Archive for December, 2009
Objective: To illustrate the necessity for an enhanced understanding of the genetic basis of male factor infertility, to present a comprehensive synopsis of these genetic elements, and to review techniques being utilized to produce new insights in fertility research.Background: Male factor infertility is a complex disorder that affects a large sector of the population; however, many of its etiologies are unknown. By elucidating the underlying genetic basis of infertile phenotypes, it may be possible to discover the causes of infertility and determine effective treatments for patients.Method(s): The PubMed database was consulted for the most relevant papers published in the last 3 years pertaining to male factor infertility using the keywords “genetics” and “male infertility.”Result(s): Advances have been made in the characterization of the roles of specific genes, but further research is necessary before these results can be used as guidelines for diagnosing and treating male factor infertility. The accurate transmission of epigenetic information also has considerable influence on fertility in males and on the fertility of their offspring.Conclusion(s): Analysis of the genetic factors that impact male factor infertility will provide valuable insights into the creation of targeted treatments for patients and the determination of the causes of idiopathic infertility. Novel technologies that analyze the influence of genetics from a global perspective may lead to further developments in the understanding of the etiology of male factor infertility through the identification of specific infertile phenotype signatures.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Clinical studies of oocyte cryopreservation have gained momentum within the recent years; however, no guidelines have yet been established for patient selection. This article discusses the controversial aspects of selecting candidates for oocyte cryopreservation research.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
In 2002, 2 million American women of reproductive age were infertile. Infertility is also common among men. The Centers for Disease Control and Prevention (CDC) conducts surveillance and research on the causes of infertility, monitors the safety and efficacy of infertility treatment, and sponsors national prevention programs. A CDC-wide working group found that, despite this effort, considerable gaps and opportunities exist in surveillance, research, communication, and program and policy development. We intend to consult with other federal agencies, professional and consumer organizations, the scientific community, the health care community, industry, and other stakeholders, and participate in the development of a national public health plan for the prevention, detection, and management of infertility.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To assess sexual function of first-time users of the contraceptive ring and contraceptive patch.Design: Open-label randomized trial.Setting: Multicenter study.Patient(s): A total of 500 healthy, premenopausal, nonpregnant women who had recently used combined oral contraceptives.Intervention(s): Contraceptive ring vs. contraceptive patch.Main Outcome Measure(s): Subjects completed the Female Sexual Function Index (FSFI) before randomization to the study product and after 3 months. Unadjusted and adjusted changes in total and domain FSFI scores from baseline to exit were compared between treatment groups using linear regression (intention-to-treat approach).Result(s): Final adjusted mean total FSFI scores increased by 0.32 points in the patch group and decreased by 0.74 points in the ring group. Subjects in the ring group had worsening scores in the areas of arousal (score change ?0.169 ring vs 0.010 patch), lubrication (score change ?0.202 ring vs. 0.031 patch), and pain (score change ?0.162 ring vs. 0.182 patch).Conclusion(s): Among recent combined oral contraceptive users, slight decrements in sexual function scores were noted with contraceptive ring use overall and in several domains of sexual functioning, whereas slight increases were noted with patch use. However, for both products, these changes are not likely to be clinically significant.