizes the aspects of female immune infertility. PMID:27123194

  15. Are human male patients with DAX1/NR0B1 mutations infertile?

    PubMed

    Ravel, Célia; Hyon, Capucine; Siffroi, Jean-Pierre; Christin-Maitre, Sophie

    2014-05-01

    DAX-1 stands for Dosage sensitive sex-reversal, Adrenal hypoplasia congenital (AHC), on the X chromosome. DAX-1 mutations usually cause primary adrenal insufficiency or congenital adrenal hypoplasia in early childhood and hypogonadotropic hypogonadism (MIM # 300200). DAX-1 protein is necessary to maintain normal spermatogenesis. In humans, male fertility has been studied in few patients carrying DAX-1 mutations. Cases of azoospermia have been reported, as well as unsuccessful gonadotropin treatments. The clinician should be informed that TESE-ICSI technique carries a potential hope to father non-affected children, as shown in this review. PMID:24751136

  16. Male infertility. 3. Endocrine causes.

    PubMed

    McNally, M R

    1987-02-01

    Endocrine causes of male infertility range from easily manageable disorders such as hypothyroidism to complex problems such as pituitary tumors. Proper management requires a thorough understanding of the hypothalamic-pituitary-testicular axis. Hormonal evaluation is performed only when the patient's history and results of physical examination indicate an endocrine problem. With proper identification and treatment, most of these problems can be successfully managed.

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

    PubMed Central

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

    2015-01-01

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

  18. Infertility as a psychological problem.

    PubMed

    Podolska, Magdalena Z; Bidzan, Mariola

    2011-01-01

    Recently there has been enormous progress in couple infertility treatment and diagnostics. Some couples cannot conceive despite the fact that there seems to be no objective somatic or immunologic reasons. In such situations gynaecologists are helpless and couples may be overwhelmed by a sense of defeat and hopelessness. Thus, consulting a psychologist or therapist on how to cope better with the problem may be a good solution. The objective of the following paper is to discuss the dilemmas of couples undergoing infertility treatment, related psychological problems, and to determine the need for psychological and therapeutic support. The study demonstrates numerous infertility causes and concludes that there is no universal method of dealing with them. Very frequently psychological and somatic problems overlap. Psychological causes are often the primary factors, but sometimes they are secondary derivatives of the therapeutic process. A wide scope of factors must be considered to attempt psychological analysis of patients treated for infertility including the influence of the family and relations within, reaction to the diagnosis and suggested treatment, the influence of religion on the treatment, the evaluation of the relations in the family of procreation, sexual life assessment, the sense of a woman's self-esteem and self-acceptance. Basing on empirical analysis it was concluded that all women treated for infertility want to create a full family. They have problems in coping with emotional liability during treatment and a sense of fear and failure. Understanding the psychological mechanisms observed in patients treated for infertility might help to diagnose the causes of their problems with facing the new, extremely difficult situation. PMID:21469521

  19. General aspects of fertility and infertility.

    PubMed

    Damario, Mark A

    2014-01-01

    Fertility rates have been declining in most Western nations over the past several decades, although it is not entirely clear if an increased rate of infertility substantially contributes to this. As compared to other species, the reproductive efficiency of humans is relatively low. Factors related to fertility include age, exposure to sexually transmitted diseases, frequency of intercourse, coital timing, as well as diet and lifestyle habits. Infertility is considered a disease due to its major disruption of major organ systems and life functions. An infertility evaluation is recommended after 12 months or more of regular, unprotected intercourse and may be considered after 6 months for those female patients over the age of 35 or with other known abnormalities. A proper infertility evaluation is a comprehensive examination of possibly identifiable infertility factors of both female and male partners, lending itself to the most appropriate and potentially effective treatment.

  20. Genetics of Male Infertility.

    PubMed

    Neto, Filipe Tenorio Lira; Bach, Phil Vu; Najari, Bobby Baback; Li, Philip Shihua; Goldstein, Marc

    2016-10-01

    While 7 % of the men are infertile, currently, a genetic etiology is identified in less than 25 % of those men, and 30 % of the infertile men lack a definitive diagnosis, falling in the "idiopathic infertility" category. Advances in genetics and epigenetics have led to several proposed mechanisms for male infertility. These advances may result in new diagnostic tools, treatment approaches, and better counseling with regard to treatment options and prognosis. In this review, we focus on clinical aspects of male infertility and the role of genetics in elucidating etiologies and the potential of treatments. PMID:27502429

  1. Evaluation of Risk Factors Associated with Endometriosis in Infertile Women

    PubMed Central

    Ashrafi, Mahnaz; Sadatmahalleh, Shahideh Jahanian; Akhoond, Mohammad Reza; Talebi, Mehrak

    2016-01-01

    Background Endometriosis affects women’s physical and mental wellbeing. Symptoms include dyspareunia, dysmenorrhea, pelvic pain, and infertility. The purpose of this study is to assess the correlation between some relevant factors and symptoms and risk of an endometriosis diagnosis in infertile women. Materials and Methods A retrospective study of 1282 surgical patients in an infertility Institute, Iran between 2011 and 2013 were evaluated by laparoscopy. Of these, there were 341 infertile women with endometriosis (cases) and 332 infertile women with a normal pelvis (comparison group). Chi-square and t tests were used to compare these two groups. Logistic regression was done to build a prediction model for an endometriosis diagnosis. Results Gravidity [odds ratio (OR): 0.8, confidence interval (CI): 0.6-0.9, P=0.01], parity (OR: 0.7, CI: 0.6-0.9, P=0.01), family history of endometriosis (OR: 4.9, CI: 2.1-11.3, P<0.001), history of galactorrhea (OR: 2.3, CI: 1.5-3.5, P=0.01), history of pelvic surgery (OR: 1.9, CI: 1.3-2.7, P<0.001), and shorter menstrual cycle length (OR: 0.9, CI: 0.9-0.9, P=0.04) were associated with endometriosis. Duration of natural menstruation and age of menarche were not correlated with subsequent risk of endometriosis (P>0.05). Fatigue, diarrhea, constipation, dysmenorrhea, dyspareunia, pelvic pain and premenstrual spotting were more significant among late-stage endometriosis patients than in those with early-stage endometriosis and more prevalent among patients with endometriosis than that of the comparison group. In the logistic regression model, gravidity, family history of endometriosis, history of galactorrhea, history of pelvic surgery, dysmenorrhoea, pelvic pain, dysparaunia, premenstrual spotting, fatigue, and diarrhea were significantly associated with endometriosis. However, the number of pregnancies was negatively related to endometriosis. Conclusion Endometriosis is a considerable public health issue because it affects many

  2. Evaluation and treatment of infertility.

    PubMed

    Lindsay, Tammy J; Vitrikas, Kristen R

    2015-03-01

    Infertility is defined as the inability to achieve pregnancy after one year of regular, unprotected intercourse. Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years. Causes of infertility include male factors, ovulatory dysfunction, uterine abnormalities, tubal obstruction, peritoneal factors, or cervical factors. A history and physical examination can help direct the evaluation. Men should undergo evaluation with a semen analysis. Abnormalities of sperm may be treated with gonadotropin therapy, intrauterine insemination, or in vitro fertilization. Ovulation should be documented by serum progesterone level measurement at cycle day 21. Evaluation of the uterus and fallopian tubes can be performed by hysterosalpingography in women with no risk of obstruction. For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended. Women with anovulation may be treated in the primary care setting with clomiphene to induce ovulation. Treatment of tubal obstruction generally requires referral for subspecialty care. Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization. PMID:25822387

  3. Genetic dosage and position effect of small supernumerary marker chromosome (sSMC) in human sperm nuclei in infertile male patient.

    PubMed

    Olszewska, Marta; Wanowska, Elzbieta; Kishore, Archana; Huleyuk, Nataliya; Georgiadis, Andrew P; Yatsenko, Alexander N; Mikula, Mariya; Zastavna, Danuta; Wiland, Ewa; Kurpisz, Maciej

    2015-11-30

    Chromosomes occupy specific distinct areas in the nucleus of the sperm cell that may be altered in males with disrupted spermatogenesis. Here, we present alterations in the positioning of the human chromosomes 15, 18, X and Y between spermatozoa with the small supernumerary marker chromosome (sSMC; sSMC(+)) and spermatozoa with normal chromosome complement (sSMC(-)), for the first time described in the same ejaculate of an infertile, phenotypically normal male patient. Using classical and confocal fluorescent microscopy, the nuclear colocalization of chromosomes 15 and sSMC was analyzed. The molecular cytogenetic characteristics of sSMC delineated the karyotype as 47,XY,+der(15)(pter->p11.2::q11.1->q11.2::p11.2->pter)mat. Analysis of meiotic segregation showed a 1:1 ratio of sSMC(+) to sSMC(-) spermatozoa, while evaluation of sperm aneuploidy status indicated an increased level of chromosome 13, 18, 21 and 22 disomy, up to 7 × (2.7 - 15.1). Sperm chromatin integrity assessment did not reveal any increase in deprotamination in the patient's sperm chromatin. Importantly, we found significant repositioning of chromosomes X and Y towards the nuclear periphery, where both chromosomes were localized in close proximity to the sSMC. This suggests the possible influence of sSMC/XY colocalization on meiotic chromosome division, resulting in abnormal chromosome segregation, and leading to male infertility in the patient.

  4. Psychosocial Consequences of Infertility on Infertile Women.

    PubMed

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

    2015-10-01

    This study explores to find out the qualitative and quantitative psychosocial consequences of infertility in women coming for infertility treatment in tertiary infertility center. A total of 400 infertile couples who agreed to participate in the study were asked to fill up the questionnaires and later interviewed to access the psychosocial consequences of infertility on their personal life in a tertiary infertility clinic in Dhaka at Center for Assisted Reproduction (CARe Hospital), Dhaka from June 2011 to December 2011 and agreed to participate in the study were included in the study. The data was analyzed and the quantitative and qualitative psychosocial factors were evaluated. Four hundred infertile couple who filled the questionnaires was included in the study. Sixty three percent of the women belonged to age group >20 30 years at the time of interview. Regarding age at marriage 43.8% of the women were married by 20 years, 51.3% were married between 20 30 years. Mean±SD duration of present married life was 7.20±4.45 (range 1 to 28) years and 74.4% of the women were living with their husbands. Of them 75.5% women were housewife. When asked whether they knew what was the reason of infertility in the couple, 32.5% knew the cause was in the female partner, 14.5%, knew the cause was in the male partner, 10.3% knew the cause was in both partners, 21.5% knew cause of infertility was not in any of the partners, and 21.3% had no idea about the cause of infertility. The male partner's response about the issue of prognosis and outcome of couple's infertility revealed 37.3% believed their wives will conceive someday, 31.3% had no intention for a second marriage, 13% were indifferent, 11.3% blamed their wives for infertility and 4.8% threatened for a second marriage. Only 2.5% of the male partners were suggested on consulting and continuing treatment by specialist. The family pressure by in-laws and relatives towards their infertility was that 57.3% insisted on consulting

  5. Psychosocial Consequences of Infertility on Infertile Women.

    PubMed

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

    2015-10-01

    This study explores to find out the qualitative and quantitative psychosocial consequences of infertility in women coming for infertility treatment in tertiary infertility center. A total of 400 infertile couples who agreed to participate in the study were asked to fill up the questionnaires and later interviewed to access the psychosocial consequences of infertility on their personal life in a tertiary infertility clinic in Dhaka at Center for Assisted Reproduction (CARe Hospital), Dhaka from June 2011 to December 2011 and agreed to participate in the study were included in the study. The data was analyzed and the quantitative and qualitative psychosocial factors were evaluated. Four hundred infertile couple who filled the questionnaires was included in the study. Sixty three percent of the women belonged to age group >20 30 years at the time of interview. Regarding age at marriage 43.8% of the women were married by 20 years, 51.3% were married between 20 30 years. Mean±SD duration of present married life was 7.20±4.45 (range 1 to 28) years and 74.4% of the women were living with their husbands. Of them 75.5% women were housewife. When asked whether they knew what was the reason of infertility in the couple, 32.5% knew the cause was in the female partner, 14.5%, knew the cause was in the male partner, 10.3% knew the cause was in both partners, 21.5% knew cause of infertility was not in any of the partners, and 21.3% had no idea about the cause of infertility. The male partner's response about the issue of prognosis and outcome of couple's infertility revealed 37.3% believed their wives will conceive someday, 31.3% had no intention for a second marriage, 13% were indifferent, 11.3% blamed their wives for infertility and 4.8% threatened for a second marriage. Only 2.5% of the male partners were suggested on consulting and continuing treatment by specialist. The family pressure by in-laws and relatives towards their infertility was that 57.3% insisted on consulting

  6. Human catalase gene polymorphism (CAT C-262T) and risk of male infertility.

    PubMed

    Sabouhi, S; Salehi, Z; Bahadori, M H; Mahdavi, M

    2015-02-01

    Infertility is the failure of a couple to engender after endeavouring at least one full year of unprotected intercourse. It has been reported that reactive oxygen species contributed to pathogenesis of various disease. To inactivate ROS cells biosynthesise several antioxidant enzymes, one of them is catalase which contributes H2 O2 to H2 O and O2 . This study set out to delineate the association of catalase C-262T polymorphism with idiopathic male infertility. The study included 195 men with idiopathic infertility and 190 healthy volunteers. Genomic DNA was extracted from peripheral blood leucocytes. Genotype and allele frequencies were determined in patients and controls using allele-specific PCR (AS-PCR). The prevalence of genotype frequencies of the CAT CC/CT/TT was 31.79%, 65.12% and 3.07%, respectively, in infertile subjects, as against 24.73%, 55.26% and 20%, respectively, in healthy volunteers. Statistical analysis has emerged significant difference from the comparison of either genotype (P < 0.05). Taking into accounts of results, the catalase C-262T polymorphism indicates that CAT-262T/T genotype confers less susceptibility to male infertility. Further studies with larger numbers of patients are required for further evaluation and confirmation of our finding.

  7. A Comparison of Pattern of Pregnancy Loss in Women with Infertility Undergoing IVF and Women with Unexplained Recurrent Miscarriages Who Conceive Spontaneously

    PubMed Central

    Tamhankar, Vidya A.; Liu, Beiyu; Yan, Junhao; Li, Tin-Chiu

    2015-01-01

    Objective. Women with infertility and recurrent miscarriages may have an overlapping etiology. The aim of this study was to compare the pregnancy loss in pregnancies after IVF treatment with spontaneous pregnancies in women with recurrent miscarriages and to assess differences related to cause of infertility. Methods. The outcome from 1220 IVF pregnancies (Group I) was compared with 611 spontaneous pregnancies (Group II) in women with recurrent miscarriages. Subgroup analysis was performed in Group I based on cause of infertility: tubal factor (392 pregnancies); male factor (610 pregnancies); and unexplained infertility (218 pregnancies). Results. The clinical pregnancy loss rate in Group I (14.3%) was significantly lower than that of Group II (25.8%, p < 0.001) and this was independent of the cause of infertility. However the timing of pregnancy loss was similar between Groups I and II. The clinical pregnancy loss rate in Group I was similar in different causes of infertility. Conclusions. The clinical pregnancy loss rate following IVF treatment is lower than that of women with unexplained recurrent miscarriages who conceived spontaneously. This difference persists whether the infertility is secondary to tubal factors, male factors, or unexplained cause. PMID:26576157

  8. Prostatitis and male infertility.

    PubMed

    Alshahrani, Saad; McGill, John; Agarwal, Ashok

    2013-11-01

    The prostate gland plays an important role in male reproduction. Inflammation of the prostate gland (prostatitis) is a common health problem affecting many young and middle aged men. Prostatitis is considered a correctable cause of male infertility, but the pathophysiology and appropriate treatment options of prostatitis in male infertility remain unclear. This literature review will focus on current data regarding prostatitis and its impact on male infertility.

  9. Small Supernumerary Marker Chromosomes in Human Infertility.

    PubMed

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

    2015-01-01

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

  10. Evaluation of the general health of the infertile couples

    PubMed Central

    Baghiani Moghadam, Mohammad Hossein; Aminian, Amir Hosein; Abdoli, Ali Mohammad; Seighal, Najmeh; Falahzadeh, Hosein; Ghasemi, Nasrin

    2011-01-01

    Background: The prevalence of infertility is variable between 5-30% around the world. In Iran, more than 2 million couples suffer from infertility. Infertility causes depression, anxiety, social isolation and sexual dysfunction. Objective: This descriptive study was undertaken to determine general health in infertile couples. Materials and Methods: One hundred and fifty infertile couples attending Yazd Research and Clinical Center for Infertility were randomly selected during March till September 2009. The GHQ-28 questionnaires were completed by researchers, based on face to face interview. It contains 28 items, which have been divided to four sub- items. The results come out by scoring the patients answer from 0 to 84. All data were analyzed by Chi-square and t-test in SPSS software. Results: GHQ scores of all sub-scales and total in women were more than men, which shows general health condition in women is worse than men. There was no relation between the duration of infertility and general health scores. Conclusion: This study suggests that the infertility has significant effect (p=0.001) on health situation of infertile couples, especially infertile women. They are at risk of somatic symptoms (p=0.0001), social dysfunction (p=0.0001) and severe depression (p=0.0001). GHQ could provided help and support in order to improve the health situation of infertile couples. PMID:26396581

  11. Infertility and Reproductive Function in Patients with Congenital Adrenal Hyperplasia: Pathophysiology, Advances in Management, and Recent Outcomes.

    PubMed

    Lekarev, Oksana; Lin-Su, Karen; Vogiatzi, Maria G

    2015-12-01

    Individuals with congenital adrenal hyperplasia have reduced fertility. However, reproductive outcomes have improved over the years. This review provides an update on the multiple pathologic processes that contribute to reduced fertility in both sexes, from alterations of the hypothalamic-pituitary-gonadal axis to the direct effect on gonadal function by elevated circulating adrenal androgens. In addition, elevated serum progesterone concentrations may hinder ovulation and embryo implantation in women, whereas in men testicular adrenal rest tumors can be a major cause of infertility. Suppression of adrenal androgen secretion represents the first line of therapy toward spontaneous conception in both sexes.

  12. What Infertility Treatments Are Available?

    MedlinePlus

    ... for Males Fertility Treatments for Females Assisted Reproductive Technology (ART) Treatments for Diseases That Cause Infertility American Society for Reproductive Medicine. (2012) Quick facts about infertility . ...

  13. Frequency and outcome of treatment in polycystic ovaries related infertility

    PubMed Central

    Arain, Farzana; Arif, Nesreen; Halepota, Hafeez

    2015-01-01

    Background: Infertility is defined as inability of couple to conceive after one year of unprotected intercourse. The prevalence of infertility in Pakistan is 21.9%. The most common cause of medically treatable infertility is polycystic ovarian syndrome (PCO). This study was conducted to see the frequency and outcome of treatment in PCOs related infertility in infertile couples coming to Mohammad Medical College Hospital, Mirpurkhas, Sindh. Methods: This prospective observational study was conducted at Muhammad Medical College for three years from 2005 to 2008. Total 1289 infertile couples were included in this study. Result: The frequency of PCOs in female related infertility was 38.5%. Other causes of female infertility were in the frequency of 44% pelvic inflammatory disease, 12.3% endometriosis, 2.9% hyperprolactenemia, and 1.35% hypothyroidism. Patients with PCOS were given different treatment modalities. One hundred fifty patients with PCO were given ovulation induction with clomephene citrate and out of them 109 (72%) conceived. Sixty three women were given combination of clomephene citrate and Metformin. Out of them 50 (79%) conceived. Five patients were given gonadotrophins, Out of them 2 (40%) patients conceived. Five patients had laparoscopic drilling out of them 3 (60%) conceived. Conclusion: In contrast to the literature review Polycystic Ovarian Syndrome turned out to be the second most common cause of female related infertility. But as the international literature shows it had very good out come after medical and /or surgical treatment. PMID:26150870

  14. A survey on depression among infertile women in Ghana

    PubMed Central

    2014-01-01

    Background The desire of many young women to become parents may be influenced by the premium placed on children by society. In Africa, children are highly valued for social, cultural and economic reasons. Infertile and childless women in Africa are therefore confronted with a series of societal discrimination and stigmatization which may lead to psychological disorders such as anxiety and depression. Even though some research has been done on the prevalence of infertility in Ghana, very little is known about the psychological impact of childlessness among infertile women. The present study aimed to examine prevalence and severity of depression in relation to age, type of infertility and duration of infertility in Ghanaian infertile women. Methods A total of 100 infertile women who met the selection criteria and had agreed to participate in the study were interviewed using the Beck Depression Inventory questionnaire from December 2012 to April 2013 at the Tamale Teaching Hospital, Tamale/Ghana. Data concerning socio-demographic characteristics such as age, monthly income, duration of infertility, marital status, educational level, number of previous conception, number of previous children, religion, as well as occupation of the respondents were recorded. Results The prevalence of depression among the women was 62.0% with the level of depression showing a significant positive correlation with age of the women and the duration of infertility. The level of depression was significantly higher among subjects with low or no formal education and among the unemployed. Women with primary infertility also presented with high depression scores as measured by BDI. Conclusions In conclusion, the prevalence of depression among the infertile women is high, especially among infertile women age 26 and above, those who are less educated, those with primary infertility, as well as those who have been diagnosed as infertile for more than 3 years. Interventions to decrease and prevent

  15. Precancerous lesions of the cervix uteri in infertile women.

    PubMed

    Holst, N; Abyholm, T

    1983-10-01

    A study of 318 patients with tubal infertility and a control group of 200 unselected infertile women yielded 14 (4.4%) and 1 (0.5%), respectively, with precancerous lesions of the cervix uteri. The one patient in the control group with severe dysplasia was later shown to have tubal infertility. The overall incidence of premalignant lesions of the cervix uteri as reported to the National Cancer Registry of Norway was 0.1% for the age group and period studied. Women with tubal infertility represent a small but comparatively high risk group for the development of precancerous lesions of the cervix uteri.

  16. Unusually low prevalence of Mycoplasma genitalium in urine samples from infertile men and healthy controls: a prevalence study

    PubMed Central

    Plecko, Vanda; Zele-Starcevic, Lidija; Tripkovic, Vesna; Skerlev, Mihael; Ljubojevic, Suzana; Plesko, Sanja; Marekovic, Ivana; Jensen, Jorgen Skov

    2014-01-01

    Objective To detect Mycoplasma genitalium in urine samples of infertile men and men without any signs of infection in order to investigate whether M. genitalium and other genital mycoplasmas (Mycoplasma hominis and Ureaplasma spp) are found more often in urine samples of infertile men than in asymptomatic controls and to determine resistance to macrolides. Methods The study included first void urine samples taken from 145 infertile men and 49 men with no symptoms of urethritis. M. genitalium, Chlamydia trachomatis and Neisseria gonorrhoeae were detected by commercial PCR. Trichomonas vaginalis was detected by microscopy and culture. M. hominis and Ureaplasma spp were detected by culture. M. genitalium was detected by in-house conventional and real-time PCR. Results Two M. genitalium positive samples were found among samples obtained from infertile men. All asymptomatic men were M. genitalium negative. Macrolide resistance was not found in either of the two positive samples. Conclusions In comparison with reported data, an unusually low prevalence of M. genitalium was found in infertile men. The reasons for this unexpected result are not known; possibly, local demographic and social characteristics of the population influenced the result. Further studies to investigate M. genitalium in infertile and other groups of patients are needed. PMID:25157184

  17. Genetic causes of male infertility.

    PubMed

    Stouffs, Katrien; Seneca, Sara; Lissens, Willy

    2014-05-01

    Male infertility, affecting around half of the couples with a problem to get pregnant, is a very heterogeneous condition. Part of patients are having a defect in spermatogenesis of which the underlying causes (including genetic ones) remain largely unknown. The only genetic tests routinely used in the diagnosis of male infertility are the analyses for the presence of Yq microdeletions and/or chromosomal abnormalities. Various other single gene or polygenic defects have been proposed to be involved in male fertility. Yet, their causative effect often remains to be proven. The recent evolution in the development of whole genome-based techniques may help in clarifying the role of genes and other genetic factors involved in spermatogenesis and spermatogenesis defects.

  18. Genetic dosage and position effect of small supernumerary marker chromosome (sSMC) in human sperm nuclei in infertile male patient

    PubMed Central

    Olszewska, Marta; Wanowska, Elzbieta; Kishore, Archana; Huleyuk, Nataliya; Georgiadis, Andrew P.; Yatsenko, Alexander N.; Mikula, Mariya; Zastavna, Danuta; Wiland, Ewa; Kurpisz, Maciej

    2015-01-01

    Chromosomes occupy specific distinct areas in the nucleus of the sperm cell that may be altered in males with disrupted spermatogenesis. Here, we present alterations in the positioning of the human chromosomes 15, 18, X and Y between spermatozoa with the small supernumerary marker chromosome (sSMC; sSMC+) and spermatozoa with normal chromosome complement (sSMC−), for the first time described in the same ejaculate of an infertile, phenotypically normal male patient. Using classical and confocal fluorescent microscopy, the nuclear colocalization of chromosomes 15 and sSMC was analyzed. The molecular cytogenetic characteristics of sSMC delineated the karyotype as 47,XY,+der(15)(pter->p11.2::q11.1->q11.2::p11.2->pter)mat. Analysis of meiotic segregation showed a 1:1 ratio of sSMC+ to sSMC− spermatozoa, while evaluation of sperm aneuploidy status indicated an increased level of chromosome 13, 18, 21 and 22 disomy, up to 7 × (2.7 − 15.1). Sperm chromatin integrity assessment did not reveal any increase in deprotamination in the patient’s sperm chromatin. Importantly, we found significant repositioning of chromosomes X and Y towards the nuclear periphery, where both chromosomes were localized in close proximity to the sSMC. This suggests the possible influence of sSMC/XY colocalization on meiotic chromosome division, resulting in abnormal chromosome segregation, and leading to male infertility in the patient. PMID:26616419

  19. Infertility, Fertility Treatment, and Risk of Hypertension

    PubMed Central

    Farland, Leslie V; Grodstein, Francine; Srouji, Serene S; Forman, John P; Rich-Edwards, Janet; Chavarro, Jorge E; Missmer, Stacey A

    2015-01-01

    Objective To evaluate the association between infertility and fertility treatments on subsequent risk of hypertension. Design Cohort Study Setting Nurses’ Health Study II Patients 116,430 female nurses followed from 1993 to June 2011 as part of the Nurses' Health Study II cohort. Intervention None Main Outcome Measures Self-reported, physician diagnosed hypertension Results Compared to women who never reported infertility, infertile women were at no greater risk of hypertension (multi-variable adjusted relative risk (RR) = 1.01 95% confidence interval [0.94–1.07]). Infertility due to tubal disease was associated with a higher risk of hypertension (RR=1.15 [1.01–1.31]) but all other diagnoses were not associated with hypertension risk compared to women who did not report infertility (ovulatory disorder: RR=1.03 [0.94–1.13], cervical: RR=0.88 [0.70–1.10], male factor: RR= 1.05 [0.95–1.15], other reason: RR=1.02 [0.94–1.11], reason not found: RR=1.02 [0.95–1.10]). Among infertile women there were 5,070 cases of hypertension. No clear pattern between use of fertility treatment and hypertension was found among infertile women (Clomiphene: RR =0.97 [0.90–1.04], Gonadotropin alone: RR=0.97 [0.87–1.08], IUI: RR=0.86 [0.71–1.03], IVF: RR=0.86 [0.73–1.01]). Conclusion Among this relatively young cohort of women, there was no apparent increase in hypertension risk among infertile women or among women who underwent fertility treatment in the past. PMID:26049054

  20. Yoga: an adjunct to infertility treatment.

    PubMed

    Khalsa, Hari Kaur

    2003-10-01

    Yoga and meditation can help women experiencing the challenges of infertility. The practice of meditation and relaxation can help increase the clarity of the mind, maintain healthy body chemistry, and give patients the patience to undergo the rigors of infertility treatments. When one understands and can attain physical relaxation, one tends to feel better about the body itself, and begins to treat the body with more respect. This understanding can lead to healthier lifestyle habits as well as increased sensitivity regarding symptoms and body processes. This is beneficial to both doctor and patient as the patient can report with more clarity and sense cycles and physical issues more readily.

  1. [Genetic risks of intracytoplasmic sperm injection for male infertility].

    PubMed

    Shao, Fa-Ming; Zhu, Xiao-Bin; Li, Zheng

    2008-01-01

    Recently, intracytoplasmic sperm injection (ICSI) has been extremely successful in the treatment of male infertility. However, the consequent transmission of sperm cytogenetic defects and genetic defects to the offspring has aroused considerable concern. Among infertile men, those with severe spermatogenic defects, including oligozoospermia and azoospermia, are mostly the subjects for ICSI. Therefore it is very important to obtain cytogenetic and chromosomal information on these infertile patients and prevent the inheritance of these genetic defects. This review offers an analysis on the genetic defects among infertile men.

  2. GESTATIONAL HYPERTENSION IN PREGNANCIES SUPPORTED BY INFERTILITY TREATMENTS. ROLE OF INFERTILITY, TREATMENTS, AND MULTIPLE GESTATIONS

    PubMed Central

    Hernández-Díaz, Sonia; Werler, Martha M.; Mitchell, Allen A.

    2009-01-01

    Objective To investigate the association between infertility treatments and gestational hypertension and preeclampsia. Design Retrospective observational cohort. Setting General population, United States and Canada. Patients 5151 women with non-malformed infants participating in the Slone Epidemiology Center Birth Defects Study between 1998 and 2006. Interventions Women were interviewed within six months after delivery about sociodemographic and medical factors, the onset of gestational hypertension and preeclampsia, and about infertility treatments. Main Outcome Measures We estimated relative risks and 95% confidence intervals using unconditional logistic regression. Results The incidence of gestational hypertension was 8.9% (423/4762) among women without infertility treatments, and 15.8% (55/349) among women undergoing infertility treatments. Compared to spontaneous pregnancies, the crude relative risk for gestational hypertension in pregnancies resulting from infertility treatments was 1.9 (95% confidence interval 1.4–2.6). Multivariate adjustment for parity and pre-pregnancy BMI resulted in a relative risk of 1.6 (1.1–2.1). Further adjustment for multiple pregnancies, or restriction of the analyses to singleton pregnancies, moved the relative risk to 1.3. Each specific infertility procedure or drug was associated with a similarly elevated risk, which disappeared after adjustment for multiple gestations. Results were similar for preeclampsia. Conclusion Pregnancies resulting from infertility treatments have a higher incidence of gestational hypertension and preeclampsia than spontaneous conceptions. This increased risk is largely explained by the higher frequency of multiple gestations. PMID:17449034

  3. STDs and Infertility

    MedlinePlus

    ... literature review to support an infertility prevention social marketing campaign Male Chlamydia Screening Consultation - Review and guidance ( ... Health Follow STD STD on Twitter STD on Facebook File Formats Help: How do I view different ...

  4. Parenthood after Primary Infertility.

    ERIC Educational Resources Information Center

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

    2003-01-01

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

  5. Hyperprolactinemia and female infertility.

    PubMed

    Jones, E E

    1989-02-01

    Hyperprolactinemia is a common endocrine cause of infertility in women. The pathophysiology of hyperprolactinemia in infertility is understood incompletely; however, the adverse effects of high circulating levels of prolactin on the hypothalamic-pituitary-ovarian axis cause chronic anovulation and other defects of ovarian function. Mechanisms for prolactin-induced anovulation have been postulated, and there are several contemporary approaches to the diagnosis and treatment of prolactin-secreting pituitary adenomas.

  6. Diagnostic imaging of infertility

    SciTech Connect

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

    1987-01-01

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

  7. Varicocele and male infertility in Northeast China: Y chromosome microdeletion as an underlying cause.

    PubMed

    Dai, R L; Hou, Y; Li, F B; Yue, J M; Xi, Q; Liu, R Z

    2015-06-12

    The prevalence of Y chromosome microdeletions among azoospermic, severe oligozoospermic, moderate oligozoospermic, and mild oligozoospermic patients with varicocele-related and idiopathic infertility shows conflicting data in Asian countries. We aimed to detect this frequency in Northeast China, and investigated spermatogenic defects whether associated with varicocele or Y chromosome microdeletions. All samples underwent a thorough physical examination, semen analysis, and PCR analyses for Y chromosome microdeletions. We randomly selected 150 infertile non-obstructive azoospermic patients with left varicocele (Group 1), 150 idiopathic non-obstructive azoospermic infertility patients (Group 2), 150 infertile severe oligozoospermic patients with left varicocele (Group 3), 150 idiopathic severe oligozoospermic infertility patients (Group 4), 150 infertile moderate oligozoospermic patients with left varicocele (Group 5), 150 idiopathic moderate oligozoospermic infertility patients (Group 6), 150 infertile mild oligozoospermic patients with left varicocele (Group 7), 150 idiopathic mild oligozoospermic infertility patients (Group 8), and 60 healthy unrelated men with proven fertility were recruited as control subjects (Group 9). We observed that our samples from Northeastern China had a higher frequency of microdeletions among the non-obstructive azoospermic individuals with varicocele, as compared with other Asian countries. Furthermore, the spermatogenic defect is due to the underlying Y chromosome microdeletion, and not the varicocele itself. Although varicocele is not the cause of male infertility, it may be associated with male infertility in the Northeastern Chinese population.

  8. Psychological issues of infertility and assisted reproductive technology.

    PubMed

    Mahlstedt, P P

    1994-08-01

    This article presents a model for conceptualizing the emotional consequences of infertility experienced by most couples with this problem. The article also discusses the need for patient preparation for alternative reproductive techniques with donor gametes and examines the main issues that need to be explored. Recommendations are made for physicians and couples challenged by infertility's intense and surprising emotional consequences. PMID:8059508

  9. A modified ultra-long pituitary downregulation protocol improved endometrial receptivity and clinical outcome for infertile patients with polycystic ovarian syndrome

    PubMed Central

    GONG, FEI; LI, XIHONG; ZHANG, SHUNJI; MA, HAINAN; CAI, SUFEN; LI, JUAN; LIN, GE; LU, GUANGXIU

    2015-01-01

    There are currently various protocols for in vitro fertilization (IVF). For patients with polycystic ovarian syndrome (PCOS), an optimized protocol for the downregulation of pituitary follicle stimulating hormone and luteinizing hormone via gonadotropin-releasing hormone agonist (GnRHa) remains a challenge. In the present study, the primary endpoint of an ultra-long and a conventional long GnRHa protocol for intracytoplasmic sperm injection/IVF treatments of patients with PCOS was retrospectively compared. In the modified ultra-long protocol group, endometrial thickness, morphology, and blood flow were significantly improved, as compared with in the conventional long protocol group. Furthermore, the serum progestogen (P) concentrations and P/estrogen (E2) [(Px1,000/E2)] ratio on the day of human chorionic gonadotrophin administration were significantly decreased in the modified ultra-long downregulation group, whereas the pregnancy and implantation rates were significantly higher. There were no significant differences in the average number of obtained oocytes, good quality embryo rates, cancel rates, fertilization rates, abortion rates, serious ovarian hyperstimulation syndrome incidences, ectopic pregnancy rates or gonadotropin (Gn) dosages between the two groups. These results suggest that the modified ultra-long protocol plus human menopausal Gn medication may be superior to the conventional long protocol, and may lead to improved implantation and pregnancy outcomes for infertile patients with PCOS. PMID:26640563

  10. Threefold increased risk of infertility: a meta‐analysis of infertility after ileal pouch anal anastomosis in ulcerative colitis

    PubMed Central

    Waljee, A; Waljee, J; Morris, A M; Higgins, P D R

    2006-01-01

    Background Increased infertility in women has been reported after ileal pouch‐anal anastomosis (IPAA) for ulcerative colitis but reported infertility rates vary substantially. Aims (1) To perform a systematic review and meta‐analysis of the relative risk of infertility post‐IPAA compared with medical management; (2) to estimate the rate of infertility post‐IPAA; and (3) to identify modifiable risk factors which contribute to infertility. Methods Medline, EMBASE, Current Contents, meeting abstracts, and bibliographies were searched independently by two investigators. The titles and abstracts of 189 potentially relevant studies were reviewed; eight met the criteria and all data were extracted independently. Consensus was achieved on each data point, and fixed effects meta‐analyses, a funnel plot, and sensitivity analyses were performed. Results The initial meta‐analysis of eight studies had significant heterogeneity (p = 0.004) due to one study with very high preoperative infertility (38%). When this study was omitted, the relative risk of infertility after IPAA was 3.17 (2.41–4.18), with non‐significant heterogeneity. The weighted average infertility rate in medically treated ulcerative colitis was 15% for all seven studies, and the weighted average infertility rate was 48% after IPAA (50% if all eight studies are included). We were unable to identify any procedural factors that consistently affected the risk of infertility. Conclusions IPAA increases the risk of infertility in women with ulcerative colitis by approximately threefold. Infertility, defined as achieving pregnancy in 12 months of attempting conception, increased from 15% to 48% in women post‐IPAA for ulcerative colitis. This provides a basis for counselling patients considering colectomy with IPAA. Further studies of modifiable risk factors are needed. PMID:16772310

  11. Infertility and uterine fibroids.

    PubMed

    Zepiridis, Leonidas I; Grimbizis, Grigoris F; Tarlatzis, Basil C

    2016-07-01

    Uterine fibroids are the most common tumors in women and their prevalence is higher in patients with infertility. At present, they are classified according to their anatomical location, as no classification system includes additional parameters such as their size or number. There is a general agreement that submucosal fibroids negatively affect fertility, when compared to women without fibroids. Intramural fibroids above a certain size (>4 cm), even without cavity distortion, may also negatively influence fertility. However, the presence of subserosal myomas has little or no effect on fertility. Many possible theories have been proposed to explain how fibroids impair fertility: mechanisms involving alteration of local anatomical location, others involving functional changes of the myometrium and endometrium, and finally endocrine and paracrine molecular mechanisms. Nevertheless, any of the above mentioned mechanisms can cause reduced reproductive potential, thereby leading to impaired gamete transport, reduced ability for embryo implantation, and creation of a hostile environment. The published experience defines the best practice strategy, as not many large, well-designed, and properly powered studies are available. Myomectomy appears to have an effect in fertility improvement in certain cases. Excision of submucosal myomas seems to restore fertility with pregnancy rates after surgery similar to normal controls. Removal of intramural myomas affecting pregnancy outcome seems to be associated with higher pregnancy rates when compared to non-operated controls, although evidence is still nοt sufficient. Treatment of subserosal myomas of reasonable size is not necessary for fertility reasons. The results of endoscopic and open myomectomy are similar; thus, endoscopic treatment is the recommended approach due to its advantages in patient's postoperative course. PMID:26856931

  12. Male infertility: biomolecular aspects.

    PubMed

    Pizzol, Damiano; Bertoldo, Alessandro; Foresta, Carlo

    2014-12-01

    Male infertility is a problem that faces increasing interest, and the continuous development of assisted reproduction techniques solicits attempts to identify a precise diagnosis, in particular for idiopathic infertile couples and those undergoing assisted reproductive technique cycles. To date, diagnosis of male infertility is commonly based on standard semen analysis, but in many cases, this is not enough to detect any sperm abnormality. A better understanding of biomolecular issues and mechanism of damaged spermatogenesis and the refinement of the molecular techniques for sperm evaluation and selection are important advances that can lead to the optimization of diagnostic and therapeutic management of male and couple infertility. Faced with a growing number of new proposed techniques and diagnostic tests, it is fundamental to know which tests are already routinely used in the clinical practice and those that are likely to be used in the near future. This review focuses on the main molecular diagnostic techniques for male infertility and on newly developed methods that will probably be part of routine sperm analysis in the near future.

  13. A Study of Couple Burnout in Infertile Couples

    PubMed Central

    Ghavi, Fatemeh; Jamale, Safieh; Mosalanejad, Leili; Mosallanezhad, Zahra

    2016-01-01

    Introduction: Infertility is a major crisis that can cause psychological problems and emotionally distressing experiences, and eventually affect a couples’ relationship. The objective of this study is to investigate couple burnout in infertile couples who were undergoing treatmentat the Infertility Clinic of Yazd, Iran. Method: The present study is a cross-sectional descriptive one on 98 infertile couples referringto the Infertility Centerof Yazd, Iran, who were chosen on a simple random sampling basis. The measuring tools consisted of the Couple Burnout Measure (CBM) and a demographic questionnaire. The collected data were analyzed using SPSS 16 and the statistical tests of ANOVA and t-test. P-values less than 0.05 were considered as significant. Results: The results show that infertile women experience higher levels of couple burnout than their husbands (p<0.001). Also, a comparison of the scales of couple burnout—psychological burnout (p<0.01), somatic burnout (p<0.01), and emotional burnout (p<0.001)—between wives and husbands show that women are at greater risk. Conclusion: Infertile couples’ emotional, mental, and sexual problems need to be addressed as part of the infertility treatment programs, and psychotherapists should be included in the medical team. PMID:26573033

  14. Clomiphene for the treatment of male infertility.

    PubMed

    Willets, Amy E; Corbo, Jason M; Brown, Jamie N

    2013-07-01

    Male infertility is a relatively common condition caused by low sperm production, immobile sperm, or blockages that prevent the delivery of sperm. This condition can be caused by a variety of illnesses, injuries, chronic health problems, lifestyle choices, other factors, or idiopathic, in which abnormal semen parameters occur without an identifiable cause. Medical management traditionally focuses on correcting endocrine abnormalities related to hormone deficiencies. Clomiphene citrate is an antiestrogen thought to increase sperm parameters in males attempting to conceive. The objective of this review was to evaluate the efficacy and safety of clomiphene citrate in the treatment of male patients with infertility. A literature search of MEDLINE (1966-June 2012) and EMBASE (1980-June 2012) was conducted using the medical terms clomiphene and male infertility and 9 clinical studies were identified. Overall, only 1 study detected a statistically significant benefit on the pregnancy rate in the clomiphene group; however, the majority of the studies demonstrated a statistically significant increase in sperm concentrations. At doses used to treat male infertility, clomiphene was well tolerated with no identified serious adverse effects. Based on the reviewed studies there is insufficient evidence to indicate that clomiphene is effective for the treatment of male infertility.

  15. Drug-induced infertility.

    PubMed

    Buchanan, J F; Davis, L J

    1984-02-01

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

  16. Psychosomatic aspects in idiopathic infertility: effects of treatment with autogenic training.

    PubMed

    O'Moore, A M; O'Moore, R R; Harrison, R F; Murphy, G; Carruthers, M E

    1983-01-01

    It has long been recognised that there is a relationship between emotional stress and some forms of infertility. We have endeavoured to estimate "stress' levels before and after Autogenic Training in 15 couples with infertility of at least two years' duration. Potential stress markers were: plasma prolactin, total urinary free cortisol and catecholamines, and four psychological tests: Spielberger State-Trait anxiety scale, Taylor Manifest Anxiety Scale, the Cattell 16 personality factor questionnaire, and the Eysenck Personality Questionnaire. A control group of ten normal couples was included for comparison. The biochemical finding of higher mean prolactin levels in the female patients vs their controls was of particular interest. The significant reduction of the prolactin level, in parallel with decreased anxiety scores following treatment, supports the hypothesis that the elevated prolactin levels in these patients are indeed linked with emotional stress.

  17. Comparison of assisted reproductive technology outcomes in infertile women with polycystic ovary syndrome: In vitro maturation, GnRH agonist, and GnRH antagonist cycles

    PubMed Central

    Choi, Min Hye; Lee, Sun Hee; Kim, Hye Ok; Cha, Sun Hwa; Kim, Jin Young; Yang, Kwang Moon; Song, In Ok; Koong, Mi Kyoung; Kang, Inn Soo

    2012-01-01

    Objective We compared the assisted reproductive technology (ART) outcomes among infertile women with polycystic ovary syndrome (PCOS) treated with IVM, conventional IVF, GnRH agonist, and GnRH antagonist cycles. Methods The prospective study included a total of 67 cycles in 61 infertile women with PCOS. The women with PCOS were randomized into three IVF protocols: IVM/IVF with FSH and hCG priming with immature oocyte retrieval 38 hours later (group A, 14 cycles), GnRH agonist long protocol (group B, 14 cycles), and GnRH antagonist multi-dose flexible protocol (group C, 39 cycles). IVF outcomes, such as clinical pregnancy rate (CPR), implantation rate (IR), miscarriage rate (MR), and live birth rate (LBR), were compared among the three groups. Results Age, BMI, and basal FSH and LH levels did not differ among the three groups. The number of retrieved oocytes and 2 pronucleus embryos was significantly lower in group A compared with groups B and C. The CPR, IR, MR, and LBR per embryo transfer showed no differences among the three groups. There was no incidence of ovarian hyperstimulation syndrome in group A. Conclusion The IR, MR, and LBR in the IVM cycles were comparable to those of the GnRH agonist and GnRH antagonist cycles. The IVM protocol, FSH and hCG priming with oocyte retrieval 38 hours later, is an effective ART option that is comparable with conventional IVF for infertile women with PCOS. PMID:23346527

  18. Infertility: Medical and Social Choices.

    ERIC Educational Resources Information Center

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

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

  19. Lycopene and male infertility.

    PubMed

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

    2014-01-01

    Excessive amounts of reactive oxygen species (ROS) cause a state of oxidative stress, which result in sperm membrane lipid peroxidation, DNA damage and apoptosis, leading to decreased sperm viability and motility. Elevated levels of ROS are a major cause of idiopathic male factor infertility, which is an increasingly common problem today. Lycopene, the most potent singlet oxygen quencher of all carotenoids, is a possible treatment option for male infertility because of its antioxidant properties. By reacting with and neutralizing free radicals, lycopene could reduce the incidence of oxidative stress and thus, lessen the damage that would otherwise be inflicted on spermatozoa. It is postulated that lycopene may have other beneficial effects via nonoxidative mechanisms in the testis, such as gap junction communication, modulation of gene expression, regulation of the cell cycle and immunoenhancement. Various lycopene supplementation studies conducted on both humans and animals have shown promising results in alleviating male infertility-lipid peroxidation and DNA damage were decreased, while sperm count and viability, and general immunity were increased. Improvement of these parameters indicates a reduction in oxidative stress, and thus the spermatozoa is less vulnerable to oxidative damage, which increases the chances of a normal sperm fertilizing the egg. Human trials have reported improvement in sperm parameters and pregnancy rates with supplementation of 4-8 mg of lycopene daily for 3-12 months. However, further detailed and extensive research is still required to determine the dosage and the usefulness of lycopene as a treatment for male infertility.

  20. Fertility and Infertility.

    ERIC Educational Resources Information Center

    Orgebin-Crist, Marie-Claire; And Others

    In this report, emphasis is placed on major research developments in the reproductive sciences, their impact on the health of individuals as well as on that of society, and on current trends that may provide new opportunities for future research in fertility and infertility. In the first section, major developments in the reproductive sciences are…

  1. Parenting after Infertility

    ERIC Educational Resources Information Center

    Olshansky, Ellen

    2009-01-01

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

  2. Psychological Component of Infertility

    MedlinePlus

    ... that they have: a graduate degree in a mental health profession a license to practice and/or state registration clinical training in the psychological aspects of infertility experience in the medical and ... to a competent mental health professional, you can check the ASRM website ...

  3. Hysteroscopy in infertility--diagnosis and treatment including falloposcopy.

    PubMed

    Hucke, J; De Bruyne, F; Balan, P

    2000-01-01

    Diagnostic hysteroscopy should be included routinely in the work-up of invasive examinations for infertility patients. Anyhow, one can rarely expect to find the definite underlying reason for infertility. In infertile patients about 20% of hysteroscopic examinations show some grade of intrauterine abnormalities. Congenital uterine malformations are the most frequently found disorders. In the group of patients with habitual abortions abnormalities are found much more often and can also be more often interpreted as the mainly underlying factor for the repeated abortions. Operative hysteroscopy has become the surgical method of first choice for the treatment of uterine septa, submucous myomas, polyps and synechia. After septum dissection results are excellent. Myoma removal also shows beneficial effects on fertility; nevertheless, cases are not too frequent among infertility patients. In cases of high-grade Asherman's syndrome, the prognosis after hysteroscopic surgery is still often poor.

  4. Introduction: choosing the main outcome of an infertility trial is harder than you think.

    PubMed

    Legro, Richard S; Wu, Xiaoke

    2014-05-01

    Clinical trials in infertility choose from a variety of outcomes including change in some surrogate marker of gamete quality to healthy live birth. Incomplete reporting of outcomes makes it difficult to compare studies and to determine the clinical impact of infertility treatments. In this Views and Reviews, we explore the merits of collecting various outcomes of interest in infertility trials from the vantage point of infertility specialists, an obstetrician, and a pediatrician. These articles support more complete reporting of maternal, paternal, fetal, and infant outcomes from infertility trials to improve patient care and ultimately public health.