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To assess a new hysteroscopic method of tubal sterilization; specifically, to examine the factors associated with placement failure of Essure implants.Design: Observational, multicenter, 6-month study.Setting: Seven gynecology clinics, including five public hospitals and two private clinics, in France.Patient(s): A total of 495 women who provided informed consent.Intervention(s): All procedures were done by a vaginoscopic approach with a 5-mm operating hysteroscope.Main Outcome Measure(s): Data collected were age, parity, type of anesthesia, premedication, endometrial aspect, ostia visualization, duration of the procedure, pain during the procedure, and associated procedures. Unilateral and bilateral placement rates were assessed. Adverse events at 3 months (expulsion, migration, perforation) were also recorded.Result(s): Mean parity was 2.45; 20 women were nulliparous. In 56.3% of cases (n = 277), none or local anesthesia was used for the placement procedure. Overall, 86% of the women (n = 423) had nonsteroidal anti-inflammatory drug (NSAID) premedication, and 8.1% (n = 40) had another intrauterine surgical procedure performed at the same time. In 24 cases, at least one of the tubal ostia could not be visualized well during hysteroscopy.Conclusion(s): The failure rate for Essure micro-insert placement was 6% at first attempt and 3.3% after two attempts. Success rate was not significantly associated with parity, mode of analgesia, NSAID premedication, or combination with another procedure. The only factor significantly associated with the failure rate was poor visualization of the tubal ostia.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To analyze the data of cases of unintended pregnancies after Essure sterilization.Design: Retrospective case series analysis.Setting: National multicenter.Patient(s): Ten cases of unintended pregnancies after Essure sterilization in the Netherlands were reported from August 2002 through May 2008.Intervention(s): Data on the hysteroscopic Essure sterilization procedures and postprocedure confirmation tests of the reported cases were reviewed and analyzed by two authors. The causes of the unintended pregnancies were determined in agreement with the physicians who performed the sterilizations.Main Outcome Measure(s): Most pregnancies occurred in patients with only one device placement and bilateral occlusion on hysterosalpingography (HSG). Other cases included misinterpretation of HSG, undetected abnormal device position by ultrasound, one undetected preprocedure pregnancy, and two patient failures to follow up with the physician advice.Conclusion(s): The risk of pregnancy after hysteroscopic sterilization may be reduced by strictly following the follow-up protocol, performing a urinary pregnancy test on the day of the procedure, and instructing the patient to return for the follow-up visit. A procedure with only a single device placement in a patient without a history of tubectomy of the heterolateral tube should be considered unsuccessful.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To examine the short-term surgical outcomes in women undergoing fertility-sparing laparoscopic excision of deeply infiltrating pelvic endometriosis.Design: Retrospective cohort study.Setting: Tertiary referral center for treatment of endometriosis, a university teaching hospital, London, United Kingdom.Patient(s): A total of 177 women who underwent fertility-sparing laparoscopic excision of deeply infiltrating endometriosis between January 1, 2006, and December 31, 2007.Intervention(s): Eligible women were identified from the surgeons’ database, and their medical notes were reviewed. Data from preoperative assessment, surgery, and postoperative outcomes were analyzed.Main Outcome Measure(s): Complication rate.Result(s): One hundred seventy-seven women underwent fertility-sparing laparoscopic excision of deeply infiltrating endometriosis including excision of uterosacral ligaments (43, 24.3%), excision of rectovaginal septum (56, 31.6%), rectal shave (56, 31.6%), disk excision (7, 4%) or bowel resection (15, 8.5%). The median operative time was 95 minutes with a range of 30 to 270 minutes (interquartile range 75–120 minutes). Overall, complications developed in 18 women (10.2%). In 12 (6.8%) of these only uncomplicated pyrexia developed whereas significant intraoperative and/or postoperative complications developed in the remaining 6 (3.4%). Women spent a median of 2 days recovering in hospital (range 1–7, interquartile range 2–3 days).Conclusion(s): Fertility-sparing laparoscopic excision of deeply infiltrating endometriosis appears to be safe with a low short-term complication rate.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To evaluate prospectively the efficacy of laparoscopic ureterolysis versus ureteroureterostomy in women with ureteral endometriosis.Design: Prospective study.Setting: Department of Obstetrics and Gynecology, Ospedale Sacro Cuore of Negrar, Verona, Italy, a tertiary care endometriosis referral center.Patient(s): Endometriotic patients with moderate-severe ureter dilatation.Intervention(s): All women underwent laparoscopic endometriosis excision and concomitant laparoscopic ureterolysis, ureteroureterostomy, nephrectomy, or laparotomic ureterocystoneostomy.Main Outcome Measure(s): Clinical outcomes were evaluated.Result(s): Fifty-six patients with preoperative or intraoperative evidence of moderate-severe ureter dilatation were enrolled. Dysmenorrhea (91%) and dyspareunia (68%) were the symptoms more frequently reported; only two patients had typical obstructive uropathy pain. In 35 cases, laparoscopic ureterolysis, in 17 laparoscopic ureteroureterostomy, in 2 laparotomic ureterocystoneostomy, and in 2 laparoscopic nephrectomy was performed. 11 out of 35 (31.4%) major complications occurred in the ureterolysis group, and 2 out of 17 (11.7%) in the ureteroureterostomy group. Median follow-up time was 21 months. Ureteral endometriosis recurrence was surgically detected in three patients who underwent conservative ureteral surgery.Conclusion(s): Preoperative planning should be rigorous, and complete surgical excision of ureteral endometriosis should be ensured by a team of experts familiar with endometriosis, its multiple manifestations, and its management.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To evaluate long-term cyclic and continuous administration of oral contraceptive pills (OCP) in preventing ovarian endometrioma recurrence after laparoscopic cystectomy.Design: Prospective, randomized, controlled trial.Setting: Tertiary care University Hospital.Patient(s): Two hundred thirty-nine women who underwent laparoscopic excision of ovarian endometriomas.Intervention(s): Patients were divided randomly into three groups: nonusers receiving no therapy and cyclic and continuous users receiving low-dose, monophasic OCP for 24 months in cyclic or continuous administration, respectively.Main Outcome Measure(s): Endometrioma recurrence, size of recurrent endometrioma, and growth rate during at least 2 years follow-up evaluated by transvaginal ultrasonography.Result(s): The crude recurrence rate within 24 months was significantly lower in cyclic (14.7%) and continuous users (8.2%) compared with nonusers (29%). The recurrence-free survival was significantly lower in nonusers compared with cyclic and continuous users. The mean recurrent endometrioma diameter at first observation was significantly lower in cyclic (2.17 ± 0.45 cm) and continuous users (1.71 ± 0.19 cm) compared with nonusers (2.73 ± 0.56 cm). The mean diameter increase every 6 months of follow-up was significantly reduced in cyclic users (0.31 ± 0.18 cm) and continuous users (0.25 ± 0.09 cm) versus nonusers (0.48 ± 0.3 cm). No significant differences between cyclic users and continuous users in terms of endometrioma recurrence were demonstrated.Conclusion(s): Long-term cyclic and continuous postoperative use of OCP can effectively reduce and delay endometrioma recurrence.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To assess the behavior of revised American Fertility Society stages I and II endometriosis after surgical treatment, by observation of location of pelvic involvement at reoperation.Design: Prospective study.Setting: Tertiary referral center at a university-based hospital.Patient(s): Thirty-nine women with persistent or recurrent chronic pelvic pain after laparoscopic excision or ablation of histologically confirmed endometriosis who underwent a second laparoscopy.Intervention(s): Laparoscopic pelvic mapping and surgical treatment of endometriosis, followed by repeat laparoscopic pelvic mapping of endometriosis at a second laparoscopy.Result(s): Superficial peritoneal endometriosis (revised American Fertility Society stage I–II) endometriosis recurred in 37% of pelvic regions after surgical treatment. Endometriosis was more likely to recur in a treated pelvic region than an adjacent or distant pelvic region (relative risk 2.54; 95% confidence interval 1.63-3.97). A region adjacent to a previously affected pelvic region that was unaffected by endometriosis at the initial laparoscopy was more likely to have endometriosis at the second laparoscopy than a pelvic region distant from the treated pelvic region (relative risk 1.29; 95% confidence interval 0.84-2.0). Unaffected regions at initial laparoscopy had a low probability of having new endometriosis (11%) in the second laparoscopy.Conclusion(s): Recurrence of histologically proven endometriosis after surgical excision is more likely to cluster close to the original area of involvement, reflecting either incomplete excision at the initial surgery or a nonrandom favored implantation of new endometrial implants in adjacent peritoneum. Further studies are needed to elucidate the pathophysiology and mechanisms of recurrence of endometriosis.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Standardized entry criteria and outcome measures for clinical trials in endometriosis-related pain would facilitate the comparison of trial results and the production of systematic reviews, improving evidence-based practice in this area. This report summarizes the recommendations from an international meeting for these criteria.