  5. Comparison of the Effect of Clomiphene- Estradiol Valerate vs Letrozole on Endometrial Thickness, Abortion and Pregnancy Rate in Infertile Women with Polycystic Ovarian Syndrome

    PubMed Central

    Seyedoshohadaei, Fariba; Zandvakili, Farnaz; Rashadmanesh, Naser

    2016-01-01

    Introduction Clomiphene citrate is the first-line therapy for ovulation induction in Polycystic Ovarian Syndrome (PCOS). This drug binds and blocks estrogen receptors and thought to have an anti estrogenic effect on endometrium volume, thus may have adverse effect on fertility. Aim This study aimed to compare the effect of Clomiphene citrate plus Estradiol Valerate with Letrozole on endometrial thickness, abortion and pregnancy rate in infertile women with PCOS undergoing ovulation induction. Materials and Methods This was a randomized double blind clinical trial study on 100 women with PCOS, with an endometrial thickness less than 7mm in spite of follicles greater than 18mm after administration of Clomiphene citrate 100mg/d from 3th to 7th day of menstruation. They were randomly divided in two groups. Group A received 100mg Clomiphene citrate from day 3 to day 7 of menstruation and 4 mg Estradiol Valerate after the 8th day of menstruation until 14th day. Group B treated by 5mg Letrozole from day 3 to 7 of menstruation with placebo from 8th to 14th day of menstruation. In both groups endometrial thickness was measured by transvaginal sonography in the 14th day of menstruation. Data were analysed using SPSS Ver.18.0. Results The mean age was 30.34 years in group A and 29.62 years in group B (p=0.381). The number of infertility years in group A was 3.73 years and in group B was 3.85 years. There was no significant relationship statistically between the two groups in terms of mean age and infertility years (p=0.99). Endometrial thickness in group A was 7.26mm and in group B was 8.17 mm. Pregnancy rates in group A and group B was 32% and 16% respectively. There was significant relationship statistically between the two groups in terms of endometrial thickness and pregnancy rates (p=0.021 and p=0.05). There was no abortion in group A and 5 cases had abortion in group B, there was a significant relationship between the two groups statistically (p=0.028). Conclusion

  6. Infertility in men with inflammatory bowel disease.

    PubMed

    Shin, Takeshi; Okada, Hiroshi

    2016-08-01

    Inflammatory bowel disease (IBD) predominantly affects young adults. Fertility-related issues are therefore important in the management of patients with IBD. However, relatively modest attention has been paid to reproductive issues faced by men with IBD. To investigate the effects of IBD and its treatment on male fertility, we reviewed the current literature using a systematic search for published studies. A PubMed search were performed using the main search terms "IBD AND male infertility", "Crohn's disease AND male infertility", "ulcerative colitis AND male infertility". References in review articles were used if relevant. We noted that active inflammation, poor nutrition, alcohol use, smoking, medications, and surgery may cause infertility in men with IBD. In surgery such as proctocolectomy with ileal pouch-anal anastomosis, rectal incision seems to be associated with sexual dysfunction. Of the medications used for IBD, sulfasalazine reversibly reduces male fertility. No other medications appear to affect male fertility significantly, although small studies suggested some adverse effects. There are limited data on the effects of drugs for IBD on male fertility and pregnancy outcomes; however, patients should be informed of the possible effects of paternal drug exposure. This review provides information on fertility-related issues in men with IBD and discusses treatment options. PMID:27602237

  7. Female infertility: role of vaginal hormonal cytology, endometrial biopsy and endocrinological evaluation.

    PubMed

    Afroz, Nishat; Singh, Mamta; Verma, Manju; Bansal, Vandana

    2006-03-01

    Female infertility can be categorised into those who fail to ovulate (anovulatory infertility) because of some defect at hypothalamic-pituitary-ovarian axis and those who are ovulatory (ovulatory infertility), but are infertile because of some lesion present in genital tract. The role of vaginal hormonal cytology, endometrial biopsy and endocrinological evaluation in the detection of ovulation and various ovulatory dysfunction was studied in 42 infertile female patients. On the basis of cytological findings, of the 42 patients, 14 were found to be ovulatory, 26 anovulatory (which include 5 cases of atrophic changes) and 2 inconsistent due to inflammatory changes. Endometrial biopsy showed evidence of ovulation in 15, anovulation in 27 cases. Hormonal evaluation indicated some sort of endocrinological disorders in 15 patients, which may underlie anovulatory infertility in these patients, while results were within normal range in the rest 27 patients. Results of vaginal cytology and endometrial biopsy showed correlation in respect to ovulation in 93.33% of the cases.

  8. Mycobacterium tuberculosis infection in women with unexplained infertility

    PubMed Central

    Eftekhar, Maryam; Pourmasumi, Soheila; Sabeti, Parvin; Aflatoonian, Abbas; Sheikhha, Mohammad Hasan

    2015-01-01

    Background: Genital tuberculosis (GTB) is an important cause of female infertility, especially in developing countries. The positive results of polymerase chain reaction (PCR) in endometrial GTB in the absence of tubal damage raise the possibility of the detection of sub-clinical or latent disease, with doubtful benefits of treatment. Objective: To evaluate the mycobacterium tuberculosis infection in endometrial biopsy samples collected from unexplained infertile women attending Yazd Research and Clinical Center for Infertility by using PCR techniques. Materials and Methods: In this cross sectional study, 144 infertile women with unexplained infertility aged 20-35 years old and normal Histro-saplango graphy findings were enrolled. Endometrial biopsy samples from each participant were tested for mycobacterium tuberculosis detecting by PCR. In 93 patients, peritoneal fluid was also taken for culture and PCR. Results: The PCR results of endometrial specimens were negative in all cases, demonstrating that there was no GTB infection among our patients. Conclusion: Our results showed that GTB could not be considered as a major problem in women with unexplained infertility. Although, studies have indicated that PCR is a useful method in diagnosing early GTB disease in infertile women with no demonstrable evidence of tubal or endometrial involvement. PMID:27141534

  9. Interactive Visualization for Patient-to-Patient Comparison.

    PubMed

    Nguyen, Quang Vinh; Nelmes, Guy; Huang, Mao Lin; Simoff, Simeon; Catchpoole, Daniel

    2014-03-01

    A visual analysis approach and the developed supporting technology provide a comprehensive solution for analyzing large and complex integrated genomic and biomedical data. This paper presents a methodology that is implemented as an interactive visual analysis technology for extracting knowledge from complex genetic and clinical data and then visualizing it in a meaningful and interpretable way. By synergizing the domain knowledge into development and analysis processes, we have developed a comprehensive tool that supports a seamless patient-to-patient analysis, from an overview of the patient population in the similarity space to the detailed views of genes. The system consists of multiple components enabling the complete analysis process, including data mining, interactive visualization, analytical views, and gene comparison. We demonstrate our approach with medical scientists on a case study of childhood cancer patients on how they use the tool to confirm existing hypotheses and to discover new scientific insights.

  10. Quality and quantity of infertility care in Bangladesh.

    PubMed

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

    2015-01-01

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

  11. Zoroastrians Support Oocyte and Embryo Donation Program for Infertile Couples

    PubMed Central

    Halvaei, Iman; Khalili, Mohammad Ali; Ghasemi-Esmailabad, Saeed; Nabi, Ali; Shamsi, Farimah

    2014-01-01

    Background The main goal was to evaluate the attitudes and knowledge of Zoroastrians living in Iran towards oocyte donation (OD) and embryo donation (ED) program. Methods This cross sectional study consisted of 318 Zoroastrians (n=175 for OD and n=143 for ED) of both sexes. The questionnaire form comprised two parts of general demographic characteristics of the participants and twenty multiple-choice questions about attitude and knowledge of participants towards OD and ED. For statistical analysis, the chi-square test was applied for comparison of data generated from ED and OD groups. Results Majority of the participants supported OD (69.7%) and ED (71.3%) for infertile patients. In addition, 40% and 42% preferred donation program (OD and ED, respectively), compared to adoption. About 60% of the respondents believed that the donors have no right to find the child and claim it as their own. In addition, more than half of the respondents thought that the recipients of oocyte/embryo should never know the name and address of the donors. More than half of the participants did not know whether their religion accepts donation program or not. Approximately, 80% of respondents supported psychological counseling for both donors and recipients. Moreover, about 56% of the participants necessitated the advertisement on OD/ED program in the mass media. Conclusion Our preliminary data showed that Zoroastrians supported both OD and ED program equally for infertile couples. PMID:25473631

  12. Symptomatic sick sinus syndrome requiring permanent pacemaker implantation in a patient uwith mirror image dextrocardia with situs inversus and infertility.

    PubMed

    Kahali, Dhiman; Mandal, Saroj; Mandal, Debasmita; Ghose, Arijit; Kanjilal, Souvik

    2013-01-01

    Situs inversus with dextrocardia is a congenital condition in which the heart is a mirror image of the anatomically normal heart on the right side. A patient presented with the sick sinus syndrome accompanying mirror image dextrocardia which was associated with double superior vena cava and a left sided inferior vena cava A permanent transvenous demand pacemaker was inserted because of repeated episodes of dizziness and a single episode of syncope with ECG showing bradycardia with junctional escape rhythm. Precise knowledge of the venous system and the location of the apex of the right ventricle were necessary prior to permanent pacemaker implantation. Without such knowledge pacing may be technically challenging.

  13. Implications of Blood Type for Ovarian Reserve and Infertility – Impact on Oocyte Yield in IVF Patients

    PubMed Central

    Spitzer, D.; Corn, C.; Stadler, J.; Wirleitner, B.; Schuff, M.; Vanderzwalmen, P.; Grabher, F.; Zech, N. H.

    2014-01-01

    Introduction: Diminished ovarian reserve (DOR) has been linked to certain subpopulations and distinct gene polymorphisms. It has even been hypothesized that the AB0 blood group system could be linked to ovarian reserve (OR) as reflected by early follicular phase follicle stimulating hormone (FSH) levels. Although estimation of OR is routinely done using levels of anti-Müllerian hormone (AMH), FSH, estradiol or inhibin B, the diagnostic accuracy of these markers is often limited. The aim of this study was to evaluate whether there is any correlation between IVF patientsʼ AB0 blood group system and ART outcome. Methods: In this retrospective observational single-center study we investigated the outcome of 1889 IVF cycles carried out between 2005 and 2012 with regard to blood type and OR in different age groups (21–36 years and 37–43 years). The number of cumulus oocyte complexes (COCs) and metaphase II oocytes obtained after ovarian stimulation, fertilization rate (FR), pregnancy rate (PR) and birth rate (BR) were evaluated with respect to maternal age (21–36 and 37–43 years, respectively). Results: We found no significant differences in the average number of COCs after ovum pick-up in either of the age groups. Moreover, the mean number of MII oocytes and 2PN stages were similar for all blood type groups. As regards IVF outcome measured in terms of PR and BR, no significant differences were observed between the different blood groups. In conclusion, no correlation was found between blood type and female fertility. Discussion: The most precise definition of OR is determining the number of competent oocytes. Based on the finding of our study, the hypothesis that there is a correlation between OR and AB0 blood group system can be dismissed for Caucasian IVF patients. PMID:25364032

  14. Clomiphene treatment in male infertility.

    PubMed

    Schellen, T M

    1982-01-01

    After the discovery that Clomiphene-citrate (Clomid) increased the secretion of gonadotropins, it was first used to induce ovulation and later on it was also used in males in certain cases of infertility. The effects of Clomid on the hypothalamic-pituitary level made it also possible to use it for a dynamic evaluation of the hypothalamic-pituitary gonadal axis in both females and males. The results obtained with Clomid are reviewed. The results are widely divergent because of the fact that the selection of the patients, the dosage, and the length of the therapy are not always appropriate. However, the experience with Clomid appears to show sufficient effectiveness in oligozoospermic men, who have a low or normal FSH-level.

  15. Models Predicting Success of Infertility Treatment: A Systematic Review

    PubMed Central

    Zarinara, Alireza; Zeraati, Hojjat; Kamali, Koorosh; Mohammad, Kazem; Shahnazari, Parisa; Akhondi, Mohammad Mehdi

    2016-01-01

    Background: Infertile couples are faced with problems that affect their marital life. Infertility treatment is expensive and time consuming and occasionally isn’t simply possible. Prediction models for infertility treatment have been proposed and prediction of treatment success is a new field in infertility treatment. Because prediction of treatment success is a new need for infertile couples, this paper reviewed previous studies for catching a general concept in applicability of the models. Methods: This study was conducted as a systematic review at Avicenna Research Institute in 2015. Six data bases were searched based on WHO definitions and MESH key words. Papers about prediction models in infertility were evaluated. Results: Eighty one papers were eligible for the study. Papers covered years after 1986 and studies were designed retrospectively and prospectively. IVF prediction models have more shares in papers. Most common predictors were age, duration of infertility, ovarian and tubal problems. Conclusion: Prediction model can be clinically applied if the model can be statistically evaluated and has a good validation for treatment success. To achieve better results, the physician and the couples’ needs estimation for treatment success rate were based on history, the examination and clinical tests. Models must be checked for theoretical approach and appropriate validation. The privileges for applying the prediction models are the decrease in the cost and time, avoiding painful treatment of patients, assessment of treatment approach for physicians and decision making for health managers. The selection of the approach for designing and using these models is inevitable. PMID:27141461

  16. The experience of infertility: A review of recent literature

    PubMed Central

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

    2011-01-01

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

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

    PubMed

    Hotaling, J; Carrell, D T

    2014-05-01

    Spermatogenesis involves the aggregated action of up to 2300 genes, any of which, could, potentially, provide targets for diagnostic tests of male factor infertility. Contrary to the previously proposed common variant hypothesis for common diseases such as male infertility, genome-wide association studies and targeted gene sequencing in cohorts of infertile men have identified only a few gene polymorphisms that are associated with male infertility. Unfortunately, the search for genetic variants associated with male infertility is further hampered by the lack of viable animal models of human spermatogenesis, difficulty in robustly phenotyping infertile men and the complexity of pedigree studies in male factor infertility. In this review, we describe basic genetic principles involved in understanding the genetic basis of male infertility and examine the utility and proper clinical use of the proven genetic assays of male factor infertility, specifically Y chromosome microdeletions, chromosomal translocations, karyotype, cystic fibrosis transmembrane conductance regulator mutation analysis and sperm genetic tests. Unfortunately, these tests are only able to diagnose the cause of about 20% of male factor infertility. The remainder of the review will be devoted to examining novel tests and diagnostic tools that have the potential to explain the other 80% of male factor infertility that is currently classified as idiopathic. Those tests include epigenetic analysis of the spermatozoa and the evaluation of rare genetic variants and copy number variations in patients. Success in advancing to the implementation of such areas is not only dependent on technological advances in the laboratory, but also improved phenotyping in the clinic.

  18. Practical guidelines for the treatment of infertility in hirsute women.

    PubMed

    Dolian, G G; Comhaire, F H; Schoonjans, F

    1988-10-01

    On the basis of retrospective investigation of 315 infertile hirsute women aged between 19 and 35 years, it was attempted to find selection criteria for infertility treatment. Cases with adrenal, ovarian and pituitary tumors, congenital adrenal hyperplasia and genetic disorders should be excluded by means of preliminary investigations. It is possible to select the optimal treatment for each individual patient using a flow-chart. Thanks to this approach, a pregnancy rate of 83% is achieved.

  19. Online psychoeducational support for infertile women: a randomized controlled trial

    PubMed Central

    Cousineau, Tara M.; Green, Traci C.; Corsini, Evelyn; Seibring, A; Showstack, Marianne T.; Applegarth, Linda; Davidson, Marie; Perloe, Mark

    2008-01-01

    BACKGROUND The study goal was to develop and test the effectiveness of a brief online education and support program for female infertility patients. METHODS A randomized-controlled trial was conducted. Using a Solomon-four group design, 190 female patients were recruited from three US fertility centers and were randomized into two experimental and two no-treatment control groups. The psychological outcomes assessed included infertility distress, infertility self-efficacy, decisional conflict, marital cohesion and coping style. Program dosage and satisfaction were also assessed at four weeks follow-up. RESULTS Women exposed to the online program significantly improved in the area of social concerns (P = 0.038) related to infertility distress, and felt more informed about a medical decision with which they were contending (P = 0.037). Trends were observed for decreased global stress (P = 0.10), sexual concerns (P = 0.059), distress related to child-free living (P = 0.063), increased infertility self-efficacy (P = 0.067) and decision making clarity (P = 0.079). A dosage response was observed in the experimental groups for women who spent >60 min online for decreased global stress (P = 0.028) and increased self efficacy (P = 0.024). CONCLUSIONS This evidence-based eHealth program for women experiencing infertility suggests that a web-based patient education intervention can have beneficial effects in several psychological domains and may be a cost effective resource for fertility practices. PMID:18089552

  20. The Impact of Emotionally Focused Therapy on Emotional Distress in Infertile Couples

    PubMed Central

    Soltani, Marzieh; Shairi, Mohammad Reza; Roshan, Rasoul; Rahimi, Changiz Rahimi

    2014-01-01

    Background: The present study investigated the effect of emotionally focused therapy (EFT) on factors contributing to emotional distress among infertile couples. Materials and Methods: In this semi-experimental study, the subjects consisted of 12 Iranian couples: six infertile men and six infertile women. They were assessed as depressed, anxious and stressful individuals using depression, anxiety and stress scale (DASS). The subjects were randomly divided into control and experimental groups. The experimental group with six couples (i.e. three infertile men and three infertile women) received EFT, while the control group with similar number of couples (i.e. three infertile men and three infertile women) was deprived of the treatment. Results: There were no significant differences between the two groups regarding job, educational level, income, age, marriage and infertility duration. The pre- and post-test comparisons of DASS subscales showed that level of depression, anxiety and stress among couples with EFT instruction was significantly less than those without such in- structions (p<0.0001). Conclusion Emotionally focused therapy could reduce the rate of depression, anxiety and stress in infertile couples, regardless of the man or woman as the cause of infertility. PMID:24520504

  1. [Indication of varicocelectomy for the treatment of male infertility].

    PubMed

    Okubo, Kazutoshi; Nishiyama, Hiroyuki; Okuno, Hiroshi; Ogawa, Osamu

    2004-08-01

    The most common and correctable known cause of male infertility is varicoceles, not all infertile patients with varicoceles present an improvement of fertility after surgical repair. In this study, we assessed preoperative factors predictive of improved fertility and/or semen parameters following varicocelectomy. We performed varicocelectomy on 148 consecutive infertile patients with varicocele between 1993 and 1999. Unassisted pregnancy was achieved in 38 (25.7%) patients. The patients with low grade varicocele, high serum follicle stimulating hormone (FSH), severe asthenozoospermia preoperatively had significant lower unassisted pregnancy rates compared to the others, respectively. Patients who have at least one of these three factors had a significantly lower unassisted pregnancy rate compared to patients without all three factors (7.7%, and 39.8%, respectively). In conclusion, certain preoperative variables in the physical and laboratory analyses appeared to predict a greater surgical response.

  2. Oral Drugs for Unexplained Infertility.

    PubMed

    Allahbadia, Gautam N

    2016-02-01

    Of the infertile couples unable to conceive without any identifiable cause, 30 % are defined as having unexplained infertility. Management depends on duration of infertility and age of female partner. The treatment of unexplained infertility is empirical, and many different regimens have been used. Among these are expectant management, ovarian stimulation with clomiphene citrate, gonadotropins and aromatase inhibitors, fallopian tube sperm perfusion, tubal flushing, intrauterine insemination, gamete intrafallopian transfer, and IVF. The first approach to treatment of unexplained infertility generally is the use of drugs that stimulate oocyte production. For over four decades, the first-line treatment for ovarian stimulation in unexplained infertility has been clomiphene citrate. Multiple reports suggest that aromatase inhibitors may be effective alternative agents for ovarian stimulation in couples with unexplained infertility. Their administration is reported to be associated with monofollicular development in most cases, which may result in enhanced fertility and a reduced risk of ovarian hyperstimulation and multiple births, as compared to current standard therapies such as gonadotropin and clomiphene. Despite world evidence to the contrary, letrozole has been banned for use for infertility management in India since 2011. PMID:26924899

  3. A Biopsychosocial Theory of Infertility.

    ERIC Educational Resources Information Center

    Gerrity, Deborah A.

    2001-01-01

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

  4. Strategies for Counseling Infertile Couples.

    ERIC Educational Resources Information Center

    Daniluk, Judith C.

    1991-01-01

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

  5. Sexual dysfunction in infertile women

    PubMed Central

    Zare, Zahra; Amirian, Malihe; Golmakani, Nahid; Mazlom, Reza; Laal Ahangar, Mojtaba

    2016-01-01

    Background: Sexual problems have different effects on the life of people by influencing their interpersonal and marital relationships and satisfaction. Relationship between sexual dysfunctions and infertility can be mutual. Sexual dysfunction may cause difficulty conceiving but also attempts to conceive, may cause sexual dysfunction. Objective: This paper compares sexual dysfunction in fertile and infertile women. Materials and Methods: In this cross-sectional study, 110 infertile couples referring to Montasarieh Infertility Clinic and 110 fertile couples referring to five healthcare centers in Mashhad were selected by class cluster sampling method. Data collection tools included demographic questionnaire and Glombok-Rust Inventory of Sexual Satisfaction. Data were analyzed through descriptive and analytical statistical methods by SPSS. Results: There was no significant difference in total score of sexual problems and other dimensions of sexual problems (except infrequency) in fertile 28.9 (15.5) and infertile 29.0 (15.4) women. Fertile women had more infrequency than infertile women (p=0.002). Conclusion: There was no significant difference between fertile and infertile women in terms of sexual problems. Paying attention to sexual aspects of infertility and presence of programs for training of sexual skills seems necessary for couples. PMID:27200422

  6. Male-factor infertility and in vitro fertilization.

    PubMed

    Yates, C A; De Kretser, D M

    1987-06-01

    In vitro fertilization (IVF) was developed primarily as a treatment for female and idiopathic infertility. However, with the discovery that relatively few sperm are required to achieve fertilization in vitro, it was proposed that IVF could be used also as an effective treatment for male-factor infertility. This review deals with the work that has been carried out by various groups in this area of male-factor infertility. As the standards of classification and the presentation of results vary from group to group, this also shows that there is a need for some standardization of how patient selection and the presentation of results are carried out in the area of male-factor infertility.

  7. Systematic characterization of seminal plasma piRNAs as molecular biomarkers for male infertility

    PubMed Central

    Hong, Yeting; Wang, Cheng; Fu, Zheng; Liang, Hongwei; Zhang, Suyang; Lu, Meiling; Sun, Wu; Ye, Chao; Zhang, Chen-Yu; Zen, Ke; Shi, Liang; Zhang, Chunni; Chen, Xi

    2016-01-01

    Although piwi-interacting RNAs (piRNAs) play pivotal roles in spermatogenesis, little is known about piRNAs in the seminal plasma of infertile males. In this study, we systematically investigated the profiles of seminal plasma piRNAs in infertile males to identify piRNAs that are altered during infertility and evaluate their diagnostic value. Seminal plasma samples were obtained from 211 infertile patients (asthenozoospermia and azoospermia) and 91 fertile controls. High-throughput sequencing technology was employed to screen piRNA profiles in seminal plasma samples pooled from healthy controls and infertile patients. The results identified 61 markedly altered piRNAs in infertile patient groups compared with control group. Next, a quantitative RT-PCR assay was conducted in the training and validation sets to measure and confirm the concentrations of altered piRNAs. The results identified a panel of 5 piRNAs that were significantly decreased in seminal plasma of infertile patients compared with healthy controls. ROC curve analysis and risk score analysis revealed that the diagnostic potential of these 5 piRNAs to distinguish asthenozoospermic and azoospermic individuals from healthy controls was high. In summary, this study identifies a panel of piRNAs that can accurately distinguish fertile from infertile males. This finding may provide pathophysiological clues about the development of infertility. PMID:27068805

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

    ERIC Educational Resources Information Center

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

    2009-01-01

    Tubal disease constitutes a major factor in infertility especially in developing countries. This study was undertaken to assess the hysterosalpingographic patterns seen in infertile patients in an urban centre in Lagos. Two hundred and twenty patients who reported from the gynaecology clinic to the radiology department of Lagos State University…

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

    PubMed

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

    2010-01-01

    Testicular microlithiasis (TM) in infertility is an uncommon pathologic condition of unclear etiology that is characterized by calcium deposits within the seminiferous tubules. Nanobacteria (NB), as novel microorganisms mediating tissue calcification, have been discovered in some diseases. In this study, we hypothesized that NB may participate in the pathogenesis of TM, particularly in infertility. Seventeen infertility patients with TM detected by scrotal color Doppler ultrasonography and 17 infertility patients without TM as controls were enrolled in the study. The NB were isolated and cultured from semen samples and urine samples. After 3 to 6 weeks of culture, 10 of 17 (58.8%) semen samples and 2 urine samples from infertile patients with TM showed the growth of white granular microbes that firmly attached to the bottom of the culture flask and were visible to the naked eye. In the control group, only 1 of 17 (5.9%) semen samples from infertile patients without TM showed the growth of white granular microbes. The cultured microbes were identified by indirect immunofluorescent staining (IIFS), transmission electron microscopy (TEM), and 16s rRNA gene expression. IIFS and TEM revealed NB to be coccoid and 100 to 500 nm in diameter. The BLAST result revealed that the 16s rRNA gene sequence from the cultured microbes was 97% the same as that of the known NB. Our results showed that NB may be linked to the development of TM, which may provide a potential target for the diagnosis and treatment of infertility with TM. PMID:19779212

  10. Protein intake and ovulatory infertility

    PubMed Central

    Chavarro, Jorge E.; Rich-Edwards, Janet W.; Rosner, Bernard A.; Willett, Walter C.

    2011-01-01

    Objective To evaluate whether intake of protein from animal and vegetable origin is associated with ovulatory infertility. Study Design 18,555 married women without a history of infertility were followed as they attempted a pregnancy or became pregnant during an eight year period. Dietary assessments were related to the incidence of ovulatory infertility. Results During follow-up, 438 women reported ovulatory infertility. The multivariate-adjusted relative risk [RR] (95% CI; P, trend) of ovulatory infertility comparing the highest to the lowest quintile of animal protein intake was 1.39 (1.01 – 1.90; 0.03). The corresponding RR (95% CI; P, trend) for vegetable protein intake was 0.78 (0.54 – 1.12; 0.07). Further, consuming 5% of total energy intake as vegetable protein rather than as animal protein was associated with a more than 50% lower risk of ovulatory infertility (P = 0.007). Conclusions Replacing animal sources of protein with vegetable sources of protein may reduce ovulatory infertility risk. PMID:18226626

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

    PubMed Central

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

    2014-01-01

    Background: Cytomegalovirus (CMV) is a prevalent infection in humans. Recent studies have shown the role of CMV infection in male infertility disorder. Aim: Here we aimed to study the role of CMV infection in men with idiopathic infertility. Materials and Methods: We performed a case-control study of CMV serology in 200 patients attending male infertility clinic of a university hospital. There were 154 men diagnosed with infertility and 46 men without infertility. The patients were asked to donate their sperm, blood, and urine. The presence of CMV infection was studied using quantitative polymerase chain reaction. Results: CMV infection was present in 25 of all the studied participants. Controls had a higher sperm count and sperm motility and sperm morphology compared to patients. There were no significant differences in the studied variables between those with and without CMV infection, nor in patients, neither in controls. Sperm morphology was negatively correlated with cigarette smoking (r=-0.15; p<0.03). Even though the prevalence of CMV infection was higher in patients with infertility in control and patient (5/46 vs. 20/154) respectively, this was not statistically significant. Conclusion: We did not show a significant role for CMV infection in male infertility. Based on the previous studies, it could be assumed that CMV infection is an important part of the male infertility and its treatment would improve the sperm quality, however this was not confirmed by the present study. PMID:24799874

  12. Estrogen promotes Leydig cell engulfment by macrophages in male infertility.

    PubMed

    Yu, Wanpeng; Zheng, Han; Lin, Wei; Tajima, Astushi; Zhang, Yong; Zhang, Xiaoyan; Zhang, Hongwen; Wu, Jihua; Han, Daishu; Rahman, Nafis A; Korach, Kenneth S; Gao, George Fu; Inoue, Ituro; Li, Xiangdong

    2014-06-01

    Male infertility accounts for almost half of infertility cases worldwide. A subset of infertile men exhibit reduced testosterone and enhanced levels of estradiol (E2), though it is unclear how increased E2 promotes deterioration of male fertility. Here, we utilized a transgenic mouse strain that overexpresses human CYP19, which encodes aromatase (AROM+ mice), and mice with knockout of Esr1, encoding estrogen receptor α (ERαKO mice), to analyze interactions between viable Leydig cells (LCs) and testicular macrophages that may lead to male infertility. In AROM+ males, enhanced E2 promoted LC hyperplasia and macrophage activation via ERα signaling. E2 stimulated LCs to produce growth arrest-specific 6 (GAS6), which mediates phagocytosis of apoptotic cells by bridging cells with surface exposed phosphatidylserine (PS) to macrophage receptors, including the tyrosine kinases TYRO3, AXL, and MER. Overproduction of E2 increased apoptosis-independent extrusion of PS on LCs, which in turn promoted engulfment by E2/ERα-activated macrophages that was mediated by AXL-GAS6-PS interaction. We further confirmed E2-dependant engulfment of LCs by real-time 3D imaging. Furthermore, evaluation of molecular markers in the testes of patients with nonobstructive azoospermia (NOA) revealed enhanced expression of CYP19, GAS6, and AXL, which suggests that the AROM+ mouse model reflects human infertility. Together, these results suggest that GAS6 has a potential as a clinical biomarker and therapeutic target for male infertility.

  13. H19 gene methylation status is associated with male infertility

    PubMed Central

    LI, XIAO-PING; HAO, CHAO-LIANG; WANG, QIAN; YI, XIAO-MEI; JIANG, ZHI-SHENG

    2016-01-01

    The present study investigated the H19 gene methylation status in male infertility. Between March 2013 and June 2014, semen samples were collected from 15 normal fertile males and 15 males experiencing infertility, and routine analysis and sperm morphological assessment were performed. The semen samples were subjected to density gradient centrifugation to separate the sperm fraction, and genomic DNA from the sperms was extracted and treated for bisulfite modification. Following in vitro amplification by polymerase chain reaction (PCR), the purified PCR products were cloned into pMD®18-T vectors and successful cloning was confirmed by restriction enzyme digestion. Positive clones were sequenced and the DNA methylation status was analyzed. The overall methylation rate in the normal fertile group was 100% (270/270), whereas in the infertile group the methylation rate was lower at 94.1% (525/558), revealing a statistically significant decrease in overall methylation rate in the infertile patients compared with the control group (χ2=15.12; P<0.001). The average methylation rates of CpG 1, 3 and 6 in the infertile group were statistically different from those in the normal control group (all P<0.05). The abnormal methylation of imprinted gene H19 is associated with male infertility, suggesting that H19 may serve as a biomarker for the detection of defects in human spermiogenesis. PMID:27347077

  14. Infertility and assisted reproduction in Denmark. Epidemiology and psychosocial consequences.

    PubMed

    Schmidt, Lone

    2006-11-01

    treatment are interwoven with each others in a complex pattern, a pattern that both differed and was similar when comparing women and men. The infertility-related communication strategy (secrecy, formal, open-minded)identified in the qualitative interviews was later confirmed in the COMPI Infertility Cohort. Using the formal strategy and not talking about the emotional aspects of infertility and its treatment suggested high fertility problem stress. The coping strategies studied showed significant social differences and active-avoidance coping was a significant predictor of high fertility problem stress. A positive effect of infertility on the marriage, marital benefit was common. Men using the secrecy communication strategy had increased risk of low marital benefit. Difficult partner communication was a significant predictor of high fertility problem stress and among men, of low marital benefit. The intervention study showed that it was possible for the participants to change their communication with partner and other people close to them and that participants achieved an increased awareness of what, how much and when to discuss with others. High fertility problem stress and high marital benefit were associated with high importance ratings of patient-centred care and intentions to use professional psychosocial services. Among women, high fertility problem stress was a predictor of lower satisfaction ratings with fertility treatment. High marital benefit was a predictor of high satisfaction ratings of both medical and patient-centred care. In conclusion, infertility is a common experience among couples attempting to become parents. Assisted reproduction in the public health-care system in Denmark has high success rates, i.e. pregnancies,deliveries and high patient satisfaction. A large minority of people in fertility treatment experience high fertility problem stress,and some use communication and coping strategies that predicts high stress. Developing and evaluating

  15. Chinese Herbal Products for Female Infertility in Taiwan

    PubMed Central

    Hung, Yu-Chiang; Kao, Chao-Wei; Lin, Che-Chen; Liao, Yen-Nung; Wu, Bei-Yu; Hung, I-Ling; Hu, Wen-Long

    2016-01-01

    Abstract Female infertility and low birth rate are significant public health issues with profound social, psychological, and economic consequences. Some infertile women resort to conventional, complementary, or alternative therapies to conceive. The aim of this study was to identify the Chinese herbal products (CHPs) most commonly used for female infertility in Taiwan. The usage of traditional Chinese medicine (TCM) and the frequency of CHP prescriptions to infertile women were determined based on a nationwide 1-million randomly sampled cohort of National Health Insurance Research Database beneficiaries. Descriptive statistics and multiple logistic regression analysis were employed to estimate the adjusted odds ratio (aOR) for TCM usage and potential risk factors. In total, 8766 women with newly diagnosed infertility were included in this study. Of those, 8430 (96.17%) had sought TCM treatment in addition to visiting the gynecologist. We noted that female infertility patients with risk factors (e.g., endometriosis, uterine fibroids, or irregular menstrual cycle) were more likely to use TCM than those without TCM medication (aOR = 1.83, 1.87, and 1.79, respectively). The most commonly used formula and single CHP were Dang-Gui-Sha-Yao-San (17.25%) and Semen Cuscutae (27.40%), respectively. CHP formula combinations (e.g., Dang-Gui-Sha-Yao-San plus Wen-Jing-Tang 3.10%) or single Chinese herbal combinations (e.g., Semen Cuscutae plus Leonurus japonicus 6.31%) were also commonly used to treat female infertility. Further well-conducted, double-blind, randomized, placebo-controlled studies will be needed to evaluate the efficacy and safety of these CHP combinations for female infertility. PMID:26986137

  16. [The validation of the use of prostatilen and testilin for treating male infertility].

    PubMed

    Boĭko, M I

    1995-01-01

    The paper substantiates the use in clinical setting of medicinal preparations obtaining from prostate and tests, in male infertility. Using male rats for an experimental model of infertility it was shown that prostatilene and testilin exert a stimulating effect on spermatogenesis and androgenic functions of the testis. Those agents appear to correct androgenic-estrogenic balance in the animal organism as a model of infertility. The experiment permitted a conclusion to be drawn to the effect that prostatilene and testilin are liable to be of clinical benefit when used to stimulate spermatogenesis in infertility and hypoandrogenization; besides, the rise in androgens may stimulate copulative function in patients with sexual problems.

  17. Infertility, infertility treatment, and congenital malformations: Danish national birth cohort

    PubMed Central

    Zhu, Jin Liang; Basso, Olga; Obel, Carsten; Bille, Camilla; Olsen, Jørn

    2006-01-01

    Objectives To examine whether infertile couples (with a time to pregnancy of > 12 months), who conceive naturally or after treatment, give birth to children with an increased prevalence of congenital malformations. Design Longitudinal study. Setting Danish national birth cohort. Participants Three groups of liveborn children and their mothers: 50 897 singletons and 1366 twins born of fertile couples (time to pregnancy ≤ 12 months), 5764 singletons and 100 twins born of infertile couples who conceived naturally (time to pregnancy > 12 months), and 4588 singletons and 1690 twins born after infertility treatment. Main outcome measures Prevalence of congenital malformations determined from hospital discharge diagnoses. Results Compared with singletons born of fertile couples, singletons born of infertile couples who conceived naturally or after treatment had a higher prevalence of congenital malformations—hazard ratios 1.20 (95% confidence interval 1.07 to 1.35) and 1.39 (1.23 to 1.57). The overall prevalence of congenital malformations increased with increasing time to pregnancy. When the analysis was restricted to singletons born of infertile couples, babies born after treatment had an increased prevalence of genital organ malformations (hazard ratio 2.32, 1.24 to 4.35) compared with babies conceived naturally. No significant differences existed in the overall prevalence of congenital malformations among twins. Conclusions Hormonal treatment for infertility may be related to the occurrence of malformations of genital organs, but our results suggest that the reported increased prevalence of congenital malformations seen in singletons born after assisted reproductive technology is partly due to the underlying infertility or its determinants. The association between untreated infertility and congenital malformations warrants further examination. PMID:16893903

  18. Bilateral ovarian maldescent: Unusual cause of infertility - A case report and literature review.

    PubMed

    Garg, D; Grazi, R; Kankanala, N; Melzer-Ross, K

    2016-08-01

    Infertility due to ovarian maldescent is extremely rare and diagnosis can be challenging in the absence of uterine anomalies. We present a case of infertility due to bilateral ovarian maldescent with normal uterine anatomy who conceived after in vitro fertilization and did not require removal of the ovaries. A 19-year-old woman presented with primary infertility. After three failed cycles of ovulation induction/intrauterine insemination and one failed cycle of fresh embryo transfer, the patient underwent laparoscopy, which showed bilateral ovaries above the pelvic brim. The patient conceived after second in vitro fertilization and delivered at 34 weeks. Accurate diagnosis of ovarian maldescent in a patient of unexplained infertility and normal uterus is crucial for successful follicular aspiration and infertility treatment. It is important to counsel patients about the benign nature of this rare entity and future fertility. PMID:27094464

  19. Medical treatment of male infertility.

    PubMed

    Dabaja, Ali A; Schlegel, Peter N

    2014-03-01

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

  20. Endometriosis: Does It Cause Infertility?

    MedlinePlus

    ... Website of the American Society for Reproductive Medicine Endometriosis: Does It Cause Infertility? This fact sheet was ... with The Society of Reproductive Surgeons What is endometriosis? When tissue like the tissue that normally lines ...

  1. Chromosomal disorders and male infertility.

    PubMed

    Harton, Gary L; Tempest, Helen G

    2012-01-01

    Infertility in humans is surprisingly common occurring in approximately 15% of the population wishing to start a family. Despite this, the molecular and genetic factors underlying the cause of infertility remain largely undiscovered. Nevertheless, more and more genetic factors associated with infertility are being identified. This review will focus on our current understanding of the chromosomal basis of male infertility specifically: chromosomal aneuploidy, structural and numerical karyotype abnormalities and Y chromosomal microdeletions. Chromosomal aneuploidy is the leading cause of pregnancy loss and developmental disabilities in humans. Aneuploidy is predominantly maternal in origin, but concerns have been raised regarding the safety of intracytoplasmic sperm injection as infertile men have significantly higher levels of sperm aneuploidy compared to their fertile counterparts. Males with numerical or structural karyotype abnormalities are also at an increased risk of producing aneuploid sperm. Our current understanding of how sperm aneuploidy translates to embryo aneuploidy will be reviewed, as well as the application of preimplantation genetic diagnosis (PGD) in such cases. Clinical recommendations where possible will be made, as well as discussion of the use of emerging array technology in PGD and its potential applications in male infertility. PMID:22120929

  2. Comparisons between written and computerised patient histories.

    PubMed Central

    Quaak, M J; Westerman, R F; van Bemmel, J H

    1987-01-01

    Patient histories were obtained from 99 patients in three different ways: by a computerised patient interview (patient record), by the usual written interview (medical record), and by the transcribed record, which was a computerised version of the medical record. Patient complaints, diagnostic hypotheses, observer and record variations, and patients' and doctors' opinions were analysed for each record, and records were compared with the final diagnosis. About 40% of the data in the patient record were not present in the medical record. Two thirds of the patients said that they could express all or most of their complaints in the patient record. The doctors found that the medical record expressed the main complaints better (52%) than the patient record (15%) but that diagnostic hypotheses were more certain in the patient record (38%) than in the medical one (26%). The number of diagnostic hypotheses in the patient record was about 20% higher than that in the medical record. Intraobserver agreement (51%) was better than interobserver agreement (32%), while the inter-record agreement varied from 25% (between the medical and patient records) to 35% (between the transcribed and patient records). One third of final diagnoses were seen in the medical record, with 29% and 22% for the transcribed and patient records, respectively. Interobserver agreement in the final diagnosis was 35%. The results of the study suggest that computerised history taking is suitable for certain patients in addition to, and not as a substitute for, the oral interview with a doctor. PMID:3115371

  3. Clinical Outcomes of Varicocele Repair in Infertile Men: A Review

    PubMed Central

    Fujisawa, Masato

    2016-01-01

    Varicoceles are a major cause of impaired spermatogenesis and the most common correctable cause of male infertility. They are found in approximately 40% of men with primary infertility and 80% of men with secondary infertility, although they also occur in 12% of men with normal semen parameters. The presence of a varicocele does not always affect spermatogenesis, as it has been reported that only 20% of men with documented varicoceles suffer fertility problems. However, varicocele repair appears to have beneficial effects in men with impaired semen parameters and palpable varicoceles. Currently, the main procedures employed for varicocele repair are microsurgical subinguinal or inguinal varicocelectomy, laparoscopic varicocelectomy, and radiological percutaneous embolization. Microsurgical varicocelectomy appears to be the optimal treatment in most cases, whereas the other procedures are useful only in specific cases. After treatment, it typically takes 3 to 6 months for patients' semen parameters to improve; thus, other therapies, including assisted reproductive technology, should be considered if infertility persists after this interval, especially in older couples. Controversies still remain regarding how varicoceles in certain subgroups, such as adolescents or men with azoospermia, should be treated. Due to their relatively high prevalence rate among the general population, varicoceles can occur concomitantly with other conditions that cause impaired spermatogenesis. Further studies are necessary in order to identify the patients who are most likely to benefit from treatment. In this review, we sought to summarize the issues currently associated with varicocele treatment in infertile men. PMID:27574593

  4. Clinical Outcomes of Varicocele Repair in Infertile Men: A Review.

    PubMed

    Chiba, Koji; Fujisawa, Masato

    2016-08-01

    Varicoceles are a major cause of impaired spermatogenesis and the most common correctable cause of male infertility. They are found in approximately 40% of men with primary infertility and 80% of men with secondary infertility, although they also occur in 12% of men with normal semen parameters. The presence of a varicocele does not always affect spermatogenesis, as it has been reported that only 20% of men with documented varicoceles suffer fertility problems. However, varicocele repair appears to have beneficial effects in men with impaired semen parameters and palpable varicoceles. Currently, the main procedures employed for varicocele repair are microsurgical subinguinal or inguinal varicocelectomy, laparoscopic varicocelectomy, and radiological percutaneous embolization. Microsurgical varicocelectomy appears to be the optimal treatment in most cases, whereas the other procedures are useful only in specific cases. After treatment, it typically takes 3 to 6 months for patients' semen parameters to improve; thus, other therapies, including assisted reproductive technology, should be considered if infertility persists after this interval, especially in older couples. Controversies still remain regarding how varicoceles in certain subgroups, such as adolescents or men with azoospermia, should be treated. Due to their relatively high prevalence rate among the general population, varicoceles can occur concomitantly with other conditions that cause impaired spermatogenesis. Further studies are necessary in order to identify the patients who are most likely to benefit from treatment. In this review, we sought to summarize the issues currently associated with varicocele treatment in infertile men. PMID:27574593

  5. Attitudes about infertility interventions among fertile and infertile couples.

    PubMed Central

    Halman, L J; Abbey, A; Andrews, F M

    1992-01-01

    BACKGROUND. There has been marked progress in the development of infertility interventions. This paper reports attitudes about 11 interventions for infertility. METHODS. Face-to-face interviews were conducted with each member of 185 infertile and 90 presumed fertile couples in southeastern Michigan. RESULTS. Seven of these interventions were generally viewed favorably and four were generally viewed negatively, regardless of the couple's fertility status. Infertile couples viewed all interventions, except for adoption, more favorably than did fertile couples. Multidimensional scaling was used to cluster the interventions according to similarity in endorsement. These clusters form a continuum from interventions that allow only one member of the couple to be a biological parent to the most noninvasive techniques. All clusters remain roughly equidistant from adoption, in which neither member of the couple is a biological parent. CONCLUSIONS. Interventions that produce a child who is biologically related to only one member of the couple were viewed most negatively. Members of couples who were receiving fertility treatment made finer discriminations among infertility interventions than did individuals who had not received treatment. PMID:1739145

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

    PubMed

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

    2016-02-01

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

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

    PubMed

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

    2016-02-01

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

  8. Aetiologic factors in male infertility: clinical, microbiological and hormonal evaluation.

    PubMed

    Nalini, K; Sethi, B K; Sharma, M; Dash, R J

    1992-03-01

    Seventy two infertile men were studied. History of small pox and mumps infection was noted in 4 and 3 patients respectively. Seven patients had varicocele (9.2%), and small atrophic testes were found in 9 (12.5%). Azoospermia was reported in 41 (58.3%) and oligospermia in 17 (23.6%), and 14 patients (19.4%) had normal sperm counts. Mycoplasma were grown from urethral swabs in 25 (35%) patients. Mean LH and FSH were elevated in azoospermics (p less than 0.001), E2-17B in oligospermics (p less than 0.001) and FSH in normospermic (p less than 0.01) patients. Hypergonadotropism suggestive of primary testicular failure was recorded in 43 (59.7%) patients. Hypogonadotropism was noted in 3 (4%) and hyperprolactinemia due to pituitary microadenoma induced infertility in only one patient. No aetiology could be determined in 11 (16%) patients.

  9. Zeta Sperm Selection Improves Pregnancy Rate and Alters Sex Ratio in Male Factor Infertility Patients: A Double-Blind, Randomized Clinical Trial

    PubMed Central

    Nasr Esfahani, Mohammad Hossein; Deemeh, Mohammad Reza; Tavalaee, Marziyeh; Sekhavati, Mohammad Hadi; Gourabi, Hamid

    2016-01-01

    Background Selection of sperm for intra-cytoplasmic sperm injection (ICSI) is usually considered as the ultimate technique to alleviate male-factor infertility. In routine ICSI, selection is based on morphology and viability which does not necessarily preclude the chance injection of DNA-damaged or apoptotic sperm into the oocyte. Sperm with high negative surface electrical charge, named “Zeta potential”, are mature and more likely to have intact chromatin. In addition, X-bearing spermatozoa carry more negative charge. Therefore, we aimed to compare the clinical outcomes of Zeta procedure with routine sperm selection in infertile men candidate for ICSI. Materials and Methods From a total of 203 ICSI cycles studied, 101 cycles were allocated to density gradient centrifugation (DGC)/Zeta group and the remaining 102 were included in the DGC group in this prospective study. Clinical outcomes were com- pared between the two groups. The ratios of Xand Y bearing sperm were assessed by fluorescence in situ hybridization (FISH) and quantitative polymerase chain reaction (qPCR) methods in 17 independent semen samples. Results In the present double-blind randomized clinical trial, a significant increase in top quality embryos and pregnancy rate were observed in DGC/Zeta group compared to DGC group. Moreover, sex ratio (XY/XX) at birth significantly was lower in the DGC/Zeta group compared to DGC group despite similar ratio of X/Y bearings sper- matozoa following Zeta selection. Conclusion Zeta method not only improves the percentage of top embryo quality and pregnancy outcome but also alters the sex ratio compared to the conventional DGC method, despite no significant change in the ratio of Xand Ybearing sperm population (Registration number: IRCT201108047223N1). PMID:27441060

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

    PubMed

    2015-10-01

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

  11. Association between RsaI polymorphism in estrogen receptor β gene and male infertility.

    PubMed

    Bordin, B M; Moura, K K V O

    2015-09-21

    The estrogen receptor β (ERβ) gene plays an important role in the regulation of fertility in both males and females. The RsaI polymorphism in ERβ is associated with male infertility in Caucasian patients. The aim of this study was to investigate the frequency of this polymorphism in the etiology of idiopathic male infertility and its correlation with smoking habits. We analyzed 287 Brazilian men, including 161 infertile and 126 fertile men, to evaluate the association between the RsaI polymorphism and male infertility. The RsaI variant alleles of all patients were determined by allele-specific polymerase chain reaction. Compared with a control group (normozoospermic men), the frequency of the RsaI AG-genotype was four times higher in infertile men (P = 0.01), five times higher in azoospermic men (P = 0.02), and seven times higher in teratozoospermic men (P = 0.001). The frequency of the RsaI AG-genotype was three times higher in infertile smokers (P = 0.038) compared with infertile nonsmokers, and nine times higher in azoospermic smokers (P = 0.035) compared with azoospermic nonsmokers. The RsaI polymorphism in ERβ may have modulating effects on human spermatogenesis. There seems to be a consistent association between RsaI polymorphism and smoking habits in infertile men.

  12. The economic impact of infertility on women in developing countries ‑ a systematic review

    PubMed Central

    Dyer, S.J.; Patel, M.

    2012-01-01

    Background: It is the responsibility of health systems to provide quality health care and to protect consumers against impoverishing health costs. In the case of infertility in developing countries, quality care is often lacking and treatment costs are usually covered by patients. Additional financial hardship may be caused by various social consequences. The economic implications of infertility and its treatment have not been systematically explored. Methods: A systematic MEDLINE search was conducted to identify English language publications providing original data from developing countries on out-of-pocket payment (OoPP) for infertility treatment and on other economic consequences of involuntary childlessness. Findings: Twenty one publications were included in this review. Information on OoPP was scant but suggests that infertility treatment is associated with a significant risk of catastrophic expenditure, even for basic or ineffective interventions. Other economic disadvantages, which may be profound, are caused by loss of access to child labour and support, divorce, as well as customary laws or negative attitudes which discriminate against infertile individuals. Women in particular are affected. Conclusion: Pertinent data on OoPP and other economic disadvantages of infertility in developing countries are limited. According to the evidence available, infertility may cause impoverishing health costs as well as economic instability or deprivation secondary to social consequences. Health systems in developing countries do not appear to meet their responsibilities vis-à-vis infertile patients. PMID:24753897

  13. Who's Most Likely to Seek Infertility Help

    MedlinePlus

    ... fullstory_159678.html Who's Most Likely to Seek Infertility Help They're more likely to be better ... 2016 (HealthDay News) -- Nearly half of people with infertility problems don't seek treatment, according to a ...

  14. Seminal biomarkers for the evaluation of male infertility

    PubMed Central

    Bieniek, Jared M; Drabovich, Andrei P; Lo, Kirk C

    2016-01-01

    For men struggling to conceive with their partners, diagnostic tools are limited and often consist of only a standard semen analysis. This baseline test serves as a crude estimation of male fertility, leaving patients and clinicians in need of additional diagnostic biomarkers. Seminal fluid contains the highest concentration of molecules from the male reproductive glands, therefore, this review focuses on current and novel seminal biomarkers in certain male infertility scenarios, including natural fertility, differentiating azoospermia etiologies, and predicting assisted reproductive technique success. Currently available tests include antisperm antibody assays, DNA fragmentation index, sperm fluorescence in situ hybridization, and other historical sperm functional tests. The poor diagnostic ability of current assays has led to continued efforts to find more predictive biomarkers. Emerging research in the fields of genomics, epigenetics, proteomics, transcriptomics, and metabolomics holds promise for the development of novel male infertility biomarkers. Seminal protein-based assays of TEX101, ECM1, and ACRV1 are already available or under final development for clinical use. Additional panels of DNA, RNA, proteins, or metabolites are being explored as we attempt to understand the pathophysiologic processes of male infertility. Future ventures will need to continue data integration and validation for the development of clinically useful infertility biomarkers to aid in male infertility diagnosis, treatment, and counseling. PMID:26975492

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

    PubMed Central

    Matzuk, Martin M; Lamb, Dolores J

    2013-01-01

    Reproduction is required for the survival of all mammalian species, and thousands of essential ‘sex’ genes are conserved through evolution. Basic research helps to define these genes and the mechanisms responsible for the development, function and regulation of the male and female reproductive systems. However, many infertile couples continue to be labeled with the diagnosis of idiopathic infertility or given descriptive diagnoses that do not provide a cause for their defect. For other individuals with a known etiology, effective cures are lacking, although their infertility is often bypassed with assisted reproductive technologies (ART), some accompanied by safety or ethical concerns. Certainly, progress in the field of reproduction has been realized in the twenty-first century with advances in the understanding of the regulation of fertility, with the production of over 400 mutant mouse models with a reproductive phenotype and with the promise of regenerative gonadal stem cells. Indeed, the past six years have witnessed a virtual explosion in the identification of gene mutations or polymorphisms that cause or are linked to human infertility. Translation of these findings to the clinic remains slow, however, as do new methods to diagnose and treat infertile couples. Additionally, new approaches to contraception remain elusive. Nevertheless, the basic and clinical advances in the understanding of the molecular controls of reproduction are impressive and will ultimately improve patient care. PMID:18989307

  16. Web-based treatment for infertility-related psychological distress.

    PubMed

    Sexton, Minden B; Byrd, Michelle R; O'Donohue, William T; Jacobs, Negar Nicole

    2010-08-01

    Infertility has been associated with stigma and negative psychosocial functioning. However, only a small proportion of this population actually receives care. Fertility patients predominantly use the Internet for information gathering, social support, and assistance with decision-making; yet, available web resources are unreliable sources of mental health care. Web-based alternatives also have the potential to assist with intervention access difficulties and may be of significant lower cost. This study evaluated the efficacy of a web-based approach to providing a cognitive behavioral intervention with 31 infertile women seeking medical reproductive technologies. Following randomized assignment, participants using the web-based intervention were compared with those in a wait-list control condition on general and infertility-related psychological stress measures. Results were mixed regarding intervention efficacy. Significant declines in general stress were evidenced in the experimental group compared with a wait-list control group. However, website access did not result in statistically significant improvements on a measure of infertility-specific stress. These findings add to the literature on psychological interventions for women experiencing fertility problems. Moreover, despite the widespread use of the Internet by this population, the present study is one of the first to investigate the usefulness of the Internet to attenuate stress in this population. Preliminary results suggest general stress may be significantly reduced in infertile women using an online cognitive behavioral approach. PMID:20127127

  17. Circulating sperm antibodies: indications for testing in infertile couples.

    PubMed

    Badawy, S Z; el Shaykh, M; Shulman, S; Cittadino, R

    1984-01-01

    Sperm antibody titers were evaluated in the serum of 73 infertile couples by the F-D and Kibrick agglutination tests, to study the relationship of the quality of post-coital tests and semen analysis. Thirty-eight couples had poor post-coital tests, fifteen couples had normal post-coital tests, and twenty couples revealed abnormal semen pictures of the males. In the first two groups, semen analysis was normal. The incidence of sperm antibodies was 10.5%, 6.6% in men, and 18.4%, 20.0% in women, with poor and normal post-coital tests, respectively. This suggests that sperm antibody testing is equally indicated in infertile couples with poor post-coital tests. In addition, there was no difference in the incidence of sperm antibodies in men with poor semen pictures and those with normal semen analysis in this infertile population. This suggests the significance of sperm antibody testing in infertile men with abnormal and normal semen pictures after correcting other infertility factors, in order to detect those patients who could benefit from treatment of such immunologic problems.

  18. Psychological stress and infertility. Part 2: Psychometric test data.

    PubMed

    Brand, H J

    1982-12-01

    The hypothesis tested in this study was that a group of female functional infertile patients would show significantly more personality maladjustment than a group with definite organic reproductive pathology and a normal fertile group. No significant differences between the functional and organic groups were found on any of the subscores of four personality questionnaires. The normal group (wives of sterile men) scored higher on extraversion than both the functional and organic groups. On self-control the normal group also scored lower (negative connotation) than the other two groups. In general no evidence for personality maladjustment in functional infertility was found.

  19. Infertility and Life Satisfaction among Women

    ERIC Educational Resources Information Center

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

    2007-01-01

    Using data from a random sample of 580 midwestern women, the authors explore the association between lifetime infertility and life satisfaction. Past research shows lower life satisfaction among those seeking help for infertility. The authors find no direct effects of lifetime infertility, regardless of perception of a problem, on life…

  20. Sex and Intimacy among Infertile Couples.

    ERIC Educational Resources Information Center

    Greil, Arthur; And Others

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

  1. Infertility: A Crisis with No Resolution.

    ERIC Educational Resources Information Center

    Butler, Robert R.; Koraleski, Stephanie

    1990-01-01

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

  2. Infertility: An Unanticipated and Prolonged Life Crisis.

    ERIC Educational Resources Information Center

    Forrest, Linda; Gilbert, Mary S.

    1992-01-01

    Reviews literature on infertility with a focus on myths and misunderstandings about the causes of infertility; a description of the crisis of infertility including common psychological responses; the additional psychological complexity introduced by medical procedures and reproductive technology; and suggestions for mental health counselors.…

  3. Childlessness: Strategies for Coping with Infertility.

    ERIC Educational Resources Information Center

    Woollett, Anne

    1985-01-01

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

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

    PubMed

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

    2016-01-15

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

  5. Demographics of infertility and management of unexplained infertility.

    PubMed

    Kamath, Mohan S; Bhattacharya, Siladitya

    2012-12-01

    The cause of infertility is unexplained in about 22-28% of all infertile couples. The prognosis for spontaneous pregnancy in such couples is better than in those with diagnosed causes of infertility. Traditional treatment options in this group have included expectant management, clomifene citrate, intrauterine insemination with (super ovulation plus intrauterine insemination) or without (intrauterine insemination) super ovulation and in-vitro fertilisation. Despite being more expensive, empirical clomifene and intrauterine insemination in an unstimulated cycle do not improve the chances of live birth compared with expectant management. Although unlikely to be more effective than no treatment in couples with a reasonably good prognosis, super ovulation plus intrauterine insemination has been shown to be more effective than intrauterine insemination. Any potential advantage of super ovulation plus intrauterine insemination has to be balanced against the relatively high risk of iatrogenic multiple pregnancy. In-vitro fertilisation remains the treatment of choice in longstanding unresolved infertility and, when coupled with the use of elective single embryo transfer, can minimise the risk of multiple pregnancies. Data from randomised trials confirming the superiority of in-vitro fertilisation over expectant management is limited.

  6. [Myoma and infertility: analysis of the literature].

    PubMed

    Poncelet, C; Benifla, J L; Batallan, A; Daraï, E; Madelenat, P

    2001-06-01

    The influence of myomas on reproduction has been clearly demonstrated, however their effects on fertility remain debated. The aim of this review, between January 1988 and December 2000, was to clarify the relation between myoma and fertility, and to assess pregnancy rates after myomectomy in infertile patients. Spontaneously, 54 publications were selected and 40 eligible. No study compared pregnancy rates with or without myomas. Pregnancy rates after myomectomy varied between 9.6% and 76.9%, with descriptive series. In medically assisted procreation, five publications were eligible. Myoma presence was associated with decreased pregnancy rates. Hysteroscopic sub-mucous myoma resection increased pregnancy rates. Relation between myoma and sterility is probable, however no proof was obtained. Myomectomy efficacy has not been statistically proven, but spontaneously almost 60% of patients became pregnant 24 months after surgery. Decreased pregnancy rates are observed when other infertility factors are associated. Concerning myomectomy in medically assisted procreation, conflicting results are available. Prospective randomised studies are needed. PMID:11462956

  7. Possible fetal determinants of male infertility.

    PubMed

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

    2014-09-01

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

  8. Lessons from elective in vitro fertilization (IVF) in, principally, non-infertile women

    PubMed Central

    2012-01-01

    Background We here report the first investigation of exclusively elective in vitro fertilization (IVF) cycles in women with no apparent history of infertility. Since IVF outcome in women with infertility are always influenced by underlying causes of infertility, a study on non-infertile women may offer new insights. Methods We investigated 88 females without history of infertility in 109 consecutive elective IVF cycles, almost exclusively performed for purposes of preimplantation genetic screening (PGS; i.e., elective gender selection). The following questions were addressed: (i) impact of PGS on IVF pregnancy chances; (ii) impact of transfer of 1 vs. ≥2 embryos on IVF pregnancy chances; (iii) correlation of anti-Müllerian hormone (AMH) levels to embryo ploidy (iv) effect of gonadotropin dosage used in stimulation on available embryos for transfer; and (v) in form of a 1:1 case control study, compared 33 elective PGS cycles with matched control cycles without PGS, performed in couples with either prior tubal ligations and/or severe male factor infertility as indication of IVF. Results The overall clinical pregnancy rate for the group was 36.7%; pregnancy was associated with number of euploid (P = 0.009) and number of embryos transferred (P = 0.001). Odds of pregnancy were 3.4-times higher if ≥4 euploid embryos were produced in comparison to <4 (95% CI 1.2 to 9.2; P = 0.019), and odds of pregnancy were 6.6-times higher if greater than or equal to 2 rather than <1 euploid embryos were transferred (95% CI 2.0 to 21.7; P = 0.002). Increasing AMH (P = 0.001) and gonadotropin dosage used in ovarian stimulation (P = 0.024), was, independently, associated with number of available euploid embryos. Increasing AMH, but not follicle stimulating hormone (FSH), was associated with number of embryos available for biopsy and PGS (P = 0.0001). Implantation rates were 26.4% with PGS and 9.5% without (P = 0.008). Women undergoing PGS, demonstrated

  9. [Imaging of male infertility: techniques and results].

    PubMed

    Eiss, D; Cornud, F; Thiounn, N; Wolf, J-P; Amar, E; Ghouadni, M; Hélénon, O

    2012-09-01

    Assessment of male infertility includes clinical examination, laboratory tests (semen analysis, hormones dosage) and sonographic examination of the urogenital tract. Male infertility is due to testicular abnormalities (secretory type) or obstructive disorder (excretory type). Imaging should provide accurate definition of anatomical causes of infertility in order to deliver appropriate treatment. Testicular Doppler ultrasound with transrectal ultrasound is the gold standard imaging technique to explore male infertility. MRI, because of its high resolution, provides a multiplanar study especially in congenital and inflammatory abnormalities of the urogenital tract. This pictorial review illustrates the most frequent causes of male infertility.

  10. Mutations of the aurora kinase C gene causing macrozoospermia are the most frequent genetic cause of male infertility in Algerian men.

    PubMed

    Ounis, Leyla; Zoghmar, Abdelali; Coutton, Charles; Rouabah, Leila; Hachemi, Maroua; Martinez, Delphine; Martinez, Guillaume; Bellil, Ines; Khelifi, Douadi; Arnoult, Christophe; Fauré, Julien; Benbouhedja, Sebti; Rouabah, Abdelkader; Ray, Pierre F

    2015-01-01

    Klinefelter syndrome and Y-chromosomal microdeletion analyses were once the only two genetic tests offered to infertile men. Analyses of aurora kinase C (AURKC) and DPY19L2 are now recommended for patients presenting macrozoospermia and globozoospermia, respectively, two rare forms of teratozoospermia particularly frequent among North African men. We carried out genetic analyses on Algerian patients, to evaluate the prevalence of these syndromes in this population and to compare it with the expected frequency of Klinefelter syndrome and Y-microdeletions. We carried out a retrospective study on 599 consecutive patients consulting for couple infertility at the assisted reproduction unit of the Ibn Rochd Clinique, Constantine, Algeria. Abnormal sperm parameters were observed in 404 men. Fourteen and seven men had typical macrozoospermia and globozoospermia profiles, respectively. Molecular diagnosis was carried out for these patients, for the AURKC and DPY19L2 genes. Eleven men with macrozoospermia had a homozygous AURKC mutation (79%), corresponding to 2.7% of all patients with abnormal spermograms. All the men with globozoospermia studied (n = 5), corresponding to 1.2% of all infertile men, presented a homozygous DPY19L2 deletion. By comparison, we would expect 1.6% of the patients in this cohort to have Klinefelter syndrome and 0.23% to have Y-microdeletion. Our findings thus indicate that AURKC mutations are more frequent than Klinefelter syndrome and constitute the leading genetic cause of infertility in North African men. Furthermore, we estimate that AURKC and DPY19L2 molecular defects are 10 and 5 times more frequent, respectively, than Y-microdeletions. PMID:25219909

  11. Mutations of the aurora kinase C gene causing macrozoospermia are the most frequent genetic cause of male infertility in Algerian men

    PubMed Central

    Ounis, Leyla; Zoghmar, Abdelali; Coutton, Charles; Rouabah, Leila; Hachemi, Maroua; Martinez, Delphine; Martinez, Guillaume; Bellil, Ines; Khelifi, Douadi; Arnoult, Christophe; Fauré, Julien; Benbouhedja, Sebti; Rouabah, Abdelkader; Ray, Pierre F

    2015-01-01

    Klinefelter syndrome and Y-chromosomal microdeletion analyses were once the only two genetic tests offered to infertile men. Analyses of aurora kinase C (AURKC) and DPY19L2 are now recommended for patients presenting macrozoospermia and globozoospermia, respectively, two rare forms of teratozoospermia particularly frequent among North African men. We carried out genetic analyses on Algerian patients, to evaluate the prevalence of these syndromes in this population and to compare it with the expected frequency of Klinefelter syndrome and Y-microdeletions. We carried out a retrospective study on 599 consecutive patients consulting for couple infertility at the assisted reproduction unit of the Ibn Rochd Clinique, Constantine, Algeria. Abnormal sperm parameters were observed in 404 men. Fourteen and seven men had typical macrozoospermia and globozoospermia profiles, respectively. Molecular diagnosis was carried out for these patients, for the AURKC and DPY19L2 genes. Eleven men with macrozoospermia had a homozygous AURKC mutation (79%), corresponding to 2.7% of all patients with abnormal spermograms. All the men with globozoospermia studied (n = 5), corresponding to 1.2% of all infertile men, presented a homozygous DPY19L2 deletion. By comparison, we would expect 1.6% of the patients in this cohort to have Klinefelter syndrome and 0.23% to have Y-microdeletion. Our findings thus indicate that AURKC mutations are more frequent than Klinefelter syndrome and constitute the leading genetic cause of infertility in North African men. Furthermore, we estimate that AURKC and DPY19L2 molecular defects are 10 and 5 times more frequent, respectively, than Y-microdeletions. PMID:25219909

  12. Potential association between male infertility and occupational psychological stress.

    PubMed

    Sheiner, Einat K; Sheiner, Eyal; Carel, Refael; Potashnik, Gad; Shoham-Vardi, Ilana

    2002-12-01

    The purpose of this work was to investigate the influence of working conditions, occupational exposures to potential reproductive toxic agents, and psychological stress on male fertility. The study population consisted of 202 consecutive male patients attending a fertility clinic. Of those, 106 patients had attended the clinic because of a male infertility problem (case group), 66 patients had attended the clinic because of a female infertility problem (control group), and 30 patients had a combined infertility problem (male and female). Male infertility was associated with working in industry and construction as compared with other occupations (78.6% vs 58.3%, P = 0.044). Industry and construction workers were of lower educational level than the other workers (mean: 12.1 vs 13.4 years, P = 0.021). These patients also tended to smoke more than the other workers (OR = 2.53, 95% CI = 1.08 to 5.98), more often worked in shifts (OR = 3.12, 95% CI = 1.19 to 8.13), reported physical exertion in work (OR = 3.35, 95% CI = 1.44 to 7.80), and were more exposed to noise and welding (OR = 3.84, 95% CI = 1.63 to 9.14, OR = 4.40, 95% CI = 1.11 to 1.76, respectively). Male infertility (case group) was found to be statistically related to higher marks in all four measures of burnout as compared with the controls. The largest difference was obtained in the measure of cognitive weariness (mean: 2.9 vs 2.1, P < 0.001). In a multiple logistic regression analysis, industry and construction jobs (adjusted OR = 2.2, 95% CI 1.2 to 2.7) and cognitive weariness (adjusted OR = 1.8, 95% CI = 1.03 to 4.6) were found to be independent risk factors for male infertility problems. Male infertility was independently associated with industry and construction jobs as well as job burnout.

  13. Evolution of psychology and counseling in infertility.

    PubMed

    Boivin, Jacky; Gameiro, Sofia

    2015-08-01

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

  14. Evolution of psychology and counseling in infertility.

    PubMed

    Boivin, Jacky; Gameiro, Sofia

    2015-08-01

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

  15. Spermatozoa protein alterations in infertile men with bilateral varicocele

    PubMed Central

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

    2016-01-01

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

  16. Patient access to pharmaceuticals: an international comparison.

    PubMed

    Cohen, Joshua; Faden, Laura; Predaris, Susan; Young, Brian

    2007-09-01

    We have identified eight sub-dimensions of patient access to pharmaceuticals: marketing approvals, time of marketing approval, coverage, cost sharing, conditions of reimbursement, speed from marketing approval to reimbursement, extent to which beneficiaries control choice of their drug benefit, and evenness of the availability of drugs to the population. For a sample of commonly used best-selling drugs in the United States (US), we measured these eight access sub-dimensions across four health systems: France, the Netherlands, the United Kingdom (UK), and the US. Although the US approved between 15 and 18% more drugs than the other three countries, the US was slower than France and the UK to approve drugs licensed in all four countries. The percentage of drugs covered is approximately the same for all four countries. For covered drugs, we observe the least cost sharing by patients in the Netherlands. The Netherlands imposes conditions of reimbursement on a much larger percentage of drugs. France seems to be the slowest in respect of speed from marketing approval to reimbursement. The US is the most flexible in terms of the extent to which beneficiaries control their choice of drug benefit but it is the least universal in terms of evenness of the availability of drugs to the population. Our study confirms the frequently cited problems of access in European countries: lag between marketing approval and reimbursement, and inflexibility in respect of the extent to which beneficiaries control their choice of drug benefit. At the same time, our study confirms, qualitatively, different kinds of access problems in the US: relatively high patient cost sharing for pharmaceuticals, and wide variation in coverage. PMID:17279403

  17. [Evaluation of GPx1 Pro198Leu Polymorphism in Idiopathic Male Infertility].

    PubMed

    Mazjin, M A; Salehi, Z; Mashayekhi, F; Bahadori, M

    2016-01-01

    Infertility is defined as failure to conceive a child after 1 year of unprotected regular sexual intercourse. Approximately half of all cases of infertility are caused by factors related to the male. In nearly 50% of infertile men it is not possible to determine the cause of infertility and this situation has been defined as unexplained or idiopathic. Oxidative stress plays an important role in the pathophysiology of male infertility. Oxidative stress results from an imbalance in free radicals and antioxidant defense mechanisms of the body. Genetic variations in the antioxidant gene coding for GPx enzyme may lead to decreased or impaired regulation of its enzymatic activity and alter reactive oxygen species (ROS) detoxification. We have investigated the possible association between polymorphism GPx1 Pro198Leu and idiopathic male infertility. One hundred patients with idiopathic male infertility and one hundred fifty healthy volunteers were enrolled. Genomic DNA was extracted from blood samples. Genotyping for the GPx1 Pro198Leu polymorphism was done by PCR-restriction fragment length polymorphism (RFLP) using ApaI. The genotype frequencies were 11% (Leu/Leu), 76% (Pro/Leu) and 13% (Pro/Pro) in the patient group and 8.7% (Leu/Leu), 67.3% (Pro/Leu) and 24% (Pro/Pro) in the control group. The genotype and allele frequencies of GPx1 Pro198Leu did not differ between the patient group and the control group (P = 0.09 and P = 0.1, respectively). In conclusion, there is no correlation between idiopathic male infertility and the GPx1 codon Pro198Leu polymorphism. Further studies are needed to investigate other genetic factors that influence the development of idiopathic male infertility.

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

    ERIC Educational Resources Information Center

    Watkins, Kathryn J.; Baldo, Tracy D.

    2004-01-01

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

  19. Testosterone and Male Infertility.

    PubMed

    Ohlander, Samuel J; Lindgren, Mark C; Lipshultz, Larry I

    2016-05-01

    Hypogonadism and its therapies have a significant impact on male fertility potential. It is necessary to determine the etiology to treat and counsel the patient appropriately on therapeutic options. For the hypogonadal male on exogenous testosterone, management should begin with cessation of the exogenous testosterone and supplemental subcutaneous human chorionic gonadotropin and an oral follicle-stimulating hormone (FSH)-inducing agent to allow reestablishment of the hypothalamic-pituitary-gonadal axis and spermatogenesis. Further supplemental therapy with recombinant FSH in some patients may be necessary to achieve optimal semen parameters.

  20. Testosterone and Male Infertility.

    PubMed

    Ohlander, Samuel J; Lindgren, Mark C; Lipshultz, Larry I

    2016-05-01

    Hypogonadism and its therapies have a significant impact on male fertility potential. It is necessary to determine the etiology to treat and counsel the patient appropriately on therapeutic options. For the hypogonadal male on exogenous testosterone, management should begin with cessation of the exogenous testosterone and supplemental subcutaneous human chorionic gonadotropin and an oral follicle-stimulating hormone (FSH)-inducing agent to allow reestablishment of the hypothalamic-pituitary-gonadal axis and spermatogenesis. Further supplemental therapy with recombinant FSH in some patients may be necessary to achieve optimal semen parameters. PMID:27132576

  1. Three years experience with local hydrocortisone treatment in women with immunological cause of infertility.

    PubMed

    Ulcová-Gallová, Z; Mráz, L; Plánicková, E; Macků, F; Ulc, I

    1990-01-01

    Two high selected groups of infertile women with proved cervical spermagglutinating antibodies by ficin, sucrose gradient ultracentrifugation, ELISA and microagglutinating test, by indirect MAR-test had been chosen for local hydrocortisone treatment. In the first group being composed of 20 infertile women we registered 16 decreasing or total disappearance of antisperm activity in cervical ovulatory mucus. Ten of them delivered healthy child. New 27 selected patients have treated in their immunological failure of reproduction by local hydrocortisone application, too, two of them are pregnant now. During the local hydrocortisone immunosuppression no side effects were registered. Hydrocortisone treatment seems to be a very perspective method in regulation of cervical immunological cause of infertility.

  2. Local hydrocortisone treatment of sperm-agglutinating antibodies in infertile women.

    PubMed

    Ulcová-Gallová, Z; Mráz, L; Plánicková, E; Macků, F; Ulc, I

    1988-01-01

    Local sperm-agglutinating antibodies (LSAA) in the cervical ovulatory mucus may be a cause of primary infertility. A group of 17 infertile women with LSAA treated without effect with artificial insemination and then condom therapy were studied. After hydrocortisone application to the ectocervix for up to four cycles, LSAA disappeared totally in 13 patients; six of them have given birth to babies. No side effects of treatment were observed. Hydrocortisone for local immunosuppression may become a new method of therapy in cervical immunological infertility.

  3. [Circulating nucleic acids and infertility].

    PubMed

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

    2015-09-01

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

  4. [Circulating nucleic acids and infertility].

    PubMed

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

    2015-09-01

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

  5. Case-control study of leatherwork and male infertility

    PubMed Central

    Kurinczuk, J; Clarke, M

    2001-01-01

    OBJECTIVES—To test the hypothesis that leatherwork is associated with male infertility mediated through the development of oligozoospermia. The basis of any association was postulated, at the outset, to be with exposure to the solvents used in leatherwork.
METHODS—All new referrals with infertility presenting in Leicestershire hospital clinics between November 1988 and September 1992 and Kettering District General Hospital from August 1990 were eligible to participate; 88.5% agreed to be interviewed. Exposure to leatherwork and work with solvents was defined by job title. Comparisons were made with fertile controls and in an analysis within men from infertile couples with oligozoospermia as the primary outcome. Effects on sperm motility and deformity were investigated secondarily. Analyses used logistic regression for binary outcomes and multilevel modelling for continuous outcomes.
RESULTS—1906 men were interviewed. Compared with the fertile controls the men from infertile couples were 1.10 times (95% confidence interval (95% CI) 0.46 to 2.63; p=0.99) more likely to be leatherworkers and 1.73 times (95% CI 1.26 to 2.38; p<0.001) more likely to work with solvents. Compared with other men, leatherworkers were 1.20 times (95% CI 0.43 to 3.33; p=0.73) more likely to present with oligozoospermia and 1.65 times (95% CI 0.37 to 7.30; p=0.51) more likely to present with teratozoospermia. Being a leatherworker was associated with only a 6% reduction in sperm concentration; motility and deformity were similarly unaffected by this exposure. Work with solvents did not statistically, nor clinically, increase the risk of oligozoospermia, teratozoospermia, or asthenozoospermia.
CONCLUSIONS—There was little evidence to support the hypothesis that leatherwork is associated with an increased risk of presenting with infertility or oligozoospermia. There was limited evidence that leatherwork is a risk factor for teratozoospermia. Workers with solvents were at

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

    PubMed Central

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

    2014-01-01

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

  7. Mitochondrial Genetic Variation in Iranian Infertile Men with Varicocele

    PubMed Central

    Heidari, Mohammad Mehdi; Khatami, Mehri; Danafar, Amirhossein; Dianat, Tahere; Farahmand, Ghazaleh; Talebi, Ali Reza

    2016-01-01

    Background: Several recent studies have shown that mitochondrial DNA mutations lead to major disabilities and premature death in carriers. More than 150 mutations in human mitochondrial DNA (mtDNA) genes have been associated with a wide spectrum of disorders. Varicocele, one of the causes of infertility in men wherein abnormal inflexion and distension of veins of the pampiniform plexus is observed within spermatic cord, can increase reactive oxygen species (ROS) production in semen and cause oxidative stress and sperm dysfunction in patients. Given that mitochondria are the source of ROS production in cells, the aim of this study was to scan nine mitochondrial genes (MT-COX2, MT-tRNALys , MT-ATP8, MT-ATP6, MT-COX3, MT-tRNAGly , MT-ND3, MT-tRNAArg and MT-ND4L) for mutations in infertile patients with varicocele. Materials and Methods: In this cross-sectional study, polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and DNA sequencing were used to detect and identify point mutations respectively in 9 mitochondrial genes in 72 infertile men with varicocele and 159 fertile men. In brief, the samples showing altered electrophoretic patterns of DNA in the SSCP gel were sent for DNA sequencing to identify the exact nucleotide variation. Results: Ten type nucleotide variants were detected exclusively in mitochondrial DNA of infertile men. These include six novel nucleotide changes and four variants previously reported for other disorders. Conclusion: Mutations in mitochondrial genes may affect respiratory complexes in combination with environmental risk factors. Therefore these nucleotide variants probably lead to impaired ATP synthesis and mitochondrial function ultimately interfering with sperm motility and infertility. PMID:27695613

  8. Male Reproductive Cancers and Infertility: A Mutual Relationship

    PubMed Central

    Tvrda, Eva; Agarwal, Ashok; Alkuhaimi, Nawaf

    2015-01-01

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

  9. Emerging molecular methods for male infertility investigation.

    PubMed

    Benkhalifa, Moncef; Montjean, Debbie; Belloc, Stephanie; Dalleac, Alain; Ducasse, Michel; Boyer, Pierre; Merviel, Philippe; Copin, Henri

    2014-01-01

    Male factors account for approximately 50% of reproductive pathology. Different disorders, including urogenital and endocrine system development abnormalities, lead to testicular and gametogenesis defects. Parallely, studies have reported that somatic and germ cell genome decay are a major cause of male infertility. It has been shown that in somatic karyotype, there is a higher incidence of chromosomal aberrations in infertile men than neonatal population and significant chromosome Y microdeletion or specific gene alterations in affected spermatogenesis. Karyotyping and FISH application at somatic and germ cell levels are no longer sufficient to investigate the potential contribution of genome disorders on male infertility. A wide range of molecular methods are required for better understanding of male infertility causes. Molecular omes and omics techniques have become a great tool to investigate male infertility from chromosome to protein. This review reports different molecular tests and methods that can be offered for male infertility investigation.

  10. Relevance of genetic investigation in male infertility.

    PubMed

    Asero, P; Calogero, A E; Condorelli, R A; Mongioi', L; Vicari, E; Lanzafame, F; Crisci, R; La Vignera, S

    2014-05-01

    Genetic causes can be directly responsible for various clinical conditions of male infertility and spermatogenic impairment. With the increased use of assisted reproduction technologies our understanding of genetic basis of male infertility has large implications not only for understanding the causes of infertility but also in determining the prognosis and management of such couples. For these reasons, the genetic investigations represent today an essential and useful tool in the treatment of male infertility. Several evidences are available for the clinical practice regarding the diagnosis; however, there are less information relative to the treatment of the genetic causes of male infertility. Focus of this review is to discuss the main and more common genetic causes of male infertility to better direct the genetics investigation in the treatment of spermatogenic impairment.

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

    PubMed Central

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

    2015-01-01

    Background: Identification of the main needs of infertile patients is essential to provision of appropriate supportive services and care based on their needs. Thus, the present study aims to explore infertile couples’ counseling needs. Materials and Methods: This study was carried out with an inductive qualitative content analysis approach during 2012–2013. The participants of this study included 26 Iranian infertile couples and 7 medical personnel (3 gynecologists and 4 midwives). The infertile couples were selected through purposive sampling and considering maximal variation from patients attending state-run and private infertility treatment centers as well as infertility specialists, offices in Isfahan and Rasht, Iran. Unstructured in-depth interviews and field notes were utilized for data gathering and replying to this research main question, “What are the counseling needs of infertile couples?” The data from medical personnel was collected through semi-structured interviews. Data analysis was carried out through conventional content analysis. Results: Data analysis revealed two main themes. The first theme was “a need for psychological counseling,” which included four subthemes: Emotional distress management, sexual counseling, marital counseling, and family counseling. The second theme was “a need for guidance and information throughout treatment process,” which included three subthemes: Treatment counseling, financial counseling, and legal counseling. Conclusions: The counseling needs of infertile couples are varied, and they require various psychosocial support and counseling interventions. The participants of this study identified clearly the significance of psychological counseling and information throughout the long and onerous journey of infertility and its treatment. PMID:26457091

  12. Modifiable Risk Factors and Infertility: What are the Connections?

    PubMed Central

    Rossi, Brooke V.; Abusief, Mary; Missmer, Stacey A.

    2015-01-01

    Infertility is a relatively common condition, greatly affecting couples medically and psychologically. Although infertility treatment is safe, it can be time-intensive, expensive and increase the risk of multiple gestations. Thus, to reduce costs and risks, couples may initially consider lifestyle change to increase their fertility and chances of pregnancy. For many of the diet factors studied (for example: caffeine, soy, protein, iron), there are conflicting data. However, there are some items men and women consume that are detrimental to fertility, such as alcohol and tobacco. The data on exercise are varied but may have an effect on ovulation and fertility - positive or negative. Body mass index appears to impact fertility also, with obesity in both men and women negatively affecting pregnancy rates. In addition, there remains concern and a growing body of research on environmental toxin exposures and reproductive health. Finally, supporting patients through infertility diagnosis and treatment is critical, as psychological stress may impact conception. It is imperative that the relationship between lifestyle factors and fertility continue to be explored as to lessen the morbidity associated with infertility. PMID:27594813

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

    PubMed Central

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

    2014-01-01

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

  14. Embryo splitting: a role in infertility?

    PubMed

    Wood, C

    2001-01-01

    Embryo splitting may be used to increase the potential fertility of couples requiring IVF. Using cattle as a model, it is possible to increase pregnancy rates from 70% per transfer of good quality in-vivo-produced embryos, to 110% by transferring the two demi-embryos resulting from the bisection of one embryo. The 30-40% greater chance of conception would reduce costs for the government, health authorities and patients, and reduce stress, time and complications for women having IVF treatment. Embryo splitting may also provide donor embryos for infertile couples that cannot conceive naturally or with IVF. The shortage of children for adoption and donor embryos may be overcome by the production of demi-embryos.

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

    PubMed

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

    2015-11-09

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

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

    ERIC Educational Resources Information Center

    Matthews, Anne Martin; Matthews, Ralph

    1986-01-01

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

  17. Age-related infertility and unexplained infertility: an intricate clinical dilemma.

    PubMed

    Somigliana, Edgardo; Paffoni, Alessio; Busnelli, Andrea; Filippi, Francesca; Pagliardini, Luca; Vigano, Paola; Vercellini, Paolo

    2016-07-01

    A diagnosis of unexplained infertility is commonly made when clinical investigations fail to identify any obvious barriers to conception. As a consequence, unexplained infertility includes several heterogeneous conditions, one being women with age-related infertility. However, the latter represent a peculiar and different situation. Women with age-related infertility may have a different prognosis and may benefit from different treatments. Unfortunately, since fecundity declines with age, discerning between unexplained infertility and age-related infertility becomes more and more difficult as the woman's age increases. In this opinion, with the use of a mathematical model we show that the rate of false positive diagnoses of unexplained infertility increases rapidly after 35 years of age. Using a threshold of 2 years of unfruitful, regular unprotected intercourse, this rate exceeds 50% in women starting pregnancy seeking after 37 years. The scenario is much worse using a threshold of 1 year. From a clinical perspective, extrapolating results obtained in a population of young women with unexplained infertility to those with age-related infertility is not justified. It is noteworthy that, if Assisted Reproductive Technologies are unable to overcome age-related infertility, the older women erroneously labeled with unexplained infertility may receive inappropriate therapies. These may expose women to unjustified risks and waste financial resources. Unfortunately, the available literature about older women is scanty and does not provide valid evidence. Randomized controlled trials aimed at identifying the most suitable clinical management of older women with a normal infertility work-up are pressingly needed. PMID:27060173

  18. Eastern medicine approaches to male infertility.

    PubMed

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

    2013-07-01

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

  19. Infertility trial outcomes: healthy moms and babies.

    PubMed

    Silver, Robert

    2014-05-01

    Traditionally, the primary outcome of infertility trials has been a positive pregnancy test or a clinically recognized pregnancy. However, parents desire a healthy baby that grows up to be a healthy adult, rather than a positive pregnancy test. Too often results of infertility trials are lacking in crucial obstetric details. This is problematic because treatments for infertility have the capacity to increase the risk for a variety of adverse obstetric outcomes. This review will outline important obstetric variables that should be included when reporting infertility research. The rationale for including these data, precise definitions of the variables, and cost-effective strategies for obtaining these obstetric details will be highlighted.

  20. Treatments for Diseases That Cause Infertility

    MedlinePlus

    ... for Males Fertility Treatments for Females Assisted Reproductive Technology ... for Diseases That Cause Infertility Skip sharing on social media links Share this: Page Content Specific treatments for ...

  1. SOCIAL CORRELATES OF FEMALE INFERTILITY IN UZBEKISTAN

    PubMed Central

    JUMAYEV, IZATULLA; HARUN-OR-RASHID, MD.; RUSTAMOV, OYBEK; ZAKIROVA, NODIRA; KASUYA, HIDEKI; SAKAMOTO, JUNICHI

    2012-01-01

    ABSTRACT The purpose of this matched case-control study was to investigate the social correlates of primary infertility among females aged 35 years or less. The study was conducted in the Clinics of Samarkand Medical Institute, Uzbekistan, among 120 infertile and 120 healthy women matched by age, residential area, and occupation from January to June 2009. Data were collected by face-to-face interviews using a structured questionnaire. Median duration of infertility was 10.0 months (interquartile range = 6.0–13.0). The rate of remarriage was 3.5 times higher among infertile women compared with healthy subjects. Insufficient family income, poor quality of life, life stress, and discontentment with daily routines as well as ‘bad’ relationships with family members (husband, mother- and father-in-law) were significant correlates of female infertility. Infertile women were more likely to underestimate the importance of sexual intimacy, and a negative attitude to sex. Female infertility is associated with various social correlates leading to higher remarriage rates and to further complicating the problem of infertility. Thus, a correction of women’s basic attitudes and their relationships to their surrounding social habitat should be an essential component of any program of infertility management. PMID:23092100

  2. [Infertility and kidney transplantation].

    PubMed

    Atallah, David; Salameh, Charbel; El Kassis, Nadine; Safi, Joelle; Lutfallah, Fouad; Bejjani, Lina; Ghaname, Wadih; Moukarzel, Maroun

    2015-01-01

    Renal failure impairs the endocrine system, especially in women, due to hyperprolactinemia, altering fertility, ovulatory cycles, libido and growth in adolescents. Renal transplantation is considered the best solution to the problems of renal failure and and of dialysis, as evidenced by comparing the rate of hyperprolactinemia (100% in chronic renal failure, 60% in patients on dialysis and 35% in post-transplantation). Kidney transplant is less efficient for restoring perfect function of the hypothalamic-pituitary-gonadal axis due in part to the immunosuppressant regimens prescribed. When these drugs are properly managed, transplantation will restore near normal sexual function.

  3. Genetics Home Reference: sensorineural deafness and male infertility

    MedlinePlus

    ... deafness and male infertility sensorineural deafness and male infertility Enable Javascript to view the expand/collapse boxes. ... All Close All Description Sensorineural deafness and male infertility is a condition characterized by hearing loss and ...

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

    MedlinePlus

    ... related nonsyndromic male infertility CATSPER1-related nonsyndromic male infertility Enable Javascript to view the expand/collapse boxes. ... All Close All Description CATSPER1 -related nonsyndromic male infertility is a condition that affects the function of ...

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

    PubMed

    de Souza, Mírley Barbosa; England, Gary C W; Mota Filho, Antônio Cavalcante; Ackermann, Camila Louise; Sousa, Carmen Vládia Soares; de Carvalho, Gabriela Guedelha; Silva, Herlon Victor Rodrigues; Pinto, José Nicodemos; Linhares, Jussiara Candeira Spíndola; Oba, Eunice; da Silva, Lúcia Daniel Machado

    2015-09-15

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

  6. [Hysteroscopy in infertility].

    PubMed

    Toro Calzada, R J; García-Luna, A M; Manterola, A D

    1992-10-01

    An evaluation of hysteroscopy as complementary study of the sterile couple, was carried out; the hysteroscopic findings were compared with laparoscopic findings, and with Hysterosalpingography (HSG); it was a longitudinal, retrospective study of 20 patients. In the obstetrical antecedents there were 58 gestations, 50 of which ended in abortion. From de five normal cavities by HSG four were for hysteroscopy. As compared with hysteroscopy, HSG detected only 75% of submucous myomas, 85% of walls, 100% of IUD's fragments and of cervical incompetences. In the case of sinechias it was confirmed by hysteroscopy 80% of the diagnosed by HSG. The only case of endometrial polyp was detected by hysteroscopy. Surgical procedures were carried out in 40%, with complications in 16.6%. It was conclude that hysteroscopy is a complementary method, but necessary, in the study of the sterile couple with the possibility at the same time of being a therapeutic method.

  7. Quantitative ultramorphological (QUM) analysis of human sperm: diagnosis and management of male infertility.

    PubMed

    Bartoov, B; Eltes, F; Reichart, M; Langzam, J; Lederman, H; Zabludovsky, N

    1999-01-01

    The advantages of quantitative ultramorphological (QUM) sperm analysis in the diagnosis and treatment of male infertility are presented. QUM methodology is based on three elements: (1) complementary SEM and TEM observations of 7 sperm cell subcellular organelles: acrosome, postacrosomal lamina, nucleus, neck, axoneme, mitochondrial sheath, and outer dense fibers; (2) systematic classification of the specific ultramorphological malformations into 4 pathological and the normal categories, which indicate the morphological state of each subcellular organelle; and (3) comparison between well-defined reference groups with opposite fertility status or treatment conditions. QUM analysis has enabled the establishment of two indices that optimally express the in vivo and in vitro male fertility potential: The Natural Fertility Index (NFI), which allowed an accurate prediction (97% sensitivity and 90% specificity) of 80% of the naturally fertile and suspected infertile male patients, and the in vitro fertilization (IVF) score, which enabled prediction of 76% of the nonfertilizing and 90% of the fertilizing IVF groups. Validation tests confirmed these data. QUM also enabled assessment of ultramorphological indications for varicocele and radiation exposure: Both male factor etiologies indicated a persistent effect on the natural fertility potential, as expressed by structural changes in the nucleus. Varicocele was found to cause defects in the sperm head organelles related to early spermatid development, whereas ionizing radiation resulted in amorphous head shape. Criteria for specific non-in vitro therapeutic interventions such as varicocelectomy, follicle-stimulating hormone (FSH) administration, and acupuncture treatment were established. A varicocele index, which enabled the correct classification of 79 and 89% of the patients pre- and post-high ligation, respectively, was suggested to be a good indicator for varicocele which affects the fertility potential. Males

  8. Analyses of optimal body mass index for infertile patients with either polycystic or non-polycystic ovary syndrome during assisted reproductive treatment in China

    PubMed Central

    Wang, Fang; Dai, Wei; Yang, Xin-hong; Guo, Yi-hong; Sun, Ying-pu

    2016-01-01

    We observed the effect of body mass index (BMI) on pregnancy outcomes in Chinese patients undergoing assisted reproductive treatment (ART). All the patients were divided into polycystic ovary syndrome (PCOS) group and non-PCOS group, and then according to BMI, each group was subdivided into 6 subgroups: group 1 (BMI < 18 kg/m2), group 2 (18–20 kg/m2), group 3 (20–22 kg/m2), group 4 (22–24 kg/m2), group 5 (24–26 kg/m2) and group 6 (BMI > 26.0 kg/m2). We found that in 20 to 25-year-old patients, the pregnancy rate was not significantly correlated with BMI in PCOS patients; while in non-POCS patients, the pregnancy rate significantly decreased at the BMI cut-off point value of 24–26 kg/m2. The pregnancy rate significantly declined at the BMI cut-off point values of 22–24 kg/m2 and 18–20 kg/m2, respectively in 25 to 35-year-old and in over 35-year-old PCOS patients; while in over 25-year-old non-PCOS patients, no significant correlation between pregnancy rate and BMI was observed. We conclude that for under 25-year-old non-PCOS patients, ART should be performed after BMI is controlled under 26 kg/m2. For PCOS patients, if age is 25 to 35 years or over 35 years, BMI should be controlled below 24 kg/m2 or below 20 kg/m2, respectively. PMID:27686055

  9. The CAG repeat polymorphism of mitochondrial polymerase gamma (POLG) is associated with male infertility in Tunisia.

    PubMed

    Baklouti-Gargouri, S; Ghorbel, M; Chakroun, N; Sellami, A; Fakhfakh, F; Ammar-Keskes, L

    2012-05-01

    Male fertility largely depends on sperm quality, which may be affected by environmental and genetic factors. Recent data emphasised the implication of the polymorphism of mitochondrial DNA polymerase gamma (POLG) CAG repeats in male infertility. In this report, we explored a possible role of the (POLG) gene polymorphism in male infertility in Tunisian men. The polymorphic CAG repeat in the nuclear POLG gene was studied in 339 male subjects (216 patients with infertility (69 azoospermic, 115 oligoasthenoteratospermic and 32 normospermic) and 123 fertile) after DNA amplification by PCR, followed by genotyping using an automatic sequencer. The heterozygous and the homozygous mutant genotypes (10/ ≠ 10 and ≠ 10/ ≠ 10) were significantly more frequent among infertile patients than among fertile controls (11.2% versus 1.6%, P = 1.3 × 10(-3) and 4.6% versus 0.8%, P = 4.2 × 10(-7) respectively). We also found a significant difference between the frequencies of 10/ ≠ 10 genotype in azoospermic (4.4%) and in oligoasthenoteratospermic (15.6%) infertile patients (P = 2.6 × 10(-2) ). However, the homozygous mutant genotype (≠ 10/ ≠ 10) was seen at similar frequencies in azoospermic, normospermic and oligoasthenospermic men (4.4%, 3.1% and 5.2% respectively). Under our conditions, the findings showed an association between POLG CAG repeat polymorphism and male infertility in Tunisian population.

  10. Domestic violence in Iranian infertile women

    PubMed Central

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

    2014-01-01

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

  11. A maternally inherited autosomal point mutation in human phospholipase C zeta (PLCζ) leads to male infertility

    PubMed Central

    Kashir, Junaid; Konstantinidis, Michalis; Jones, Celine; Lemmon, Bernadette; Chang Lee, Hoi; Hamer, Rebecca; Heindryckx, Bjorn; Deane, Charlotte M.; De Sutter, Petra; Fissore, Rafael A.; Parrington, John; Wells, Dagan; Coward, Kevin

    2012-01-01

    BACKGROUND Male factor and idiopathic infertility contribute significantly to global infertility, with abnormal testicular gene expression considered to be a major cause. Certain types of male infertility are caused by failure of the sperm to activate the oocyte, a process normally regulated by calcium oscillations, thought to be induced by a sperm-specific phospholipase C, PLCzeta (PLCζ). Previously, we identified a point mutation in an infertile male resulting in the substitution of histidine for proline at position 398 of the protein sequence (PLCζH398P), leading to abnormal PLCζ function and infertility. METHODS AND RESULTS Here, using a combination of direct-sequencing and mini-sequencing of the PLCζ gene from the patient and his family, we report the identification of a second PLCζ mutation in the same patient resulting in a histidine to leucine substitution at position 233 (PLCζH233L), which is predicted to disrupt local protein interactions in a manner similar to PLCζH398P and was shown to exhibit abnormal calcium oscillatory ability following predictive 3D modelling and cRNA injection in mouse oocytes respectively. We show that PLCζH233L and PLCζH398P exist on distinct parental chromosomes, the former inherited from the patient's mother and the latter from his father. Neither mutation was detected utilizing custom-made single-nucleotide polymorphism assays in 100 fertile males and females, or 8 infertile males with characterized oocyte activation deficiency. CONCLUSIONS Collectively, our findings provide further evidence regarding the importance of PLCζ at oocyte activation and forms of male infertility where this is deficient. Additionally, we show that the inheritance patterns underlying male infertility are more complex than previously thought and may involve maternal mechanisms. PMID:22095789

  12. Differential Genes Expression between Fertile and Infertile Spermatozoa Revealed by Transcriptome Analysis

    PubMed Central

    Bansal, Sandeep Kumar; Gupta, Nishi; Sankhwar, Satya Narayan; Rajender, Singh

    2015-01-01

    Background It was believed earlier that spermatozoa have no traces of RNA because of loss of most of the cytoplasm. Recent studies have revealed the presence of about 3000 different kinds of mRNAs in ejaculated spermatozoa. However, the correlation of transcriptome profile with infertility remains obscure. Methods Total RNA from sperm (after exclusion of somatic cells) of 60 men consisting of individuals with known fertility (n=20), idiopathic infertility (normozoospermic patients, n=20), and asthenozoospermia (n=20) was isolated. After RNA quality check on Bioanalyzer, AffymetrixGeneChip Human Gene 1.0 ST Array was used for expression profiling, which consisted of >30,000 coding transcripts and >11,000 long intergenic non-coding transcripts. Results Comparison between all three groups revealed that two thousand and eighty one transcripts were differentially expressed. Analysis of these transcripts showed that some transcripts [ribosomal proteins (RPS25, RPS11, RPS13, RPL30, RPL34, RPL27, RPS5), HINT1, HSP90AB1, SRSF9, EIF4G2, ILF2] were up-regulated in the normozoospermic group, but down-regulated in the asthenozoospermic group in comparison to the control group. Some transcripts were specific to the normozoospermic group (up-regulated: CAPNS1, FAM153C, ARF1, CFL1, RPL19, USP22; down-regulated: ZNF90, SMNDC1, c14orf126, HNRNPK), while some were specific to the asthenozoospermic group (up-regulated: RPL24, HNRNPM, RPL4, PRPF8, HTN3, RPL11, RPL28, RPS16, SLC25A3, C2orf24, RHOA, GDI2, NONO, PARK7; down-regulated: HNRNPC, SMARCAD1, RPS24, RPS24, RPS27A, KIFAP3). A number of differentially expressed transcripts in spermatozoa were related to reproduction (n = 58) and development (n= 210). Some of these transcripts were related to heat shock proteins (DNAJB4, DNAJB14), testis specific genes (TCP11, TESK1, TSPYL1, ADAD1), and Y-chromosome genes (DAZ1, TSPYL1). Conclusion A complex RNA population in spermatozoa consisted of coding and non-coding RNAs. A number of

  13. Studies on infertility in males.

    PubMed

    Fattah, A A; Azim, A A; Habeib, M; Rafik, M

    1980-02-01

    One hundred and fifteen infertile men were examined for circulating spermagglutinating antibodies by the Kibrick spermagglutination test; thirty-three (28%) were found to have positive agglutination titers--1:32 or more in thirteen samples. This high figure may be explained by the high incidence of genital tract infection and of urinary schistosomiasis in our study group. Of the 33 men who demonstrated autoantibodies in their sera, 21 had microscopic agglutination of more than 10%. There was a positive correlation between the serum autoantibody titer and spermagglutination. Eight cases (6.9%) of sperm-immobilizing antibodies were found.

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

    PubMed Central

    Kumar, Naina; Singh, Amit Kant

    2015-01-01

    Infertility and problems of impaired fecundity have been a concern through ages and is also a significant clinical problem today, which affects 8–12% of couples worldwide. Of all infertility cases, approximately 40–50% is due to “male factor” infertility and as many as 2% of all men will exhibit suboptimal sperm parameters. It may be one or a combination of low sperm concentration, poor sperm motility, or abnormal morphology. The rates of infertility in less industrialized nations are markedly higher and infectious diseases are responsible for a greater proportion of infertility. The present literature will help in knowing the trends of male factor infertility in developing nations like India and to find out in future, various factors that may be responsible for male infertility. PMID:26752853

  15. Hysteroscopy for infertile women: a review.

    PubMed

    Cholkeri-Singh, Aarathi; Sasaki, Kirsten J

    2015-01-01

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

  16. Is Infertility Associated with Childhood Autism?

    ERIC Educational Resources Information Center

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

    2013-01-01

    Concerns persist about a possible link between infertility and risk of autism spectrum disorders (ASD). Interpretation of existing studies is limited by racial/ethnic homogeneity of study populations and other factors. Using a case-control design, we evaluated infertility history and treatment documented in medical records of members of Kaiser…

  17. Choices and Motivations of Infertile Couples.

    ERIC Educational Resources Information Center

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

    1997-01-01

    Infertile couples' (N=131) consideration of options for dealing with infertility (medical help, adoption, fostering, alternative medicine, and focusing on other life goals) is studied. Options were related to specific motivations including altruistic motives for adoption or foster care. Results, timing of choices, and motivations are discussed.…

  18. Pastoral Care to the Infertile Couple.

    ERIC Educational Resources Information Center

    Louw, D. J.