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: Persistent Chlamydia trachomatis infections are associated with tubal pathology. We studied whether sampling from multiple sites would increase the identification of the infections.Design: Prospective cohort study.Setting: Tertiary care facility.Patient(s): Two hundred two infertile women.Intervention(s): Smears were taken from the cervix, urethra, high vagina, fimbriae and the Douglas cavity. Blood samples were collected and tubal patency was assessed by pertubation with lipiodol and methylene blue.Main Outcome Measure(s): Detection of C. trachomatis DNA, detection of IgA and IgG antibodies against C. trachomatis, and antibodies against chlamydial heat-shock protein 60, tubal patency.Result(s): Chlamydia trachomatis was detected in 2 of 202 patients, for an overall prevalence of 1%. In both patients PCR results were positive in the cervical, vaginal, and urethral specimens. Chlamydia trachomatis IgG, IgA, and chlamydial heat-shock protein 60 IgG were significantly more prevalent in women with distal tubal pathology than in those without (26/40 [65.0%] vs. 16/162 [9.9%], 9/40 [22.5%] vs. 7/162 [4.3%], and 34/40 [85.0%] vs. 34/162 [21.0%]). Bacterial colonization was found in 1 of 202 samples from the Douglas cavity.Conclusion(s): Routine DNA testing for C. trachomatis should be confined to cervical sampling. The association between tubal pathology and seropositivity of IgG, IgA, and cHSP60 IgG was confirmed but did not add clinically valuable information during the diagnostic workup of infertility patients.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To determine the prevalence of eating disorders in a sample of infertile women.Design: A descriptive comparative two-group design in which collected data were compared with a published community sample.Setting: Private infertility center.Patient(s): Eighty-two participants beginning their first gonadotropin/intrauterine insemination (IUI) treatment cycle completed self-report measures that assessed eating disorder pathology and exercise habits. Each subject was telephone-administered the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) Module H (Eating Disorders) and a demographic questionnaire.Intervention(s): None.Main Outcome Measure(s): Past or current diagnosis of an eating disorder.Result(s): Seventeen participants (20.7%) met criteria for a past or current eating disorder, which is five times higher than the U.S. lifetime prevalence rate. None of the participants who met the criteria for an eating disorder had disclosed their past or current diagnosis to their reproductive endocrinologist.Conclusion(s): Infertility clinics are likely to be treating women with a past or current eating disorder history. Therefore, an eating disorder screening tool should be included in the initial intake, because these patients may be at a higher risk for negative maternal and fetal outcomes than non–eating disorder patients. Additionally, patients with a past or current eating disorder may not disclose this information to reproductive health care providers, which may limit providers’ ability to provide appropriate medical and psychologic referrals.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To determine the predictive factors for pregnancy after IUI.Design: Retrospective study.Setting: A single university medical center.Patient(s): One thousand thirty-eight IUI cycles in 353 couples were studied between 2002 and 2005.Intervention(s): Ovarian stimulation via SC injection of FSH or hMG was performed daily; IUI was then performed 36 hours after triggering ovulation if at least one follicle measuring >16 mm and an endometrial thickness of >7 mm (with triple-line development) were obtained.Main Outcome Measure(s): Clinical pregnancy rates were analyzed according to the woman’s age, the type of infertility, the spermogram characteristics, the total motile spermatozoa (TMS) count, the E2 level before hCG injection, and the number of mature follicles.Result(s): The couple with the best chance of pregnancy can be described as follows: an under 30 woman with cervical or anovulatory infertility and a man with a TMS ?5 million spermatozoa. The “ideal” stimulation cycle enables the recruitment of two follicles measuring >16 mm with an E2 concentration >500 pg/mL on the day of hCG administration. The best results are obtained when IUI is performed using a soft catheter.Conclusion(s): This study enabled the characterization of many prognostic factors for pregnancy and particularly those for women at risk of multiple pregnancies after IUI.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To assess the association between recent cigarette smoking (CS) in female and male partners and assisted reproduction technology (ART) outcomes.Design: Cohort prospective study.Setting: University ART program in Chile.Patient(s): One hundred sixty-six couples seeking pregnancy through ART.Intervention(s): Follicular fluid (FF) and serum cotinine concentrations were measured in female partners. Self-reported CS data were collected through personal interviews.Main Outcome Measure(s): The association between female recent smoking, assessed by FF and serum cotinine concentrations, and ART outcomes, such as number of ova retrieved and implantation rates, and the association between self-reported male recent smoking and live birth rates.Result(s): A significant age-adjusted association between increased FF cotinine level and decreased number of ova retrieved was found. The male partner’s smoking habit significantly decreased the live birth rate from 21.1% to 7.8%. Serum cotinine concentrations paralleled those of FF.Conclusion(s): The hypothesis of a detrimental effect of recent female smoking over implantation rates is rejected. However, recent male smoking is associated with significantly decreased live birth rates even after adjusting for confounders. Female recent smoking was significantly associated with decreased number of retrieved ova.