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

  19. Principles of Nutrition in Patients with Polycystic Ovary Syndrome in Iranian Traditional Medicine and Comparison with Modern Medicine

    PubMed Central

    Tansaz, Mojgan; Bahmani, Maryam

    2016-01-01

    Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age with metabolic and gynecological complications. Despite the high prevalence of this disease, many challenges remain regarding its diagnosis and treatment. According to many studies, lifestyle modification especially diet is the first line of the treatment in PCOS patients. The aim of this article was to study the principles of nutrition for PCOS patients in Iranian traditional medicine (ITM) in comparison with modern medicine. Methods: This is a descriptive study done using ITM references such as Canon of Medicine, Exir-e-Azam, Tib-e-Akbari, and the keywords feed, nutrition, lifestyle, and PCOS were searched in modern medicine databases. Results: In ITM resources, the symptoms of PCOS were discussed under the topic of several diseases, including “Ehtebase tams”, “infertility and uterine inflammation” and “urame rahem”. In “Ehtebase tams”, like other diseases, the first line of the treatment is diet based on disease etiology. The most common cause of “Ehtebase tams” is dystemperament of the uterus and ovaries especially cold and wet dystemperament. Conclusion: According to ITM, patients with “Ehtebase tams” should limit cold and wet foods in their diet and more hot, dry, and soft foods are most suitable for them. In modern medicine, reducing of carbohydrates and fats is considered. In other studies, there was no preference for different food groups. These differences may be due to the temperament of foods in the food groups. It seems that by combining ITM guidelines with the findings of modern medicine, a proper diet in these patients can be achieved. PMID:27516680

  20. [Doctor Ma Kun's experience of applying tonifying kidney and promoting blood circulation treatment of anovulatory infertility].

    PubMed

    Shan, Jing

    2014-02-01

    With the ascending attack rate of anovulatory infertility year by year, people also began to pay attention to its treat methods. According to Doctor Ma Kun,who are engaged in clinical work about the treatment for anovulatory infertility, kidney deficiency is the basic pathogenesis and blood stasis is an important factor that has been through. Flexible use of tonifying the kidney and promoting blood circulation treatment of anovulatory infertility in clinic, has achieved remarkable curative effect. Director Ma adjusts menstruation by the different periods, and regulates both patients' negative emotions and sleep quality. Through years of clinical experience accumulation, Director Ma gradually formes special treatment of anovulatory infertility by flexibly using of tonifying the kidney and promoting blood circulation individually.

  1. Is infertility associated with childhood autism?

    PubMed

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

    2013-03-01

    Concerns persist about a possible link between infertility and risk of autism spectrum disorders (ASD). Interpretation of existing studies is limited by racial/ethnic homogeneity of study populations and other factors. Using a case-control design, we evaluated infertility history and treatment documented in medical records of members of Kaiser Permanente Northern California. Among singletons (349 cases, 1,847 controls), we found no evidence to support an increase in risk of ASD associated with infertility. Among multiple births (21 cases, 54 controls), we found an increased risk associated with infertility history and with infertility evaluations and treatment around the time of index pregnancy conception; however, small sample size and lack of detailed data on treatments preclude firm interpretation of results for multiple births.

  2. Consequences of infertility in developing countries.

    PubMed

    Rouchou, Brittany

    2013-05-01

    Infertility affects more than 10% of the world's population. In developing countries, there are severe social, psychological and economic consequences for infertile men and women. All of the cited references are compiled from primary peer-reviewed research articles that were conducted through one-to-one interviews or focus groups in countries of developing regions, such as Africa, Asia and the Middle East. The following paper seeks to raise awareness of the consequences of infertility in developing nations and identify infertility as an under-observed, but significant public health issue. It is proposed that education programmes tailored to each society's specific religious beliefs and grounded traditions must be implemented in order to reverse the social stigma, detrimental psychological effects, and loss of economic security that results from infertility.

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

    PubMed

    Richardson, Marcy E; Bleiziffer, Andreas; Tüttelmann, Frank; Gromoll, Jörg; Wilkinson, Miles F

    2014-01-01

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

  4. A comparison of ejaculated and testicular spermatozoa aneuploidy rates in patients with high sperm DNA damage.

    PubMed

    Moskovtsev, Sergey I; Alladin, Naazish; Lo, Kirk C; Jarvi, Keith; Mullen, J Brendan M; Librach, Clifford L

    2012-06-01

    Testicular spermatozoa are utilized to achieve pregnancy in couples with severe male factor infertility. Several studies suggest that aneuploidy rates in spermatozoa are elevated at the testicular level in infertile patients compared to ejaculates of normal controls. However, essential data regarding aneuploidy rates between ejaculated and testicular spermatozoa in the same individuals is lacking. The purpose of our study was to compare aneuploidy rates at the testicular and post-testicular level from the same patients with persistently high sperm DNA damage. Ejaculates and testicular biopsies were obtained from eight patients with persistently high DNA damage (>30%). Both ejaculated and testicular samples were analyzed for sperm DNA damage and sperm aneuploidy for chromosomes 13, 18, 21, X, and Y. In addition, semen samples from ten normozoospermic men presenting for fertility evaluation served as a control group. A strong correlation between the alteration of spermatogenesis and chromatin deterioration was observed in our study. In the same individuals, testicular samples showed a significantly lower DNA damage compared to ejaculated spermatozoa (14.9% ± 5.0 vs. 40.6% ± 14.8, P<0.05), but significantly higher aneuploidy rates for the five analyzed chromosomes (12.41% ± 3.7 vs. 5.77% ± 1.2, P<0.05). While testicular spermatozoa appear favourable for ICSI in terms of lower DNA damage, this potential advantage could be offset by the higher aneuploidy rates in testicular spermatozoa.

  5. Hyperprolactinemia and infertility: new insights

    PubMed Central

    Kaiser, Ursula B.

    2012-01-01

    Clinical vignette: A 29-year-old woman is referred for management of infertility. After menarche at age 12, menses occurred irregularly for a year and then became regular. She initiated use of oral contraceptive pills at the age of 18, then stopped at age 27 to try to conceive. Evaluation revealed hyperprolactinemia with serum prolactin of 90 ng/ml; pituitary MRI showed a 6-mm microadenoma. Other pituitary function tested was normal. Therapy was initiated with bromocriptine, but it was poorly tolerated, with fatigue, nausea, and lightheadedness to the point of syncopal events during her work as a hairdresser. Treatment was changed to cabergoline, with similar difficulties. Prolactin levels declined to the 30s–40s, but she was never able to tolerate the medication sufficiently to attain normal prolactin levels, and menses were sporadic and infrequent, with only 2–3 occurring per year. She and her husband had not conceived despite regular unprotected intercourse. She asks whether other medical treatment options might be available for her infertility. PMID:23193578

  6. Abortion and infertility in Russia.

    PubMed

    Kulakov, V I

    1995-03-01

    The exceptionally high rate of induced abortion in Russia (204/100 live births in 1991) and of abortion-related genital tract infection and infertility implies an urgent need for both the prevention of unwanted pregnancy and less invasive abortion techniques. Vacuum aspiration is gradually replacing curettage as the abortion method of choice for first-trimester abortions, and research is being conducted on pharmacologic abortion involving prostaglandins in combination with RU-486. Infertility, which affects 10-15% of married Russian couples, accounts for 50% of visits to the largest gynecologic hospitals. 92% of women and 49% of men in couples with impaired fertility exhibit pathology of the reproductive system, primarily prior inflammatory morbidity of the genitalia. The use of surgery to correct these impairments is largely unsuccessful, especially when there has been prior treatment with the hydroturbation method. The Federal Family Planning Program for 1993-97 reflects increased awareness of the problem; among its goals are the creation of state and social structures for a family planning service, mass media campaigns, the preparation of educational materials on the avoidance of unwanted pregnancy, and staff training in sex education and family planning.

  7. Cadmium toxicity: a possible cause of male infertility in Nigeria.

    PubMed

    Akinloye, Oluyemi; Arowojolu, Ayodele O; Shittu, Olayiwola B; Anetor, John I

    2006-03-01

    Serum and seminal plasma cadmium (Cd) concentrations were estimated by atomic absorption spectrophotometry in 60 infertile adult male Nigerians (40 oligozoospermics and 20 azoospermics). The results were compared with Cd level in 40 normozoospermic subjects (matched age, with proven evidence of fertility). The relationship between Cd levels and spermatograms or the hypothalamic-pituitary-gonadal (HPG) -axis was investigated by correlating serum and seminal plasma Cd levels with semen characteristics and hormone levels. The seminal plasma Cd level was significantly higher than those of serum in all studied groups (p<0.001). The serum and seminal plasma Cd levels were increased (p<0.001) in azoospermics in comparison to oligozoospermic and control subjects. A significant negative correlation was observed between serum Cd level and all examined biophysical semen characteristics except sperm volume. A positive correlation was also observed between seminal plasma Cd and FSH. Results of the study for the first time implicate cadmium as a cause of infertility in male Nigerians as well as extend and support previous findings concerning cadmium toxicity and male infertility. The strong deleterious effect of cadmium on spermatogenesis may be due to the systemic and cellular toxicity. A possible relationship between this element and the HPG axis is also suggested.

  8. Study of Three Single Nucleotide Polymorphisms in the SLC6A14 Gene in Association with Male Infertility.

    PubMed

    Noveski, P; Mircevska, M; Plaseski, T; Peterlin, B; Plaseska-Karanfilska, D

    2014-12-01

    Although several genetic causes of male infertility are known, the condition in around 60.0-75.0% of infertile male patients appears to be idiopathic. In some, genetic causes may be polygenic and require several low-penetrance genes to produce a phenotype outcome. In others, pleiotropy, when a gene can produce several phenotypic traits, may be involved. We have investigated whether single nucleotide polymorphisms (SNPs) in the SLC6A14 [solute carrier family 6 (amino acid transporter), member 14] gene are associated with male infertility. This gene has previously been linked with obesity and cystic fibrosis, which are associated with male infertility. It has a role in the transport of tryptophan and synthesis of serotonin that are important for normal spermatogenesis and testicular function. We have analyzed three SNPs (rs2312054, rs2071877 and rs2011162) in 370 infertile men and 241 fertile controls from two different populations (Macedonian and Slovenian). We found that the rs2011162(G) allele and rs2312054(A)-rs2071877(C)-rs2011162(G) haplotype are present at lower frequencies in the infertile rather than the fertile men (p = 0.044 and p = 0.0144, respectively). We concluded that the SLC6A14 gene may be a population-specific, low-penetrance locus which confers susceptibility to male infertility/subfertility. Additional follow-up studies of a large number of infertile men of different ethnic backgrounds are needed to confirm such a susceptibility.

  9. Male factors in infertility--a preliminary report.

    PubMed

    Chowdhury, T A; Habib, F; Khanam, S T

    1981-06-01

    Findings in 325 consecutive primary seminal analysis done at the Infertility Treatment Centre of IPGMR, are discussed. The clinical profile of the infertile couples was recorded. Semen was examined for quantity, sperm density, motility and morphology. An attempt was also made to correlate past illnesses with the quality of semen. 65 patients (20%) showed azoospermia, while 29 (8.9%) showed sperm count of less than 10 million/ml. History of past illnesses which contribute to azoospermia/oligospermia was obtained in 46% of azoospermia cases compared to only 10% in subjects showing sperm count of over 10 million/ml. Commonest association between azoospermia and past illness was found in the case of small-pox, where out of 31 subjects with past history of small-pox, 15 showed complete azoospermia, one showed sperm density of less then 10 million/ml.

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

    PubMed Central

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

    2010-01-01

    Abstract Aim We aim to determine the safety and effectiveness of a standard therapeutic package of Korean medicine for the treatment of unexplained infertility in a cross-section of women who sought treatment at an integrative hospital in Seoul, Korea. Background Infertility affects more than 1.2 million women in the United States alone. Treatment options for infertility vary, yet the barriers of invasiveness, cost, and access inhibit treatment use for many women. Alternative medical approaches exist for this indication, and sustain certain popularity. Therefore, we systematically studied a standard therapeutic package of Korean medicine to treat unexplained infertility in women. Methods Female participants included in this observational study met inclusion criteria before receiving a set of treatments including herbal medicine, acupuncture, and moxibustion. A study physician screened each patient in accordance with inclusion criteria, provided study information, and after the patients consented, performed the baseline assessment. Assessments included age, the history of assisted reproductive technology, and duration of infertility. The key outcome measure included the number who achieved pregnancy and any neo-natal morbidity and mortality at follow-up stage for those who got pregnant. Any other adverse events including aggravation of existing symptoms, and the number of dropouts, were recorded. Treatments were supposed to be completed after 6 menstrual cycles between February 2005 and April 2006. Results One hundred and four (104) women with unexplained infertility were included in this observational study. Participant mean age was 32 years (SD: 2.7), with a range between 26 and 41 years. The median duration of infertility after diagnosis was 33.5 weeks (interquartile range: 20.8–50.3). In total, 41 participants (39.4%) had undergone a mean number of 1.4 (SD: 2.2) assisted reproductive technology treatments prior to joining the study. The number of patients

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

    PubMed

    Török, Péter; Major, Tamás

    2013-08-18

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

  12. 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

  13. 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

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

    PubMed

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

    2010-03-01

    Most men with spinal cord injury (SCI) are infertile. Erectile dysfunction, ejaculatory dysfunction and semen abnormalities contribute to the problem. Treatments for erectile dysfunction include phosphodiesterase type 5 inhibitors, intracavernous injections of alprostadil, penile prostheses, and vacuum constriction devices. In anejaculatory patients who wish to father children, semen retrieval is necessary. Penile vibratory stimulation is recommended as the first line of treatment. Patients who fail penile vibratory stimulation can be referred for electroejaculation. If this approach is not possible, prostate massage is an alternative. Surgical sperm retrieval should be considered as a last resort when other methods fail. Most men with SCI have a unique semen profile characterized by normal sperm count but abnormally low sperm motility. Scientific investigations indicate that accessory gland dysfunction and abnormal semen constituents contribute to the problem. Despite abnormalities, sperm from men with SCI can successfully induce pregnancy. In selected couples, the simple method of intravaginal insemination is a viable option. Another option is intrauterine insemination. The efficacy of intrauterine insemination increases as the total motile sperm count inseminated increases. In vitro fertilization and intracytoplasmic sperm injection are options in cases of extremely low total motile sperm count. Reproductive outcomes for SCI male factor infertility are similar to outcomes for general male factor infertility. PMID:20157304

  15. Infertility

    MedlinePlus

    ... alcohol Exercising too much Eating disorders or poor nutrition Growths (such as fibroids or polyps) in the uterus and cervix Medicines such as chemotherapy drugs Hormone imbalances Obesity Older age Ovarian cysts ...

  16. Prevalence and factors associated with use of herbal medicine among women attending an infertility clinic in Uganda

    PubMed Central

    2014-01-01

    Background Infertility is a public health problem associated with devastating psychosocial consequences. In countries where infertility care is difficult to access, women turn to herbal medicines to achieve parenthood. The aim of this study was to determine the prevalence and factors associated with herbal medicine use by women attending the infertility clinic. Methods This was a cross-sectional study of 260 women attending the infertility clinic at Mulago hospital. The interviewer administered questionnaire comprised socio-demographic characteristics, infertility-related aspects and information on herbal medicine use. The main outcome measure was herbal medicines use for infertility treatment. Determinants of herbal medicine use were assessed using multivariable logistic regression. Results The majority (76.2%) of respondents had used herbal medicines for infertility treatment. The mean age of the participants was 28.3 years ± 5.5. Over 80% were married, 59.6% had secondary infertility and 2/3 of the married participants were in monogamous unions. In a multivariable model, the variables that were independently associated with increased use of herbal medicine among infertile patients were being married (OR 2.55, CI 1.24-5.24), never conceived (OR 4.08 CI 1.86-8.96) and infertility for less than 3 years (OR 3.52 CI 1.51-8.821). Factors that were associated with less use of herbal medicine among infertile women were being aged 30 years or less (OR 0.18 CI 0.07-0.46), primary and no education (OR 0.12 CI 0.05-0.46) and living with partner for less than three years (OR 0.39 CI 0.16-0.93). Conclusions The prevalence of herbal medicine use among women attending the infertility clinic was 76.2%. Herbal medicine use was associated with the participants’ age, level of education, marital status, infertility duration, nulliparity, and duration of marriage. Medical care was often delayed and the majority of the participants did not disclose use of herbal medicines to

  17. Does transferring three or more embryos make sense for a well-defined population of infertility patients undergoing IVF/ICSI?

    PubMed Central

    Masschaele, T.; Gerris, J.; Vandekerckhove, F.; De Sutter, P.

    2012-01-01

    Recently, there has been a marked increase in the use of Single Embryo Transfer (SET) subsequent to In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI), with the aim of reducing the risk of multiple gestations. However, critics have stated that by reducing the number of embryos transferred, a group of women with an a priori reduced chance of pregnancy are at particular greater risk of undertreatment. This group includes women who are of a certain age (≥ 40 years) or have already received a number of – failed – IVF attempts. We wanted to study whether the practice of three or more embryos being transferred would be of added value to these patients and whether the strategy of Heavy Load Transfer (HLT) is likely to boost the pregnancy rates to an acceptable level. We performed both a literature study and a retrospective cohort analysis of 7,850 IVF/ICSI cycles of early cleavage stage embryo transfer. Notwithstanding the limitations associated with this approach, we contend that HLT in the group of patients with poor prognosis should be recommended. This article outlines a suggested protocol within the legal framework relevant to Belgium. PMID:24753889

  18. Cultural comparison of symptoms in patients on maintenance hemodialysis.

    PubMed

    Weisbord, Steven D; Bossola, Maurizio; Fried, Linda F; Giungi, Stefania; Tazza, Luigi; Palevsky, Paul M; Arnold, Robert M; Luciani, Giovanna; Kimmel, Paul L

    2008-10-01

    Although symptoms are common and frequently severe in patients on maintenance hemodialysis, little is known about the relationship between cultural background and symptom burden. The aim of this study was to explore differences in the prevalence and severity of symptoms between American and Italian hemodialysis patients. We administered the 30-item Dialysis Symptom Index to American and Italian patients receiving maintenance hemodialysis during routine dialysis sessions. The prevalence and severity of individual symptoms were compared between patient populations, adjusting for multiple comparisons. Multivariable logistic regression and ordinal logistic regression were used to assess the independent associations of cultural background with the prevalence and severity of symptoms, respectively. We enrolled 75 American and 61 Italian patients. American patients were more likely to be black (36% vs. 0%, P<0.001) and diabetic (53% vs. 13%, P<0.001). Italian patients were more likely to report decreased interest in sex, decreased sexual arousal, feeling nervous, feeling irritable, and worrying (P<0.001, respectively). Adjustment for demographic and clinical variables had no impact on these cultural differences in symptom prevalence. The median severity of 11 symptoms including muscle soreness, muscle cramps, and itching was greater among Americans (P<0.001, respectively), although nearly all of these differences were rendered nonstatistically significant with adjustment for race, diabetes, and/or Kt/V. Italian patients receiving chronic hemodialysis report a greater burden of symptoms than American patients, particularly those related to sexual dysfunction and psychosocial distress. These findings suggest that cultural background may affect adaptation to chronic hemodialysis therapy.

  19. Social and Cultural Aspects of Infertility in Mozambique.

    ERIC Educational Resources Information Center

    Gerrits, Trudie

    1997-01-01

    The sociocultural aspects of infertility among members of the matrilineal ethnic group Macua are studied. Strategies applied by infertile women, the use of traditional healers versus modern hospital, and explanations given for infertility are presented. Solutions attempted, social consequences of infertility, and recommendations for culturally…

  20. Variations in Antioxidant Genes and Male Infertility.

    PubMed

    Yu, Bolan; Huang, Zhaofeng

    2015-01-01

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

  1. Variations in Antioxidant Genes and Male Infertility.

    PubMed

    Yu, Bolan; Huang, Zhaofeng

    2015-01-01

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

  2. Variations in Antioxidant Genes and Male Infertility

    PubMed Central

    Yu, Bolan; Huang, Zhaofeng

    2015-01-01

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

  3. Definition and epidemiology of unexplained infertility.

    PubMed

    Gelbaya, Tarek A; Potdar, Neelam; Jeve, Yadava B; Nardo, Luciano G

    2014-02-01

    The diagnosis of unexplained infertility can be made only after excluding common causes of infertility using standard fertility investigations,which include semen analysis, assessment of ovulation, and tubal patency test. These tests have been selected as they have definitive correlation with pregnancy. It is estimated that a standard fertility evaluation will fail to identify an abnormality in approximately 15% to 30% of infertile couples. The reported incidence of such unexplained infertility varies according to the age and selection criteria in the study population. We conducted a review of the literature via MEDLINE. Articles were limited to English-language, human studies published between 1950 and 2013. Since first coined more than 50 years ago, the term unexplained infertility has been a subject of debate. Although additional investigations are reported to explain or define other causes of infertility, these have high false-positive results and therefore cannot be recommended for routine clinical practice. Couples with unexplained infertility might be reassured that even after 12 months of unsuccessful attempts, 50% will conceive in the following 12 months and another 12% in the year after.

  4. Male infertility: an obstacle to sexuality?

    PubMed

    Bechoua, S; Hamamah, S; Scalici, E

    2016-05-01

    Interactions between infertility and sexuality are numerous and complex. Infertile men may suffer from sexual dysfunction (SD) when undergoing an assisted reproductive technology programme. We undertook a review both in French and English of the available data on male SD when being diagnosed with a fertility problem with a specific focus on azoospermic men. The review was performed over a 30-year time period using PubMed/Medline. The sexual concerns and needs of infertile/sterile men for whom potential parenting can be compromised were evaluated. When diagnosed with infertility, men usually go through a crisis that can have a deleterious effect on their sexuality with sometimes a feeling of sexual inadequacy. Infertile men will feel stigmatized because they are perceived as being deficient in a specific component of their masculinity. Hence, subsequent SD may occur that can impact the couple sexuality and the infertility management. However, little is known on how the announcement of azoospermia may affect male on a sexual and psychological point of view. The present review suggests that a global management through a healthcare network (biologist, andrologist, sexologist and psychologist) is required which will allow to consider infertility and its subsequent sexual disorders as a whole and not as dichotomized issues. PMID:27061770

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

    SciTech Connect

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

    1994-09-01

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

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

    PubMed

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

    2013-12-01

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

  7. Chinese Herbal Products for Female Infertility in Taiwan: A Population-Based Cohort Study.

    PubMed

    Hung, Yu-Chiang; Kao, Chao-Wei; Lin, Che-Chen; Liao, Yen-Nung; Wu, Bei-Yu; Hung, I-Ling; Hu, Wen-Long

    2016-03-01

    Female infertility and low birth rate are significant public health issues with profound social, psychological, and economic consequences. Some infertile women resort to conventional, complementary, or alternative therapies to conceive. The aim of this study was to identify the Chinese herbal products (CHPs) most commonly used for female infertility in Taiwan. The usage of traditional Chinese medicine (TCM) and the frequency of CHP prescriptions to infertile women were determined based on a nationwide 1-million randomly sampled cohort of National Health Insurance Research Database beneficiaries. Descriptive statistics and multiple logistic regression analysis were employed to estimate the adjusted odds ratio (aOR) for TCM usage and potential risk factors. In total, 8766 women with newly diagnosed infertility were included in this study. Of those, 8430 (96.17%) had sought TCM treatment in addition to visiting the gynecologist. We noted that female infertility patients with risk factors (e.g., endometriosis, uterine fibroids, or irregular menstrual cycle) were more likely to use TCM than those without TCM medication (aOR = 1.83, 1.87, and 1.79, respectively). The most commonly used formula and single CHP were Dang-Gui-Sha-Yao-San (17.25%) and Semen Cuscutae (27.40%), respectively. CHP formula combinations (e.g., Dang-Gui-Sha-Yao-San plus Wen-Jing-Tang 3.10%) or single Chinese herbal combinations (e.g., Semen Cuscutae plus Leonurus japonicus 6.31%) were also commonly used to treat female infertility. Further well-conducted, double-blind, randomized, placebo-controlled studies will be needed to evaluate the efficacy and safety of these CHP combinations for female infertility.

  8. Chinese Herbal Products for Female Infertility in Taiwan: A Population-Based Cohort Study.

    PubMed

    Hung, Yu-Chiang; Kao, Chao-Wei; Lin, Che-Chen; Liao, Yen-Nung; Wu, Bei-Yu; Hung, I-Ling; Hu, Wen-Long

    2016-03-01

    Female infertility and low birth rate are significant public health issues with profound social, psychological, and economic consequences. Some infertile women resort to conventional, complementary, or alternative therapies to conceive. The aim of this study was to identify the Chinese herbal products (CHPs) most commonly used for female infertility in Taiwan. The usage of traditional Chinese medicine (TCM) and the frequency of CHP prescriptions to infertile women were determined based on a nationwide 1-million randomly sampled cohort of National Health Insurance Research Database beneficiaries. Descriptive statistics and multiple logistic regression analysis were employed to estimate the adjusted odds ratio (aOR) for TCM usage and potential risk factors. In total, 8766 women with newly diagnosed infertility were included in this study. Of those, 8430 (96.17%) had sought TCM treatment in addition to visiting the gynecologist. We noted that female infertility patients with risk factors (e.g., endometriosis, uterine fibroids, or irregular menstrual cycle) were more likely to use TCM than those without TCM medication (aOR = 1.83, 1.87, and 1.79, respectively). The most commonly used formula and single CHP were Dang-Gui-Sha-Yao-San (17.25%) and Semen Cuscutae (27.40%), respectively. CHP formula combinations (e.g., Dang-Gui-Sha-Yao-San plus Wen-Jing-Tang 3.10%) or single Chinese herbal combinations (e.g., Semen Cuscutae plus Leonurus japonicus 6.31%) were also commonly used to treat female infertility. Further well-conducted, double-blind, randomized, placebo-controlled studies will be needed to evaluate the efficacy and safety of these CHP combinations for female infertility. PMID:26986137

  9. Improving the reporting of clinical trials of infertility treatments (IMPRINT): modifying the CONSORT statement†‡.

    PubMed

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

    2014-10-10

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

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

    PubMed

    2014-10-01

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

  11. From endometrial receptivity to infertility.

    PubMed

    Tabibzadeh, S; Shea, W; Lessey, B A; Broome, J

    1999-01-01

    Implantation of the blastocyst in endometrium requires establishment of a coordinated molecular dialogue between the embryo and the endometrium. Factors instrumental in the preparation of a receptive endometrium are derived from the hypothalamic-pituitary-gonadal axis. These factors modulate the expression of genes that drive the endometrium throughout the characteristic menstrual cycles. During each menstrual cycle, a series of coordinated, architectural, morphological, cytochemical, and molecular changes ultimately lead to the preparation of a receptive endometrium during the putative "receptive period" or "implantation window." It is during this critical period that a proper dialogue can be established between an intrusive blastocyst and a receptive endometrium. If, for any reason, this dialogue is not established or is perturbed, the embryo is aborted. The natural fate of the receptive endometrium, in the absence of implantation, is development of a second set of changes that ultimately lead to menstruation. The identity of the molecular repertoire that makes endometrium receptive to implantation and/or lead to menstruation is being revealed and broadly includes cytokines, heat shock factors, adhesion molecules and matrix metalloproteases. We identified a novel gene of the transforming growth factor-beta, superfamily of molecules, the so-called endometrial bleeding--associated factor or ebaf, whose expression is confined to the late secretory and menstrual phases. Various forms of female infertility were associated with dysregulated expression of ebaf during the implantation window. The findings show an occult molecular defect of endometrial receptivity that seems to be due to dysregulated and premature expression of a member of the premenstrual molecular repertoire. The dysregulated expression of ebaf may assist in the identification, prognostication, and monitoring of treatment of infertile women.

  12. Genital tract infections and infertility.

    PubMed

    Pellati, Donatella; Mylonakis, Ioannis; Bertoloni, Giulio; Fiore, Cristina; Andrisani, Alessandra; Ambrosini, Guido; Armanini, Decio

    2008-09-01

    Infectious agents can impair various important human functions, including reproduction. Bacteria, fungi, viruses and parasites are able to interfere with the reproductive function in both sexes. Infections of male genito-urinary tract account for about 15% of the case of male infertility. Infections can affect different sites of the male reproductive tract, such as the testis, epididymis and male accessory sex glands. Spermatozoa themselves subsequently can be affected by urogenital infections at different levels of their development, maturation and transport. Among the most common microorganisms involved in sexually transmitted infections, interfering with male fertility, there are the Chlamydia trachomatis and Neisseria gonorrhoeae. Less frequently male infertility is due to non-sexually transmitted epididymo-orchitis, mostly caused by Escherichia coli. In female, the first two microorganisms are certainly involved in cervical, tubal, and peritoneal damage, while Herpes simplex cervicitis is less dangerous. The overall importance of cervical involvement is still under discussion. Tubo-peritoneal damage seems to be the foremost manner in which microorganisms interfere with human fertility. C. trachomatis is considered the most important cause of tubal lacerations and obstruction, pelvic inflammatory disease (PID) and adhesions. N. gonorrhoeae, even though its overall incidence seems to decline, is still to be considered in the same sense, while bacterial vaginosis should not be ignored, as causative agents can produce ascending infections of the female genital tract. The role of infections, particularly co-infections, as causes of the impairment of sperm quality, motility and function needs further investigation. Tropical diseases necessitate monitoring as for their diffusion or re-diffusion in the western world. PMID:18456385

  13. Infertility in men with inflammatory bowel disease

    PubMed Central

    Shin, Takeshi; Okada, Hiroshi

    2016-01-01

    Inflammatory bowel disease (IBD) predominantly affects young adults. Fertility-related issues are therefore important in the management of patients with IBD. However, relatively modest attention has been paid to reproductive issues faced by men with IBD. To investigate the effects of IBD and its treatment on male fertility, we reviewed the current literature using a systematic search for published studies. A PubMed search were performed using the main search terms “IBD AND male infertility”, “Crohn’s disease AND male infertility”, “ulcerative colitis AND male infertility”. References in review articles were used if relevant. We noted that active inflammation, poor nutrition, alcohol use, smoking, medications, and surgery may cause infertility in men with IBD. In surgery such as proctocolectomy with ileal pouch-anal anastomosis, rectal incision seems to be associated with sexual dysfunction. Of the medications used for IBD, sulfasalazine reversibly reduces male fertility. No other medications appear to affect male fertility significantly, although small studies suggested some adverse effects. There are limited data on the effects of drugs for IBD on male fertility and pregnancy outcomes; however, patients should be informed of the possible effects of paternal drug exposure. This review provides information on fertility-related issues in men with IBD and discusses treatment options. PMID:27602237

  14. Infertility in men with inflammatory bowel disease

    PubMed Central

    Shin, Takeshi; Okada, Hiroshi

    2016-01-01

    Inflammatory bowel disease (IBD) predominantly affects young adults. Fertility-related issues are therefore important in the management of patients with IBD. However, relatively modest attention has been paid to reproductive issues faced by men with IBD. To investigate the effects of IBD and its treatment on male fertility, we reviewed the current literature using a systematic search for published studies. A PubMed search were performed using the main search terms “IBD AND male infertility”, “Crohn’s disease AND male infertility”, “ulcerative colitis AND male infertility”. References in review articles were used if relevant. We noted that active inflammation, poor nutrition, alcohol use, smoking, medications, and surgery may cause infertility in men with IBD. In surgery such as proctocolectomy with ileal pouch-anal anastomosis, rectal incision seems to be associated with sexual dysfunction. Of the medications used for IBD, sulfasalazine reversibly reduces male fertility. No other medications appear to affect male fertility significantly, although small studies suggested some adverse effects. There are limited data on the effects of drugs for IBD on male fertility and pregnancy outcomes; however, patients should be informed of the possible effects of paternal drug exposure. This review provides information on fertility-related issues in men with IBD and discusses treatment options.

  15. Altered miRNA Signature of Developing Germ-cells in Infertile Patients Relates to the Severity of Spermatogenic Failure and Persists in Spermatozoa

    PubMed Central

    Muñoz, Xavier; Mata, Ana; Bassas, Lluís; Larriba, Sara

    2015-01-01

    The aim of this study was to assess the cellular miRNA expression behaviour in testes with spermatogenic failure (SpF). We performed a high-throughput screen of 623 mature miRNAs by a quantitative RT-qPCR-based approach in histologically well-defined testicular samples with spermatogenic disruption at different germ-cell stages, which revealed altered patterns of miRNA expression. We focussed on the differentially expressed miRNAs whose expression correlated with the number of testicular mature germ-cells and described the combined expression values of a panel of three miRNAs (miR-449a, miR-34c-5p and miR-122) as a predictive test for the presence of mature germ-cells in testicular biopsy. Additionally, we determined decreased cellular miRNA content in developing germ-cells of SpF testis; this was more noticeable the earlier the stage of germ-cell differentiation was affected by maturation failure. Furthermore, we showed that the miRNA expression profile in mature sperm from mild SpF patients was widely altered. Our results suggest that the cellular miRNA content of developed germ-cells depends heavily on the efficacy of the spermatogenic process. What is more, spermatozoa that have fulfilled the differentiation process still retain the dysregulated miRNA pattern observed in the developing SpF germ-cells. This altered miRNA molecular signature may have functional implications for the male gamete. PMID:26648257

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

    PubMed Central

    Yuan, Yiming; Xin, Zhongcheng

    2016-01-01

    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.

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

    PubMed Central

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

    2013-01-01

    Infertility in men is a common condition. At the core of the medical evaluation of the male partner in a couple who are unable to conceive is the history and physical examination. Special attention should be directed to the patient’s developmental history and any use of testosterone products. The physical examination focuses on the genitals, and includes assessments of the size and consistency of the testicles, epididymis, vas deferens, and presence of varicoceles. Although many sophisticated tests are available, semen analysis is still the most important diagnostic tool used to assess fertility, and includes parameters such as sperm count, motility and viability. Treatment of male factor infertility can involve targeted agents, in the case of specific conditions such as hypogonadotropic hypogonadism, or it can be empirical—using medical therapy or assisted conception techniques—for patients in whom no underlying cause has been identified. Although an all-encompassing treatment for male factor infertility has not yet been developed, the field offers many promising avenues of research. PMID:21243017

  18. Prevalence of Y chromosome microdeletions in infertile Tunisian men.

    PubMed

    Hammami, Wajih; Kilani, Olfa; Ben Khelifa, Mariem; Ayed, Wiem; Abdelhak, Sonia; Bouzouita, Abderrezzak; Zhioua, Fethi; Amouri, Ahlem

    2014-01-01

    Yq microdeletions are the leading genetic cause of male infertility and its detection in clinically relevant for appropriate genetic counseling. The objective of this study was to determine the frequency of Y microdeletion in a group of Tunisian infertile men and to compare the prevalence of these abnormalities with other countries and other Tunisian reported series. Totally, 105 Tunisian idiopathic infertile men (74 azoospermic and 31 severe oligozoospermic) were screened for the presence of Y chromosome microdeletions. The screening of Yq microdeletions was performed by two multiplex PCRs using six STS markers recommended by the EAA/EMQN. No microdeletions were detected in the men with severe oligozoospermia. In the azoospermic group, 2/74 (2.7%) patients showed Y chromosome microdeletions. Both had complete deletion of the AZFc region. No microdeletion was identified in the AZFa region or in the AZFb region. The estimated frequency of Y chromosome microdeletions in the present survey was similar to some other reports but lower than that of previous reports in Tunisian populations.

  19. [Specific variability of teicoplanin protein binding in patients receiving continuous hemodiafiltration-comparison with hypoalbuminemia patients].

    PubMed

    Yanagimoto, Hiromi; Teramatsu, Tsuyoshi; Goto, Junko; Yanagisawa, Masahiko; Harii, Norikazu; Suzuki, Masahiko; Hanawa, Takehisa; Matsuda, Kenichi; Oguchi, Toshio

    2013-01-01

    Variation in protein binding ratio (PBR) of teicoplanin (TEIC) was investigated in continuous hemodiafiltration (CHDF) patients. TEIC is classified as a high PBR drug (≧90%), and it was reported that the PBR of TEIC decreased with an decrease in the serum albumin level in hypoalbuminemia patients. However, few reports can be found about the variation of PBR of TEIC for CHDF patient. An antibiotic activity is directly determined by the level of unbound antibiotics species (Cfree) in the target site, namely, an increase in the Cfree enhances the risks of TEIC as well as the therapeutic effect against Methicillin-resistant Staphylococcus aureus (MRSA). In this study, both the total concentration (Ctotal) and Cfree of TEIC were determined and the PBRs were compared between a patient with normal albumin level, hypoalbuminemia patients and CHDF patients. Similarly to the previous report, the lowering of PBR of TEIC was demonstrated in the hypoalbuminemia patients. On the other hand, the CHDF patients showed lower value of PBR suggesting some change in the protein binding ability, although showed higher values of serum albumin level in comparison with the hypoalbuminemia patients. It was not necessary to measure the Cfree value for the hypoalbuminemia patient routinely, but the monitoring of Cfree as well as Ctotal for the CHDF patients can be important for the proper TEIC use because of the potential specialty of PBR.

  20. Factors Affecting Response to Infertility Treatment: Case of Iran

    PubMed Central

    Peyromusavi, Fatemeh; Barouni, Mohsen; Naderi, Tayebeh; Shahravan, Arash

    2016-01-01

    Introduction: Infertility affects both women and men in all the countries. Infertility often has profound long-term or short-term impacts on the people involved and puts them at risk of familial and social pressures. According to WHO estimates, between 8% and 12% of all the couples worldwide experience some form of infertility during their reproductive life, i.e. 50–80 million people are affected. The aim of this study was to evaluate the response to infertility treatment by taking into account factors such as age, hirsutism, menstruation and galactose among women in Kerman. Methodology: Of a total of 300 patient files evaluated 220 cases were flawless, of which the study factors were recorded. These data were estimated by Logit model. The dependent variable was the response to treatment (0 and 1) and the independent variables included age of men and women, hirsutism, menstruation, galactose, duration of the period no preventive measures were used and body mass index. After entering the data, model output was analyzed by using the STATA software. Results: The results showed that of all the model variables, female age (prob=0.0065), menstruation (prob=0.04), hirsutism (prob=0.02), marriage age (in months) (prob=0.02) and BMI were significant and other variables were not significant. McFadden analysis for goodness of fit was 0.92. Conclusion: The study results showed that women should pay more attention to variables such as BMI, menstruation quality (regular and irregular) and aging because clinical disregard of any of the above can have a significant impact on the individual’s fertility. PMID:26234994

  1. Genetics Home Reference: Y chromosome infertility

    MedlinePlus

    ... chromosome infertility is a condition that affects the production of sperm , making it difficult or impossible for ... several genes. The missing genetic material likely prevents production of a number of proteins needed for normal ...

  2. Psychological and ethical implications related to infertility.

    PubMed

    Minucci, Daria

    2013-12-01

    Being a parent is deeply demanding and one of the most important events in life; parents experience the deepening of human relationships with their partner, within their families, and in society, and moreover the fundamental relationship between parent and child. Every medical, social, and political effort must be made to prevent infertility but also to offer infertile couples the best diagnostic and therapeutic paths. Understanding the suffering of the couple and their families prevents and helps ease the possible psychological and social complications of infertility. Therefore, infertility concerns not only biomedical sciences but also psychological and social ones-ethics and law-in their combined efforts to identify areas of understanding and of research for solutions while respecting the dignity of the couple and unborn child. The Catholic Church offers an ongoing contribution through dialogue in looking for ethical principles guiding scientific and medical research respectful of the true life of human beings.

  3. Society for Reproductive Endocrinology and Infertility

    MedlinePlus

    The Society for Reproductive Endocrinology and Infertility SREI Members-only Forum Home About Us About SREI Vision and Mission ... Fact Sheets and Booklets SREI is an affiliated society to the American Society for Reproductive Medicine . Below ...

  4. Endometriosis and Infertility: Can Surgery Help?

    MedlinePlus

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

  5. DNA methylation in spermatogenesis and male infertility

    PubMed Central

    Cui, Xiangrong; Jing, Xuan; Wu, Xueqing; Yan, Meiqin; Li, Qiang; Shen, Yan; Wang, Zhenqiang

    2016-01-01

    Infertility is a significant problem for human reproduction, with males and females equally affected. However, the molecular mechanisms underlying male infertility remain unclear. Spermatogenesis is a highly complex process involving mitotic cell division, meiosis cell division and spermiogenesis; during this period, unique and extensive chromatin and epigenetic modifications occur to bring about specific epigenetic profiles in spermatozoa. It has recently been suggested that the dysregulation of epigenetic modifications, in particular the methylation of sperm genomic DNA, may serve an important role in the development of numerous diseases. The present study is a comprehensive review on the topic of male infertility, aiming to elucidate the association between sperm genomic DNA methylation and poor semen quality in male infertility. In addition, the current status of the genetic and epigenetic determinants of spermatogenesis in humans is discussed. PMID:27698683

  6. Unexplained male infertility: diagnosis and management.

    PubMed

    Hamada, Alaa; Esteves, Sandro C; Nizza, Mark; Agarwal, Ashok

    2012-01-01

    Unexplained male infertility is a diagnosis reserved for men in whom routine semen analyses results are within normal values and physical as well as endocrine abnormalities were ruled out. In addition to erectile problems and coital factors, immunologic causes and sperm dysfunction may contribute to such condition. New etiologies of unexplained male infertility include low level leukocytospermia and mitochondrial DNA polymerase gene polymorphism. Contemporary andrology may reveal cellular and sub-cellular sperm dysfunctions which may explain subfertility in such cases, thus aiding the clinician to direct the further work-up, diagnosis and counseling of the infertile male. The objective of this article is to highlight the concept of unexplained male infertility and focuses on the diagnosis and treatment of this condition in the era of modern andrology and assisted reproductive techniques. Extensive literature review was performed using the search engines: Pubmed, Science-direct, Ovid and Scopus.

  7. DNA methylation in spermatogenesis and male infertility

    PubMed Central

    Cui, Xiangrong; Jing, Xuan; Wu, Xueqing; Yan, Meiqin; Li, Qiang; Shen, Yan; Wang, Zhenqiang

    2016-01-01

    Infertility is a significant problem for human reproduction, with males and females equally affected. However, the molecular mechanisms underlying male infertility remain unclear. Spermatogenesis is a highly complex process involving mitotic cell division, meiosis cell division and spermiogenesis; during this period, unique and extensive chromatin and epigenetic modifications occur to bring about specific epigenetic profiles in spermatozoa. It has recently been suggested that the dysregulation of epigenetic modifications, in particular the methylation of sperm genomic DNA, may serve an important role in the development of numerous diseases. The present study is a comprehensive review on the topic of male infertility, aiming to elucidate the association between sperm genomic DNA methylation and poor semen quality in male infertility. In addition, the current status of the genetic and epigenetic determinants of spermatogenesis in humans is discussed.

  8. Association of FCRL3 Genetic Polymorphisms With Endometriosis-Related Infertility Risk

    PubMed Central

    Zhang, Haiyan; Zhang, Zhen; Li, Guang; Wang, Surong; Zhang, Shiqian; Xie, Beibei

    2015-01-01

    Abstract The Fc receptor-like 3 (FCRL3) gene was reported to be linked to a variety of autoimmune diseases, including endometriosis-related infertility. However, this linkage has not been studied in Chinese population and there has been no meta-analysis on the interrelationship of FCRL3 gene and endometriosis-related infertility. The aim of the study was to investigate the association between FCRL3 genetic polymorphisms and the risk of endometriosis-related infertility in Han Chinese, and a further meta-analysis was conducted to confirm our results. Four single nucleotide polymorphisms (SNPs) (rs7528684 [FCRL3_3], rs11264799 [FCRL3_4], rs945635 [FCRL3_5], and rs3761959 [FCRL3_6]) on FCRL3 gene were genotyped in a case–control cohort composed of 217 patients suffering from endometriosis-related infertility and 220 healthy controls using cleaved amplification polymorphism sequence-tagged sites (polymerase chain reaction–restriction fragment length polymorphism, PCR–RFLP). Odds ratio (OR) and its 95% confidence interval (CI) was used to evaluate the association quantitatively. Furthermore, a meta-analysis of previous studies including the present study was implemented through Stata 11.0 (Stata Corporation, College Station, TX). We found an approximately 1.4-fold significantly increased frequency of the FCRL3_3 variant in women with endometriosis-related infertility over the controls (OR = 1.41 [95% CI = 1.08–1.84], P = 0.013). However, no significant difference was found between women with endometriosis-related infertility and controls for FCRL3_4, FCRL3_5, and FCRL3_6. Regardless of the symptoms and the revised classification of the American Society of Reproductive Medicine (rASRM) stage of endometriosis, there was a significant association between FCRL3_3 variant and an increased risk of endometriosis-related infertility. Meta-analysis of previous studies combined with the present study further confirmed the association between FCRL3_3 and the

  9. Use of Diagnostic Testing to Detect Infertility

    PubMed Central

    Hwang, Kathleen; Lipshultz, Larry I.; Lamb, Dolores J.

    2011-01-01

    The evaluation of the infertile male continues to be a clinical challenge of increasing significance with considerable emotional and financial burdens. Many physiological, environmental and genetic factors are implicated; however, the etiology of suboptimal semen quality is poorly understood. This review focuses on the diagnostic testing currently available, as well as future directions that will be helpful for the practicing urologist and other clinicians to fully evaluate the infertile male. PMID:21088937

  10. Gestational surrogacy: Viewpoint of Iranian infertile women

    PubMed Central

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

    2011-01-01

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

  11. Family-Related Opinions and Stressful Situations Associated with Psychological Distress in Women Undergoing Infertility Treatment

    PubMed Central

    Takaki, Jiro; Hibino, Yuri

    2014-01-01

    The purpose of this study is to investigate how family-related opinions and stressful situations are related to psychological distress in women undergoing infertility treatment. The subjects in this cross-sectional study were recruited from female patients undergoing infertility treatment (n = 2540) at 70 infertility treatment institutions in Japan. Because of non-participation or missing data, the number of subjects included in the analysis was 635 (response rate, 25.0%). The family-related opinions and stressful situations were evaluated using the original questions. Psychological distress was assessed using a self-report measure, the Kessler Six-question Psychological Distress Scale (K6). The K6 scores of the following participants were significantly (p < 0.05) and independently high: those with more frequent miscarriage/stillbirth/abortions, those with repeated miscarriages as the cause of infertility, those with infertility of unknown causes, those living with no child, those having a low joint income with their partner, those with the opinion that “women should devote themselves to their household duties” those who had considered stopping treatment, those without the opinion that “married life without children is favorable” and those who had experienced stressful situations such as inadequate explanation by doctors, frustration of multiple failed attempts, differences of opinion with the partner, and lack of knowledge regarding when to stop treatment. Family-related opinions and stressful situations associated with psychological distress in women undergoing infertility treatment are outlined. The results of this study may contribute to the prevention of and care for psychological distress in female patients undergoing infertility treatment. PMID:25184788

  12. Oxidation-reduction potential of semen: what is its role in the treatment of male infertility?

    PubMed Central

    Agarwal, Ashok; Roychoudhury, Shubhadeep; Bjugstad, Kimberly B.; Cho, Chak-Lam

    2016-01-01

    The diagnosis of male infertility relies largely on conventional semen analysis, and its interpretation has a profound influence on subsequent management of patients. Despite poor correlation between conventional semen parameters and male fertility potential, inclusion of advanced semen quality tests to routine male infertility workup algorithms has not been widely accepted. Oxidative stress is one of the major mediators in various etiologies of male infertility; it has deleterious effects on spermatozoa, including DNA damage. Alleviation of oxidative stress constitutes a potential treatment strategy for male infertility. Measurement of seminal oxidative stress is of crucial role in the identification and monitoring of patients who may benefit from treatments. Various tests including reactive oxygen species (ROS) assay, total antioxidant capacity (TAC) assay or malondialdehyde (MDA) assay used by different laboratories have their own drawbacks. Oxidation-reduction potential (ORP) is a measure of overall balance between oxidants and antioxidants, providing a comprehensive measure of oxidative stress. The MiOXSYS™ System is a novel technology based on a galvanostatic measure of electrons; it presents static ORP (sORP) measures with static referring to the passive or current state of activity between oxidants and antioxidants. Preliminary studies have correlated sORP to poor semen qualities. It is potentially useful in prognostication of assisted reproductive techniques outcomes, screening of antioxidants either in vivo or during IVF cycles, identification of infertile men who may benefit from treatment of oxidative stress, and monitoring of treatment success. The simplified laboratory test requiring a small amount of semen would facilitate clinical application and research in the field. In this paper, we discuss the measurement of ORP by the MiOXSYS System as a real-time assessment of seminal oxidative stress, and argue that it is a potential valuable clinical test

  13. Oxidation-reduction potential of semen: what is its role in the treatment of male infertility?

    PubMed Central

    Agarwal, Ashok; Roychoudhury, Shubhadeep; Bjugstad, Kimberly B.; Cho, Chak-Lam

    2016-01-01

    The diagnosis of male infertility relies largely on conventional semen analysis, and its interpretation has a profound influence on subsequent management of patients. Despite poor correlation between conventional semen parameters and male fertility potential, inclusion of advanced semen quality tests to routine male infertility workup algorithms has not been widely accepted. Oxidative stress is one of the major mediators in various etiologies of male infertility; it has deleterious effects on spermatozoa, including DNA damage. Alleviation of oxidative stress constitutes a potential treatment strategy for male infertility. Measurement of seminal oxidative stress is of crucial role in the identification and monitoring of patients who may benefit from treatments. Various tests including reactive oxygen species (ROS) assay, total antioxidant capacity (TAC) assay or malondialdehyde (MDA) assay used by different laboratories have their own drawbacks. Oxidation-reduction potential (ORP) is a measure of overall balance between oxidants and antioxidants, providing a comprehensive measure of oxidative stress. The MiOXSYS™ System is a novel technology based on a galvanostatic measure of electrons; it presents static ORP (sORP) measures with static referring to the passive or current state of activity between oxidants and antioxidants. Preliminary studies have correlated sORP to poor semen qualities. It is potentially useful in prognostication of assisted reproductive techniques outcomes, screening of antioxidants either in vivo or during IVF cycles, identification of infertile men who may benefit from treatment of oxidative stress, and monitoring of treatment success. The simplified laboratory test requiring a small amount of semen would facilitate clinical application and research in the field. In this paper, we discuss the measurement of ORP by the MiOXSYS System as a real-time assessment of seminal oxidative stress, and argue that it is a potential valuable clinical test

  14. Super Infection of An Ovarian Dermoid Cyst with Actinomyces in An Infertile Woman

    PubMed Central

    Salehpour, Saghar; Akbari Sene, Azadeh

    2013-01-01

    We present super infection of an ovarian dermoid cyst with actinomyces in an infertile patient. This is a case-report study for evaluation a couple with male factor infertility, who was a good candidate for intracytoplasmic sperm injection (ICSI), while a 10 cm dermoid cyst was found in the woman’s right ovary. Patient complained of pelvic pain, intermittent fever, dysmenorrhea, and dyspareunia. The cyst was extracted using laparoscopy, whilst in histopathological examination, an actinomycosis super infection was reported. Actinomyc super infection of an ovarian dermoid cyst is a very rare incident which can also occur in women with no history of intrauterine device (IUD) usage or previous fertility. PMID:24520476

  15. Effect of sesame on sperm quality of infertile men

    PubMed Central

    Khani, Behnaz; Bidgoli, Soroor Rabbani; Moattar, Fariborz; Hassani, Hassan

    2013-01-01

    Background: High level of semen reactive oxygen species is considered as an important factor in male infertility. Sesame has antioxidant properties, which could be effective on improvement of semen parameters. This study was designed to determine the effects of sesame on sperm quality. Materials and Methods: Twenty-five infertile men entered this clinical trial. They were treated with a 3-months course of taking 0.5 mg/kg sesame. The pre intervention sperm analysis (sperm count, motile sperm percentage and normal morphology sperm percentage) was compared with post treatment sperm analysis. Based on the post intervention seamen analysis, patients were advised to undergo either IVF or ICSI to assess their fertility status. Results: There was significant improvement in the sperm count (10.56 ± 5.25 vs. 22.71 ± 30.14 million per ml) and motility (15.32 ± 13.58 vs. 23.32 ± 20.61 percent) after treatment with sesame (P value: 0.04 and <0.0001 respectively), but there was no significant improvement in sperm morphology after the treatment (10.72 ± 6.66 vs. 13.20 ± 11.14 percent, P value: 0.10). Three patients (12%) underwent IUI, which resulted in 1 successful pregnancy. Two patients (8%) underwent ICSI, which was not successful; however 2 (8%) patients had spontaneous pregnancy. Fortunately, all pregnancies led to live birth. Except 1 case of diarrhea, no other major side effect was reported. Conclusion: Sesame improved sperm count and motility, and can be prescribed as an effective and safe method for male factor infertility. PMID:23930112

  16. Insurance coverage for male infertility care in the United States.

    PubMed

    Dupree, James M

    2016-01-01

    Infertility is a common condition experienced by many men and women, and treatments are expensive. The World Health Organization and American Society of Reproductive Medicine define infertility as a disease, yet private companies infrequently offer insurance coverage for infertility treatments. This is despite the clear role that healthcare insurance plays in ensuring access to care and minimizing the financial burden of expensive services. In this review, we assess the current knowledge of how male infertility care is covered by insurance in the United States. We begin with an appraisal of the costs of male infertility care, then examine the state insurance laws relevant to male infertility, and close with a discussion of why insurance coverage for male infertility is important to both men and women. Importantly, we found that despite infertility being classified as a disease and males contributing to almost half of all infertility cases, coverage for male infertility is often excluded from health insurance laws. Excluding coverage for male infertility places an undue burden on their female partners. In addition, excluding care for male infertility risks missing opportunities to diagnose important health conditions and identify reversible or irreversible causes of male infertility. Policymakers should consider providing equal coverage for male and female infertility care in future health insurance laws.

  17. Insurance coverage for male infertility care in the United States

    PubMed Central

    Dupree, James M

    2016-01-01

    Infertility is a common condition experienced by many men and women, and treatments are expensive. The World Health Organization and American Society of Reproductive Medicine define infertility as a disease, yet private companies infrequently offer insurance coverage for infertility treatments. This is despite the clear role that healthcare insurance plays in ensuring access to care and minimizing the financial burden of expensive services. In this review, we assess the current knowledge of how male infertility care is covered by insurance in the United States. We begin with an appraisal of the costs of male infertility care, then examine the state insurance laws relevant to male infertility, and close with a discussion of why insurance coverage for male infertility is important to both men and women. Importantly, we found that despite infertility being classified as a disease and males contributing to almost half of all infertility cases, coverage for male infertility is often excluded from health insurance laws. Excluding coverage for male infertility places an undue burden on their female partners. In addition, excluding care for male infertility risks missing opportunities to diagnose important health conditions and identify reversible or irreversible causes of male infertility. Policymakers should consider providing equal coverage for male and female infertility care in future health insurance laws. PMID:27030084

  18. Lessons learned from the implementation of an online infertility community into an IVF clinic's daily practice.

    PubMed

    Aarts, Johanna W M; Faber, Marjan J; Cohlen, Ben J; Van Oers, Anne; Nelen, WillianNe L D M; Kremer, Jan A M

    2015-01-01

    The Internet is expected to innovate healthcare, in particular patient-centredness of care. Within fertility care, information provision, communication with healthcare providers and support from peers are important components of patient-centred care. An online infertility community added to an in vitro fertilisation or IVF clinic's practice provides tools to healthcare providers to meet these. This study's online infertility community facilitates peer-to-peer support, information provision to patients and patient provider communication within one clinic. Unfortunately, these interventions often fail to become part of clinical routines. The analysis of a first introduction into usual care can provide lessons for the implementation in everyday health practice. The aim was to explore experiences of professionals and patients with the implementation of an infertility community into a clinic's care practice. We performed semi-structured interviews with both professionals and patients to collect these experiences. These interviews were analyzed using the Normalisation Process Model. Assignment of a community manager, multidisciplinary division of tasks, clear instructions to staff in advance and periodical evaluations could contribute to the integration of this online community. Interviews with patients provided insights into the possible impact on daily care. This study provides lessons to healthcare providers on the implementation of an online infertility community into their practice.

  19. Addressing the particular recordkeeping needs of infertile Orthodox Jewish couples considering the use of donated eggs.

    PubMed

    Grazi, Richard V; Wolowelsky, Joel B

    2014-03-01

    Infertility counseling is a specialized field that will continue to grow in coming years as the impact of infertility and its treatment is documented more and more in terms of emotional, physical, social and life consequences. Counselors should anticipate issues that may arise in the future and assist couples in their efforts to address them. We report here on recordkeeping issues of possible future concern that should be addressed when Orthodox Jewish couples make use of donor eggs. Good medical practice values the importance of understanding the patient's individual concerns and values, including the complex psychological, sociological and cultural context in which they experience their infertility. Good counseling anticipates and addresses future problems about which patients might not currently be aware. PMID:24446049

  20. Addressing the particular recordkeeping needs of infertile Orthodox Jewish couples considering the use of donated eggs.

    PubMed

    Grazi, Richard V; Wolowelsky, Joel B

    2014-03-01

    Infertility counseling is a specialized field that will continue to grow in coming years as the impact of infertility and its treatment is documented more and more in terms of emotional, physical, social and life consequences. Counselors should anticipate issues that may arise in the future and assist couples in their efforts to address them. We report here on recordkeeping issues of possible future concern that should be addressed when Orthodox Jewish couples make use of donor eggs. Good medical practice values the importance of understanding the patient's individual concerns and values, including the complex psychological, sociological and cultural context in which they experience their infertility. Good counseling anticipates and addresses future problems about which patients might not currently be aware.

  1. Antibodies to the chlamydial 60 kilodalton heat shock protein in women with tubal factor infertility.

    PubMed Central

    Ault, K A; Statland, B D; King, M M; Dozier, D I; Joachims, M L; Gunter, J

    1998-01-01

    INTRODUCTION: Fallopian tube damage and subsequent infertility are common sequelae of upper genital tract infection with Chlamydia trachomatis. This fallopian tube damage is thought to be immune mediated. The 60 kilodalton chlamydial heat shock protein (hsp) may be the key antigen associated with this pathogenic response. Our objective was to study the relationship between antibody response to 60 kilodalton chlamydial hsp and tubal factor infertility (TFI). SUBJECTS AND METHODS: Twenty-three women with TFI and 33 women with male factor infertility (controls) were studied. Tubal factor infertility was defined as infertility for one year with hydrosalpinx or distal tubal occlusion. Patients' sera were tested for antibodies to the chlamydial hsp using an enzyme-linked immunosorbent assay (ELISA). A stepwise logistic regression was performed by each patient's age, race/ethnicity, self-reported history of chlamydia infection, gonorrhea, or pelvic inflammatory disease (PID), history of ectopic pregnancy, and antibodies to the chlamydial hsp. RESULTS: Eighteen of the 23 women with TFI had a positive result on the hsp ELISA (78.6%) versus 23.4% of controls. Risk factors for TFI were a history of PID (P = 0.022), "nonwhite" race (P = 0.004), history of ectopic pregnancy (P = 0.027), and antibodies to the 60 kilodalton chlamydial hsp (P < 0.001). CONCLUSIONS: Antibodies to 60 kilodalton chlamydial hsp are strongly associated with TFI. PMID:9812248

  2. Clinical outcome after IMSI procedure in an unselected infertile population: a pilot study

    PubMed Central

    2013-01-01

    Background To date the IMSI procedure represents the only real-time and unstained method available to discard spermatozoa with ultrastructural defects. Several studies demonstrated that IMSI provides positive results in couples with severe male factor infertility or repeated ICSI failures. Aim of this pilot study is to evaluate the differences between IMSI and ICSI in terms of IVF outcomes in an unselected infertile patient population. Methods Three hundred and thirty-two couples were analyzed: 281 couples underwent conventional ICSI procedure and 51 underwent IMSI technique. Results No statistically significant differences were found between implantation rate (ICSI: 16,83%; IMSI: 16,67%), fertilization rate (ICSI: 77,27%; IMSI: 80,00%) and pregnancy rate (ICSI: 25,30%; IMSI: 23,50%). Both groups were comparable when considering live birth rate (ICSI: 11,39%; IMSI:13,72%), ongoing pregnancy rate (ICSI: 7,47%; IMSI: 5,88%) and miscarriage rate (ICSI: 17,78; IMSI: 5,26%). The subgroup analyses did not show a statistical difference between ICSI and IMSI neither in male factor infertility subgroup nor in patients with more than one previous ICSI attempt. A trend towards better laboratory and clinical outcomes was detected in the male factor infertility subgroup when IMSI was applied. Conclusions Our preliminary results show that the IMSI technique does not significantly improve IVF outcomes in an unselected infertile population. PMID:23521828

  3. Disability, psychiatric symptoms, and quality of life in infertile women: a cross-sectional study in Turkey

    PubMed Central

    SEZGIN, Hacer; HOCAOGLU, Cicek; GUVENDAG-GUVEN, Emine Seda

    2016-01-01

    significantly more severe depressive symptoms than fertile married controls, but they do report greater physical and psychological disability and a poorer quality of life. The negative effects of infertility were more severe in infertile women who were employed than in those who were not employed. Larger follow-up studies are needed to assess the reasons for the differences between these results and those reported in western countries which usually report a higher prevalence of depression and anxiety in infertile patients.

  4. Disability, psychiatric symptoms, and quality of life in infertile women: a cross-sectional study in Turkey

    PubMed Central

    SEZGIN, Hacer; HOCAOGLU, Cicek; GUVENDAG-GUVEN, Emine Seda

    2016-01-01

    significantly more severe depressive symptoms than fertile married controls, but they do report greater physical and psychological disability and a poorer quality of life. The negative effects of infertility were more severe in infertile women who were employed than in those who were not employed. Larger follow-up studies are needed to assess the reasons for the differences between these results and those reported in western countries which usually report a higher prevalence of depression and anxiety in infertile patients. PMID:27605864

  5. Quantitative ultramorphological analysis of human sperm: fifteen years of experience in the diagnosis and management of male factor infertility.

    PubMed

    Bartoov, B; Eltes, F; Reichart, M; Langzam, J; Lederman, H; Zabludovsky, N

    1999-01-01

    The advantages of quantitative ultramorphological (QUM) sperm analysis in the diagnosis and treatment of male infertility are presented. The QUM methodology is based on three elements: complementary scanning electron microscopy and transmission electron microscopy observations of 7 sperm cell subcellular organelles (acrosome, postacrosomal lamina, nucleus, neck, axoneme, mitochondrial sheath, and outer dense fibers); systematic classification of the specific ultramorphological malformations into 4 pathological and the normal categories, indicating the morphological state of each subcellular organelle; and comparison between well-defined reference groups with opposite fertility status or treatment conditions. QUM has established 2 indices for the in vivo and in vitro male fertility potential: (1) Natural Fertility Index (NFI), with accurate prediction (97% sensitivity and 90% specificity) of 80% of the male patients; and (2) IVF score, with prediction of 76% of the nonfertilizing and 90% of fertilizing IVF groups. QUM has enabled assessment of ultramorphological indications for varicocele and radiation exposure. Varicocele causes defects in sperm head organelles related to early spermatid development, whereas ionizing radiation causes amorphous head shape. QUM established criteria for specific non-in-vitro therapeutic interventions, including varicocelectomy, follicle-stimulating hormone (FSH) administration, and acupuncture. The varicocele index enabled correct classification of 79 and 89% of patients with and without varicocele. Males with idiopathic impairment of sperm acrosome and nucleus are potential responders to FSH treatment, whereas patients exhibiting low sperm activity are candidates for acupuncture treatment. Patients with a low Natural Fertility Index are recommended for an assisted reproduction technique (ART). based on the ultramorphology of the tail axoneme. Patients who achieved pregnancy following intrauterine insemination or in vitro

  6. [Causes and Factors of Male Infertility].

    PubMed

    Kolesnikova, L I; Kolesnikov, S I; Kurashova, N A; Bairova, T A

    2015-01-01

    The preservation of reproductive health of the population is an important factor of demographic policy of the state. According to some authors from 14 to 30% of couples of reproductive age suffer from infertility, malefactor in such marriages is detected in more than half of the cases. As you know, in recent years there has been a significant deterioration in the main indicators of reproductive function of men. Increased the number of andrological diseases, morphological disorders of the male reproductive system, almost halved the production of sperm in men of reproductive age. The reason probably lies behind a whole range ofstressfactors, such as medical ignorance, uncontrolled and inappropriate use of medication, metabolic disturbances, lack of vitamins and minerals, the impact of industrial pollutants, as well as the growth of addictive disorders (alcoholism, smoking and drug addiction). The forms of infertility differ according to its etiology and severity from minor changes to complete spermatogenesis dysfunction of the gonads, and can also occur due to genetic disorders. The lack of analysis of the relationship between clinical and genetic-biochemical components in men with infertility makes it impossible to understand the pathogenesis of infertility and to assess the risks of male infertility. High level of current medicine does not always guarantee an identification of the cause of male infertility. The article analyzes data from the review of specialized literature on the diagnosis and etiopathogenesis of male infertility. Frequency and clinical signs of pathology of the male reproductive system depend on the combinatorial effects of environmental influences, manifested most often in mutually reinforcing effect. A combination of several, seemed to be imperceptible factors makes the risk of development of male reproductive pathology very high. This situation compels specialists to conduct comprehensive studies on the men reproductive potential. PMID

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

    PubMed

    Hall, J; Fishel, S

    1997-12-01

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

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

    PubMed

    Hall, J; Fishel, S

    1997-12-01

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

  9. Association between infertility factors and non-physical partner abuse in infertile couples

    PubMed Central

    Taebi, Mahboubeh; Gandomani, Sedighe Jamali; Nilforoushan, Parisa; GholamiDehaghi, Ali

    2016-01-01

    Background: Infertility predisposes the couples to mental and psychological problems such as anxiety, depression, anger, and partner abuse. This study aimed to investigate the association between infertility factors and the non-physical abuse between infertile spouses. Materials and Methods: This is a descriptive cross-sectional study conducted on 262 infertile couples (131 female and 131 male), selected through convenient sampling, who referred to infertility centers in Isfahan. Data were collected by Partner Abuse Scale: Non-physical (PASNP), designed to measure the non-physical abuse experienced in relationship with partner and Non-physical Abuse of Partner Scale (NPAPS), designed to measure the non-physical abuse delivered upon the partner. All data were analyzed through SPSS version 16. Results: Mean scores of NPAPS were 23.1% and 21.3% in men and women, respectively. Mean scores of PASNP were 13.8% and 20.3% among men and women, respectively. There was a significant difference in the mean scores of perceived non-physical partner abuse between men and women (P < 0.001). There was also a significant difference in the mean scores of perceived non-physical partner abuse and factor of infertility (P < 0.01). Conclusions: Perceived non-physical abuse and delivered non-physical abuse upon the partner were low among infertile couples. Women had a higher perception of abuse when the cause of infertility was female factor, compared to men. However, special attention should be paid to infertile couples. Marital counseling, besides infertility counseling, should be conducted for these couples. PMID:27563319

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

    PubMed Central

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

    2015-01-01

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

  11. Association of body mass index with some fertility markers among male partners of infertile couples

    PubMed Central

    Hajshafiha, Masoumeh; Ghareaghaji, Rasul; Salemi, Sedigheh; Sadegh-Asadi, Nahid; Sadeghi-Bazargani, Homayoun

    2013-01-01

    Background The available evidence on the role of obesity and body mass index (BMI) on male infertility has been controversial or inconclusive to some extent. Objectives The aim of this study was to investigate the role of BMI on some male-fertility laboratory indicators both among infertile and fertile men in an Iranian population. Methods and materials A total of 159 male patients who had lived as a partner in an infertile couple for at least 1 year, after regular reproductive activity in their married life, and who sought infertility consultation, were investigated. BMI was assessed, and a morning blood sample was taken assessing serum levels of testosterone, sex hormone-binding globulin, prolactin, luteinizing hormone (LH), follicle-stimulating hormone, and estradiol. Semen-analysis parameters were also measured. Results In this study, it was found that the likelihood of oligospermia was increased at higher BMI values. Obese men were found to be 3.5 times more likely to have oligospermia than those with normal BMI. BMI was not found to be associated with mean numeric values of the semen-analysis parameters, including sperm count, sperm morphology, and sperm motility. BMI was not significantly correlated with some hormone levels, such as LH, prolactin, and LH/follicle-stimulating hormone ratio. However, a statistically significant association was observed between BMI and estradiol (P < 0.01), sex hormone-binding globulin (P < 0.001), and also the testosterone/estradiol ratio (P < 0.001). A different pattern of associations in this study was observed when the associations between BMI and sexual hormone levels were compared between fertile and subfertile/infertile men. Conclusion The association explored between BMI and some sexual hormones and semen characteristics, as well as different patterns of this association between fertile and subfertile/infertile men, will be of help to broaden our understanding of the effect of obesity on some male reproductive

  12. Eurycoma longifolia Jack in managing idiopathic male infertility

    PubMed Central

    Bin Mohd Tambi, Mohd Ismail; Imran, M. Kamarul

    2010-01-01

    This study investigated the effect of treatment with the proprietary standardized, water-soluble extract of the root of the Malaysian plant, Eurycoma longifolia Jack, which is thought to enhance male fertility with regard to higher semen volumes, sperm concentrations, the percentage of normal sperm morphology and sperm motility in male partners of sub-fertile couples with idiopathic infertility. A total of 350 patients were given 200 mg of the extract daily and follow-up semen analyses were performed every 3 months for 9 months. Of these 350 patients, 75 patients completed one full cycle of 3 months. Follow-up semen analyses in these patients showed significant improvement in all semen parameters. The proprietary extract of Eurycoma longifolia Jack significantly improved the sperm quality in these patients, allowing for 11 (14.7%) spontaneous pregnancies. PMID:20348942

  13. Women's beliefs about infertility and sexual behaviors: A qualitative study

    PubMed Central

    Bokaie, Mahshid; Simbar, Masoumeh; Ardekani, Seyed Mojtaba Yassini; Majd, Hamid Alavi

    2016-01-01

    Background: Infertility is a reproductive health problem and its prevalence is increasing in developing countries. This problem has some significant effects on the sexual behaviors of infertile women, especially during infertility treatment periods. Discovering the existing beliefs in the field of sexual and reproductive health and also determining the misconceptions would define the educational needs for providing sexual health programs for infertile women. Women should be able to distinguish risky behaviors from healthy behaviors that falsely have been marked as infertility-related behaviors. This qualitative study was conducted to determine women's beliefs about infertility and sexual behaviors among Iranian infertile women. Materials and Methods: The present study was a qualitative conventional content analysis study conducted on 15 infertile women and 8 key informants until reaching data saturation. Guba and Lincoln evaluative criteria were used for ensuring rigor of the study. Results: Data analysis defined three classes of beliefs that directly or indirectly affected sexual behaviors in infertile women: 1) Cultural, religious, or ethnic beliefs, 2) believing in the effect of diet on infertility, and 3) effect of the type of intercourse on getting pregnant. Conclusions: Three themes of religious, cultural, and ethnic beliefs, believing in the effect of diet on infertility, and the effect of the type of intercourse were the most important factors indicating sexual behaviors among infertile women. It seems that cultural and social matters are the most effective factors on sexual behaviors of infertile Iranian women. PMID:27563321

  14. Array comparative genomic hybridization analysis of small supernumerary marker chromosomes in human infertility.

    PubMed

    Guediche, N; Tosca, L; Kara Terki, A; Bas, C; Lecerf, L; Young, J; Briand-Suleau, A; Tou, B; Bouligand, J; Brisset, S; Misrahi, M; Guiochon-Mantel, A; Goossens, M; Tachdjian, G

    2012-01-01

    Small supernumerary marker chromosomes (sSMC) are structurally abnormal chromosomes that cannot be unambiguously identified by conventional banding cytogenetics. This study describes four patients with sSMC in relation with infertility. Patient 1 had primary infertility. His brother, fertile, carried the same sSMC (patient 2). Patient 3 presented polycystic ovary syndrome and patient 4 primary ovarian insufficiency. Cytogenetic studies, array comparative genomic hybridization (CGH) and sperm analyses were compared with cases previously reported. sSMC corresponded to the 15q11.2 region (patients 1 and 2), the centromeric chromosome 15 region (patient 3) and the 21p11.2 region (patient 4). Array CGH showed 3.6-Mb gain for patients 1 and 2 and 0.266-Mb gain for patient 4. Sperm fluorescent in-situ hybridization analyses found ratios of 0.37 and 0.30 of sperm nuclei with sSMC(15) for patients 1 and 2, respectively (P < 0.001). An increase of sperm nuclei with disomy X, Y and 18 was noted for patient 1 compared with control and patient 2 (P < 0.001). Among the genes mapped in the unbalanced chromosomal regions, POTE B and BAGE are related to the testis and ovary, respectively. The implication of sSMC in infertility could be due to duplication, but also to mechanical effects perturbing meiosis.

  15. [Protamine gene polymorphisms and male infertility].

    PubMed

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

    2015-12-01

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

  16. Relevance of semen polymerase chain reaction positive for tuberculosis in asymptomatic men undergoing infertility evaluation

    PubMed Central

    Regmi, Subodh Kumar; Singh, Urvashi B.; Sharma, Jai Bhagwan; Kumar, Rajeev

    2015-01-01

    OBJECTIVE: Male partners of infertile women with genital tuberculosis (TB) are often screened for genital TB. We aimed to evaluate the clinical significance of a positive screening semen polymerase chain reaction (PCR) for Mycobacterium tuberculosis test (TB-PCR) in asymptomatic men undergoing infertility evaluation and determine the need for a detailed investigation and treatment for TB. MATERIALS AND METHODS: Between March 2012 and January 2013, male partners of 15 infertile women with a diagnosis of genitourinary TB (GUTB) as the cause of infertility, tested positive either on semen PCR for TB (13 cases), or Mycobacterium Growth Indicator Tube-960 test (2 cases). These asymptomatic men underwent infertility evaluation along with evaluation for GUTB. Diagnosis of GUTB was based on standard clinical criteria, which included a high index of suspicion along with clinical, laboratory, and/or radiological evidence of GUTB. Men who had no clinical evidence of GUTB were followed up with clinical evaluation, semen analysis, and repeat semen PCR for TB after 6 months. RESULTS: Fourteen subjects consented for inclusion in the study. One had a history of pulmonary TB 20 years earlier. Another patient was found to have mediastinal lymphadenopathy (tubercular). All except one had a normal semen analysis. None of the patients met the standard clinical criteria for GUTB diagnosis. 8 patients followed up at 6 months with repeat semen analysis, which was similar to the baseline values and no clinical evidence of TB. INTERPRETATION AND CONCLUSIONS: Asymptomatic men with positive screening semen PCR for TB do not have clinical evidence of TB. Male partners of women with infertility and GUTB should not be screened if they have no symptoms. PMID:26538860

  17. Treatments for Infertility Resulting from Polycystic Ovary Syndrome (PCOS)

    MedlinePlus

    ... Information Clinical Trials Resources and Publications Treatments for Infertility Resulting from PCOS Skip sharing on social media ... reason for these problems. Before beginning treatment for infertility possibly related to PCOS, be sure that your ...

  18. Genetic Cause of Infertility Associated with Uterine Fibroids

    MedlinePlus

    ... Advances Supported Networks, Programs & Initiatives Genetic Cause of Infertility Associated with Uterine Fibroids Skip sharing on social ... To determine whether TSC genes were involved in infertility related to fibroids, scientists funded by the Fertility ...

  19. What Treatment Options Are Available for Male Infertility?

    MedlinePlus

    ... Publications What treatment options are available for male infertility? Skip sharing on social media links Share this: ... deliver a live-born infant, in most cases, infertility has no other outward symptoms. The evaluation of ...

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

    ERIC Educational Resources Information Center

    Allison, Janet R.

    1979-01-01

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

  1. Ethical considerations for informed consent in infertility research: The use of electronic health records

    PubMed Central

    Wells, Kristen J.; Gordon, Janna R.; Su, H. Irene; Plosker, Shayne; Quinn, Gwendolyn P.

    2015-01-01

    The growing use of electronic health records (EHRs) in healthcare provides rich opportunities for biomedical research. Using EHRs, massive quantities of patient data can be extracted for research without the need to recruit patients, schedule study visits, or rely on self-reporting. However, this innovation poses significant concerns about patient privacy and confidentiality of data. Patients receiving infertility treatment may be particularly vulnerable to data breaches, as their EHRs often include sensitive health information about themselves, their partner, and their offspring. Helping patients with infertility to make informed decisions about sharing data is crucial, yet little is known about best practices for obtaining informed consent to use EHR data for research. This commentary reviews possible options for obtaining informed consent for EHR use among patients seeking fertility services. In addition, this commentary summarizes the limited research available on patient preferences for informed consent practices. PMID:27066591

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

    PubMed Central

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

    2015-01-01

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

  3. Polymorphic variants in vitamin D signaling pathway genes and the risk of endometriosis-associated infertility.

    PubMed

    Szczepańska, Malgorzata; Mostowska, Adrianna; Wirstlein, Przemyslaw; Skrzypczak, Jana; Misztal, Matthew; Jagodziński, Paweł P

    2015-11-01

    It has recently been reported that vitamin D blood plasma levels are associated with reduced risk of endometriosis. The present study aimed to investigate whether the vitamin D binding protein (GC), vitamin D receptor (VDR), and retinoid X receptor (RXR) gene variants may be genetic risk factors for endometriosis‑associated infertility. The subjects consisted of 154 women with endometriosis‑associated infertility and 347 controls. Using polymerase chain reaction restriction fragment length polymorphism and high resolution melt techniques, the GC rs1155563, rs2298849 and rs7041; RXRA rs10881578, rs10776909 and rs749759; VDR BsmI rs1544410; and FokI rs2228570 single nucleotide polymorphisms (SNPs) were investigated in the patients with endometriosis and the healthy controls. The results indicated that no significant differences were observed between the genotype and allele frequencies of all experimental SNPs in the vitamin D signaling pathway genes in women with endometriosis-associated infertility and controls. However, a significant association was present between the A‑T haplotype, consisting of VDR rs1544410 and rs222857 minor alleles, and endometriosis-associated infertility [OR=1.659 (1.122‑2.453), P=0.011]. The results of the present study suggested that VDR gene variants act as genetic risk factors for endometriosis‑associated infertility.

  4. Treatment of infertility associated with deep endometriosis: definition of therapeutic balances.

    PubMed

    Somigliana, Edgardo; Garcia-Velasco, Juan Antonio

    2015-10-01

    Deep endometriosis is a demanding condition that is associated with infertility. However, evidence supporting a direct link between deep endometriosis and infertility is weak. In fact, infertility in affected patients is more likely to be explained by the strong association between deep endometriosis and adhesions, superficial endometriotic implants, ovarian endometriomas, and adenomyosis. The purported beneficial effects of surgery on infertility are mainly based on the 40%-42% pregnancy rate (PR) after surgery observed in published case series. However, this level of evidence is questionable and overestimates the benefits of the intervention. Even if comparative studies are lacking, IVF may be a valid alternative. The procedure may be less effective in affected women compared with other indications and it is not without additional deep endometriosis-related risks. Some case reports suggest that lesions might progress during IVF causing ureteral or intestinal complications or can decidualize during pregnancy causing intestinal perforation, pneumothorax, and pelvic vessels rupture. Finally, in the decision-making process, physicians should also consider that women with a history of deep endometriosis may face an increased risk of pregnancy complications. In conclusion, clear recommendation for the management of infertile women with deep endometriosis cannot be extrapolated from the literature. The therapeutic decision should be based on a comprehensive evaluation that includes clinical history, instrumental findings, pain symptoms, risks of pregnancy complications, and the woman's wishes.

  5. Developing an educational scheme for undergraduate medical Curriculum: the unit of "INFERTILITY" as a sample

    PubMed Central

    Aflatoonian, A; Baghianimoghadam, B; Abdoli, A; Partovi, P; Hemmati, P; Tabibnejad, N; Harasym, P

    2012-01-01

    Objectives: to present our first experience in scheme development based on CPC philosophy in Iran. Hypothesis: One of the most important reasons of an obvious gap between medical education and professional expectations (outcomes) encountered by recent medical graduates is due to applying conventional curricula, which rely on hypothetical-deductive reasoning model. The University of Calgary has implemented a new curriculum which is organized according to 125 ways in which patients may present to a physician. In this study we will present our first experience in scheme development based on CPC philosophy in Iran. Methods: In 2007, research and clinical center for infertility (Yazd University of medical sciences, IRAN), began developing a full module for infertility (lesson plan) with fourteen components based on the new curricular philosophy. We recruited a scheme of infertility according to a specific way. Results: Thus, at the first step of the module creation, a scheme was made as the most important mainstay of presentation module, i.e. a structured scheme that includes all causative diseases of infertility. Conclusions: Any effort in the organization of knowledge around schemes including in the domain of infertility would be valuable to meet some of the standards of WFME. Also, development of modules, by the teams composed of experts and students, can improve the quality of medical education. PMID:22574082

  6. Intrauterine insemination for treatment of male infertility.

    PubMed

    Keck, C; Gerber-Schäfer, C; Wilhelm, C; Vogelgesang, D; Breckwoldt, M

    1997-01-01

    Intrauterine inseminations (IUI) have been performed since the beginning of this century for treatment of infertility. Despite its widespread use the clinical value of this technique remains unclear. Today, indications for IUI include male factor, cervical factor, immunological and unexplained infertility and infertility due to ejaculatory disorders. IUI is superior to intravaginal (IVI) or intracervical insemination (ICI). Before insemination, semen has to be processed using one of the established sperm preparation techniques. Different techniques seem to be equally effective in preparing a highly concentrated sperm fraction with progressively motile, morphologically normal sperm. Ovarian stimulation further improves pregnancy rates achieved by insemination. Human menopausal gonadotropin (HMG) stimulation seems to be superior to clomiphene citrate stimulation. Among other factors, timing and number of inseminations are crucial when influencing the outcome of IUI treatment. PMID:9466187

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

    PubMed Central

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

    2008-01-01

    BACKGROUND Worldwide more than 70 million couples suffer from infertility, the majority being residents of developing countries. Negative consequences of childlessness are experienced to a greater degree in developing countries when compared with Western societies. Bilateral tubal occlusion due to sexually transmitted diseases and pregnancy-related infections is the most common cause of infertility in developing countries, a condition that is potentially treatable with assisted reproductive technologies (ART). New reproductive technologies are either unavailable or very costly in developing countries. This review provides a comprehensive survey of all important papers on the issue of infertility in developing countries. METHODS Medline, PubMed, Excerpta Medica and EMBASE searches identified relevant papers published between 1978 and 2007 and the keywords used were the combinations of ‘affordable, assisted reproduction, ART, developing countries, health services, infertility, IVF, simplified methods, traditional health care'. RESULTS The exact prevalence of infertility in developing countries is unknown due to a lack of registration and well-performed studies. On the other hand, the implementation of appropriate infertility treatment is currently not a main goal for most international non-profit organizations. Keystones in the successful implementation of infertility care in low-resource settings include simplification of diagnostic and ART procedures, minimizing the complication rate of interventions, providing training-courses for health-care workers and incorporating infertility treatment into sexual and reproductive health-care programmes. CONCLUSIONS Although recognizing the importance of education and prevention, we believe that for the reasons of social justice, infertility treatment in developing countries requires greater attention at National and International levels. PMID:18820005

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

    SciTech Connect

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

    1984-02-01

    The specific radioimmunoassay system was developed for the titration of the antibodies to porcine zona pellucida (ZP) in human sera by using /sup 125/I-labeled purified porcine ZP as antigen, which is known to have cross-reactivity with human ZP. The antibodies in human sera were detected in 3 of 11 (27%) women with unexplained infertility, in 16 of 48 (33%) amenorrheic patients, in 4 of 12 (33%) fertile women, and in 3 of 10 (30%) men. Moreover, antibody titers in infertile women were no higher than those in fertile women and in men. These results seem to suggest that the antibodies in human sera that cross-react with porcine ZP may not be an important factor in causing infertility in women.

  9. Academy of Medicine-Ministry of Health Clinical Practice Guidelines: Assessment and Management of Infertility at Primary Healthcare Level

    PubMed Central

    Loh, Seong Feei; Agarwal, Rachna; Chan, Jerry; Chia, Sing Joo; Cho, Li Wei; Lim, Lean Huat; Lau, Matthew Sie Kuei; Loh, Sheila Kia Ee; Hendricks, Marianne Sybille; Nair, Suresh; Quah, Joanne Hui Min; Tan, Heng Hao; Wong, PC; Yeong, Cheng Toh; Yu, Su Ling

    2014-01-01

    The Academy of Medicine (AMS) and Ministry of Health (MOH) have developed the clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level to provide doctors and patients in Singapore with evidence-based treatment for infertility. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the AMS-MOH clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_ medical/2013/cpgmed_infertility.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines. PMID:24570313

  10. Academy of Medicine-Ministry of Health Clinical Practice Guidelines: assessment and management of infertility at primary healthcare level.

    PubMed

    Loh, Seong Feei; Agarwal, Rachna; Chan, Jerry K; Chia, Sing Joo; Cho, Li Wei; Lim, Lean Huat; Lau, Matthew Sie Kuei; Loh, Sheila Kia Ee; Hendricks, Marianne Sybille; Nair, Suresh; Quah, Joanne Hui Min; Tan, Heng Hao; Wong, P C; Yeong, Cheng Toh; Yu, Su Ling

    2014-02-01

    The Academy of Medicine (AMS) and Ministry of Health (MOH) have developed the clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level to provide doctors and patients in Singapore with evidence-based treatment for infertility. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the AMS-MOH clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical/2013/cpgmed_infertility.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

  11. Genetic causes and workup of male and female infertility. 2. Abnormalities presenting between birth and adult life.

    PubMed

    Opitz, J M; Shapiro, S S; Uehling, D T

    1979-06-01

    At birth some 6/1,000 persons have chromosome abnormalities; in about 60% of cases these abnormalities cause death or infertility, and in one third fertility is reduced. Some 1.7% of persons (3.4% of couples) with recurrent spontaneous abortion, infertility, or both have a chromosome abnormality. Chromosome abnormalities are far more common in men than in women with infertility; 15% to 20% of men with azoospermia have the Klinefelter syndrome. Meiotic defects explain 20% of male infertility in patients with apparently normal somatic chromosomes. Congenital malformations of the genitalia are more common in males than in females; about 0.82% of liveborn males have hypospadias. Almost one sixth of women with primary amenorrhea have some form of müllerian atresia, usually with associated renal anomalies.

  12. Complementary and Alternative Medicine Use in Infertility: Cultural and Religious Influences in a Multicultural Canadian Setting

    PubMed Central

    Read, Suzanne C.; Carrier, Marie-Eve; Whitley, Rob; Gold, Ian; Tulandi, Togas

    2014-01-01

    Abstract Objectives: To explore the use of complementary and alternative medicine (CAM) for infertility in a multicultural healthcare setting and to compare Western and non-Western infertility patients' reasons for using CAM and the meanings they attribute to CAM use. Design: Qualitative semi-structured interviews using thematic analysis. Settings/location: Two infertility clinics in Montreal, Quebec, Canada. Participants: An ethnoculturally varied sample of 32 heterosexual infertile couples. Results: CAM used included lifestyle changes (e.g., changing diet, exercise), alternative medicine (e.g., acupuncture, herbal medicines), and religious methods (e.g., prayers, religious talismans). Patients expressed three attitudes toward CAM: desperate hope, casual optimism, and amused skepticism. Participants' CAM use was consistent with cultural traditions of health and fertility: Westerners relied primarily on biomedicine and used CAM mainly for relaxation, whereas non-Westerners' CAM use was often influenced by culture-specific knowledge of health, illness and fertility. Conclusions: Understanding patients' CAM use may help clinicians provide culturally sensitive, patient-centered care. PMID:25127071

  13. Using Acceptance and Commitment Therapy to Treat Infertility Stress

    ERIC Educational Resources Information Center

    Peterson, Brennan D.; Eifert, Georg H.

    2011-01-01

    Women and men diagnosed with infertility experience a variety of infertility-related stressors, including changes to their family and social networks, strain on their sexual relationship, and difficulties and unexpected challenges in their relationship. Infertility stress is linked with depression and psychological distress, and can lead to…

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

    ERIC Educational Resources Information Center

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

    2003-01-01

    Tests the hypothesis that women who have experienced infertility report higher psychological distress. Examines whether roles or resources condition the effects of infertility or whether its effects are limited to childless women. Infertility combined with involuntary childlessness is associated with significantly greater distress. For women in…

  15. Aspects of Psychosocial Development in Infertile Versus Fertile Men

    PubMed Central

    Akhondi, Mohammad Mehdi; Binaafar, Sima; Ardakani, Zohreh Behjati; Kamali, Kourosh; Kosari, Haleh; Ghorbani, Behzad

    2013-01-01

    Background Infertility is one of the most difficult life experiences that a couple might encounter. Infertility as a bio-psycho-social phenomenon, could influence all aspects of life. While paying special attention to the psychological aspects of infertility in couples; many studies have investigated the non-clinical aspects of infertility, however, they rarely have evaluated the psychosocial development of infertile versus fertile men. We aimed to study the effects of infertility on psychosocial development in men. Methods In fact, we designed the study based on “Erikson's theory of psychosocial development”. We focused on the relationship between psychosocial development and some self-conceived indices. For this purpose, we divided the participants volunteers into two groups of cases (80 infertile men) and controls (40 fertile men) and asked them to complete a 112 (questions questionnaire based on “self description”). The statistical analysis was performed by SPSS (version 13) using independent t-test, Pearson correlation coefficient and analysis of covariance. A p-value <0.05 was considered significant. Results Data analysis showed significant inter and intra group differences. Infertile and fertile groups showed significant differences in trust, autonomy, generativity and integrity stages (p < 0.05). Infertile intergroup analysis represents us to higher scores in positive than negative stages. Conclusion Infertility as a phenomenon had its own effects on the psychosocial development of infertile men. However, good coping skills are powerful tools to manage these myriad of feelings surrounding infertile men. PMID:23926571

  16. Noninvasive Electrocardiographic Imaging (ECGI): Comparison to intraoperative mapping in patients

    PubMed Central

    Ghanem, Raja N.; Jia, Ping; Ramanathan, Charulatha; Ryu, Kyungmoo; Markowitz, Alan; Rudy, Yoram

    2007-01-01

    OBJECTIVES/BACKGROUND Cardiac arrhythmias are a leading cause of death and disability. Electrocardiographic imaging (ECGI) is a noninvasive imaging modality that reconstructs potentials, electrograms, and isochrones on the epicardial surface from body surface measurements. We previously demonstrated in animal experiments through comparison with simultaneously measured epicardial data the high accuracy of ECGI in imaging cardiac electrical events. Here, images obtained by noninvasive ECGI are compared to invasive direct epicardial mapping in open heart surgery patients. METHODS Three patients were studied during sinus rhythm and right ventricular endocardial and epicardial pacing (total of five datasets). Body surface potentials were acquired preoperatively or postoperatively using a 224-electrode vest. Heart-torso geometry was determined preoperatively using computed tomography. Intraoperative mapping was performed with two 100-electrode epicardial patches. RESULTS Noninvasive potential maps captured epicardial breakthrough sites and reflected general activation and repolarization patterns, localized pacing sites to ∼1 cm and distinguished between epicardial and endocardial origin of activation. Noninvasively reconstructed electrogram morphologies correlated moderately with their invasive counterparts (cross correlation = 0.72 ± 0.25 [sinus rhythm], 0.67 ± 0.23 [endocardial pacing], 0.71 ± 0.21 [epicardial pacing]). Noninvasive isochrones captured the sites of earliest activation, areas of slow conduction, and the general excitation pattern. CONCLUSIONS Despite limitations due to nonsimultaneous acquisition of the surgical and noninvasive data under different conditions, the study demonstrates that ECGI can capture important features of cardiac electrical excitation in humans noninvasively during a single beat. It also shows that general excitation patterns and electrogram morphologies are largely preserved in open chest conditions. PMID:15851333

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

    PubMed Central

    Richardson, Marcy E.; Bleiziffer, Andreas; Tüttelmann, Frank; Gromoll, Jörg; Wilkinson, Miles F.

    2014-01-01

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

  18. Genetic Association Between Androgen Receptor Gene CAG Repeat Length Polymorphism and Male Infertility: A Meta-Analysis.

    PubMed

    Pan, Bihui; Li, Rui; Chen, Yao; Tang, Qiuqin; Wu, Wei; Chen, Liping; Lu, Chuncheng; Pan, Feng; Ding, Hongjuan; Xia, Yankai; Hu, Lingqing; Chen, Daozhen; Sha, Jiahao; Wang, Xinru

    2016-03-01

    The association between polymorphism of androgen receptor gene CAG (AR-CAG) and male infertility in several studies was controversial. Based on studies on association between AR-CAG repeat length and male infertility in recent years, an updated meta-analysis is needed. We aimed to evaluate the association between AR-CAG repeat length and male infertility in advantage of the data in all published reports.We searched for reports published before August 2015 using PubMed, CNKI, VIP, and WanFang. Data on sample size, mean, and standard deviation (SD) of AR-CAG repeat length were extracted independently by 3 investigators.Forty-four reports were selected based on criteria. The overall infertile patients and azoospermic patients were found to have longer AR-CAG repeat length (standard mean difference (SMD) = 0.19, 95% confidence interval (CI): 0.10-0.28, P < 0.01; SMD = 0.36, 95% CI: 0.10-0.61, P < 0.01). AR-CAG repeat length was longer in infertile men in Asian, Caucasian, and mixed races (SMD = 0.25, 95% CI: 0.08-0.43, P <0.01; SMD = 0.13, 95% CI: 0.02-0.25, P <0.05; SMD = 0.39, 95% CI: 0.15-0.63, P <0.01). The overall study shows that increased AR-CAG repeat length was associated with male infertility. The subgroup study on races shows that increased AR-CAG repeat length was associated with male infertility in Asian, Caucasian, and mixed races. Increased AR-CAG repeat length was also associated with azoospermia.This meta-analysis supports that increased androgen receptor CAG length is capable of causing male infertility susceptibility.

  19. Genetic Association Between Androgen Receptor Gene CAG Repeat Length Polymorphism and Male Infertility: A Meta-Analysis

    PubMed Central

    Pan, Bihui; Li, Rui; Chen, Yao; Tang, Qiuqin; Wu, Wei; Chen, Liping; Lu, Chuncheng; Pan, Feng; Ding, Hongjuan; Xia, Yankai; Hu, Lingqing; Chen, Daozhen; Sha, Jiahao; Wang, Xinru

    2016-01-01

    Abstract The association between polymorphism of androgen receptor gene CAG (AR-CAG) and male infertility in several studies was controversial. Based on studies on association between AR-CAG repeat length and male infertility in recent years, an updated meta-analysis is needed. We aimed to evaluate the association between AR-CAG repeat length and male infertility in advantage of the data in all published reports. We searched for reports published before August 2015 using PubMed, CNKI, VIP, and WanFang. Data on sample size, mean, and standard deviation (SD) of AR-CAG repeat length were extracted independently by 3 investigators. Forty-four reports were selected based on criteria. The overall infertile patients and azoospermic patients were found to have longer AR-CAG repeat length (standard mean difference (SMD) = 0.19, 95% confidence interval (CI): 0.10–0.28, P < 0.01; SMD = 0.36, 95% CI: 0.10–0.61, P < 0.01). AR-CAG repeat length was longer in infertile men in Asian, Caucasian, and mixed races (SMD = 0.25, 95% CI: 0.08–0.43, P <0.01; SMD = 0.13, 95% CI: 0.02–0.25, P <0.05; SMD = 0.39, 95% CI: 0.15–0.63, P <0.01). The overall study shows that increased AR-CAG repeat length was associated with male infertility. The subgroup study on races shows that increased AR-CAG repeat length was associated with male infertility in Asian, Caucasian, and mixed races. Increased AR-CAG repeat length was also associated with azoospermia. This meta-analysis supports that increased androgen receptor CAG length is capable of causing male infertility susceptibility. PMID:26962784

  20. Care strategies for schizophrenic patients in a transcultural comparison.

    PubMed

    von Zerssen, D; León, C A; Möller, H J; Wittchen, H U; Pfister, H; Sartorius, N

    1990-01-01

    This study was conducted in order to test the hypothesis derived from the International Pilot Study of Schizophrenia (IPSS) that the existence of extended families in developing countries contributes to the more favorable course and outcome of schizophrenia in these countries in comparison with industrial countries. For this purpose, we compared data from the 5- and 10-year follow-up obtained within the IPSS at Cali, Colombia with data from two 5- to 8-year follow-up studies of former schizophrenic inpatients of the Max Planck Institute of Psychiatry (MPIP) in Munich, FRG. Although, in Cali, schizophrenics are hospitalized and treated with drugs only during acute episodes of the psychosis and no facilities exist for long-term treatment, the psychopathological outcome was, on the whole, not worse than in Munich. Furthermore, the duration of hospitalization during the follow-up period was much lower at Cali and a significantly lower number of Colombian than of German patients was not separated from their families. However, contrary to the hypothesis, family size did not predict course and outcome at both centers.

  1. Prevalence and predictors of infertility-specific stress in women diagnosed with primary infertility: A clinic-based study

    PubMed Central

    Patel, Ansha; Sharma, P. S. V. N.; Narayan, Pratapkumar; Binu, V. S.; Dinesh, N.; Pai, Praveena Joglekar

    2016-01-01

    BACKGROUND: According to the existing literature on infertility, stress appears to be inevitably associated with infertility diagnosis and treatment in sub-fertile individuals. The epidemiological data on the prevalence and predictors of infertility-specific stress in cultural specific scenario are scarce. The objective of the present study was to estimate the prevalence of infertility-specific stress and identify predictors of infertility-specific stress in women diagnosed with primary infertility. MATERIALS AND METHODS: This cross-sectional study was conducted on 300 infertile married women, diagnosed with primary infertility. The tools used for the assessment were “semi-structured questionnaire” compiled by the authors, “ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines),” and “Psychological Evaluation Test for infertility.” STATISTICAL ANALYSIS: Data were analyzed using SPSS (version 15). Chi-square test was used for univariate analysis followed by multiple logistic regressions between stress and the predictor variables. RESULTS AND DISCUSSION: The prevalence of stress among women was 80%. Univariate analysis revealed that predictors of stress were years of marital life, duration of infertility, infertility type, history of gynecological surgery, cycles of ovulation induction with timed intercourse and intra-uterine inseminations, present and past psychiatric morbidity, coping difficulties, gynecological diagnosis, and severity of premenstrual dysphoria. Multivariate analysis showed leading associations of stress with infertility type and coping difficulties. PMID:27110075

  2. Sexual behavior of infertile women: a qualitative study

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Kawamura, Kazuhiro; Cheng, Yuan; Suzuki, Nao; Deguchi, Masashi; Sato, Yorino; Takae, Seido; Ho, Chi-hong; Kawamura, Nanami; Tamura, Midori; Hashimoto, Shu; Sugishita, Yodo; Morimoto, Yoshiharu; Hosoi, Yoshihiko; Yoshioka, Nobuhito; Ishizuka, Bunpei; Hsueh, Aaron J

    2013-10-22

    Primary ovarian insufficiency (POI) and polycystic ovarian syndrome are ovarian diseases causing infertility. Although there is no effective treatment for POI, therapies for polycystic ovarian syndrome include ovarian wedge resection or laser drilling to induce follicle growth. Underlying mechanisms for these disruptive procedures are unclear. Here, we explored the role of the conserved Hippo signaling pathway that serves to maintain optimal size across organs and species. We found that fragmentation of murine ovaries promoted actin polymerization and disrupted ovarian Hippo signaling, leading to increased expression of downstream growth factors, promotion of follicle growth, and the generation of mature oocytes. In addition to elucidating mechanisms underlying follicle growth elicited by ovarian damage, we further demonstrated additive follicle growth when ovarian fragmentation was combined with Akt stimulator treatments. We then extended results to treatment of infertility in POI patients via disruption of Hippo signaling by fragmenting ovaries followed by Akt stimulator treatment and autografting. We successfully promoted follicle growth, retrieved mature oocytes, and performed in vitro fertilization. Following embryo transfer, a healthy baby was delivered. The ovarian fragmentation-in vitro activation approach is not only valuable for treating infertility of POI patients but could also be useful for middle-aged infertile women, cancer patients undergoing sterilizing treatments, and other conditions of diminished ovarian reserve.

  4. Masculinity, infertility, stigma and media reports.

    PubMed

    Gannon, Kenneth; Glover, Lesley; Abel, Paul

    2004-09-01

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

  5. Mechanisms linking obesity to male infertility

    PubMed Central

    2015-01-01

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

  6. ACR appropriateness Criteria® infertility.

    PubMed

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

    2015-03-01

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

  7. Coping Processes of Couples Experiencing Infertility

    ERIC Educational Resources Information Center

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

    2006-01-01

    This study explored the coping processes of couples experiencing infertility. Participants included 420 couples referred for advanced reproductive treatments. Couples were divided into groups based on the frequency of their use of eight coping strategies. Findings suggest that coping processes, which are beneficial to individuals, may be…

  8. Characteristics of the Biopsychosocial Crisis of Infertility.

    ERIC Educational Resources Information Center

    Cook, Ellen Piel

    1987-01-01

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

  9. A new classification for female infertility.

    PubMed

    Aflatoonian, A; Baghianimoghadam, B; Partovi, P; Abdoli, A; Hemmati, P; Tabibnejad, N; Dehghani, M

    2011-01-01

    Infertility is defined as the inability of a couple to conceive after 12 months of regular, unprotected intercourse. However infertility is a clinical presentation and not a disease. Thus to be able to offer a new classification, it is necessary to apply a clinical presentation (philosophy) suggested by the University of Calgary in 1991. In recent years several classification algorithms have been proposed which apply key predictors of clinical, imaging, or morphological types to determine the diseases that can cause infertility. On the other hand, an algorithm is a product of an expert's mind after many years of practice and experience, which is too difficult to understand by a medical student. However there has not been any simple schematic classification based on a logical justification applying integration of etiologies with basic science to break down etiologies into categories, subcategories and disease classes of this clinical presentation. Because etiology has also become an important criterion for the characterization of causes of infertility, a classification proposal is presented here that attempts to include all relevant (basic science) features of the causative diseases of this clinical presentation.