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To compare the results of IVF and intracytoplasmic sperm injection (ICSI) in extremely low oocyte retrieval cycles.Design: Case–control study.Setting: An IVF laboratory in a university hospital in Taiwan.Patient(s): Between January 2003 and December 2007, infertile couples with one, two, or three oocytes per retrieval were divided into two groups: 56 IVF cycles based on 28 demographic characteristics from the ICSI group.Intervention(s): None.Main Outcome Measure(s): Fertilization rate, cycle cancellation rate, clinical pregnancy rate, and implantation rate per transfer.Result(s): The normal fertilization rate was significantly higher after ICSI than after standard IVF (86.4% vs. 69.3%). The cycle cancellation and complete fertilization failure rates were comparable between the two groups. The clinical pregnancy rate per transfer (38.5% vs. 21.6%), implantation rate (23.5% vs. 11.1%), and live birth rate per transfer (30.8% vs. 13.7%) had a favorable trend, but no statistically significant differences, in the ICSI group compared with the IVF group.Conclusion(s): A higher normal fertilization rate can be achieved by ICSI in comparison with conventional IVF in extremely low oocyte retrieval cycles.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To explore the long- and short-term trends in LH-suppression protocol use and patient profile characteristics.Design: Descriptive study, retrospective cohort.Setting: Large, university-based IVF center.Patient(s): Four thousand five hundred one fresh IVF cycles categorized by use of GnRH antagonist, luteal GnRH agonist, and follicular microdose GnRH agonist.Intervention(s): None.Main Outcome Measure(s): Frequency of use of LH-suppression protocol, patient and cycle characteristics, and outcomes at 10-year (1996–2005), 5-year (2001–5), and 3-year intervals (2004–6).Result(s): In both the <40 and ?40 age groups, GnRH antagonist use increased from 2001 to 2005, while luteal GnRH agonist and microdose use decreased. The most recent luteal agonist patients were better responders and had higher implantation, clinical pregnancy, and delivery rates. Antagonist patients in the <40 and ?40 age groups had a better response in 2005 than in 2001 with higher clinical pregnancy rates. Microdose patients responded worse in 2005 than in 2001, although pregnancy rates did not change significantly. Such trends were echoed from 2004 to 2006.Conclusion(s): The target population for GnRH antagonist has broadened to include younger, normal responders in addition to the traditional poor responder. Luteal agonist and microdose protocols are chosen less frequently and remain targeted toward good and poor responders, respectively.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To evaluate the impact of cryopreservation storage duration on embryo survival, implantation competence, and pregnancy outcome.Design: Retrospective study.Setting: Academic tertiary-referral infertility center.Patient(s): In vitro fertilization patients and recipients of oocyte donation cycles who had cryopreserved embryos and underwent at least one thaw cycle from 1986 to 2007.Intervention(s): None.Main Outcome Measure(s): Postthaw survival proportion and implantation, clinical pregnancy, miscarriage, and live birth rates.Result(s): Length of storage time did not have a significant effect on postthaw survival for IVF or oocyte donation cycles, or for embryos frozen at the pronuclear or cleavage stages. There was no significant impact of the duration of storage on clinical pregnancy, miscarriage, implantation, or live birth rate, whether from IVF or oocyte donation cycles. Logistic regression analysis demonstrated that the length of storage time or developmental stage at freezing were not predictive of embryo survival or pregnancy outcome. Only oocyte age, survival proportion, and number of transferred embryos were positive predictors of pregnancy outcome.Conclusion(s): Cryostorage duration did not adversely affect postthaw survival or pregnancy outcome in IVF or oocyte donation patients.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To evaluate the level of macrophage colony-stimulating factor (M-CSF) in serum in response to ovarian stimulation (group 1) in low-response (n = 26), moderate-response (n = 40), and high-response (n = 29) patients and to compare its changes (n = 23, group 2) throughout the menstrual cycle between pregnant and nonpregnant patients.Design: Randomized controlled trial.Setting: University IVF program.Patient(s): Ninety-five women undergoing IVF.Intervention(s): Serum and FF collection from 95 women.Main Outcome Measure(s): The M-CSF concentration was determined by ELISA.Result(s): The M-CSF levels in FF were higher than in serum. The M-CSF levels in serum increased from low-, through moderate-, to high-response patients; pregnancy rates were 11.5%, 22.5%, and 51.7%, respectively. Levels of M-CSF in serum increased throughout stimulation until the day of oocyte retrieval and decreased until ET. During the postretrieval days, from the day of ET, through implantation, to the day of confirmation of pregnancy, the M-CSF levels of those patients who became pregnant (n = 13) increased significantly and reached their highest level. After implantation the M-CSF level decreased slightly and reached a plateau during gestation.Conclusion(s): Macrophage colony-stimulating factor is involved in follicle development and ovulation and could be an additional predictor for IVF outcome.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To study concordance rates of cryptorchidism (undescended testis) in pairs of boys with varying family structure, to evaluate the risk contribution from the intrauterine environment and genetic factors.Design: Population based study of 1,024,500 Danish boys born from January 1, 1973 to December 31, 2004. Classic twin method and computerized square dance design.Setting: Hospitals and outpatient clinics.Patient(s): Six groups of boy pairs: boys with no relation, paternal half-brothers, maternal half-brothers, full brothers, dizygotic twin brothers, and monozygotic twin brothers.Intervention(s): Observational study.Main Outcome Measure(s): Status on each individual regarding cryptorchidism and orchiopexy from the Danish National Patient Register.Result(s): Concordance rates of cryptorchidism in the groups were as follows: boys with no relation 3.2% (95% confidence interval 2.7%-3.6%), paternal half-brothers 3.4% (2.3%-4.7%), maternal half-brothers 6.0% (4.5%-7.7%), full brothers 8.8% (8.3%-9.8%), dizygotic twin brothers 24.1% (16.0%-33.6%), and monozygotic twin brothers 27.3% (15.5%-41.2%).Conclusion(s): The concordance rate was higher in maternal than in paternal half-brothers, and much higher but of equal magnitude in both twin groups. The findings strongly support that the intrauterine environment and maternal inheritance are contributing to the occurrence of cryptorchidism.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To explore associations between exposure to metals and male reproductive hormone levels.Design: Cross-sectional epidemiology study with adjustment for potential confounders.Setting: University Medical Center.Patient(s): Men recruited through two infertility clinics in Michigan.Intervention(s): Metal concentrations and reproductive hormone levels were measured in blood samples collected from 219 men.Main Outcome Measure(s): Serum FSH, LH, inhibin B, T, and sex hormone-binding globulin levels.Result(s): Cadmium, copper, and lead were all significantly or suggestively positively associated with T when modeled individually, findings that are consistent with limited previous human and animal studies. Conversely, molybdenum was associated with reduced T. A significant inverse trend between molybdenum and T remained when additionally considering other metals in the model, and a positive association between T and zinc was also found. Finally, in exploratory analysis there was evidence for an interaction between molybdenum and zinc, whereby high molybdenum was associated with a 37% reduction in T (relative to the population median level) among men with low zinc.Conclusion(s): Although reductions in T and reproductive toxicity after molybdenum exposure have been previously demonstrated in animal studies, more research is needed to determine whether molybdenum poses a risk to human reproductive health.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To establish a multilocus model for studying the effect of estrogen-related genes on impaired spermatogenesis.Design: Prospective study.Setting: University-based reproductive clinics and genetics laboratory.Patient(s): A total of 183 oligozoospermatic (sperm count <20 × 106/mL) or azoospermatic males and 120 fertile control males were included.Intervention(s): A total of 16 single nucleotide polymorphisms (SNPs) from nine genes (estrogen receptors [ER-?, ER-?], estrogen synthesizing/metabolizing genes [CYP17, CYP19A1, HSD17B2, CYP1A1, CYP1B1, COMT], and transport genes [SHBG]) were genotyped. The combinatorial effect of multiple genetic variants was assessed using the multilocus model.Main Outcome Measure(s): Significantly associated SNPs and odds ratio (OR).Result(s): Six SNPs from five genes (rs180113 of ER-? gene, rs1256049 of ER-? gene, rs1048943 of CYP1A1 gene, rs8191246 of HSD17B2 gene, and rs1799941 along with rs6259 of SHBG gene) were found to be significantly associated with spermatogenic defect. The genes were further divided into three categories according to their functions (receptors, synthesis and metabolism, and transporter). Based on our multilocus risk model, men with risk alleles in two of the three gene families had increased risk of impaired sperm production (OR = 10.5). The OR further increased to 34.6 for men with unfavorable alleles for all three gene families.Conclusion(s): Polymorphisms of estrogen-related genes jointly confer susceptibility to human spermatogenic defect at the prereceptor, receptor, and postreceptor levels in the Taiwanese Han population.