  10. Letrozole as the first-line treatment of infertile women with poly cystic ovarian syndrome (PCOS) compared with clomiphene citrate: A clinical trial

    PubMed Central

    Ghahiri, Ataollah; Mogharehabed, Neda; Mamourian, Mahboobeh

    2016-01-01

    Background: The purpose of this study was to determine the efficacy and safety of letrozole on ovulation induction and pregnancy in comparison with clomiphene citrate in PCOS patients. Materials and Methods: The study was based on prospective randomized clinical trial comparing the efficacy of letrozole as the first-line management of the PCOS patients in comparison to clomiphene citrate during 2009 to 2011 and was performed in one private infertility clinic. The study included 100 patients divided into 2 equal groups. Results: Pregnancy occurred in 29 of 50 patients in letrozole group (58%) and 24 of 51 patients in clomiphene group (47%). The difference was not statistically significant (P value = 0.23). Thirty patients in clomiphene group and 36 patients in letrozole group showed regular menses after or during the treatment course. No significant difference between the 2 groups was observed (P value = 0.21). Conclusion: Our findings suggest letrozole and clomiphene citrate are equally effective for induction of ovulation and achieving pregnancy in patients with PCOS. PMID:26962508

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

    PubMed Central

    2013-01-01

    Background Infertility is a global reproductive health issue that affects many individuals and couples. Despite the high prevalence of infertility in Ghana, no study has been done on the experiences of infertile couples in Northern Ghana. This study therefore explored the experiences of infertile couples in Northern Ghana using the Upper West Region as a case study. Methods We interviewed fifteen childless couples, forty-five couples with children, and eight key informants using a semi-structured interview guide. We also carried out three focus group discussions; one for childless women, one for women with children and one for men with children. The data were transcribed, coded, arranged and analyzed for categories and themes. Results Infertile couples are socially stigmatised and excluded from leadership roles in their communities. Couples without children are denied membership in the ancestral world thereby losing the opportunity to live again. Both males and females are engaged in sex with multiple partners to prove their fertility. Conclusions Both men and women suffer from the social effects of childlessness. The desire to have biological children in a pronatalist society results in unhealthy practices. Health policy makers and gender advocates should be more concerned about infertility. PMID:23517021

  12. Anti-GAPDHS antibodies: a biomarker of immune infertility.

    PubMed

    Fu, Jun; Yao, Rongyan; Luo, Yanyun; Yang, Dantong; Cao, Yang; Qiu, Yi; Song, Wei; Miao, Shiying; Gu, Yiqun; Wang, Linfang

    2016-04-01

    Numerous investigations have focused on the detection of antisperm antibodies, which have a naturally occurring impact on male and female fertility. In this study, spermatogenic glyceraldehyde-3-phosphate dehydrogenase (GAPDHS) was considered to be a candidate biomarker of immune infertility. The concentrations of anti-GAPDHS antibodies in the sera of sterile individuals and fertile couples were measured by enzyme-linked immunosorbent assay. Sera were collected from immune infertile (n = 175) and fertile (n = 237) individuals and were screened by tray agglutination tests (TAT). Infertile sera were further divided into two groups according to the serum titers obtained by TAT (titers ≤ 1:8, n = 58; titers > 1:8, n = 117). The concentrations of anti-GAPDHS antibodies were significantly higher in the immune infertile group than in the fertile group and were much higher with regard to the increased degrees of sperm agglutination (titers > 1:8). Surprisingly, we found statistically significantly higher concentrations of antibodies in the sera of infertile men than in those of infertile women, and a similar statistical result was obtained in the sera when primary infertility was compared with secondary infertility. Thus, anti-GAPDHS antibodies seem to be a sensitive parameter in immune infertile detection and might be one of the main factors causing immune infertility. This factor might be valuable as an indicator in the clinical diagnosis and monitoring treatment of infertility. PMID:26846113

  13. Unexplained infertility: an update and review of practice.

    PubMed

    Ray, Arpita; Shah, Amit; Gudi, Anil; Homburg, Roy

    2012-06-01

    Of the couples unable to conceive without any identifiable cause, 30% are defined as having unexplained infertility. Management depends on duration of infertility and age of female partner. This review describes and comments on the definition and evidence for the management of unexplained infertility. A literature search was conducted in EMBASE, Medline, Ovid and Cochrane Database of Systematic reviews using the terms 'infertility', 'unexplained infertility', 'idiopathic infertility', 'definition of infertility', 'treatment options', 'intrauterine insemination', 'ovulation induction', 'Fallopian tube sperm', 'GIFT' and 'IVF'. There is no uniform definition for unexplained infertility. This varies in the literature depending on the duration of infertility and the age of the female partner. The treatment of unexplained infertility is empirical and many different regimens have been used. Among these are expectant management, ovulation stimulation with clomiphene citrate, gonadotrophins and aromatase inhibitors, Fallopian tube sperm perfusion, tubal flushing, intrauterine insemination, gamete intra-Fallopian transfer and IVF. The standard protocol is to progress from low-technology to high-technology treatment options. On the best available evidence, an algorithm for management is suggested. There is a definite need for multicentre randomized controlled trials to identify the best treatment option in unexplained infertility using a standard definition. PMID:22503948

  14. Unexplained infertility: an update and review of practice.

    PubMed

    Ray, Arpita; Shah, Amit; Gudi, Anil; Homburg, Roy

    2012-06-01

    Of the couples unable to conceive without any identifiable cause, 30% are defined as having unexplained infertility. Management depends on duration of infertility and age of female partner. This review describes and comments on the definition and evidence for the management of unexplained infertility. A literature search was conducted in EMBASE, Medline, Ovid and Cochrane Database of Systematic reviews using the terms 'infertility', 'unexplained infertility', 'idiopathic infertility', 'definition of infertility', 'treatment options', 'intrauterine insemination', 'ovulation induction', 'Fallopian tube sperm', 'GIFT' and 'IVF'. There is no uniform definition for unexplained infertility. This varies in the literature depending on the duration of infertility and the age of the female partner. The treatment of unexplained infertility is empirical and many different regimens have been used. Among these are expectant management, ovulation stimulation with clomiphene citrate, gonadotrophins and aromatase inhibitors, Fallopian tube sperm perfusion, tubal flushing, intrauterine insemination, gamete intra-Fallopian transfer and IVF. The standard protocol is to progress from low-technology to high-technology treatment options. On the best available evidence, an algorithm for management is suggested. There is a definite need for multicentre randomized controlled trials to identify the best treatment option in unexplained infertility using a standard definition.

  15. Hormonal evaluation of female infertility and reproductive disorders.

    PubMed

    Scott, M G; Ladenson, J H; Green, E D; Gast, M J

    1989-04-01

    Performance of the male and female reproductive systems reflects the orderly operation of the hypothalamic-pituitary-gonadal axis. Aberrant operation of this axis can result in many different reproductive disorders, including various forms of infertility. Proper evaluation of these disorders involves a multifaceted diagnostic approach, which includes a critical contribution from the clinical laboratory. This adjunctive testing, involving the measurements of peptide and sex-steroid hormone concentrations, allows the clinician to biochemically "dissect" the hypothalamic-pituitary-gonadal axis and ascertain the presence as well as location of the specific defect. In practice, the specific tests utilized during the evaluation of a patient depend upon the underlying disorder. Typically, in evaluating the reproductive disorders discussed in this review, a primary battery of tests is obtained that reflects the initial clinical presentation and physical examination. The results of these initial studies then dictate any secondary testing required to complete the evaluation. Such an approach, in use at our institution, is provided in Table 5. Although this discussion has concentrated on the laboratory assessment of the female reproductive system, it is important to remember the special case of infertility, where couples, in general, are evaluated together by the clinician. The cause of infertility can reside with the female, the male, or, in the cases of immunological "incompatibilities," a combination of the male and the female. As such, rigorous schemes for evaluating male reproductive disorders (1, 3, 89-94) and immunological incompatibilities (95-98) have been developed, and the information derived from such testing represents a critical contribution to establishing the etiology of a couple's infertility. Although the laboratory assessment of peptide and sex-steroid hormone concentrations clearly plays a pivotal role in the evaluation of reproductive disorders, these

  16. Psychological adjustment to twins after infertility.

    PubMed

    Klock, Susan C

    2004-08-01

    The birth of twins and other multiples is physically and emotionally stressful. The increase in the use of the assisted reproductive technologies has lead to an exponential increase in the rates of twins and triplets in the US. Whereas the medical complications of twins and other multiples has been well studied, the psychological and social implications of these events has not. Very little empirical research has been conducted to assess the differential impact of twins, as compared to singletons, on maternal adjustment, postpartum depression and marital functioning. In addition, assessment of infant health, disposition and behavior and its relation to maternal adjustment is lacking. The birth of twins after a period of infertility complicates the clinical picture and the impact of infertility on subsequent parental adjustment is only beginning to be understood. Although research suggests that infertile couples often desire multiples, the experience of parenting multiples after infertility has not been studied. Research on fertile couples indicate that: (i) approximately 10% of women develop postpartum depression and; (ii) marital adjustment declines after the birth of the first child. Because of the unique demands of parenting multiples, it is hypothesized that mothers of twins who have a history of infertility would be at increased risk for depression and marital decline. Descriptive studies of these families support this view, although additional studies are needed to determine the degree and extent of the problem. Additionally, variables such as, prepregnancy adjustment, equitable division of child-care tasks and perceived social support should be studied to determine if they buffer against the expected effects.

  17. Molecular detection of potential sexually transmitted pathogens in semen and urine specimens of infertile and fertile males.

    PubMed

    Abusarah, Eman A; Awwad, Ziad M; Charvalos, Ekatherina; Shehabi, Asem A

    2013-12-01

    A total of 93 infertile and 70 fertile men attending various urology and gynecology clinics in Jordan were investigated in this prospective study. First void urine and the corresponding semen specimens were collected from 96% of the patients. Presence of Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU), and Mycoplasma genitalium (MG) DNA in specimen was detected using polymerase chain reaction. The distribution of NG, CT, UU, and MG in semen and FVU specimens among infertile versus fertile men was 6.5% versus 0%, 4.3% versus 1.4%, 10.8% versus 5.7%, and 3.2% versus 1.4%, respectively. Two of infertile and 1 of fertile men harbored mixed pathogens. The highest number of positive potential pathogens was found among young men aged 20-29 years old. The present study found a very high concordance between the detection of CT, UU, and MG DNA in semen and the corresponding FVU specimens, while NG DNA found only in semen and not in the corresponding FVU specimens. This study also revealed that Ureaplasma parvum species is more prevalent than Ureaplasma urealyticum in specimens of infertile men (90%). The study demonstrates that infertile men have higher prevalence of NG, CT, UU, and MG compared with fertile men and NG as significantly associated with infertile men.

  18. Bioethical dilemmas of assisted reproduction in the opinions of Polish women in infertility treatment: a research report.

    PubMed

    Dembinska, Aleksandra

    2012-12-01

    Infertility Accepted treatment is replete with bioethical dilemmas regarding the limits of available medical therapies. Poland has no legal acts regulating the ethical problems associated with infertility treatment and work on such legislation has been in progress for a long time, arousing very intense emotions in Polish society. The purpose of the present study was to find out what Polish women undergoing infertility treatment think about the most disputable and controversial bioethical problems of assisted reproduction. An Attitudes towards Bioethical Problems of Infertility Scale was constructed specifically for this study. Items were taken from the Bioethics Bills currently under discussion in Polish Parliament (Seym). 312 women were enrolled in the study. Women experiencing infertility favoured more liberal legislation. Participants disagreed, for example, with the following regulations: prohibition of embryo freezing, prohibition of preimplantation genetic diagnosis of embryos, age limits for women using in vitro fertilisation and prohibition of in vitro fertilisation for single women. The opinions of patients undergoing infertility treatment are an important voice in the Polish debate on the Bioethics Bills.

  19. Comparison of conventional in vitro fertilisation and intracytoplasmic sperm injection outcomes in patients with moderate oligoasthenozoospermia.

    PubMed

    Shuai, H-L; Ye, Q; Huang, Y-H; Xie, B-G

    2015-06-01

    The method of choice for assisted reproductive technology treatment in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) is usually based on the evaluation of male infertility factors. Decisions for couples with moderate oligoasthenozoospermia (OA) are often empirical because uniform treatment criteria are lacking. This study aimed to evaluate the effect of patients with moderate OA treated with conventional IVF and ICSI. A total of 199 couples with moderate OA undergoing their first IVF/ICSI cycle were included in the study. The patients were divided into two groups according to the type of insemination: conventional IVF group (n = 97) and ICSI group (n = 102). All patients were randomised to be inseminated either by conventional IVF or ICSI. The fertilisation rate, embryo quality, implantation rate and clinical pregnancy rate were examined. No differences in the fertilisation, implantation and pregnancy rates were observed between conventional IVF and ICSI groups (P > 0.05). However, the number of good-quality embryos was significantly higher in the ICSI group than in the IVF group (P < 0.05). Couples with moderate OA did not influence on the overall clinical outcomes between IVF and ICSI treatments, and a negative influence by ICSI on blastocyst development was not confirmed.

  20. An evolutionary perspective on Y-chromosomal variation and male infertility

    PubMed Central

    Tyler-Smith, Chris

    2008-01-01

    Genetic variation on the Y chromosome is one of the best-documented causes of male infertility, but the genes responsible have still not been identified. This review discusses how an evolutionary perspective may help with interpretation of the data available and suggest novel approaches to identify key genes. Comparison with the chimpanzee Y chromosome indicates that USP9Y is dispensable in apes, but that multiple copies of TSPY1 may have an important role. Comparisons between infertile and control groups in search of genetic susceptibility factors are more complex for the Y chromosome than for the rest of the genome because of population stratification and require unusual levels of confirmation. But the extreme population stratification exhibited by the Y also allows populations particularly suitable for some studies to be identified, such as the partial AZFc deletions common in Northern European populations where further dissection of this complex structural region would be facilitated. PMID:18399979

  1. Sperm Cells Induce Distinct Cytokine Response in Peripheral Mononuclear Cells from Infertile Women with Serum Anti-Sperm Antibodies

    PubMed Central

    Kverka, Miloslav; Ulcova-Gallova, Zdenka; Bartova, Jirina; Cibulka, Jan; Bibkova, Katarina; Micanova, Zdenka; Tlaskalova-Hogenova, Helena

    2012-01-01

    Background and Aims Anti-sperm antibodies in can markedly reduce the likelihood of natural conception. The etiology of this anti-sperm immunity in human females is unknown. We compared the cytokine response of peripheral blood mononuclear cells (PBMCs) from infertile patients with or without anti-sperm antibodies (ASA) and fertile women. Methodology/Principal Findings We cultivated the PBMCs together with sperm antigens (whole cells or cell lysate), and screened the supernatants for 40 cytokines by antibody array. When stimulated with whole sperm cells, the PBMCs from patients with ASA produce less IL-3, IL-11, IL-13, ICAM-1, GCSF and more IL-2, IL-4 and IL-12p70 as compared to healthy women. PBMCs from patients with ASA produce typically less IL-13, IL-7, IL-17 and MIG, and more MIP-1β and IL-8, as compared to PBMCs from patients without ASA. In response to sperm cell lysate, PBMCs from infertile women without ASA respond initially by increase in production of growth factors (GCSF, GM-CSF and PDGF-BB) followed by increase in chemokines (e.g. IL-8, MCP-1 and MIP-1β). Conclusions Cellular immune responses to sperm antigens, measured by production of cytokines, differ among infertile women with ASA, infertile women without ASA and healthy women. This difference could play an important role in the initial steps of the infertility pathogenesis. PMID:22952917

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

    PubMed Central

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

    2015-01-01

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

  3. A rare case of respiratory disorders associated with two autosomal recessive diseases and male infertility.

    PubMed

    Mendeluk, Gabriela Ruth; Costa, Sergio López; Scigliano, Sergio; Menga, Guillermo; Demiceu, Sergio; Palaoro, Luis Alberto

    2013-01-01

    The study of nasal ciliary beat frequency (CBF) and ultrastructure may contribute to the understanding of pathognomonic cases of male infertility associated with defects in sperm motility. This study was designed to report a particular case of male infertility, characterized by the association of two respiratory autosomal recessive genetic diseases (alpha-1-antitrypsin deficiency [AAT-D] and primary ciliary dyskinesia [PCD]). A 39-year-old patient with complete sperm immotility, AAT-D, and bronchiectasis was studied in the Laboratory of Male Fertility, the Department of Urology, the Respiratory Center of a Pediatric Hospital, and in the Department of Clinical Medicine of a Rehabilitation Respiratory Hospital. Family history, physical examination, hormonal analysis, microbial assays, semen analysis, nasal ciliary function, and structure study by digital high-speed video photography and transmission electron microscopy are described. A noninvasive nasal biopsy to retrieve ciliated epithelium lining the inferior surface of the inferior nasal turbinates was performed and CBF was determined. Beat pattern was slightly curved and rigid, not wide, and metacronic in all the observed fields analyzed. CBF was 8.2 Hz in average (reference value, 10-15 Hz) Ultrastructural assay revealed absence of the inner dynein arms in 97% of the cilia observed. The final infertility accurate diagnosis was achieved by the study of nasal CBF and ultrastructure contributing to the patient health management and genetic counseling while deciding fatherhood. Beyond this particular case, the present report may open a new field of studies in male infertility, mainly in cases of asthenozoospermia.

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

    PubMed

    Culley, Lorraine; Hudson, Nicky; Lohan, Maria

    2013-09-01

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

  5. Terminal Mannose Residues in Seminal Plasma Glycoproteins of Infertile Men Compared to Fertile Donors

    PubMed Central

    Olejnik, Beata; Jarząb, Anna; Kratz, Ewa M.; Zimmer, Mariusz; Gamian, Andrzej; Ferens-Sieczkowska, Mirosława

    2015-01-01

    The impact of seminal plasma components on the fertilization outcomes in humans is still under question. The increasing number of couples facing problems with conception raises the need for predictive biomarkers. Detailed understanding of the molecular mechanisms accompanying fertilization remains another challenge. Carbohydrate–protein recognition may be of key importance in this complex field. In this study, we analyzed the unique glycosylation pattern of seminal plasma proteins, the display of high-mannose and hybrid-type oligosaccharides, by means of their reactivity with mannose-specific Galanthus nivalis lectin. Normozoospermic infertile subjects presented decreased amounts of lectin-reactive glycoepitopes compared to fertile donors and infertile patients with abnormal semen parameters. Glycoproteins containing unveiled mannose were isolated in affinity chromatography, and 17 glycoproteins were identified in liquid chromatography-tandem mass spectrometry with electrospray ionization. The N-glycome of the isolated glycoproteins was examined in matrix-assisted laser desorption ionization mass spectrometry. Eleven out of 27 identified oligosaccharides expressed terminal mannose residues, responsible for lectin binding. We suggest that lowered content of high-mannose and hybrid type glycans in normozoospermic infertile patients may be associated with impaired sperm protection from preterm capacitation and should be considered in the search for new infertility markers. PMID:26147424

  6. Role of antioxidants in treatment of male infertility: an overview of the literature.

    PubMed

    Agarwal, Ashok; Nallella, Kiran P; Allamaneni, Shyam S R; Said, Tamer M

    2004-06-01

    Seminal oxidative stress in the male reproductive tract is known to result in peroxidative damage of the sperm plasma membrane and loss of its DNA integrity. Normally, a balance exists between concentrations of reactive oxygen species and antioxidant scavenging systems. One of the rational strategies to counteract the oxidative stress is to increase the scavenging capacity of seminal plasma. Numerous studies have evaluated the efficacy of antioxidants in male infertility. In this review, the results of different studies conducted have been analysed, and the evidence available to date is provided. It was found that although many clinical trials have demonstrated the beneficial effects of antioxidants in selected cases of male infertility, some studies failed to demonstrate the same benefit. The majority of the studies suffer from a lack of placebo-controlled, double-blind design, making it difficult to reach a definite conclusion. In addition, investigators have used different antioxidants in different combinations and dosages for varying durations. Pregnancy, the most relevant outcome parameter of fertility, was reported in only a few studies. Most studies failed to examine the effect of antioxidants on a specific group of infertile patients with high oxidative stress. Multicentre, double-blind studies with statistically accepted sample size are still needed to provide conclusive evidence on the benefit of antioxidants as a treatment modality for patients with male infertility. PMID:15169573

  7. Proteomics, oxidative stress and male infertility.

    PubMed

    Agarwal, Ashok; Durairajanayagam, Damayanthi; Halabi, Jacques; Peng, Jason; Vazquez-Levin, Monica

    2014-07-01

    Oxidative stress has been established as one of the main causes of male infertility and has been implicated in many diseases associated with infertile men. It results from high concentrations of free radicals and suppressed antioxidant potential, which may alter protein expression in seminal plasma and/or spermatozoa. In recent years, proteomic analyses have been performed to characterize the protein profiles of seminal ejaculate from men with different clinical conditions, such as high oxidative stress. The aim of the present review is to summarize current findings on proteomic studies performed in men with high oxidative stress compared with those with physiological concentrations of free radicals, to better understand the aetiology of oxidative stress-induced male infertility. Each of these studies has suggested candidate biomarkers of oxidative stress, among them are DJ-1, PIP, lactotransferrin and peroxiredoxin. Changes in protein concentrations in seminal plasma samples with oxidative stress conditions were related to stress responses and to regulatory pathways, while alterations in sperm proteins were mostly associated to metabolic responses (carbohydrate metabolism) and stress responses. Future studies should include assessment of post-translational modifications in the spermatozoa as well as in seminal plasma proteomes of men diagnosed with idiopathic infertility. Oxidative stress, which occurs due to a state of imbalance between free radicals and antioxidants, has been implicated in most cases of male infertility. Cells that are in a state of oxidative stress are more likely to have altered protein expression. The aim of this review is to better understand the causes of oxidative stress-induced male infertility. To achieve this, we assessed proteomic studies performed on the seminal plasma and spermatozoa of men with high levels of oxidative stress due to various clinical conditions and compared them with men who had physiological concentrations of free

  8. Dehydroepiandrosterone as an adjunct to gonadotropins in infertile Indian women with premature ovarian aging: A pilot study

    PubMed Central

    Malik, Nisha; Kriplani, Alka; Agarwal, Nutan; Bhatla, Neerja; Kachhawa, Garima; Yadav, Raj Kumar

    2015-01-01

    BACKGROUND: Dehydroepiandrosterone (DHEA) supplementation is a relatively recent development that augments ovarian responsiveness in patients with poor ovarian reserve and premature ovarian aging (POA). AIMS: To evaluate the efficacy of DHEA supplementation prior to gonadotropins for ovulation induction in women with POA. DESIGN: Prospective randomized controlled study. METHODS: Fifty infertile women with POA were randomized into two groups of 25 each. Group 1 received tablet DHEA 25 mg while group 2 received placebo thrice daily for 6 months. After 3 months, gonadotropin induction with intrauterine insemination was done. STATISTICAL ANALYSIS: Groups were compared using t-test and Mann–Whitney U-test as appropriate. Pre- and post-parameters were compared using t-test -paired and Wilcoxon signed-rank tests as appropriate. RESULTS: Of 50 patients, 62% (31/50) presented with primary and 38% (19/50) with secondary infertility. The mean age was 32.1 ± 4.7 years. Serum antimullerian hormone levels (1.5 ± 0.6–1.9 ± 0.4 ng/ml vs. 1.4 ± 0.5–1.5 ± 0.6 ng/ml) and antral follicle count (3.2 ± 1.0–9.3 ± 3.1 vs. 3.3 ± 1.1–3.4 ± 1.4) improved significantly in DHEA group after 3 months. Serum follicular stimulating hormone and estradiol levels though showed significant intra-group improvement (16.9 ± 5.5 mIU/ml to 14.7 ± 6.2 mIU/ml and 86.6 ± 57.5 pg/ml to 105.6 ± 54.3 pg/ml, respectively) with DHEA, the inter group difference was not significant. Ovulation increased from 48% to 86.3% in DHEA group versus 44–66% in placebo group. Six women (24%) conceived after DHEA in comparison to none in the placebo group. CONCLUSIONS: DHEA supplementation may have a beneficial role as an adjunct to gonadotropins in the treatment of infertility with POA, but further evidence is required. PMID:26538855

  9. Molecular and serologic diagnostic approaches; the prevalence of herpes simplex in idiopathic men infertile

    PubMed Central

    Amirjannati, Nasser; Yaghmaei, Farhad; Akhondi, Mohammad Mehdi; Nasiri, Mahboubeh; Heidari-Vala, Hamed; Sehhat, Zahra

    2014-01-01

    Background: Human pathogens that can cause infertility may also affect sperm count and quality. Viral infections can be considered as direct and/or indirect cause of male factor infertility. Objective: Our goal was to investigate the prevalence of herpes simplex virus in the semen of infertile men attending the Avicenna Infertility Clinic, and to compare it with the herpes virus serology results. Materials and Methods: This cross sectional study was conducted during 2009-2010. Infertile men participating without any clinical signs of infection with herpes simplex virus, and no obvious cause for their infertility were included. Semen and blood samples were used for Polymerase Chain Reaction (PCR) and serologic testing for these people. Two samples were collected: one ml semen sample to verify the existence of genital herpes simplex virus in infertile men, and blood samples of 217 individuals tested for antibodies to herpes simplex virus. Data were analyzed by SPSS 16. Results: According to the PCR results of semen samples the prevalence of herpes simplex in semen was 12% and serologic test showed 3.2% prevalence within blood. Nine to 10% of IgM negative were PCR positive and only 2-3% of IgM positive were PCR positive. Between herpes serologic studies with positive controls and negative controls by using both tests, there was a significant positive relationship (r=0.718 and p<0.001). The relationship between semen PCR test results and serological survey of herpes patients with a negative control in both Pearson and Spearman tests was positive and significant (r=0.229 and p=0.001). Correlation between the PCR results of semen samples with two positive control subjects and a positive IgM test was statistically confirmed (r=0.235 and p<0.001). Conclusion: We recommend that if there is suspicion to herpes simplex as a microorganism that theoretically could impact semen parameters and cause infertility it is prudent to use PCR technique on semen sample rather than ELISA

  10. Effect of second-line surgery on in vitro fertilization outcome in infertile women with ovarian endometrioma recurrence after primary conservative surgery for moderate to severe endometriosis

    PubMed Central

    Park, Hana; Kim, Eun-Young; Moon, Jei-Won; Kim, Sung-Hoon; Chae, Hee-Dong; Kang, Byung-Moon

    2015-01-01

    Objective To evaluate the effect of second-line conservative surgery on in vitro fertilization (IVF) outcome in comparison with IVF without second-line surgery in infertile women with ovarian endometrioma recurrence after primary conservative surgery. Methods In this retrospective cohort study, 121 consecutive IVF/intracytoplasmic sperm injection cycles that were performed after second-line surgery (n=53) or without second-line surgery (control group, n=68) between January 2006 and December 2011 in 121 infertile women with ovarian endometrioma(s) recurrence after primary conservative surgery for moderate to severe endometriosis were included. The two groups were compared in terms of controlled ovarian stimulation and IVF outcomes. Results There were no differences in patients' characteristics between the two groups. Total dose and days of gonadotropins administered were significantly higher in the second-line surgery group than in the control group (P<0.001, P=0.008). The numbers of oocytes retrieved, mature oocytes and grade 1 or 2 embryos were significantly lower in the second-line surgery group (P=0.007, P=0.001, P<0.001, respectively). Clinical pregnancy rate per cycle and embryo implantation rate were also significantly lower in the second-line surgery group of 24.5% and 11.8% compared with 48.5% and 25.3% in the control group (P=0.008, P=0.005, respectively). Conclusion Ovarian response to controlled ovarian stimulation and IVF outcome after second-line surgery is worse than those in IVF cycles without second-line surgery in infertile women with ovarian endometrioma recurrence after primary surgery for moderate or severe endometriosis. PMID:26623412

  11. Personal Overview of the Application of LLLT in Severely Infertile Japanese Females

    PubMed Central

    2012-01-01

    Background and Aims: The rapidly graying population in Japan is being compounded by the rapidly-dropping birth rate. The latter is mostly due to the later ages at which women are giving birth as the marriage age has also been increasing. Giving birth at a later stage is associated with problems for both mother and child, but for older would-be mothers the greatest problem is infertility, sometimes severe. The present article will show how the application of low level laser therapy (LLLT) is a potentially effective treatment for severe infertility. Subjects and Methods: Seventy-four females (average age 39.28 yr) with severe infertility in whom assisted reproductive technology (ART) had been unsuccessful (average of 9.13 yr) participated in the first part of a study from October 1996 — April 2000. LLLT was applied (830 nm, CW, GaAlAs 60 mW diode LLLT) in Ohshiro's proximal priority technique (average 21.08 sessions) with or without other ART approaches. Based on successful outcomes, the study was then extended to March 2012, amassing a final total of 701 patients. Results: Pregnancy was achieved in the first part of the trial in 16 patients (21.7% of 74) of whom 11 (68%) achieved successful live delivery. In the extended trial, pregnancy was achieved in 156 (22.3% of 701) with 79 live deliveries (50.1%). Conclusions: The use of 830 nm LLLT in the proximal priority technique at the parameters used in the present study, on its own or as an adjunct to other techniques, resulted in successful induction of pregnancy in just over 21% of severely infertile females, with a substantial number of these achieving live births. No adverse events were noted in any patient. LLLT is a pain-free and sideeffect free modality which could give hope to the increasing numbers of older females with infertility in Japan and potentially worldwide. Multinational studies are warranted. PMID:24610987

  12. Psychological profile of women with infertility: A comparative study

    PubMed Central

    Poddar, Shuvabrata; Sanyal, Nilanjana; Mukherjee, Urbi

    2014-01-01

    Background: An endeavour to probe into the psychological profile of infertile women in a comparative stance with the fertile women is not very common. This study is an attempt to explore the possible non-apparent personality factors which contribute to the unexplained pain of infertility. Methods: The main objectives of the present study were (a) to examine whether infertile women are different from fertile women in terms of selected psychological variables- narcissistic components, dimensions of attachment style and uses of defensive manoeuvres; and (b) whether the primary infertile women (n=18) are different from the secondary infertile women (n=12) with respect to those variables. A total of 60 individuals (30 infertile women and 30 matched fertile women) were assessed through Attachment Style Questionnaire (ASQ), Narcissistic Personality Inventory (NPI) and Defense Style Questionnaire (DSQ-40). General Health Questionnaire (GHQ) was administered on to the fertile women to rule out the psychiatric morbidity. Results: Findings revealed that infertile women group differed from fertile women group with respect to narcissism, dimensions of attachment style and uses of defense mechanism. The primary infertile group also showed marked difference from the secondary infertile group with respect to those variables. Conclusions: This study endeavours to enrich the knowledge regarding the personality dynamics of infertile women to design psychotherapeutic programme to aid their well-being, help them to cherish the flavour of parenthood and improve their quality of life. PMID:25788801

  13. Emoting infertility online: A qualitative analysis of men's forum posts.

    PubMed

    Hanna, Esmée; Gough, Brendan

    2016-07-01

    Relatively little research on infertility focuses exclusively or significantly on men's experiences, particularly in relation to emotional aspects. Evidence that does exist around male infertility suggests that it is a distressing experience for men, due to stigma, threats to masculinity and the perceived need to suppress emotions, and that men and women experience infertility differently. Using thematic analysis, this article examines the online emoting of men in relation to infertility via forum posts from a men-only infertility discussion board. It was noted that men 'talked' to each other about the emotional burdens of infertility, personal coping strategies and relationships with others. Three major themes were identified following in-depth analysis: 'the emotional rollercoaster', 'the tyranny of infertility' and 'infertility paranoia'. This article then offers insights into how men experience infertility emotionally, negotiate the emotional challenges involved (especially pertaining to diagnosis, treatment outcomes and their intimate relationships) and how they share (and find value in doing so) with other men the lived experience of infertility. PMID:27246813

  14. Association of FCRL3 Genetic Polymorphisms With Endometriosis-Related Infertility Risk: An Independent Study in Han Chinese.

    PubMed

    Zhang, Haiyan; Zhang, Zhen; Li, Guang; Wang, Surong; Zhang, Shiqian; Xie, Beibei

    2015-09-01

    The Fc receptor-like 3 (FCRL3) gene was reported to be linked to a variety of autoimmune diseases, including endometriosis-related infertility. However, this linkage has not been studied in Chinese population and there has been no meta-analysis on the interrelationship of FCRL3 gene and endometriosis-related infertility. The aim of the study was to investigate the association between FCRL3 genetic polymorphisms and the risk of endometriosis-related infertility in Han Chinese, and a further meta-analysis was conducted to confirm our results.Four single nucleotide polymorphisms (SNPs) (rs7528684 [FCRL3_3], rs11264799 [FCRL3_4], rs945635 [FCRL3_5], and rs3761959 [FCRL3_6]) on FCRL3 gene were genotyped in a case-control cohort composed of 217 patients suffering from endometriosis-related infertility and 220 healthy controls using cleaved amplification polymorphism sequence-tagged sites (polymerase chain reaction-restriction fragment length polymorphism, PCR-RFLP). Odds ratio (OR) and its 95% confidence interval (CI) was used to evaluate the association quantitatively. Furthermore, a meta-analysis of previous studies including the present study was implemented through Stata 11.0 (Stata Corporation, College Station, TX).We found an approximately 1.4-fold significantly increased frequency of the FCRL3_3 variant in women with endometriosis-related infertility over the controls (OR = 1.41 [95% CI = 1.08-1.84], P = 0.013). However, no significant difference was found between women with endometriosis-related infertility and controls for FCRL3_4, FCRL3_5, and FCRL3_6. Regardless of the symptoms and the revised classification of the American Society of Reproductive Medicine (rASRM) stage of endometriosis, there was a significant association between FCRL3_3 variant and an increased risk of endometriosis-related infertility. Meta-analysis of previous studies combined with the present study further confirmed the association between FCRL3_3 and the risk of endometriosis

  15. Treatment of Infertility in Men with Post-traumatic Stress Disorder (PTSD) with the Method of Intrauterine Insemination

    PubMed Central

    Elezaj, Shkelzen; Gashi, Zafer; Zeqiraj, Afrim; Grabanica, Driton; Shllaku, Anton; Gruda, Bujar; Musaj, Vesel

    2015-01-01

    Objective: Our objective was to determine the effect of PTSD on changing the quality of sperm in veterans with PTSD, and the percentage of successful procedures intrauterine insemination (IUI) as a first-line treatment of male infertility patients with post-traumatic stress disorder (PTSD). Patients and methods: The study is designed as a prospective observational study. The study was started from February 2013 until May of 2014. Our study included a total of 51 patients who were treatment for infertility in private Hospital for gynecology, endocrinology and infertility, IVF Center in Peja, and those who were outpatients treated for chronic PTSD in the Polyclinic, Biolab-Zafi, in Klina the Republic of Kosovo. All subjects divide into two groups; The first, consisting of 21 respondents to the participants of the war in Kosovo, which was established diagnosis of PTSD. The second group of 30 who have not lived in Kosovo for the time War, and without signs of PTSD. Results: Subjects with PTSD were somewhat older than the control group (p = 0.235) but it was not a significant difference (44.5 ± 5.6 vs 43.8 ± 2.3). When the question of type of infertility, secondary infertility is significantly higher in patients with PTSD (62% vs 20%). The total number of sperm and semen volume no significant differences between the two groups (p > 0.05). Sperm motility showed a significant reduction in cases of PTSD (p <0.0001), from observation semen parameters were found more abnormal forms of spermatozoa in the ejaculate cases with PSD (p < 0.0001) (Table 2). The percentage of pregnancies IUI procedure was slightly higher in patients with PTSD than the control group without PTSD (19% vs. 16.6%). Conclusion: A combination of analytical oriented psychotherapy techniques and assisted reproductive techniques (ART) such as IUI procedures, increases the chances for healing infertility in patients with PTSD. PMID:26622087

  16. Pregnancy Outcome after Office Microhysteroscopy in Women with Unexplained Infertility

    PubMed Central

    Seyam, Emaduldin Mostafa; Hassan, Momen Mohamed; Mohamed Sayed Gad, Mohamed Tawfeek; Mahmoud, Hazem Salah; Ibrahim, Mostafa Gamal

    2015-01-01

    Background Hysteroscopy offers diagnostic accuracy and the ability to treat uterine pathology. The current study aimed to review the findings and feasibility of the proposed office-based diagnostic and operative microhysteroscopy in previously diagnosed wom- en with unexplained infertility and to evaluate the post-microhysteroscopic pregnancy outcome in a-year follow-up period. Materials and Methods This prospective controlled study was conducted between 2006 and 2013. Two hundreds women with unexplained infertility were randomized into two groups: A. study group including 100 women recruited for office micohysteroscopic session and B. control group including 100 without the proposed microhysteroscopic intervention. A malleable fiberoptic 2-mm, 0 and 30 degrees angled hysteroscopy along with an operative channel for grasping forceps, scissors, or coaxial bipolar electrode were used for both diagnostic and operative indications. The findings, complications, and patient tolerance were recorded. A-year follow-up of pregnancy outcome for both groups was also performed. Results Seventy cases (70%) of patients had a normal uterine cavity. Twenty wom- en (20%) had endometrial polyps. Other pathology included submucous myomas in 3 cases (3%), intrauterine adhesions in 3 cases (3%), polypoid endometrium in 3 cases (3%), and bicornuate uterus in one case (1%). The pathological findings were treated in all patients without complication. Also a-year follow-up of the to- tal developing cumulative pregnancy rate (CPR) was evaluated in groups A and B (control). Group A revealed the total CPR of 28.5%, among which 25% in women without pathology, 40% in women with endometrial polyps, 23% in women with adhesions, 33% in women with polypoid endometrium, and 21% in those with bi- cornuate uterus. However, A-year follow-up of spontaneous pregnancy outcome in group B showed a total CPR of 15%. Conclusion Women tolerance, safety, and feasibility of simultaneous operative correc- tion

  17. [Treatment options for age-related infertility].

    PubMed

    Belaisch-Allart, Joëlle

    2010-06-20

    There has been a consistent trend towards delayed childbearing in most Western countries. Treatment options for age-related infertility includes controlled ovarian hyperstimulation with intrauterine insemination and in vitro fertilization (IVF). A sharp decline in pregnancy rate with advancing female age is noted with assisted reproductive technologies (ART) including IVF. Evaluation and treatment of infertility should not be delayed in women 35 years and older. No treatment other than oocyte donation has been shown to be effective for women over 40 and for those with compromised ovarian reserve, but its pratice is not easy in France hence the procreative tourism. As an increasing number of couples choose to postpone childbearing, they should be informed that maternal age is an important risk factor for failure to conceive. PMID:20623902

  18. Isolated adrenocorticotropin deficiency presenting as primary infertility.

    PubMed

    Atkin, S L; Masson, E A; White, M C

    1995-06-01

    A 31 year old female presented with primary infertility and gave a two year history of amenorrhea without symptoms or signs of endocrine dysfunction. Examination was normal and investigation showed low oestradiol and progesterone levels with decreased LH pulsatility. The cortisol responses were impaired following hypoglycaemic stress and a short synacthen test, but the cortisol response to a prolonged synacthen test was normal. An inadequate ACTH response to CRF testing confirmed the diagnosis of isolated ACTH deficiency. Hydrocortisone therapy was followed by an ovulatory menstrual cycle. Amenorrhea again ensued following the reduction of the steroid dose and normal menses resumed on normal steroid replacement therapy. Six hourly gonadotrophin pulsatility showed a significant increase in both pulse amplitude and mean LH and FSH levels following steroid treatment. Isolated ACTH deficiency is a rare but treatable cause of hypogonadism and infertility, and this case gives further insight on the role of cortisol on the hypothalamo-pituitary gonadal axis.

  19. Comparison of Sun Protection Behaviors among Physicians and Patients.

    ERIC Educational Resources Information Center

    Sciamanna, Christopher N.; Zampi, Amy; Weinstock, Martin A.

    2002-01-01

    Compared the sun protection behaviors (SPBs) of physicians and patients from a Rhode Island teaching hospital. Survey data indicated that physicians and patients did not differ in their overall use of SPBs, though they differed in their regular use of specific SPBs (physicians were more likely to use sunscreen, while patients were more likely to…

  20. Prerequisite Testing for Infertility Treatment

    MedlinePlus

    ... partner first. If he or she is positive, test the other. ‹ Go back to Patient's Guide Index | Go to Next Topic › ©1996 - 2016 SART, Society for Assisted Reproductive Technology . All Rights Reserved. ASRM/SART Nondiscrimination Policy ASRM/ ...

  1. Infertility in male aquatic invertebrates: a review.

    PubMed

    Lewis, Ceri; Ford, Alex T

    2012-09-15

    As a result of endocrine disruptor studies, there are numerous examples of male related reproductive abnormalities observed in vertebrates. Contrastingly, within the invertebrates there have been considerably less examples both from laboratory and field investigations. This has in part been due to a focus of female related endpoints, inadequate biomarkers and the low number of studies. Whether contaminant induced male infertility is an issue within aquatic invertebrates and their wider communities therefore remains largely unknown and represents a key knowledge gap in our understanding of pollutant impacts in aquatic wildlife. This paper reviews the current knowledge regarding pollutants impacting male infertility across several aquatic invertebrate phyla; which biomarkers are currently being used and where the science needs to be expanded. The limited studies conducted so far have revealed reductions in sperm numbers, examples of poor fertilisation success, DNA damage to spermatozoa and inhibition of sperm motility that can be induced by a range of environmental contaminants. This limited data is mainly comprised from laboratory studies with only a few studies of sperm toxicity in natural populations. Clearly, there is a need for further studies in this area, to include both laboratory and field studies from clean and reference sites, with a focus on broadcast spawners and those with direct fertilisation. Biomarkers developed for measuring sperm quantity and quality in vertebrates are easily transferable to invertebrates but require optimisation for particular species. We discuss how sperm tracking and techniques for measuring DNA strand breaks and sperm viability have been successfully transferred from human infertility clinics to aquatic invertebrate ecotoxicology. Linking sperm toxicity and male infertility effects to higher level impacts on the reproductive biology and dynamics of populations requires a much greater understanding of fertilisation dynamics and

  2. [Stress and distress in infertility among women].

    PubMed

    Damti, Osnat Bloch; Sarid, Orly; Sheiner, Eyal; Zilberstein, Tali; Cwikel, Julie

    2008-03-01

    In the industrialized world, approximately 12% of couples suffer from infertility. As a result of its collective political and historical experience, Israel boasts one of the world's most progressive fertility policies ranging from hormonal treatment to In Vitro Fertilization (IVF). Approximately 40% of the causes of infertility are attributed to the woman. Among the factors contributing to reduced fertility are endocrine factors, immune factors and mechanical factors. Studies have accumulated information regarding the contribution of psychological factors to infertility in women. Among the identified risk factors are depression, anxiety and stress-dependent changes like altered heart rate and increased blood cortisol levels. The hypothalamic-pituitary-adrenal axis (HPA) has been shown to be an important mediator of infertility, involved in the excretion of CRH, ACTH and cortisol, respectively. Data gathered in the literature suggests the involvement of the HPA axis on the hypothalamic-pituitary-gonadotropic axis (HPG). Specifically, changes in diurnal excretion patterns of cortisol have been shown to accompany mental stress and to mediate the down-regulation of the HPG axis. This impact could possibly involve inhibitory mechanisms at the pituitary level, by reducing the release of FSH and LH by GnRH. Furthermore, research has shown that the effect of cortisol on the HPG axis is dependent on the endocrine status of the ovary in its different stages within the menstrual cycle. From the studies presented in this review it can be hypothesized that stress can induce altered cortisol-excretion patterns along the menstrual cycle, which ultimately affect the hormonal profile in critical stages of the fertilization process.

  3. Anabolic steroids abuse and male infertility.

    PubMed

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

    2016-01-01

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

  4. Anabolic steroids abuse and male infertility.

    PubMed

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

    2016-01-01

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

  5. Human infertility: are endocrine disruptors to blame?

    PubMed Central

    Marques-Pinto, André; Carvalho, Davide

    2013-01-01

    Over recent decades, epidemiological studies have been reporting worrisome trends in the incidence of human infertility rates. Extensive detection of industrial chemicals in human serum, seminal plasma and follicular fluid has led the scientific community to hypothesise that these compounds may disrupt hormonal homoeostasis, leading to a vast array of physiological impairments. Numerous synthetic and natural substances have endocrine-disruptive effects, acting through several mechanisms. The main route of exposure to these chemicals is the ingestion of contaminated food and water. They may disturb intrauterine development, resulting in irreversible effects and may also induce transgenerational effects. This review aims to summarise the major scientific developments on the topic of human infertility associated with exposure to endocrine disruptors (EDs), integrating epidemiological and experimental evidence. Current data suggest that environmental levels of EDs may affect the development and functioning of the reproductive system in both sexes, particularly in foetuses, causing developmental and reproductive disorders, including infertility. EDs may be blamed for the rising incidence of human reproductive disorders. This constitutes a serious public health issue that should not be overlooked. The exposure of pregnant women and infants to EDs is of great concern. Therefore, precautionary avoidance of exposure to EDs is a prudent attitude in order to protect humans and wildlife from permanent harmful effects on fertility. PMID:23985363

  6. Association between DNMT3L polymorphic variants and the risk of endometriosis-associated infertility.

    PubMed

    Mostowska, Adrianna; Szczepańska, Malgorzata; Wirstlein, Przemyslaw; Skrzypczak, Jana; Jagodziński, Paweł P

    2016-01-01

    Endometriosis is considered to be an epigenetic disease. It has previously been reported that the DNA methyltransferase 3-like (DNMT3L) rs8129776 single nucleotide polymorphism (SNP) contributes to endometrioma. In the present study, high‑resolution melting curve analysis was used to investigate the risks associated with the DNMT3L c.910‑635A/G (rs8129776), c.832C/T (rs7354779), c.812C/T (rs113593938) and c.344+62C/T (rs2276248) SNPs on stage I‑II endometriosis‑associated infertility. Included in the present study were patients presenting with stage I‑II endometriosis‑associated infertility (n=154) and a control cohort of healthy patients with confirmed fertility (n=383). No significant association between the above‑listed DNMT3L SNPs and the development of endometriosis‑associated infertility was identified. The lowest P‑values generated from trend analysis were observed in the DNMT3L c.832C/T (rs7354779) SNP (Ptrend=0.114). Furthermore, haplotype analyses of the DNMT3L SNPs failed to reveal any risk association between the development of endometriosis‑associated infertility and the above‑listed polymorphisms, even when the SNPs were present in combinations. Finally, a meta‑analysis was performed to examine the association between the DNMT3L rs8129776 SNP and the development of endometrioma, from which no association between the two was identified. On the basis of these results, the present study has demonstrated that variations in the DNMT3L gene do not contribute to stage I-II endometriosis-associated infertility.

  7. Prevalence of Psychiatric Morbidity in Females amongst Infertile Couples- A Hospital Based Report

    PubMed Central

    Sethi, Pragati; Goyal, Lajya Devi; Kaur, Gurmeet

    2016-01-01

    Introduction Infertility leads to significant stress among couple and the reaction to infertility differs among males and females. Aim To know the prevalence of psychiatric morbidity in infertile couples and compare the prevalence of various psychiatric disorders among husband and wife. Materials and Methods A cross-sectional study was conducted on 50 couples diagnosed with infertility from outdoor clinics. Both male and female partner of couple were interviewed for detailed history and clinical examination was done. General Health Questionnaire (GHQ-12) was applied to detect any psychological strain in couples and in those with illness, final diagnosis were made on the basis of DSM -IV (TR). The data thus generated was subjected to appropriate Statistical Analysis. Results Out of the 50 couples, 54% of females had psychiatric morbidity. The most common diagnosis amongst the female participants was MDD (Major Depressive Disorder) (18%), whereas the second most common diagnosis was GAD (Generalized Anxiety Disorder) (16%). Psychiatric morbidity was found in only 26% of males suffering with Adjustment Disorder being most common diagnosis (8%) and Dysthymia and MDD as the second most common diagnosis (6% each). Majority of patients having psychiatric morbidity were from age group 20-29 years. The difference between females and male counterparts was statistically significant. Conclusion Psychiatric morbidity was higher among female partners than male partners. The difference was statistically significant and the situation needs further workup. PMID:27630933

  8. Combined effects of urinary phytoestrogens metabolites and polymorphisms in metabolic enzyme gene on idiopathic male infertility.

    PubMed

    Qin, Yufeng; Du, Guizhen; Chen, Minjian; Hu, Weiyue; Lu, Chuncheng; Wu, Wei; Hang, Bo; Zhou, Zuomin; Wang, Xinru; Xia, Yankai

    2014-08-01

    Phytoestrogens are plant-derived compounds that may interact with estrogen receptors and mimic estrogenic effects. It remains unclear whether the individual variability in metabolizing phytoestrogens contributes to phytoestrogens-induced beneficial or detrimental effects. Our aim was to determine whether there is any interaction between metabolic rates (MR) of phytoestrogens and genetic polymorphisms in related xenobiotic metabolizing enzyme genes. MR was used to assess phytoestrogen exposure and individual metabolic ability. The amount of phytoestrogens in urine was measured by ultra-high performance liquid chromatography-tandem mass spectrometry in 600 idiopathic infertile male patients and 401 controls. Polymorphisms were genotyped using the SNPstream platform combined with the Taqman method. Prototypes and metabolites of secoisolariciresinol (SEC) have inverse effects on male reproduction. It was found that low MR of SEC increased the risk of male infertility (OR 2.49, 95 % CI 1.78, 3.48, P trend = 8.00 × 10(-8)). Novel interactions were also observed between the MR of SEC and rs1042389 in CYP2B6, rs1048943 in CYP1A1, and rs1799931 in NAT2 on male infertility (P inter = 1.06 × 10(-4), 1.14 × 10(-3), 3.55 × 10(-3), respectively). By analyzing the relationships between urinary phytoestrogen concentrations, their metabolites and male infertility, we found that individual variability in metabolizing SEC contributed to the interpersonal differences in SEC's effects on male reproduction.

  9. Prevalence of Psychiatric Morbidity in Females amongst Infertile Couples- A Hospital Based Report

    PubMed Central

    Sethi, Pragati; Goyal, Lajya Devi; Kaur, Gurmeet

    2016-01-01

    Introduction Infertility leads to significant stress among couple and the reaction to infertility differs among males and females. Aim To know the prevalence of psychiatric morbidity in infertile couples and compare the prevalence of various psychiatric disorders among husband and wife. Materials and Methods A cross-sectional study was conducted on 50 couples diagnosed with infertility from outdoor clinics. Both male and female partner of couple were interviewed for detailed history and clinical examination was done. General Health Questionnaire (GHQ-12) was applied to detect any psychological strain in couples and in those with illness, final diagnosis were made on the basis of DSM -IV (TR). The data thus generated was subjected to appropriate Statistical Analysis. Results Out of the 50 couples, 54% of females had psychiatric morbidity. The most common diagnosis amongst the female participants was MDD (Major Depressive Disorder) (18%), whereas the second most common diagnosis was GAD (Generalized Anxiety Disorder) (16%). Psychiatric morbidity was found in only 26% of males suffering with Adjustment Disorder being most common diagnosis (8%) and Dysthymia and MDD as the second most common diagnosis (6% each). Majority of patients having psychiatric morbidity were from age group 20-29 years. The difference between females and male counterparts was statistically significant. Conclusion Psychiatric morbidity was higher among female partners than male partners. The difference was statistically significant and the situation needs further workup.

  10. Correlation between chromosomal polymorphisms and male infertility in a Northeast Chinese population.

    PubMed

    Li, L L; Peng, D; Wang, R X; Zhu, H B; Wang, W J; Liu, R Z

    2015-12-01

    The aim of this study was to evaluate the correlation between chromosomal polymorphisms and male infertility. The patients were diagnosed with azoospermia or oligospermiaby a semen analysis. Chromosomal analysis was performed on peripheral blood lymphocytes obtained from the patients, with standard G-banding and C-banding. Y chromosome microdeletions were detected by multiplex polymerase chain reaction (PCR) amplification. The parents of 35 polymorphic probands were also subjected to chromosomal analysis, and their detailed reproductive histories were surveyed. The frequency of autosomal polymorphisms did not differ significantly among the infertile patients and fertile control individuals. The frequency of the Yqh-variant increased with the decrease in sperm count; this appeared at a significantly higher frequency in the azoospermia group (57.2 vs 24.3 vs 0%). The results of PCR amplification indicated that 32.14% of the patients with Yqh ± had microdeletions in the Y chromosome. The parents of the probands with the same chromosomal polymorphisms as the probands (among the 35 recalled families) did not show any adverse reproductive history. We observed no significant correlations between autosomal polymorphisms and male infertility. However, we observed a significant increase in the frequency of Yqh- in the azoospermic patients. This may be attributed to Y chromosome microdeletions, although the association between Y chromosome microdeletions and Y chromosome variants remains to be elucidated.

  11. Comparison of preoperative anxiety in reconstructive and cosmetic surgery patients.

    PubMed

    Sönmez, Ahmet; Bişkin, Nurdan; Bayramiçli, Mehmet; Numanoğlu, Ayhan

    2005-02-01

    Surgery is a serious stressor and a cause of anxiety for the patients. Reconstructive surgery patients are mostly operated on because of certain functional impairment or disability; on the contrary, cosmetic surgery patients do not have any physical impairment and they are operated on because of mostly psychologic reasons. The aim of this study was to compare the anxiety levels in the reconstructive surgery patients and cosmetic surgery patients preoperatively. Thirty-two patients in the reconstructive surgery group and 30 patients in the cosmetic surgery group were included in the study. State Trait Anxiety Inventory was used to measure the anxiety levels in these 2 groups preoperatively. The 2 groups were similar in characteristics such as age, gender distribution, number of previous operations, and trait anxiety scores. Mean state anxiety scores obtained for the reconstructive surgery group was 38.0 +/- 8.7, while it was 44.2 +/- 10.79 for the cosmetic surgery group (t test, degrees of freedom = 60, P = 0.015). This study reveals that preoperative anxiety levels in the cosmetic surgery patients are higher than those of the reconstructive surgery patients. Therefore, adequate preoperative preparation for cosmetic surgery should include attempts to cope with anxiety. Anxiolytics may be used more liberally and professional psychologic assistance may be required.

  12. Comparison of packages for suppositories by patients with rheumatoid arthritis.

    PubMed

    Verheggen-Laming, B N; Phiferons, H; Mulder, E F; van der Meij, N T; van Harten, R P; Dijkmans, B A

    1988-01-01

    Ninety-four patients with rheumatoid arthritis were asked via a questionnaire about the convenience of packages containing tablets, capsules, or suppositories for home use. Almost half of the patients stated that they had difficulty in opening packages containing capsules or tablets, and two-thirds had difficulty with the packages used for suppositories. The characteristics of six packages used for suppositories were also compared. Patients were given the packages in random order and were asked to open them and remove a suppository. Many of them were unable to open three of the packages with their hands. The evaluation of the six packages by the patients differed widely.

  13. Male infertility: lifestyle factors and holistic, complementary, and alternative therapies

    PubMed Central

    Yao, David F; Mills, Jesse N

    2016-01-01

    While we may be comfortable with an allopathic approach to male infertility, we are also responsible for knowledge about lifestyle modifications and holistic, complementary, and alternative therapies that are used by many of our patients. This paper provides an evidence-based review separating fact from fiction for several of these therapies. There is sufficient literature to support weight reduction by diet and exercise, smoking cessation, and alcohol moderation. Supplements that have demonstrated positive effects on male fertility on small randomized controlled trial (RCT) include aescin, coenzyme Q10, glutathione, Korean red ginseng, L-carnitine, nigella sativa, omega-3, selenium, a combination of zinc and folate, and the Menevit antioxidant. There is no support for the use of Vitamin C, Vitamin E, or saffron. The data for Chinese herbal medications, acupuncture, mind-body practice, scrotal cooling, and faith-based healing are sparse or inconclusive. PMID:26952957

  14. Infertility, obstetric and gynaecological problems in coeliac sprue.

    PubMed

    Sher, K S; Jayanthi, V; Probert, C S; Stewart, C R; Mayberry, J F

    1994-01-01

    There is now substantial evidence that coeliac sprue is associated with infertility both in men and women. In women it can also lead to delayed menarche, amenorrhoea, early menopause, recurrent abortions, and a reduced pregnancy rate. In men it can cause hypogonadism, immature secondary sex characteristics and reduce semen quality. The real mechanism by which coeliac sprue produces these changes is unclear, but factors such as malnutrition, iron, folate and zinc deficiencies have all been implicated. In addition in men gonadal dysfunction is believed to be due to reduced conversion of testosterone to dihydrotestosterone caused by low levels of 5 alpha-reductase in coeliac sprue. This leads to derangement of the hypothalamic-pituitary axis. Hyperprolactinaemia is seen in 25% of coeliac patients, which causes impotence and loss of libido. Gluten withdrawal and correction of deficient dietary elements can lead to a return of fertility both in men and women.

  15. Outdoor air pollution and human infertility: a systematic review.

    PubMed

    Checa Vizcaíno, Miguel A; González-Comadran, Mireia; Jacquemin, Benedicte

    2016-09-15

    Air pollution is a current research priority because of its adverse effects on human health, including on fertility. However, the mechanisms through which air pollution impairs fertility remain unclear. In this article, we perform a systematic review to evaluate currently available evidence on the impact of air pollution on fertility in humans. Several studies have assessed the impact of air pollutants on the general population, and have found reduced fertility rates and increased risk of miscarriage. In subfertile patients, women exposed to higher concentrations of air pollutants while undergoing IVF showed lower live birth rates and higher rates of miscarriage. After exposure to similar levels of air pollutants, comparable results have been found regardless of the mode of conception (IVF versus spontaneous conception), suggesting that infertile women are not more susceptible to the effects of pollutants than the general population. In addition, previous studies have not observed impaired embryo quality after exposure to air pollution, although evidence for this question is sparse.

  16. Male infertility: lifestyle factors and holistic, complementary, and alternative therapies.

    PubMed

    Yao, David F; Mills, Jesse N

    2016-01-01

    While we may be comfortable with an allopathic approach to male infertility, we are also responsible for knowledge about lifestyle modifications and holistic, complementary, and alternative therapies that are used by many of our patients. This paper provides an evidence-based review separating fact from fiction for several of these therapies. There is sufficient literature to support weight reduction by diet and exercise, smoking cessation, and alcohol moderation. Supplements that have demonstrated positive effects on male fertility on small randomized controlled trial (RCT) include aescin, coenzyme Q 10 , glutathione, Korean red ginseng, L-carnitine, nigella sativa, omega-3, selenium, a combination of zinc and folate, and the Menevit antioxidant. There is no support for the use of Vitamin C, Vitamin E, or saffron. The data for Chinese herbal medications, acupuncture, mind-body practice, scrotal cooling, and faith-based healing are sparse or inconclusive. PMID:26952957

  17. Dioxins in the semen of men with infertility.

    PubMed

    Galimova, E F; Amirova, Z K; Galimov, Sh N

    2015-10-01

    The purpose of the present study was to assess ejaculate contamination by polychlorinated dibenzo-p-dioxins/furans in male infertility. The database of 168 infertile and 49 fertile men was included in the study. Dioxin content was determined using gas chromatography/high-resolution mass spectrometry (GC/HRMS). In the ejaculate of infertile men, the content of dioxins and furans was 2.2-2.3 times higher than in fertile donors. The maximum level of the most toxic dioxin congener was detected in pathospermia. Contamination of semen of infertile men by polychlorinated dibenzo-p-dioxins/furans supports the hypothesis about the relationship between environmental factors and reproductive health.

  18. Current medical management of endocrine-related male infertility

    PubMed Central

    Ring, Joshua D; Lwin, Aye A; Köhler, Tobias S

    2016-01-01

    Male factor contributes to 50%–60% of overall infertility but is solely responsible in only 20% of couples. Although most male factor infertility is ascertained from an abnormal semen analysis, other male factors can be contributory especially if the sample returns normal. Male infertility can be due to identifiable hormonal or anatomical etiologies that may be reversible or irreversible. This manuscript will highlight existing guidelines and our recommendations for hormone evaluation for male infertility and empiric therapies including multivitamins, estrogen receptor modulators (clomiphene), estrogen conversion blockers (anastrozole), and hormone replacement. PMID:27098657

  19. Assessing infertility-related stress: the factor structure of the Fertility Problem Inventory in Italian couples undergoing infertility treatment.

    PubMed

    Donarelli, Zaira; Gullo, Salvatore; Lo Coco, Gianluca; Marino, Angelo; Scaglione, Piero; Volpes, Aldo; Allegra, Adolfo

    2015-01-01

    The factor structure of the Fertility Problem Inventory (FPI) and its invariance across gender were examined in Italian couples undergoing infertility treatment. About 1000 subjects (both partners of 500 couples) completed two questionnaires prior to commencing infertility treatment at a private Clinic in Palermo, Italy. Confirmatory Factor Analysis demonstrated that the original factor structure of the FPI was partially confirmed. Two correlated factors (Infertility Life Domains and Importance of Parenthood) were obtained via a post hoc Exploratory Factor Analysis. Finally, the invariance of this factor structure across gender was confirmed. The study supported the relevance of two interrelated factors specific to infertility stress which could help clinicians to focus on the core infertility-related stress domains of infertile couples.

  20. Assessing infertility-related stress: the factor structure of the Fertility Problem Inventory in Italian couples undergoing infertility treatment.

    PubMed

    Donarelli, Zaira; Gullo, Salvatore; Lo Coco, Gianluca; Marino, Angelo; Scaglione, Piero; Volpes, Aldo; Allegra, Adolfo

    2015-01-01

    The factor structure of the Fertility Problem Inventory (FPI) and its invariance across gender were examined in Italian couples undergoing infertility treatment. About 1000 subjects (both partners of 500 couples) completed two questionnaires prior to commencing infertility treatment at a private Clinic in Palermo, Italy. Confirmatory Factor Analysis demonstrated that the original factor structure of the FPI was partially confirmed. Two correlated factors (Infertility Life Domains and Importance of Parenthood) were obtained via a post hoc Exploratory Factor Analysis. Finally, the invariance of this factor structure across gender was confirmed. The study supported the relevance of two interrelated factors specific to infertility stress which could help clinicians to focus on the core infertility-related stress domains of infertile couples. PMID:25853286

  1. Cardiovascular disease risk profiles comparison among dialysis patients.

    PubMed

    Sharabas, Islam; Siddiqi, Nauman

    2016-01-01

    This study was performed to assess the cardiovascular disease (CVD) risk factors in the prevalent peritoneal dialysis (PD) and hemodialysis (HD) patients and their association with cardiovascular events (CVEs) in a Saudi end-stage renal disease cohort. This was a prospective, observational, single-center study. A total of 192 patients were screened of which 157 patients were eligible (HD = 121, PD = 36). All patients underwent assessment of cardiovascular risk factors at the time of enrollment including electrocardiogram and echocardiography, lipid profile, homocysteine, and insulin levels. Patients were followed for one year and CVE [acute myocardial infarction, cerebrovascular accident (CVA), and congestive heart failure] and mortality were recorded. SPSS ® Version 16 was used for the analysis. T-test and ANOVA were used for continuous data; categorical data were analyzed using Chi-square and Mann-Whitney tests. The primary end-point of CVE and all-cause mortality was compared in the two groups using Kaplan-Meier survival analysis. HD patients were older and had been longer on dialysis. While PD patients had higher urine output and better Kt/V values, they were more edematous and using more antihypertensive medications. PD patients also had a lower ejection fraction (EF). Age >57 years and the use of more than one antihypertensive medication were associated with higher risk of CVE, while EF >53 was found to be protective. Age >57 years and EF <53 at enrollment were predictive of all-cause mortality. Saudi patients undergoing PD have worse CVD risk profiles compared to HD patients. Age less than 57 years and an EF >53 were cardioprotective.

  2. Cardiovascular disease risk profiles comparison among dialysis patients.

    PubMed

    Sharabas, Islam; Siddiqi, Nauman

    2016-01-01

    This study was performed to assess the cardiovascular disease (CVD) risk factors in the prevalent peritoneal dialysis (PD) and hemodialysis (HD) patients and their association with cardiovascular events (CVEs) in a Saudi end-stage renal disease cohort. This was a prospective, observational, single-center study. A total of 192 patients were screened of which 157 patients were eligible (HD = 121, PD = 36). All patients underwent assessment of cardiovascular risk factors at the time of enrollment including electrocardiogram and echocardiography, lipid profile, homocysteine, and insulin levels. Patients were followed for one year and CVE [acute myocardial infarction, cerebrovascular accident (CVA), and congestive heart failure] and mortality were recorded. SPSS ® Version 16 was used for the analysis. T-test and ANOVA were used for continuous data; categorical data were analyzed using Chi-square and Mann-Whitney tests. The primary end-point of CVE and all-cause mortality was compared in the two groups using Kaplan-Meier survival analysis. HD patients were older and had been longer on dialysis. While PD patients had higher urine output and better Kt/V values, they were more edematous and using more antihypertensive medications. PD patients also had a lower ejection fraction (EF). Age >57 years and the use of more than one antihypertensive medication were associated with higher risk of CVE, while EF >53 was found to be protective. Age >57 years and EF <53 at enrollment were predictive of all-cause mortality. Saudi patients undergoing PD have worse CVD risk profiles compared to HD patients. Age less than 57 years and an EF >53 were cardioprotective. PMID:27424685

  3. Quantitative Analysis of the Shape of the Corpus Callosum in Patients with Autism and Comparison Individuals

    ERIC Educational Resources Information Center

    Casanova, Manuel F.; El-Baz, Ayman; Elnakib, Ahmed; Switala, Andrew E.; Williams, Emily L.; Williams, Diane L.; Minshew, Nancy J.; Conturo, Thomas E.

    2011-01-01

    Multiple studies suggest that the corpus callosum in patients with autism is reduced in size. This study attempts to elucidate the nature of this morphometric abnormality by analyzing the shape of this structure in 17 high-functioning patients with autism and an equal number of comparison participants matched for age, sex, IQ, and handedness. The…

  4. Lifestyle of Hemodialysis Patients in Comparison with Outpatients

    PubMed Central

    Moghadasian, Sima; Sahebi Hagh, Mohammad Hasan; Aghaallah Hokmabadi, Leila

    2012-01-01

    Introduction: Nowadays, the chronic diseases are known to be associated with lifestyle risk factors. Hemodialysis patients encounter considerable amount of physical, mental and social pressure. Lifestyle is important because it affects quality of life and has important role in prevention. This study aimed to compare the lifestyle of hemodialysis patients and outpatients in health clinics of Tabriz. Methods: This was a case-control study on 155 hemodialysis patients and 155 outpatients referring to five dialysis centers and clinics, who met the inclusion criteria. Demographic data and some questions about lifestyle in nutrition, stress, physical activity and smoking were asked. Results: The history of hypertension among hemodialysis patients was 34.6% greater than outpatients. High daily salt consumption (more than two tablespoons a day) was 40.5% higher among hemodialysis patients than outpatients. In terms of saturated oil intake, it was 30.8%higher among hemodialysis patients. Problem in communicating with family members was 69.8% higher in hemodialysis patients. In terms of physical activity, 46.4% of outpatients had higher physical activity like walking. Conclusion: Lifestyle in different dimensions was associated with chronic kidney disease (CKD); therefore, the officials of health system are recommended to develop a program to combat chronic diseases and integrate it with providing the first-level health services. It seems that public education can have a major role in life-style modification and in chronic kidney diseases prevention. PMID:25276683

  5. Implementation of hysteroscopy in an infertility clinic: The one-stop uterine diagnosis and treatment.

    PubMed

    Campo, R; Meier, R; Dhont, N; Mestdagh, G; Ombelet, W

    2014-01-01

    Magnetic Resonant Imaging (MRI) has demonstrated that we can differentiate the uterus in 3 important functional areas. Exploration of the uterus in the infertile patient should implement the evaluation of the endometrium, the Junctional zone myometrium (JZ), the outer myometrium and the cervical canal. Especially the JZ myometrium should receive our close attention in the exploration and treatment of the infertile patient. MRI cannot be implemented as a screening examination but also limiting the imaging of the womb to a 2 or 3 D ultrasound exam only does not meet the scientific requirements of sensitivity and specificity. Modern ambulatory uterine diagnosis in a one-stop approach includes transvaginal ultrasound, fluid mini Hysteroscopy, contrast sonography and endomyometrial tissue sampling. Transvaginal Ultrasound being the gold standard for global uterine screening has a cardinal importance for diagnosis of myometrial disorders and uterine congenital malformations whereas hysteroscopy remains the gold standard for the evaluation of the endometrium and cervical canal. The major challenge remains to perform a tissue sampling of the endo-myometrium in an ambulatory, patient friendly and reliable way for which the newly designed Trophy hysteroscope provide a satisfactory answer. This one-stop approach opens a total new and advanced dimension to the screening, diagnosis and treatment of uterine pathology in the infertile patient. PMID:25593699

  6. Comparison of patients with orofacial pain of different diagnostic categories.

    PubMed

    Karibe, Hiroyuki; Goddard, Greg; McNeill, Charles; Shih, Sandy Thai

    2011-04-01

    The authors compared the pain intensity and difficulty experienced in performing activities of daily living (ADL) among 237 patients with orofacial pain. The patients underwent comprehensive examinations and recorded their subjective symptoms on a form (five items for pain intensity and six for ADL-related difficulty). On the basis of the primary diagnosis, the patients were divided into the temporomandibular joint dysfunction (TMJ), myofascial pain (MP), neuropathic pain (NP), and fibromyalgia (FM) groups. The intensity of pain in the jaw/face, tightness in the jaw/face, pain in the neck, and toothache significantly differed among the groups (p < 0.01, Kruskal-Wallis test). Compared to other patients, the FM and NP groups reported greater pain intensity, whereas those in the TMJ group reported lesser pain intensity. The ADL-related difficulty was not significantly different among the groups. Thus, compared to pain due to joint-related disorders, myalgic and neuropathic pain seem to be of higher intensity.

  7. Psychological and social aspects of infertility in men: an overview of the evidence and implications for psychologically informed clinical care and future research.

    PubMed

    Fisher, Jane R W; Hammarberg, Karin

    2012-01-01

    Research concerning the psychosocial aspects of infertility and infertility treatment focuses more often on women than men. The aim of this review was to synthesize the English-language evidence related to the psychological and social aspects of infertility in men and discuss the implications of these reports for clinical care and future research. A structured search identified 73 studies that reported data concerning the desire for fatherhood and the psychological and social aspects of diagnosis, assisted reproductive technology (ART) treatment and unsuccessful treatment among men with fertility difficulties. The studies are diverse in conceptualisation, design, setting and data collection, but the findings were reasonably consistent. These studies indicated that fertile and infertile childless men of reproductive age have desires to experience parenthood that are similar to those of their female counterparts; in addition, diagnosis and initiation of treatment are associated with elevated infertility-specific anxiety, and unsuccessful treatment can lead to a state of lasting sadness. However, rates of clinically significant mental health problems among this patient population are no higher than in the general population. Infertile men who are socially isolated, have an avoidant coping style and appraise stressful events as overwhelming, are more vulnerable to severe anxiety than men without these characteristics. Men prefer oral to written treatment information and prefer to receive emotional support from infertility clinicians rather than from mental health professionals, self-help support groups or friends. Nevertheless, structured, facilitated psycho-educational groups that are didactic but permit informal sharing of experiences might be beneficial. There are gaps in knowledge about factors governing seeking, persisting with and deciding to cease treatment; experiences of invasive procedures; parenting after assisted conception; adoption and infertility

  8. Psychological and social aspects of infertility in men: an overview of the evidence and implications for psychologically informed clinical care and future research

    PubMed Central

    Fisher, Jane RW; Hammarberg, Karin

    2012-01-01

    Research concerning the psychosocial aspects of infertility and infertility treatment focuses more often on women than men. The aim of this review was to synthesize the English-language evidence related to the psychological and social aspects of infertility in men and discuss the implications of these reports for clinical care and future research. A structured search identified 73 studies that reported data concerning the desire for fatherhood and the psychological and social aspects of diagnosis, assisted reproductive technology (ART) treatment and unsuccessful treatment among men with fertility difficulties. The studies are diverse in conceptualisation, design, setting and data collection, but the findings were reasonably consistent. These studies indicated that fertile and infertile childless men of reproductive age have desires to experience parenthood that are similar to those of their female counterparts; in addition, diagnosis and initiation of treatment are associated with elevated infertility-specific anxiety, and unsuccessful treatment can lead to a state of lasting sadness. However, rates of clinically significant mental health problems among this patient population are no higher than in the general population. Infertile men who are socially isolated, have an avoidant coping style and appraise stressful events as overwhelming, are more vulnerable to severe anxiety than men without these characteristics. Men prefer oral to written treatment information and prefer to receive emotional support from infertility clinicians rather than from mental health professionals, self-help support groups or friends. Nevertheless, structured, facilitated psycho-educational groups that are didactic but permit informal sharing of experiences might be beneficial. There are gaps in knowledge about factors governing seeking, persisting with and deciding to cease treatment; experiences of invasive procedures; parenting after assisted conception; adoption and infertility

  9. A comparison of governance types and patient satisfaction outcomes.

    PubMed

    Stumpf, L R

    2001-04-01

    Given our dynamic healthcare marketplace, it is imperative to examine the context in which nurses function. A unit level study was conducted to investigate the influence of governance type on organizational culture, nurse work satisfaction, nurse retention, and patient satisfaction. The results of the study will be of value to nurse executives wanting to redesign the context for nursing service to improve outcomes, including nurse and patient satisfaction.

  10. The value of hysteroscopy in the diagnosis of infertility and habitual abortion.

    PubMed

    Wang, Y; Han, M; Li, C; Sun, A; Guo, X; Zhang, Y

    1992-12-01

    Ninety cases of infertility and habitual abortion were analyzed by hysteroscopy between April 1983 and July 1990 in PUMC hospital. Abnormal changes of the uterine cavity were seen in 74.4%. The result of hysterosalpingography corresponded with that of hysteroscopy in 62.5%, and the result of B-ultrasound corresponded to that of hysteroscopy in 52.5%. The diagnosis of adhesion and polyps of the uterine cavity was made accurately by hysteroscopy, and both could be operated under hysteroscopy. After operative removal of the adhesion, an IUD should be put into the uterine cavity for 3 months. In 60 cases operations were performed during or after hysteroscopy. Of the 45 patients followed, 19 achieved pregnancy. Five patients achieved pregnancy after operative removal of the adhesion. It is concluded that hysteroscopy is more important than B-ultrasound and hysterosalpingography in the examination and treatment of infertility.

  11. The importance of periadnexal adhesions in tubal reconstructive surgery for infertility.

    PubMed

    Caspi, E; Halperin, Y; Bukovsky, I

    1979-03-01

    In only a few studies of reconstructive surgery for infertility has the importance of periadnexal adhesions been examined with regard to the pregnancy rate. In the present study, 101 patients underwent reconstructive surgery for correction of infertility. Subsequent to surgery, 38.6% of the patients conceived, and 72% of the pregnancies terminated in live births. In analyzing the results, attention was focused upon the correlation between the severity of the periadnexal adhesions and the surgical outcome. By classifying the adhesions into four grades, an inverse relationship was noted between the grade of adhesions and the pregnancy rate. This relationship was consistent regardless of tubal condition, and thus became an important prognostic parameter. In the light of these findings it is felt that, in order to improve the results, more effort should be directed to the prevention of adhesion formation, together with the use of microsurgical technique in this particular field.

  12. [The psychic state of women suffering infertility in the old reproductive age].

    PubMed

    Kolesnikov, D B; Ermolenko, K S; Solov'eva, A V

    2013-01-01

    A total 60 infertile women aged 36-42 years treated by ART were examined to evaluate their psychic condition using CES-D and Spielberg-Khanin scales, SF-36 questionnaire. 15 (25%) patients were found (CES-D) to have mild depressive disorder; it was more pronounced in one woman. More than half of the patients exhibited enhanced anxiety, with 32 (53.3%) and 19 (31.6%) having generalized and strong anxiety respectively. Estimation of the quality of life revealed difficulties in maintaining social contacts up to complete isolation, low self-assessment of psychic health and prospects for recovery. It is concluded that comprehensive diagnostics and combined treatment are needed to manage infertile women of old reproductive age with the use of both traditional and psychocorrective methods.

  13. Cost comparison of mechanically ventilated patients across the age span

    PubMed Central

    Hayman, William R.; Leuthner, Steven R.; Laventhal, Naomi T.; Brousseau, David; Lagatta, Joanne M.

    2016-01-01

    Objective to compare use of mechanical ventilation and hospital costs across ventilated patients of all ages, preterm through adults, in a nationally-representative sample. Study Design secondary analysis of the 2009 Agency for Healthcare Research and Quality National Inpatient Sample. Results 1,107,563 (2.8%) patients received mechanical ventilation. For surviving ventilated patients, median costs for infants ≤32 weeks’ gestation were $51,000–$209,000, whereas median costs for older patients were lower, from $17,000–$25,000. For non-surviving ventilated patients, median costs were $27,000–$39,000 except at the extremes of age; the median cost was $10,000 for <24 week newborns, and $14,000 for 91+ year adults. Newborns of all gestational ages had a disproportionate share of hospital costs relative to their total volume. Conclusions Most ICU resources at the extremes of age are not directed toward non-surviving patients. From a perinatal perspective, attention should be directed toward improving outcomes and reducing costs for all infants, not just at the earliest gestational ages. PMID:26468935

  14. Association between the JC polyomavirus infection and male infertility.

    PubMed

    Comar, Manola; Zanotta, Nunzia; Croci, Eleonora; Murru, Immacolata; Marci, Roberto; Pancaldi, Cecilia; Dolcet, Ornella; Luppi, Stefania; Martinelli, Monica; Giolo, Elena; Ricci, Giuseppe; Tognon, Mauro

    2012-01-01

    In recent years the incidence of male infertility has increased. Many risk factors have been taken into consideration, including viral infections. Investigations into viral agents and male infertility have mainly been focused on human papillomaviruses, while no reports have been published on polyomaviruses and male infertility. The aim of this study was to verify whether JC virus and BK virus are associated with male infertility. Matched semen and urine samples from 106 infertile males and 100 fertile males, as controls, were analyzed. Specific PCR analyses were carried out to detect and quantify large T (Tag) coding sequences of JCV and BKV. DNA sequencing, carried out in Tag JCV-positive samples, was addressed to viral protein 1 (VP1) coding sequences. The prevalence of JCV Tag sequences in semen and urine samples from infertile males was 34% (72/212), whereas the BKV prevalence was 0.94% (2/212). Specifically, JCV Tag sequences were detected in 24.5% (26/106) of semen and 43.4% (46/106) of urine samples from infertile men. In semen and urine samples from controls the prevalence was 11% and 28%, respectively. A statistically significant difference (p<0.05) in JCV prevalence was disclosed in semen and urine samples of cases vs. controls. A higher JC viral DNA load was detected in samples from infertile males than in controls. In samples from infertile males the JC virus type 2 strain, subtype 2b, was more prevalent than ubiquitous type 1. JCV type 2 strain infection has been found to be associated with male infertility. These data suggest that the JC virus should be taken into consideration as an infectious agent which is responsible for male infertility.

  15. Clomiphene citrate or letrozole as first-line ovulation induction drug in infertile PCOS women: A prospective randomized trial

    PubMed Central

    Kar, Sujata

    2012-01-01

    OBJECTIVE: To compare Letrozole (5 mg) and clomiphene citrate (100 mg) as first line ovulation induction drug in infertile PCOS women. STUDY DESIGN: Prospective Randomised trial. SETTING: A Tertiary level infertility centre. Patients: 103 infertile PCOS women INTERVENTION(S): Treatment naïve infertile PCOS women were randomised to treatment with 5 mg letrozole (51 patients) or 100 mg clomiphene citrate (52 patients) daily starting day 2 to day 6 of menstrual cycle. Timed intercourse or Intra Uterine Insemination (IUI) was advised 24 to 36 hours after Human Chorionic Gonadotropin (HCG) injection. MAIN OUTCOME MEASURES: Ovulation rate, mono or multi follicular rate, days to ovulation, endometrial thickness, serum progesterone, serum estrogen, pregnancy rate, miscarriage rate. RESULTS: The mean age, Body Mass Index (BMI), duration of infertility in both Clomiphene Citrate (CC) and Letrozole groups were similar.Ovulation rate was 73.08% in letrozole group and 60.78% in CC, which was not statistically significant (P=0.398). There was no statistically significant difference between Endometrial thickness (CC 7.61 ±1.96, Let 7.65 ± 2.10), Sr E2 on day of HCG (CC 178.3 ± 94.15, Let 162.09 ± 73.24), Days to ovulation (CC 14.2 ± 3.41; Let 13.13 ± 2.99) and Sr P4 on D21 (CC 10.58 ± 6.65; Let 11.86 ± 6.51). Monofolliculo genesis (CC 54.84, Let 79.49 %, P=0.027) and Pregnancy rate (CC 7.84%, Let 21.56% P=0.0125) were statistically significantly higher in letrozole group. CONCLUSION: Our study shows that letrozole has excellent pregnancy rates compared to clomiphene citrate. Letrozole should be considered at par with clomiphene citrate as first line drug for ovulation induction in infertile PCOS women. PMID:23531705

  16. Psychosocial impacts of infertility on Greek couples.

    PubMed

    Tarlatzis, I; Tarlatzis, B C; Diakogiannis, I; Bontis, J; Lagos, S; Gavriilidou, D; Mantalenakis, S

    1993-03-01

    Psychosocial impacts of infertility were investigated in couples undergoing different treatment procedures in our clinic. Couples were interviewed in a semi-structured way by a psychologist or a psychiatrist and responded to three specially structured questionnaires: the Life Events Scale, the Marlowe-Crowne/Taylor Scale and the Side Effect Checklist. The data were analysed in terms of demographic characteristics as well as treatment procedure. The psychosocial, psychosexual and emotional outcomes of their infertility problem and Greek traditional culture laws are discussed. Stress has been identified in both sexes, depression mostly in women, while men showed a tendency towards repressed anxiety and thus a greater risk of psychosomatic illness, a finding supported by their response to the Side Effect Checklist. Women showed a high defensive anxiety and also reported numerous psychosomatic symptoms. These couples seem to have special needs and fears, both general and treatment specific. Very few of our couples would be considered as severely emotionally disturbed. Women seem to have more difficulties in social adjustment. Sexual dysfunction was reported by almost half of our subjects, although this was associated with a degree of deterioration in their marriage. Guilt feelings, particularly connected with previous abortions, seem to be torturing most women. Finally, both partners seem to have psychological problems irrespective of the one in whom the aetiological problem was found. Moreover, traditional rules seem to impose a special burden on people coming from rural areas. Our results strongly support the belief that infertile couples undergoing different treatments need psychological counselling and supportive psychotherapy. PMID:8473455

  17. A comparison of pain measures used with patients with fibromyalgia.

    PubMed

    Bigatti, Silvia M; Cronan, Terry A

    2002-01-01

    The objective of the present study was to evaluate instruments used to assess pain in patients with fibromyalgia (FMS). Participants were 602 patients with FMS. Pain was measured with five scales: a visual analog scale (VAS), the Pain Rating, Present Pain, and Number of Words Chosen Indexes from the McGill Pain Questionnaire; and intensity of pain obtained from a manual tender point exam. The VAS had the highest correlations with other measures of pain and with self-efficacy for pain, physical functioning, fatigue, and stiffness. The correlations between the VAS and fatigue and stiffness were significantly higher than those of other pain measures (p < .01). Our findings suggest that the easy-to-administer VAS may be the most useful measure of pain with patients with FMS. PMID:12048970

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

    PubMed

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

    2016-02-01

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

  19. Infertility Part I: Pathophysiology and diagnosis.

    PubMed

    Burns, T

    1977-03-01

    There appears to be an increasing incidence of infertility, defined as the inability to conceive after a year of unprotected coitus. The hypothalamic-pituitary-gonadal axis of sexual development and function is briefly reviewed. The history-taking procedure and physical examination of the female and male is described. Basic screening procedures to define the general problem areas are: 1) basal body temperature recordings, 2) further evaluation of ovulatory function through an endometrial biopsy and plasma progesterone analysis, 3) semen analysis, 4) tubal patency tests by tubal insufflation or hysterosalpingography, and 5) Sims-Huhner postcoital examination.

  20. Patients' rights in England and the United States of America: The Patient's Charter and the New Jersey Patient Bill of Rights: a comparison.

    PubMed

    Silver, M H

    1997-08-01

    The Patient's Charter has been in effect for nearly five years. This article considers the purpose and value of the document through a comparison with the New Jersey Patient Bill of Rights. Patient rights statements have been posted in American hospitals for more than twenty years. However, the New Jersey document and the patient rights programme it established seven years ago, have proven to be economically effective, successful in their representation of patients and enforceable, due to the adoption of state legislation and regulation to oversee the process. Several examples of how the programme works are included in the comparison, with a similar review of The Patient's Charter. In the comparison the author argues that for the programme to succeed as it has done in New Jersey, the government will need to develop legislative backing to ensure enforcement, and an efficient system for monitoring compliance. The programme will need to become credible in the eyes of the health service user. The author suggests this may be best achieved by developing an efficient, accessible and user-friendly means of redress, should the patient consider his or her rights have been violated. A "mish-mash" of quality assurance standards and levels of care which patients can "expect" from the health service providers only serves to distract the health service user from the government's failure to commit the resources that would empower the patients rights portion of The Patient's Charter.

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

    ERIC Educational Resources Information Center

    Schneider, Myra G.; Forthofer, Melinda S.

    2005-01-01

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

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

    ERIC Educational Resources Information Center

    Sundby, Johanne

    1997-01-01

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

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

    ERIC Educational Resources Information Center

    Myers, Lisa B.; Wark, Linda

    1996-01-01

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

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

    ERIC Educational Resources Information Center

    Daniluk, Judith C.; Hurtig-Mitchell, Joss

    2003-01-01

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

  5. Management of the infertile couple: an evidence-based protocol

    PubMed Central

    2010-01-01

    Background Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse. It remains a major clinical and social problem, affecting perhaps one couple in six. Evaluation usually starts after 12 months; however it may be indicated earlier. The most common causes of infertility are: male factor such as sperm abnormalities, female factor such as ovulation dysfunction and tubal pathology, combined male and female factors and unexplained infertility. Objectives The aim of this study is to provide the healthcare professionals an evidence-based management protocol for infertile couples away from medical information overload. Methods A comprehensive review where the literature was searched for "Management of infertility and/or infertile couples" at library website of University of Bristol (MetaLib) by using a cross-search of different medical databases besides the relevant printed medical journals and periodicals. Guidelines and recommendations were retrieved from the best evidence reviews such as that from the American College of Obstetricians and Gynaecologists (ACOG), American Society for Reproductive Medicine (ASRM), Canadian Fertility and Andrology Society (CFAS), and Royal College of Obstetricians and Gynaecologists (RCOG). Results A simple guide for the clinicians to manage the infertile couples. Conclusions The study deploys a new strategy to translate the research findings and evidence-base recommendations into a simplified focused guide to be applied on routine daily practice. It is an approach to disseminate the recommended medical care for infertile couple to the practicing clinicians. PMID:20205744

  6. Counseling and diagnostic evaluation for the infertile couple.

    PubMed

    Marshburn, Paul B

    2015-03-01

    Educating couples about natural means to improve fertility should include a discussion about appropriate timing to initiate a diagnostic evaluation for infertility. Complete infertility testing for both male and female factors allows directed care for all abnormalities to optimize chances for conception.

  7. An employer's experience with infertility coverage: a case study.

    PubMed

    Silverberg, Kaylen; Meletiche, Dennis; Del Rosario, Gina

    2009-12-01

    A case study of Southwest Airlines, a Fortune 500 company, demonstrates that a well-designed infertility coverage plan can control resource use. This successful model could be used by employers who wish to ensure that their employees have access to high-quality, cost-effective infertility services in a managed-care environment. PMID:19631318

  8. Coenzyme Q10 supplementation in infertile men with low-grade varicocele: an open, uncontrolled pilot study.

    PubMed

    Festa, R; Giacchi, E; Raimondo, S; Tiano, L; Zuccarelli, P; Silvestrini, A; Meucci, E; Littarru, G P; Mancini, A

    2014-09-01

    Many conditions associated with male infertility are inducers of oxidative stress, including varicocele. Antioxidants, such as coenzyme Q10, may be useful in this case. To evaluate the antioxidant capacity of seminal plasma of infertile men with varicocele before and after an oral supplementation with coenzyme Q10 , 38 patients were recruited from a pilot clinical trial. A standard semen analysis was also performed at baseline and 3 months after an oral supplementation with exogenous coenzyme Q10 100 mg per die. Seminal plasma antioxidant capacity was measured using a spectroscopic method. Coenzyme Q10 therapy improved semen parameters and antioxidant status. This study highlights the importance of oxidative stress in the pathogenesis of male infertility, namely in varicocele, and strengthens the possibility of the usefulness of the antioxidant therapy.

  9. To Evaluate the Efficacy of Combination Antioxidant Therapy on Oxidative Stress Parameters in Seminal Plasma in the Male Infertility

    PubMed Central

    Singh, Alpana; Radhakrishnan, Gita; Banerjee, B.D.

    2016-01-01

    Introduction Infertility is defined as inability to conceive after 1 year of unprotected intercourse and it affects 7% of male population and 8–10% of couples. According to estimates WHO, 13-19 million couples in India are infertile. Oxidative stress is the causative factor in 25% of infertile males. Aim To study the efficacy of antioxidant therapy on oxidative stress parameters in seminal plasma of infertile male. Materials and Methods Forty patients of male infertility were enrolled in study after two abnormal semen analyses reports at 2-3 weeks interval, of oligozoospermia and/or asthenozoospermia, as per WHO guide line 1999. First semen sample was collected at a time of enrollment of study and second semen sample was collected three months after combined antioxidant therapy. Semen samples from the infertile male (the second confirmatory sample of oligoasthenozoospermia) were taken and after liquefaction semen sample were utilized for various analyses, 0.5 ml of sample for standard semen analysis, 1.2 ml sample for separation of seminal plasma to evaluate Oxidative stress (OS) parameters like Malondialdehyde (MDA), Protein Carbonyl (PC) and antioxidant capacity by Glutathione (GSH). We followed the patient for three months after completion of the treatment. Results Semen parameters – Out of 40 patients recruited in the study group 7 patients had only oligospermia (1 to 20 million/ml) and 31 patients had oligoasthenozoospermia (motility range 0-50%) and 2 patients had oligoasthenoteratozoospermia. There was no patient with asthenospermia alone as abnormal semen parameters. After the three months treatment with combined antioxidants the semen parameters like count (mean SD = -1.70±1.44) and motility (mean +SD= -9.56±9.05) were significantly increased (p-value=0.000). Oxidative Stress Assessment – The level of MDA which is a marker of oxidative stress was significantly lower after the three months therapy of antioxidants (p-value=0.002) whereas another

  10. To Evaluate the Efficacy of Combination Antioxidant Therapy on Oxidative Stress Parameters in Seminal Plasma in the Male Infertility

    PubMed Central

    Singh, Alpana; Radhakrishnan, Gita; Banerjee, B.D.

    2016-01-01

    Introduction Infertility is defined as inability to conceive after 1 year of unprotected intercourse and it affects 7% of male population and 8–10% of couples. According to estimates WHO, 13-19 million couples in India are infertile. Oxidative stress is the causative factor in 25% of infertile males. Aim To study the efficacy of antioxidant therapy on oxidative stress parameters in seminal plasma of infertile male. Materials and Methods Forty patients of male infertility were enrolled in study after two abnormal semen analyses reports at 2-3 weeks interval, of oligozoospermia and/or asthenozoospermia, as per WHO guide line 1999. First semen sample was collected at a time of enrollment of study and second semen sample was collected three months after combined antioxidant therapy. Semen samples from the infertile male (the second confirmatory sample of oligoasthenozoospermia) were taken and after liquefaction semen sample were utilized for various analyses, 0.5 ml of sample for standard semen analysis, 1.2 ml sample for separation of seminal plasma to evaluate Oxidative stress (OS) parameters like Malondialdehyde (MDA), Protein Carbonyl (PC) and antioxidant capacity by Glutathione (GSH). We followed the patient for three months after completion of the treatment. Results Semen parameters – Out of 40 patients recruited in the study group 7 patients had only oligospermia (1 to 20 million/ml) and 31 patients had oligoasthenozoospermia (motility range 0-50%) and 2 patients had oligoasthenoteratozoospermia. There was no patient with asthenospermia alone as abnormal semen parameters. After the three months treatment with combined antioxidants the semen parameters like count (mean SD = -1.70±1.44) and motility (mean +SD= -9.56±9.05) were significantly increased (p-value=0.000). Oxidative Stress Assessment – The level of MDA which is a marker of oxidative stress was significantly lower after the three months therapy of antioxidants (p-value=0.002) whereas another

  11. Cytogenetic Investigation in a Group of Ten Infertile Men with Non-Obstructive Azoospermia: First Algerian 46, XX Syndrome

    PubMed Central

    BAZIZ, Meriem; HAMOULI-SAID, Zohra; RATBI, Ilham; HABEL, Mohamed; GUAOUA, Soukaina; SBITI, Aziza; SEFIANI, Abdelaziz

    2016-01-01

    Background: In Algeria, the data on infertility and its various causes are rare. Recently, the introduction of assisted reproduction has allowed expecting that 300000 couples, which represent 7% of couples of reproductive age, face difficulty conceiving a child. Knowing that most idiopathic cases are likely to be due to chromosomal abnormalities, we aimed to investigate genetic defects by karyotype analysis in Algerian infertile men, using peripheral blood lymphocytes. Methods: A cytogenetic study was conducted on 10 men from infertile couples by Karyotype analysis of R-banding performed by lymphocyte culture technique. Fluorescence in situ hybridization was performed and molecular abnormalities were investigated by polymerase chain reaction. Follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were evaluated by immunoradiometric method. Results: Chromosomal abnormalities were observed in 30% of the patients. We identified a homogenous Klinefelter syndrome patient with 47, XXY karyotype, a mosaic Klinefelter syndrome patient with 47, XXY/46, XY karyotype and a 46, XX male. Fluorescence in situ hybridization showed that the sex-determining region Y was translocated to the short arm of the X chromosome in patient with 46, XX chromosomal constitution and the presence of the SRY gene was confirmed by polymerase chain reaction and electrophoresis. Conclusion: The occurrence of chromosomal abnormalities in 30% of the infertile men strongly supports the inclusion of routine cytogenetic testing for diagnostic establishment and suitable counseling for couples seeking for assisted reproduction technologies. PMID:27648416

  12. Comparison of elastography methods in patients with pancreatic masses

    PubMed Central

    Rustemovic, N.; Opacic, D.; Ostojic, Z.; Opacic, M.; Ledinsky, I.; Višijić, A.; Ravić, K. Grubelić; Iveković, H.; Markoš, P.

    2014-01-01

    Introduction: Endoscopic ultrasonography (EUS) quantitative elastography methods are developed for non-invasive differentiation of pancreatic masses. Aims: First: To evaluate the diagnostic value of strain ratio (SR) and hue histogram (HH) in patients with pancreatic masses and to determine the cut-off value between pancreatic cancer and focal pancreatitis using a pancreatic tissue close to the mass as a reference area. Second: To calculate new variable HH ratio (HHR) in an attempt to improve sensitivity, specificity and accuracy of the method. Methods: In a prospective single center study, 149 patients were examined: 105 with the pancreatic masses and 44 controls using Pentax EUS linear probes in combination with Hitachi platforms. SR and HH were automatically calculated by machine software. Finally, two groups were formed: Pancreatic cancer group (58 patients) and focal pancreatitis group (47 patients). All statistical analysis has been made in SPSS 14.0 (SPSS Inc., Chicago, USA). Conclusion: Statistical analysis in our study showed that SR with a cut-off value of 7.59 reaches 100% sensitivity and 95% specificity with overall accuracy of 97% (confidence intervals [CI]: 92-97%) in detection of pancreatic cancer. Statistical analysis also showed that HH with a cut-off value of ≥86 reaches 100% sensitivity and just 45% specificity with overall accuracy of 66% (CI: 61-66%) in detection of pancreatic cancer. New variable HHR with cut-off ≥1.153 was slightly better with 98% sensitivity and 50% specificity, with overall accuracy of 69% (CI: 63-70%). SR showed significantly higher specificity compared with HH and HHR. More HH studies on Hitachi platforms are needed. PMID:26425528

  13. Interpretation of semen analysis among infertile couples.

    PubMed Central

    Small, D R; Collins, J A; Wilson, E H; Wrixon, W

    1987-01-01

    Among the male partners of 1074 infertile couples the mean results of semen analysis were sperm count 78 X 10(6)/ml, seminal volume 4.0 ml, proportion of progressively motile sperm 54%, proportion of sperm with normal morphologic features 81.4% and total motile sperm count 152.3 X 10(6) per ejaculate. After excluding 65 couples who chose donor insemination and 300 with known female causes of infertility, the cumulative pregnancy rates in the remaining 709 couples were higher with increasing sperm density and motility and seminal volume, but the higher rates were significant only when these variables were combined into total motile sperm count per ejaculate. The cumulative pregnancy rates were 20% with a total motile sperm count of 9 X 10(6) or less, 37% with a count of 10 to 19 X 10(6) and 52% with a count of 20 X 10(6) or more (p = 0.001). Counts higher than 20 X 10(6) were not associated with a further improvement in pregnancy rates, but variability in the results was high, which suggests that the test should be repeated as necessary to determine the true range. Although standards for these and other seminal variables are ill defined, the total motile sperm count incorporates the most useful prognostic information from semen analysis, and the associated pregnancy rates can help guide clinical decisions. PMID:3567795

  14. Developments in infertility counselling and its accreditation.

    PubMed

    Monach, Jim

    2013-03-01

    Infertility counselling was placed in a unique position by the passage of the Human Fertilisation and Embryology Act 1990 and the requirement that couples being treated should be offered counselling. However professional counselling was, and largely still is, at a stage at which there was no universal agreement on the knowledge, standards or qualifications required for practice. Nevertheless, infertility counselling became the first example of counselling to be required by statute, beyond the more generalised requirement in adoption birth records access. Counselling is intended to describe skilled talking therapy offered by a professional with specific training and qualifications directed to helping individuals and couples to achieve goals they own themselves. The therapeutic intervention of counselling is primarily directed to helping clients in a stressful situation to deploy their own coping skills effectively and thus make the difficult choices inseparable from ART. Counselling outcome research consistently demonstrates the effectiveness of the sort of counselling delivered in assisted conception units with mild-moderate anxiety and depression delivered by skilled and experienced practitioners. This article reviews the role of counsellors as members of the assisted conception clinical team and the status of regulation and accreditation in this very new profession.

  15. A comparison of two patient-friendly ERG electrodes.

    PubMed

    Hidajat, R R; McLay, J L; Elder, M J; Goode, D H; Morton, J P; Burley, C D

    2003-03-01

    The ideal electroretinography (ERG) electrode does not exist. In deciding which electrode should be used in clinical practice the capacity to provide reproducible waveforms, maximal amplitudes and minimal irritation to the patient's eyes are the most important characteristics. This study tested two patient friendly electrodes, the gold foil (CH Electrodes, UK) and the H-K loop (Avanta, Slovenia). Seventeen normal volunteers were subjected to three standard measurements namely flash ERGs under photopic and scotopic conditions and the transient pattern ERG (PERG). Each test followed the guidelines set by the International Society for Clinical Electrophysiology of Vision (ISCEV). It was found that the mean values of the flash ERG a and b wave amplitudes and the PERG P50 and N95 amplitudes from the gold foil electrodes were approximately a factor of two larger than those from the H-K loop. In addition most of the subjects (13/17) felt less discomfort with the gold foil electrodes. We reached the conclusion that gold foil electrodes are the electrode of choice because they provide good patient comfort, reasonably high amplitudes and relatively reproducible results. PMID:12854623

  16. [Study of anti-DR antibodies in sterility and infertility (author's transl)].