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To verify whether chemotaxis is in part an oxidative process mediated by reactive oxygen species (ROS).Design: In this prospective study, after removal of seminal plasma, the sperm suspension received no treatment (control), ROS formation by stimulation with phorbol 12-myristate 13-acetate (PMA), antioxidant treatment (with catalase), or PMA stimulus in the presence of catalase. At time zero and after 3 hours of incubation, the percentage of capacitated and oriented spermatozoa and the ROS levels were determined.Setting: Andrology laboratory in a medical research institution.Patient(s): Normal semen was obtained from eight men.Intervention(s): The semen samples were evaluated to determine the effect of ROS production by stimulation with PMA and/or antioxidant treatment (with catalase) on the percentage of capacitated and oriented spermatozoa.Main Outcome Measure(s): The sperm capacitation, chemotaxis and reactive oxygen species were assessed before and after PMA and/or antioxidant treatment.Result(s): Prolonged exposure to high quantities of ROS decrease the sperm chemotactic response, probably because of oxidative damage of the cell. However, this effect may be reduced by the addition of antioxidants like catalase.Conclusion(s): Similar to capacitation, chemotaxis seems to depend on the production of ROS, but in the latter process there may be a critical level of ROS necessary for chemotaxis to occur.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To evaluate the predictive value of a sperm maturation test using the hyaluronan-binding assay (HBA) for freezability potential; and to determine the effect of freezing–thawing on HBA results.Design: Prospective study.Setting: Andrology laboratory at a teaching hospital.Patient(s): Candidates for sperm bank donation (n = 113) and active sperm bank donors (n = 16).Intervention(s): Semen analyses including HBA and sperm freezing–thawing.Main Outcome Measure(s): Percentage of sperm HBA results and other sperm parameters in relation to freezing–thawing results.Result(s): The predictive value of HBA for high freezability value (?40% postthaw motility) was significant. However, 1- and 4-hour percentage of motility had a higher predictive value for good freezability. A better prognostic value than that of HBA resutlts was also found for sperm concentration and percentage of normal morphology. Freezing–thawing had no significant influence on HBA results.Conclusion(s): To the best of our knowledge this is the first demonstration that sperm maturation, determined by the HBA test, has a low value for predicting freezing–thawing sperm survival.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
Objective: To evaluate the effect of cryopreservation on sperm motility and viability and to assess sperm DNA fragmentation and oxidation in men undergoing infertility investigation before and after cryopreservation in liquid nitrogen.Design: Analysis of cryopreservation effects on sperm DNA integrity.Setting: Laboratory of Histology–Embryology of medicine faculty, Sfax, Tunisia.Patient(s): Fifteen semen samples from men undergoing infertility investigation.Intervention(s): Neat semen samples were cryopreserved in liquid nitrogen using a commercial freezing medium (SpermFreeze, Fertipro, Belgium) according to the manufacturer’s instructions. Samples were thawed at room temperature.Main Outcome Measure(s): Sperm DNA fragmentation was assessed using terminal deoxynucleotidyl transferase (Tdt) mediated dUTP nick end labeling and sperm DNA oxidation was determined using a fluorescent assay (OxyDNA test) for the detection of 8-oxoguanine. Evaluation of DNA fragmentation and oxidation rates was carried out before and after cryopreservation using flow cytometry.Result(s): A significant decrease in sperm motility and viability was observed after cryostorage. In addition, sperm DNA fragmentation and DNA oxidative damage increased significantly after cryopreservation/thaw.Conclusion(s): Cryopreservation has deleterious effects on sperm DNA by inducing DNA fragmentation and oxidation but the mechanisms underlying such damages need to be elucidated by further investigations.
Posted on December 31, 2009 | Filed under Fertility News | Permalink
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