    PubMed

    Balasch, J; Vanrell, J A; González-Merlo, J; Ercilla, M G; Vives, J; Castillo, R

    1980-01-01

    The presence of anti-DR antibodies with lymphocyte cytotoxicity test was studied in five groups of patients: 50 males with no history of blood transfusions who comprised the control group, 44 contraceptive-using women, 55 pregnant women, 41 primary sterile and 47 infertile patients. The high and similar degree of sensitization found in both pregnant and sterile patients lead us to the conclusion that anti-DR antibodies are not a cause of sterility and that spermatozoa are highly immunogenic. The biological significance of the antibodies is discussed.

  17. Infertility in Men with Spinal Cord Injury: Research and Treatment

    PubMed Central

    Brackett, Nancy L.

    2012-01-01

    Spinal cord injury (SCI) occurs most often to young men. Following SCI, most men are infertile due to a combination of erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Erectile dysfunction may be treated by the same therapies that are used in the general population. Similarly, the same treatments that are effective to assist conception in couples with non-SCI male factor patients are effective in assisting conception in SCI male-factor patients. The most apparent differences in male-factor symptoms between SCI and non-SCI patients are the high occurrences of anejaculation and atypical semen profiles in men with SCI. Methods available to assist ejaculation in men with SCI include penile vibratory stimulation and EEJ. Use of surgical sperm retrieval as the first line of treatment for anejaculation in men with SCI is controversial. Most men with SCI have a unique semen profile characterized by normal sperm concentration, but abnormally low sperm motility. Toxic substances in the semen contribute to this problem. Despite impaired sperm parameters, pregnancy outcomes using sperm from men with SCI are similar to pregnancy outcomes using sperm from non-SCI men. Future studies should focus on improving natural ejaculation and improving semen quality in these men. PMID:24278717

  18. Homozygous Mutation in SPATA16 Is Associated with Male Infertility in Human Globozoospermia

    PubMed Central

    Dam, Anika H. D. M. ; Koscinski, Isabelle ; Kremer, Jan A. M. ; Moutou, Céline ; Jaeger, Anne-Sophie ; Oudakker, Astrid R. ; Tournaye, Herman ; Charlet, Nicolas ; Lagier-Tourenne, Clotilde ; van Bokhoven, Hans ; Viville, Stéphane 

    2007-01-01

    Globozoospermia is a rare (incidence <0.1% in male infertile patients) form of teratozoospermia, mainly characterized by round-headed spermatozoa that lack an acrosome. It originates from a disturbed spermiogenesis, which is expected to be induced by a genetic factor. Several family cases and recessive mouse models with the same phenotype support this expectation. In this study, we present a consanguineous family with three affected brothers, in whom we have identified a homozygous mutation in the spermatogenesis-specific gene SPATA16. This is the first example of a nonsyndromic male infertility condition in humans caused by an autosomal gene defect, and it could also mean that the identification of other partners like SPATA16 could elucidate acrosome formation. PMID:17847006

  19. Two-dimensional and three-dimensional imaging of uterus and fallopian tubes in female infertility.

    PubMed

    Carrascosa, Patricia; Capuñay, Carlos; Vallejos, Javier; Carpio, Jimena; Baronio, Mariano; Papier, Sergio

    2016-06-01

    Noninvasive imaging techniques play an important role in the female infertility diagnostic algorithm. In this review article, a description of the diagnostic performance and potential clinical value of both computerized tomographic virtual hysterosalpingography (CT-VHGS) and magnetic-resonance virtual hysterosalpingography (MR-VHSG) is made, describing for both techniques, to guarantee the best possible diagnostic outcome, patient preparation and normal and principal pathologic findings. Both noninvasive diagnostic imaging modalities improve the diagnostic confidence in identification of the specific cause of female infertility. These procedures are well tolerated and can be performed without tenaculum and sedation. The combined analysis of all the imaging data offers the gynecologist a wide information spectrum, enabling a better therapeutic decision. CT-VHSG and MR-VHSG are consistent diagnostic imaging modalities for the evaluation of the female reproductive system, with an excellent diagnostic performance compared with traditional diagnostic exams and allowing a comprehensive assessment of the female reproductive system. PMID:27140290

  20. Comparison of energy expenditure measurement techniques in severely burned patients.

    PubMed

    Schane, J; Goede, M; Silverstein, P

    1987-01-01

    The degree of accuracy of existing formulas for calculating energy expenditure can be determined by comparing them to the measured energy expenditure via indirect calorimetry. As a result, one can modify traditional predicted recommendations for nutrition alimentation of the burn patient with real-time data. In this study, 21 sequential adult admissions with second- and third-degree total body surface area (TBSA) burn wounds (range 21%-81% TBSA) underwent serial assessments of energy expenditure by indirect calorimetry. On admission, maximum, and discharge, measured energy expenditure (MEE) was compared with the calculations for predicted energy expenditure by the Curreri (CEE) and modified Harris-Benedict (MBEE) equations. The mean energy expenditure calculated from the Curreri equation on admission (CEEA) overestimated the mean MEE on admission (MEEA) by 25% (P less than 0.001) and on discharge (MEED) by 36% (P less than 0.0005). The mean modified Harris-Benedict equation overestimated the mean MEEA by 32% (P less than 0.0005) and the mean MEED by 39% (P less than 0.0005). No significant difference was noted between the mean MEE at maximum (MEEM) and the mean CEEA or the mean MBEEA. This indicates excessive overfeeding of the burn patient from admission to discharge by both standard formulas. Actual measured data provide a better indicator of varying nutritional needs throughout the hospital course than the standard formulas, and their use would result in significant savings in the expenses of enteral/parenteral nutritional supplements. PMID:3667663

  1. A comparison of eating disorder patients in India and Australia

    PubMed Central

    Lal, Maala; Abraham, Suzanne; Parikh, Samir; Chhibber, Kamna

    2015-01-01

    Background: Eating disorders (EDs) are an emerging concern in India. There are few studies comparing clinical samples in western and nonwestern settings. Aim: The aim was to compare females aged 16–26 years being treated for an ED in India (outpatients n = 30) and Australia (outpatients n = 30, inpatients n = 30). Materials and Methods: Samples were matched by age and body mass index, and had similar diagnostic profiles. Demographic information and history of eating and exercise problems were assessed. All patients completed the quality-of-life for EDs (QOL EDs) questionnaire. Results: Indians felt they overate and binge ate more often than Australians; frequencies of food restriction, vomiting, and laxative use were similar. Indians were less aware of ED feelings, such as, “fear of losing control over food or eating” and “being preoccupied with food, eating or their body.” Indians felt eating and exercise had less impact on their relationships and social life but more impact on their medical health. No differences were found in the global quality-of-life, body weight, eating behaviors, psychological feelings, and exercise subscores for the three groups. Conclusion: Indian and Australian patients are similar but may differ in preoccupation and control of their ED-related feelings. PMID:25657455

  2. Higher SOD1 Gene Expression in Cumulus Cells From Infertile Women With Moderate and Severe Endometriosis.

    PubMed

    Donabela, Flávia Cappello; Meola, Juliana; Padovan, Cristiana Carolina; de Paz, Cláudia Cristina Paro; Navarro, Paula Andrea

    2015-11-01

    It is questioned whether worsening of oocyte quality and oxidative stress (OS) are involved in the pathogenesis of infertility related to endometriosis and in compromised intracytoplasmic sperm injection (ICSI) outcomes. Cumulus cells (CCs) protect oocytes from entering apoptosis induced by OS. Thus, we carried out a case-control study comparing expression of superoxide dismutase 1 (SOD1), superoxide dismutase 2 (SOD2), and glutathione peroxidase 4 (GPX4; genes encoding for the main antioxidant enzymes) in CCs from mature oocytes of 26 infertile patients with minimal/mild endometriosis, 14 patients with moderate/severe endometriosis, and 41 controls undergoing controlled ovarian stimulation for ICSI, using real-time polymerase chain reaction. As a secondary objective, we investigated the interaction between the expression of these genes and clinical pregnancy (CP) by a statistical model. Only infertile women with moderate/severe endometriosis showed increased expression of the SOD1 in CCs compared to women with minimal/mild endometriosis and controls, with a positive interaction between increased expression and the occurrence of CP, suggesting that SOD1 might be a potential biomarker of CP following ICSI.

  3. Effect of smoking on reproductive hormones and semen parameters of infertile Saudi Arabians

    PubMed Central

    Al-Turki, Haifa A.

    2015-01-01

    Objective: The purpose of this retrospective study is to look into the effect of smoking on semen and hormonal profile of Saudi Arabians attending infertility clinics. Materials and Methods: Medical record numbers of patients who attended infertility clinics and who underwent full assessment were identified rom Quadramed system and out-patient log books between January 2010 and December 2012. The standard protocol of the patients include full history, age, number of years of marriage personal habits of smoking, alcohol consumption, primary or secondary infertility. Standard laboratory tests which were performed, included, complete blood picture, random blood sugar, testosterone, follicle stimulation hormone, luteinizing hormone, prolactin level and semen analysis; volume, count, progressive motility and morphology. The data was entered in the database and analyzed. Results: During the study period, 279 patients attended and infertility clinic and only 258 gave the sample for analysis. The average age of patients in the smoking group was 34.23 ± 7.66 and in the nonsmokers 34.07 ± 7.92 years. Primary infertility was more common in smokers versus nonsmokers P < 0.001 confidence interval (CI)< −44.0705, total serum testosterone level was lower 383.8 ± 239.5 versus 422.5 ± 139.2 ng/dL (0.009 CI< −9.9415), serum prolactin level was higher 18.68 ± 13.28 versus 12.85 ± 12.34 ng/mL (0.001 CI < 8.3794). The average volume of the semen among the smokers was 2.8 ± 1.35 mL and in nonsmokers it was 3.08 ± 0.76 mL (P < 0.008 CI< −0.123). The mean progressive motility in smokers was 31.5 ± 23.1 compared to nonsmokers 40.05 ± 25.43% (0.002 CI< −3.2962) and total sperm count was 119.52 ± 114.12 and 139.71 ± 104.82 million/mL (0.07 CI < 1.4657). Conclusions: This study shows that the effect of smoking is dramatic reduction in the hormonal levels and semen parameters. It is recommended that smoking men undergoing fertility treatment should stop smoking to increase

  4. Comparisons of Patient Demographics in Prospective Sports, Shoulder, and National Database Initiatives

    PubMed Central

    Saltzman, Bryan M.; Cvetanovich, Gregory L.; Bohl, Daniel D.; Cole, Brian J.; Bach, Bernard R.; Romeo, Anthony A.

    2016-01-01

    Background: There has been increased emphasis in orthopaedics on high-quality prospective research to provide evidence-based treatment guidelines, particularly in sports medicine/shoulder surgery. The external validity of these studies has not been established, and the generalizability of the results to clinical practice in the United States is unknown. Hypothesis: Comparison of patient demographics in major prospective studies of arthroscopic sports and shoulder surgeries to patients undergoing the same procedures in the National Surgical Quality Improvement Program (NSQIP) database will show substantial differences to question the generalizability and external validity of those studies. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study utilized patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR), meniscectomy (MX), rotator cuff repair (RCR), and shoulder stabilization (SS) from the NSQIP database (2005-2013). Two prospective studies (either randomized controlled trials or, in 1 case, a major cohort study) were identified for each of the 4 procedures for comparison. Demographic variables available for comparison in both the identified prospective studies and the NSQIP included age, sex, and body mass index (BMI). Results: From the NSQIP database, 5576 ACLR patients, 18,882 MX patients, 7282 RCR patients, and 993 SS patients were identified. The comparison clinical studies included cohort sizes as follows: ACLR, n = 121 and 2683; MX, n = 146 and 330; RCR, n = 90 and 103; SS, n = 88 and 196. Age differed significantly between the NSQIP and the patients in 6 of the 8 prospective clinical studies. Sex differed significantly between the NSQIP and the patients in 7 of the 8 prospective clinical studies. BMI differed significantly between the NSQIP and the patients of all 4 of the prospective clinical studies that reported this demographic variable. Conclusion: Significant differences exist for patient age, sex

  5. Comparisons of Patient Demographics in Prospective Sports, Shoulder, and National Database Initiatives

    PubMed Central

    Saltzman, Bryan M.; Cvetanovich, Gregory L.; Bohl, Daniel D.; Cole, Brian J.; Bach, Bernard R.; Romeo, Anthony A.

    2016-01-01

    Background: There has been increased emphasis in orthopaedics on high-quality prospective research to provide evidence-based treatment guidelines, particularly in sports medicine/shoulder surgery. The external validity of these studies has not been established, and the generalizability of the results to clinical practice in the United States is unknown. Hypothesis: Comparison of patient demographics in major prospective studies of arthroscopic sports and shoulder surgeries to patients undergoing the same procedures in the National Surgical Quality Improvement Program (NSQIP) database will show substantial differences to question the generalizability and external validity of those studies. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study utilized patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR), meniscectomy (MX), rotator cuff repair (RCR), and shoulder stabilization (SS) from the NSQIP database (2005-2013). Two prospective studies (either randomized controlled trials or, in 1 case, a major cohort study) were identified for each of the 4 procedures for comparison. Demographic variables available for comparison in both the identified prospective studies and the NSQIP included age, sex, and body mass index (BMI). Results: From the NSQIP database, 5576 ACLR patients, 18,882 MX patients, 7282 RCR patients, and 993 SS patients were identified. The comparison clinical studies included cohort sizes as follows: ACLR, n = 121 and 2683; MX, n = 146 and 330; RCR, n = 90 and 103; SS, n = 88 and 196. Age differed significantly between the NSQIP and the patients in 6 of the 8 prospective clinical studies. Sex differed significantly between the NSQIP and the patients in 7 of the 8 prospective clinical studies. BMI differed significantly between the NSQIP and the patients of all 4 of the prospective clinical studies that reported this demographic variable. Conclusion: Significant differences exist for patient age, sex

  6. A rare case of respiratory disorders associated with two autosomal recessive diseases and male infertility

    PubMed Central

    Costa, Sergio López; Scigliano, Sergio; Menga, Guillermo; Demiceu, Sergio; Palaoro, Luis Alberto

    2013-01-01

    The study of nasal ciliary beat frequency (CBF) and ultrastructure may contribute to the understanding of pathognomonic cases of male infertility associated with defects in sperm motility. This study was designed to report a particular case of male infertility, characterized by the association of two respiratory autosomal recessive genetic diseases (alpha-1-antitrypsin deficiency [AAT-D] and primary ciliary dyskinesia [PCD]). A 39-year-old patient with complete sperm immotility, AAT-D, and bronchiectasis was studied in the Laboratory of Male Fertility, the Department of Urology, the Respiratory Center of a Pediatric Hospital, and in the Department of Clinical Medicine of a Rehabilitation Respiratory Hospital. Family history, physical examination, hormonal analysis, microbial assays, semen analysis, nasal ciliary function, and structure study by digital high-speed video photography and transmission electron microscopy are described. A noninvasive nasal biopsy to retrieve ciliated epithelium lining the inferior surface of the inferior nasal turbinates was performed and CBF was determined. Beat pattern was slightly curved and rigid, not wide, and metacronic in all the observed fields analyzed. CBF was 8.2 Hz in average (reference value, 10–15 Hz) Ultrastructural assay revealed absence of the inner dynein arms in 97% of the cilia observed. The final infertility accurate diagnosis was achieved by the study of nasal CBF and ultrastructure contributing to the patient health management and genetic counseling while deciding fatherhood. Beyond this particular case, the present report may open a new field of studies in male infertility, mainly in cases of asthenozoospermia. PMID:23772318

  7. An overview of male infertility in the era of intracytoplasmic sperm injection.

    PubMed

    Kim, E D

    2001-02-01

    As a result of the technological advance provided by intracytoplasmic sperm injection (ICSI) in 1992, the evaluation and treatment of the infertile male has changed significantly. Many men who were previously thought to be irreversibly infertile have the potential to initiate their own biologic pregnancy. However, not all men having impaired semen parameters are ideal candidates for ICSI for numerous reasons including a lack of addressing the underlying problem causing the male infertility, unknown genetic consequences, and cost-effectiveness issues. In this era of ICSI, the fundamental approach to the male with suspected subfertility is unchanged and is based on a history, physical examination, and focused laboratory testing. The urologist should approach the patient with an intent to identify remediable causes of subfertility given the specific clinical situation. For instance, should a gentleman have his varicocele repaired or vasectomy reversed, or should he proceed directly with ICSI? If no factors can be improved in a timely manner, then ICSI should be considered using the available sperm. Examples of recent advances include the diagnosis and treatment of ejaculatory duct obstruction, indications and techniques for performing testis biopsy, and techniques for sperm harvesting. Potential genetic causes should be diagnosed and discussed with the patient. Cystic fibrosis gene mutations, karyotype abnormalities, and Y-chromosome microdeletions all have recently been identified as causative for male infertility in otherwise phenotypically normal men. While the long-term genetic consequences for these offspring are largely undefined, recent studies suggest that serious birth defects are not significantly increased in ICSI babies. An understanding of these advances by all physicians is important as we progress into the 21st century.

  8. [Experience of use of allokin-alfa in the treatment of genitourinary infections complicated by excretory-toxic infertility].

    PubMed

    Akimov, O V; Kostromeev, S A; Dyshkovets, A A

    2013-01-01

    The results of the examination and treatment of 67 patients aged 18 to 45 years are presented. Patients suffered from chronic prostatitis, chronic prostatovesiculitis, chronic uretroprostatitis complicated by excretory-toxic infertility. Pathogens, including sexually transmitted infections (STIs), were identified in all patients. The control group received conventional therapy (causative agents, a-adrenoblockers, enzyme therapy). In the study group, patients received allokin alpha in addition to conventional therapy. The use of allokin-alfa promoted more rapid and complete eradication of STI pathogens, and normalization of the spermogram. The results of this study allow to recommend allokin-alfa for the combined treatment of patients with infectious and inflammatory diseases of the genitourinary system, complicated by excretory-toxic infertility.

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

    ERIC Educational Resources Information Center

    Abbey, Antonia; And Others

    1994-01-01

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

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

    ERIC Educational Resources Information Center

    Abbey, Antonia; And Others

    1994-01-01

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

  11. Evaluation of urinary metal concentrations and sperm DNA damage in infertile men from an infertility clinic.

    PubMed

    Zhou, Yan; Fu, Xiao-Ming; He, Dong-Liang; Zou, Xue-Min; Wu, Cheng-Qiu; Guo, Wei-Zhen; Feng, Wei

    2016-07-01

    This study aimed to examine associations between urinary metal concentrations and sperm DNA damage. Thirteen metals [arsenic (As), cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), lead (Pb), manganese (Mn), molybdenum (Mo), mercury (Hg), nickel (Ni), selenium (Se), and zinc (Zn)] were detected in urine samples of 207 infertile men from an infertility clinic using inductively coupled plasma mass spectrometry, and also, sperm DNA damage (tail length, percent DNA tail, and tail distributed moment) were assessed using neutral comet assay. We found that urinary Hg and Ni were associated with increasing trends for tail length (both p for trend<0.05), and that urinary Mn was associated with increasing trend for tail distributed moment (p for trend=0.02). These associations did persist even when considering multiple metals. Our results suggest that environmental exposure to Hg, Mn, and Ni may be associated with increased sperm DNA damage. PMID:27262988

  12. Association of exposure to phenols and idiopathic male infertility.

    PubMed

    Chen, Minjian; Tang, Rong; Fu, Guangbo; Xu, Bin; Zhu, Pengfei; Qiao, Shanlei; Chen, Xiaojiao; Xu, Bo; Qin, Yufeng; Lu, Chuncheng; Hang, Bo; Xia, Yankai; Wang, Xinru

    2013-04-15

    Widespread human exposure to phenols has been documented recently, and some phenols which are potential endocrine disruptors have demonstrated adverse effects on male reproduction in animal and in vitro studies. However, implications about exposure to phenols and male infertility are scarce in humans. Case-control study of 877 idiopathic infertile men and 713 fertile controls was conducted. Urinary levels of bisphenol A, benzophenone-3, pentachlorophenol, triclosan, 4-tert-octylphenol (4-t-OP), 4-n-octylphenol (4-n-OP) and 4-n-nonylphenol (4-n-NP) and semen parameters were measured. After multivariate adjustment, we found 4-t-OP, 4-n-OP and 4-n-NP exposure was associated with idiopathic male infertility (p-value for trend: <0.0001, 0.014 and 0.001, respectively). Aside from these associations, 4-t-OP and 4-n-NP exposure was also associated with idiopathic male infertility with abnormal semen parameters. Moreover, we observed significant associations between sum alkylphenols (APs) exposure and idiopathic male infertility. There were no relationships between exposure to other phenols and idiopathic male infertility in the present study. Our study provides the first evidence that exposure to APs (4-t-OP, 4-n-OP and 4-n-NP) is associated with idiopathic male infertility.

  13. The endocrine basis of infertility in women.

    PubMed

    Alexander, N B; Cotanch, P H

    1980-09-01

    In treating infertile couples an understanding of the endocrine system and its relationship to reproduction is essential. The reproductive capacity in women is regulated by the hypothalamic-pituitary-ovarian axis, a system which controls hormonal synthesis, secretion, and inhibition. Unregulated positive feedback systems produce disequilibrium which can cause hormonal imbalance predisposing the individual to possible infertility. The hypothalamus receives, processes, and acts upon various signals associated with reproductive processes. At the pituitary level, short, negative feedback loops inhibit the release of gonadotropin releasing hormone once adequate levels of pituitary hormones are reached. Hypothalamic dysfunction may be attributable to abnormalities in the amount of sequence of estrogen secretion or the inability of the hypothalamus to respond to the estrogen cue. The pituitary gland responds to levels of gonadotropin releasing hormone through inhibition or secretion of follicle stimulating hormone and luteinizing hormone. A direct outcome of pituitary gonadotropin stimulation is the rhythmicity of ovarian function. The key events in the menstrual cycle are dependent on the central role of estrogen. Ovarian failure is generally attributed to the absence of follicular tissue, which presents as some type of gonadal disgenesis. During the initial interview, the infertile couple must be informed as to the time and financial considerations and statistical outcomes of treatments and the couple's psychological status must be determined to some extent as well. Clomiphene citrate is the most widely used drug in the management of anovulatory conditions related to inadequate cycle stimulation by the pituitary gonadotropins; the usual dose os 50 mg for 5 days, increased up to 200 mg for 5 days if success is not achieved. While it does not directly stimulate ovulation, this drug starts a sequence of events that are physiologically similar to a specific phase of the

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

    PubMed

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

    2015-11-27

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

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

    PubMed

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

    2015-01-01

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

  16. Tubal Factor Infertility and Perinatal Risk After Assisted Reproductive Technology

    PubMed Central

    Kawwass, Jennifer F.; Crawford, Sara; Kissin, Dmitry M.; Session, Donna R.; Boulet, Sheree; Jamieson, Denise J.

    2014-01-01

    OBJECTIVE To assess trends of tubal factor infertility and to evaluate risk of miscarriage and delivery of preterm or low birth weight (LBW) neonates among women with tubal factor infertility using assisted reproductive technology (ART). METHODS We assessed trends of tubal factor infertility among all fresh and frozen, donor, and nondonor ART cycles performed annually in the United States between 2000 and 2010 (N=1,418,774) using the National ART Surveillance System. The data set was then limited to fresh, nondonor in vitro fertilization cycles resulting in pregnancy to compare perinatal outcomes for cycles associated with tubal compared with male factor infertility. We performed bivariate and multivariable analyses controlling for maternal characteristics and calculated adjusted risk ratios (RRs) and 95% confidence intervals (CI). RESULTS The percentage of ART cycles associated with tubal factor infertility diagnoses decreased from 2000 to 2010 (26.02–14.81%). Compared with male factor infertility, tubal factor portended an increased risk of miscarriage (14.0% compared with 12.7%, adjusted RR 1.08, 95% CI 1.04–1.12); risk was increased for both early and late miscarriage. Singleton neonates born to women with tubal factor infertility had an increased risk of pre-term birth (15.8% compared with 11.6%, adjusted RR 1.27, 95% CI 1.20–1.34) and LBW (10.9% compared with 8.5%, adjusted RR 1.28, 95% CI 1.20–1.36). Significant increases in risk persisted for early and late preterm delivery and very low and moderately LBW delivery. A significantly elevated risk was also detected for twin, but not triplet, pregnancies. CONCLUSION Tubal factor infertility, which is decreasing in prevalence in the United States, is associated with an increased risk of miscarriage, preterm birth, and LBW delivery as compared with couples with male factor infertility using ART. PMID:23812461

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

    PubMed Central

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

    2015-01-01

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

  18. Evaluation of Patient Perceptions After Vestibuloplasty Procedure: A Comparison of Diode Laser and Scalpel Techniques

    PubMed Central

    Farista, Sana; Koppolu, Pradeep; Baroudi, Kusai; Uppada, Udaykiran; Mishra, Ashank; Savarimath, Abhishek; Lingam, Amara Swapna

    2016-01-01

    Introduction Inadequate vestibular depth results in poor plaque control owing to an insufficient width of keratinized gingiva. Vestibuloplasty provides the necessary vestibular depth and can be performed either with a scalpel, electrocautery or lasers. Aim To evaluate the patient perceptions related to pain and discomfort on the 1st, 3rd and the 7th day post vestibuloplasty and also assess the healing outcomes related to the treatment of inadequate vestibular depth either with the diode laser or the scalpel. Materials and Methods Twenty patients who had inadequate vestibular depth and required vestibuloplasty were assigned randomly to undergo the procedure either with the scalpel or the laser. The data obtained was analysed for intergroup comparison with an independent paired t-test and intragroup comparison was determined by a paired t-test. Results Intragroup comparison within the laser group for VAS scores of pain and discomfort within all the reported days exhibited a significant difference (p<0.05). Inter group comparison revealed that the patients in the laser group had lower VAS cores for pain and discomfort compared to the scalpel group (p<0.05). Analysis of the three pointer scale for healing revealed that the patients in the laser group exhibited better healing outcomes on the 1st, 3rd and the 7th day compared to the scalpel group. Conclusion Observations from the study highlight the opinion that laser can be a safe and effective alternative to traditional vestibuloplasty performed with the scalpel. PMID:27437370

  19. Assessment of chromosomal abnormalities in sperm of infertile men using sperm karyotyping and multicolour fluorescence in situ hybridization (FISH)

    SciTech Connect

    Moosani, N.; Martin, R.H.

    1994-09-01

    Individuals with male factor infertility resulting from idiopathic oligo-, astheno- or teratozoospermia are frequently offered IVF in an attempt to increase their chances of having a child. A concern remains whether these infertile males have an elevated risk of transmitting chromosomal abnormalities to their offspring. Sperm chromosomal complements from these men were assayed using the human sperm/hamster oocyte fusion system and fluorescence in situ hybridization (FISH) on sperm nuclei. For each of 5 infertile patients, 100 sperm karyotypes were analyzed and multicolour FISH analysis was performed on a minimum of 10,000 sperm nuclei for each chromosome-specific DNA probe for chromosomes 1 (pUC1.77), 12 (D12Z3), X (XC) and Y (DYZ3). As a group, the infertile patients showed increased frequencies of both numerical ({chi}{sup 2}=17.26, {proportional_to} <0.001) and total abnormalities ({chi}{sup 2}=7.78, {proportional_to} <0.01) relative to control donors when assessed by sperm karyotypes. Analysis of sperm nuclei by FISH indicated a significant increase in the frequency of disomy for chromosome 1 in three of the five patients as compared to control donors ({chi}{sup 2}>8.35, {proportional_to} <0.005). In addition, the frequency of XY disomy was significantly higher in four of the five patients studied by FISH ({chi}{sup 2}>10.58, {proportional_to}<0.005), suggesting that mis-segregation caused by the failure of the XY bivalent to pair may play a role in idiopathic male infertility.

  20. Evaluation of transvaginal sonography in detecting endometrial polyps and the pregnancy outcome following hysteroscopic polypectomy in infertile women

    PubMed Central

    Zhu, Huili; Fu, Jing; Lei, Haike; Song, Yong; Shen, Licong; Huang, Wei

    2016-01-01

    The aims of the present study were to evaluate the effectiveness of transvaginal sonography (TVS) in the detection of endometrial polyps (EPs), and to assess the pregnancy outcome in infertile women following hysteroscopic polypectomy. A total of 145 women diagnosed with primary or secondary infertility and intrauterine disorders by TVS and hysterosalpingography (HSG) were included in the current study. All subjects were divided into three groups based on hysteroscopic findings, including the EP, intrauterine adhesion and normal groups. EPs were removed for biopsy and intrauterine adhesions were treated. Pregnancy rates between groups were compared. In total, 34 EPs were detected by TVS, while 45 subjects were later confirmed with EP by hysteroscopy. The sensitivity, specificity, positive predictive value and negative predictive value of TVS in the detection of EPs were 67, 96, 88.23 and 86.49%, respectively. Of the included patients, 120 subjects were followed up, including 40 patients diagnosed with EPs, 42 with intrauterine adhesions and 38 with normal cavities. The results indicated no statistically significant differences in the age, type and duration of infertility, least function (LF) score and classification of the extent of tubal disease with the distal fimbrial obstruction between the three groups. In addition, pregnancy rate and spontaneous abortion rate in the EP group following hysteroscopic polypectomy were 45 and 5.6%, respectively. No significant difference was observed in the fertility rate following surgery. In conclusion, TVS features high sensitivity, specificity and certain unique sonographic characteristics in diagnosing EPs, and may be used as a preliminary diagnostic procedure to select patients for hysteroscopy. Furthermore, hysteroscopic polypectomy is an important approach for the treatment of infertile patients with EPs and appears to help increase the pregnancy rate of previously infertile women. PMID:27446343

  1. Robot-assisted laparoscopy for infertility treatment: current views.

    PubMed

    Carbonnel, Marie; Goetgheluck, Julie; Frati, Albane; Even, Marc; Ayoubi, Jean Marc

    2014-03-01

    To determine the interest of using robotic laparoscopic surgery in the management of female infertility, we reviewed our own activity and searched the Medline database for publications on robotic technology in infertility surgery, with the use of the following search words: robotic laparoscopy, tubal anastomosis, myomectomy, deep infiltrating endometriosis, and adnexal surgery. Robot-assisted laparoscopic surgery has seen rapid progression over the past few years. It has been mostly used for myomectomy, proximal tubal reanastomosis, and deep endometriosis surgery. Despite its increased range of indications, no randomized control studies are available. The place of robotic surgery in the management of infertility remains undetermined. PMID:24559616

  2. Introduction: Training in reproductive endocrinology and infertility: meeting worldwide needs.

    PubMed

    de Ziegler, Dominique; Meldrum, David R

    2015-07-01

    Training in reproductive endocrinology (REI) and its male variant, andrology, has been profoundly influenced by the central role captured by assisted reproductive technologies (ART). The marked differences in financial, regulatory, and societal/ethical restrictions on ART in different countries of the world also prominently influence the clinical management of infertility. Training should strive for comprehensive teaching of all medically indicated procedures, even if only to optimize cross-border care. Better international standardization of infertility practices and training would benefit worldwide infertility care and should be promoted by international societies.

  3. Infertility in spinal-cord injured male.

    PubMed

    Ver Voort, S M

    1987-02-01

    Sterility in spinal-cord injured (SCI) men is believed to be caused by ejaculatory dysfunction, genital ductal blockage secondary to infection, and/or impaired spermatogenesis. Semen from SCI men demonstrates diminished numbers of motile, morphologically normal sperm. Testicular biopsies demonstrate impaired spermatogenesis. Leydig and Sertoli cells appear to be normal. Endocrine evaluations reveal normal testosterone levels with an adequate Leydig cell reserve. Luteinizing hormone (LD) and follicle-stimulating hormone (FSH) levels are normal or high with normal or exaggerated stimulation responses. Acute depressions in testosterone, FSH, and LH levels can be seen following SCI, most markedly in quadriplegics. A normal hypothalamic-pituitary-testicular axis is implied by these findings, indicating a primary hypogonadism. Causes of impaired spermatogenesis may include local testicular temperature elevations, nondrainage of the reproductive tract, antisperm antibodies, and recurrent genitourinary infections. Treatment of infertility involves removal of these offending factors, and research is needed to correlate the impaired spermatogenesis with these factors.

  4. Distributive justice and infertility treatment in Canada.

    PubMed

    Nisker, Jeff

    2008-05-01

    An exploration of distributive justice in Canadian infertility treatment requires the integration of ethical, clinical, and economic principles. In 1971, American philosopher John Rawls proposed a theoretical model for fair decision-making in which "rational" and "self-interested" citizens are behind a "veil of ignorance" with respect to both their own position and the position of other decision-makers. Rawls proposed that these self-interested decision-makers, fearing that they are among the least advantaged persons who could be affected by the decision, will agree only upon rules that encode equality of opportunity and that bestow the greatest benefit on the least advantaged citizens. Regarding health policy decision-making, Rawls' model is best illustrated by Canadian philosopher Warren Bourgeois in his panel of "volunteers." These rational and self-interested volunteers receive an amnestic drug that renders them unaware of their health, social, and financial position, but they know that they are representative of diverse spheres of citizens whose well-being will be affected by their decision. After describing fair decision-making, Bourgeois considers the lack of a distributive justice imperative in Canada's Assisted Human Reproduction Act, in contrast to legislation in European nations and Australia, summarizes the economic and clinical considerations that must be provided to the decision-makers behind the "veil of ignorance" for fair decisions to occur, and considers altruism in relation to equality of access. He concludes by noting that among countries with legislation governing assisted reproduction Canada is alone in having legislation that is void of distributive justice in providing access to clinically appropriate infertility care.

  5. How does lead induce male infertility?

    PubMed Central

    Vigeh, Mohsen; Smith, Derek R.; Hsu, Ping-Chi

    2011-01-01

    An important part of male infertility of unknown etiology may be attributed to various environmental and occupational exposures to toxic substances, such as lead. The reproductive effects of lead are complex and appear to involve multiple pathways, not all of which are fully understood. It is still unclear, for example, if male reproductive issues in lead-exposed persons are mostly related to the disruption of reproductive hormones, whether the problems are due to the lead’s direct effects on the gonads, or both? This question has been difficult to answer, because lead, especially at high levels, may adversely affect many human organs. Although lead can potentially reduce male fertility by decreasing sperm count and motility, inducing abnormal morphology and affecting functional parameters; not all studies have been able to clearly demonstrate such findings. In addition, research has shown that the blood-testis barrier can protect testicular cells from direct exposure to high levels of blood lead. For these reasons and considering the wide spectrum of lead toxicity on reproductive hormones, the present review suggests that lead’s main influence on male reproduction probably occurs by altering the reproductive hormonal axis and the hormonal control on spermatogenesis, rather than by a direct toxic effect on the seminiferous tubules of the testes. As blood lead concentrations below the currently accepted worker protection standard may still adversely affect male fertility, future studies should aim to establish more concrete links between lead exposure (especially at low levels) and subsequent male infertility. Research should also pay more attention to lead’s effects on reducing male fertility rates based on not only hormonal axis alteration, but also on the changes in sperm characteristic among exposed subjects. PMID:25356074

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

    PubMed Central

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

    2014-01-01

    Background: Assisted reproductive technology (ART) provide the hope of pregnancy for infertile women, but do not always turn this hope into reality. Objective: The purpose of this study was to explore the lived experience of infertile women from increasing and decreasing factors of hope in infertile women with failure in infertility treatment. Materials and Methods: Using a qualitative research design (Phenomenology study), 23 subjects were selected who had experienced infertility failure visited by gynecologist (Rasekh Infertility center) in 2012. The data were collected through semi structured interviews and analyzed using interpretive research strategies of phenomenology by Collizi's seven-stage method. Results: Totally 96 codes were identified. The data arranged in two categories. The factors decreasing and increasing hope in infertility treatments. Totally 5 themes and 20 sub themes were extracted. The increasing factors which emerged from the data contain "spiritual source", "family interaction and support" and "information through the media", and decreasing factors contain "nature of treatments" and "negatively oriented mind". PMID:24799869

  7. Comparison between intracytoplasmic sperm injection and intracytoplasmic morphologically selected sperm injection in oligo-astheno-teratozoospermia patients

    PubMed Central

    Yoon, Hye Jin; Jang, Jung Mi; Oh, Hwa Soon; Lee, Yong Jun; Lee, Won Don; Yoon, San Hyun; Lim, Jin Ho

    2014-01-01

    Objective The aim of this study was to evaluate the efficiency of the intracytoplasmic morphologically selected sperm injection (IMSI) technique compared with conventional ICSI and previous ICSI attempts in oligo-astheno-teratozoospermia (OAT) patients. Methods The sperms were selected under high magnification (6,600×) and used to induce fertilization in previous ICSI patients by IMSI. These results were compared with previous conventional ICSI cycles in patients with OAT infertility. Results These results demonstrated no significant difference in the fertilization rate between IMSI and previous ICSI cycles (67.7% vs. 65.0%). However, the pregnancy and implantation rates with IMSI were significantly higher than those of the ICSI cycles (33.3% vs. 12.5% and 14.6% vs. 5.4%, respectively; p<0.05). The miscarriage rate among pregnant patients (18.2% vs. 37.5%) showed no statistically significant difference between groups. Conclusion Compared to conventional ICSI, this study found that IMSI increased the IVF-ET success rates in patients with OAT. PMID:24693492

  8. Clinical management of infertile men with nonobstructive azoospermia

    PubMed Central

    Esteves, Sandro C

    2015-01-01

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

  9. Clinical management of infertile men with nonobstructive azoospermia.

    PubMed

    Esteves, Sandro C

    2015-01-01

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

  10. Characteristics of Dysphagia in Severe Traumatic Brain Injury Patients: A Comparison With Stroke Patients

    PubMed Central

    Lee, Won Kyung; Yeom, Jiwoon; Lee, Woo Hyung; Seo, Han Gil; Oh, Byung-Mo

    2016-01-01

    Objective To compare the swallowing characteristics of dysphagic patients with traumatic brain injury (TBI) with those of dysphagic stroke patients. Methods Forty-one patients with TBI were selected from medical records (between December 2004 to March 2013) and matched to patients with stroke (n=41) based on age, sex, and disease duration. Patients' swallowing characteristics were analyzed retrospectively using a videofluoroscopic swallowing study (VFSS) and compared between both groups. Following thorough review of medical records, patients who had a history of diseases that could affect swallowing function at the time of the study were excluded. Dysphagia characteristics and severity were evaluated using the American Speech-Language-Hearing Association National Outcome Measurement System swallowing scale, clinical dysphagia scale, and the videofluoroscopic dysphagia scale. Results There was a significant difference in radiological lesion location (p=0.024) between the two groups. The most common VFSS finding was aspiration or penetration, followed by decreased laryngeal elevation and reduced epiglottis inversion. Swallowing function, VFSS findings, or quantified dysphagia severity showed no significant differences between the groups. In a subgroup analysis of TBI patients, the incidence of tube feeding was higher in patients with surgical intervention than in those without (p=0.011). Conclusion The swallowing characteristics of dysphagic patients after TBI were comparable to those of dysphagic stroke patients. Common VFSS findings comprised aspiration or penetration, decreased laryngeal elevation, and reduced epiglottis inversion. Patients who underwent surgical intervention after TBI were at high risk of tube feeding requirement. PMID:27446779

  11. Comparison of hair from rectum cancer patients and from healthy persons by Raman microspectroscopy and imaging

    NASA Astrophysics Data System (ADS)

    Wei, Xiaoli; Wang, Xin; Fang, Yusheng; Huang, Qing

    2013-09-01

    In this work, Raman microspectroscopy and imaging was employed to analyze cancer patients' hair tissue. The comparison between the hair from rectum cancer patients and the hair from healthy people reveals some remarkable differences, such as for the rectum cancer patients, there are more lipids but less content of α-helix proteins in the hair medulla section. Though more statistic data are required to establish universary rules for practical and accurate diagnosis, this work based on case study demonstrates the possibility of applying Raman microspectroscopy to reveal abnormality in non-cancer tissues such as hair in order to predict and diagnose cancers.

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

    PubMed Central

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

    2014-01-01

    Background: Infertility is a major life event that brings about social and psychological problems. The type and rate these problems in the context of socio-cultural of different geographical areas and sex of people is different. Objective: The aim of this qualitative study was to explain the psychological consequences of infertility in Iranian infertile women seeking treatment. Materials and Methods: This qualitative study was done using qualitative content analysis on 25 women affected by primary and secondary infertility with no surviving children in 2012. They were purposefully selected with maximum sample variation from a large Fertility Health Research Center in Tehran, Iran. Data were collected using 32 semi-structured interviews and analyzed by the conventional content analysis method. Results: The findings of this study include four main themes: 1. Cognitive reactions of infertility (mental engagement; psychological turmoil). 2. Cognitive reactions to therapy process (psychological turmoil; being difficult to control in some situations; reduced self-esteem; feelings of failure). 3. Emotional-affective reactions of infertility (fear, anxiety and worry; loneliness and guilt; grief and depression; regret). 4. Emotional-affective reactions to therapy process (fear, anxiety and worry; fatigue and helplessness; grief and depression; hopelessness). Conclusion: This study revealed that Iranian infertile women seeking treatment face several psychological-emotional problems with devastating effects on the mental health and well-being of the infertile individuals and couples, while the infertility is often treated as a biomedical issue in Iranian context with less attention on the mental-emotional, social and cultural aspects. This article extracted from Ph.D. thesis. (Seyede Batool Hasanpoor-Azghady) PMID:24799871

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

    PubMed

    Chia, S E; Tay, S K

    2001-11-01

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

  14. Pregnancy Predictors after Intrauterine Insemination in Cases of Unexplained Infertility: A Prospective Study

    PubMed Central

    Ganguly, Ishita; Bhandari, Shilpa; Agrawal, Pallavi; Gupta, Nitika

    2016-01-01

    Introduction. Aim of the study was to find the effect of various prognostic factors in cases of unexplained infertility undergoing controlled ovarian stimulation (COS) with intrauterine insemination (IUI). Methods. 146 cases of unexplained infertility were included. A maximum of 3 cycles of IUI were done with clomiphene citrate/HMG. Ovulation trigger was given when the largest follicle diameter was >18 mm, and IUI was planned 36 hours later. Luteal phase support was given for 15 days, urine pregnancy test was done on day 15, ultrasonography was done at 7 weeks, and pregnancy was followed up till delivery. Results. A total of 146 couples have undergone 239 cycles of IUI out of which 27 had UPT positive after 15 days. 14.8% had 1st-trimester abortion while 3.7% were ectopic. 86.3% were singleton pregnancies and 13.6% were twins. CPR was 11.29% per cycle and 18.4% per couple; LBR was 9.2% per cycle. Apart from duration of stimulation (p = 0.037) and number of treatment cycles (p = 0.045), no other factors had significant prognostic value. Conclusion. For unexplained infertility, IUI can be done to provide patients with the time that they need before moving on to IVF while providing a respectable chance of pregnancy. PMID:27738654

  15. Surgical treatment of male infertility in the era of intracytoplasmic sperm injection - new insights.

    PubMed

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

    2011-01-01

    Assisted reproductive technology is an evolving area, and several adjuvant procedures have been created to increase a couple's chance of conceiving. For male infertility, the current challenges are to properly accommodate old and new techniques that are both cost-effective and evidence-based. In this context, urologists are expected to diagnose, counsel, provide medical or surgical treatment whenever possible and/or correctly refer male patients for assisted conception. Urologists are sometimes part of a multiprofessional team in an assisted reproduction unit and are responsible for the above-cited tasks as well as the surgical retrieval of sperm from either the epididymides or testicles. We present a comprehensive review of the surgical treatment options for infertile males, including the perioperative planning and prognostic aspects, with an emphasis on the role of microsurgery in the optimization of treatment results. This review also discusses current techniques for sperm retrieval that are used in association with assisted reproductive technology and includes sperm retrieval success rates according to the technique and the type of azoospermia. New insights are provided with regard to each surgical treatment option in view of the availability of assisted conception to overcome male infertility.

  16. Personality characteristics, psychoendocrinological stress and outcome of IVF depend upon the etiology of infertility.

    PubMed

    Demyttenaere, K; Nijs, P; Evers-Kiebooms, G; Koninckx, P R

    1994-12-01

    Personality characteristics, psychoendocrinological stress responses and course and outcome of treatment were investigated in 40 women undergoing in vitro fertilization (IVF). In addition to classification by the major causes of infertility (mechanical infertility or male infertility), the subjects were also divided in two subgroups of 17 women with completely 'normal' menstrual cycles and 23 women with subtle disturbances of their menstrual cycle. These disturbances were due to either minimal endometriosis, luteinized unruptured follicle (LUF) syndrome or luteal phase insufficiency. Women with subtle cycle disturbances have been shown to have a lower pregnancy rate in IVF than women with normal cycles. The correlation of the state anxiety level of the patient in the early follicular phase with negative outcome in IVF is seen to be higher in women with subtle cycle disturbances. Furthermore, prolactin concentrations are always higher in women with subtle cycle disturbances. Our data contribute to the hypothesis that subtle cycle disturbances, i.e. LUF syndrome, luteal phase insufficiency and endometriosis, could be associated with higher psychoendocrinological stress levels.

  17. Enterobius vermicularis infection of the fallopian tube in an infertile female.

    PubMed

    Young, Carmen; Tataryn, Ivanna; Kowalewska-Grochowska, Kinga T; Balachandra, Brinda

    2010-06-15

    Enterobius vermicularis (EV) is the most common nematode to infect humans. It inhabits the intestinal lumen, but rare, ectopic infections have been documented. The female genital tract is the most common ectopic site. We present a unique case of an EV infection of the fallopian tube resulting in inflammation, tubal obstruction, and infertility. A 30-year-old woman presented with infertility. Investigations included a laparoscopy with hydrotubation using methylene blue dye. This showed a left fallopian tube obstruction and extensive pelvic adhesions. A left salpingectomy was performed. Microscopic examination of the fallopian tube revealed numerous calcified and non-calcified ova associated with granulomatous reaction. The microscopic features were compatible with EV infection. Ectopic EV infections of the female genital tract result when the gravid female worm migrates from the perianal area to the vagina and ascends through the uterus and fallopian tubes to the peritoneal cavity. Microscopic examination of these ectopic sites can reveal adult worms or ova with granulomata formation, eosinophilic infiltrate, chronic inflammatory reaction, and fibrosis. The ova have a characteristic asymmetric oval configuration with flattening on one side. We postulate that our patient's salpingitis due to EV with accompanying fibrosis is a cause of her infertility.

  18. Decision for disclosure: The experiences of Iranian infertile couples undergoing assisted reproductive donation procedures.

    PubMed

    Hadizadeh-Talasaz, Fatemeh; Roudsari, Robab Latifnejad; Simbar, Masoumeh

    2015-01-01

    Controversy surrounding disclosure among the recipients of assisted reproductive donation procedures is escalating worldwide, but little research has been conducted in this topic. The purpose of this qualitative study was to explore the experiences of infertile couples undergoing assisted reproductive donation procedures. In this exploratory qualitative study, 32 patients (nine couples and 14 women) who were candidates to use donor eggs, donor embryos or surrogacy, and 5 members of infertility treatment team including gynaecologists, midwives and psychologist (total 37) were purposively selected from the Montaserieh Infertility Research Centre at Mashhad, Iran in 2012 and interviewed using a semi-structured in-depth method. Data were analysed using conventional qualitative content analysis with MAXqda software. One overarching theme, entitled 'experiencing uncertainty surrounding the disclosure to others' was identified from the data. This theme contained two subthemes including 'Couples' decisions to not disclose to others' and 'Couples' decisions to disclose to others'. Five categories formed the first subtheme, and the second subtheme emerged from four categories which are discussed in this paper. The main reason for secrecy was concern over societal negative views about assisted reproductive donation procedures. This worry deprived the couples from support from family and friends and as a result requires them to tolerate psychological pressure when using such procedures. PMID:26428703

  19. The green grass on the other side: crossing borders to obtain infertility treatment

    PubMed Central

    Pennings, G.

    2009-01-01

    Background: Cross-border reproductive care, also known as reproductive tourism, is a growing phenomenon. More and more treatments, or parts thereof, are taking place in countries other than the patient’s home country. Results: The phenomenon is presented as a safety valve that takes the pressure of the restrictive legislation and simultaneously allows people to obtain the treatment they desire. These movements also hold a number of risks, both for the travelling patients and for the gamete donors and infertile couples in the country of destination. Finally, the possible role of patient organisations and medical professional societies is discussed. PMID:25478065

  20. The Effects of Total Motile Sperm Count on Spontaneous Pregnancy Rate and Pregnancy After IUI Treatment in Couples with Male Factor and Unexplained Infertility

    PubMed Central

    Hajder, Mithad; Hajder, Elmira; Husic, Amela

    2016-01-01

    Introduction: Male infertility factor is defined if the total number of motile spermatozoa (TMSC) < 20 × 106/ejaculated, and unexplained infertility if spermiogram is normal with normal female factor. The aim: of this study was to determine the predictive value of TMSC for spontaneous pregnancy (ST) and pregnancy after treatment with intrauterine insemination (IUI) in couples with male factor and unexplained infertility. What is known already: According to the WHO qualification system abnormal spermiogram can be diagnosed as oligozoospermia (O), asthenozoospermia (A), teratozoospermia (T) or combination (O+A+T) and azoospermia (A). Although this classification indicates the accuracy of findings its relevance for prognosis in infertile couple and the choice of treatment is questionable. Materials and Methods: The study included 98 couples with male infertility factor (bad spermiogram) and couples with normospermia and normal female factor (unexplained infertility). Testing group is randomized at: group (A) with TMSC> 3,106 / ejaculate and a spontaneous pregnancy, group (B) with TMSCl <3 x 106 / ejaculate and pregnancy after IUI, plus couples who have not achieved SP with TMSC> 3 x 106 / ejaculate and couples who have not achieved pregnancy. Main results: From a total of 98 pairs of men’s and unexplained infertility, 42 of them (42.8%) achieved spontaneous pregnancy, while 56 (57.2%) pairs did not achieve spontaneous pregnancy. TMSC was significantly higher (42.4 ± 28.4 vs. 26.2 ± 24, p <0.05) in the group A compared to group B. Couples with TMSC 1-5 × 106 ejaculate had significantly lower (9.8% vs. 22.2%, p <0.0001) rate of spontaneous pregnancy in comparison to couples after IUI treatment. Couples with unexplained infertility had significantly higher (56.8% vs. 29.9%, p <0.01) spontaneous pregnancy rate compared to couples after IUI treatment. Infertile couples had significant pregnancy rate with TMSC 5-10 x 106 / ejaculate (OR = 1.45, 95% CI:1.26-1.78, <0