Objective:To bring out current evidence regarding psycho-social interventions for infertility care,and identify the best practices in clinical care.Methods:An in-depth literature review on infertility care interventio...Objective:To bring out current evidence regarding psycho-social interventions for infertility care,and identify the best practices in clinical care.Methods:An in-depth literature review on infertility care intervention was conducted using data from multiple databases:PubMed,EMBASE,Google Scholar,and PsycINFO.The relevant articles selected were between 2008 and 2022.Results:A literature search turned up 1798 citations,of which 25 studies were included after rigorous analysis.Various intervention categories have been constantly utilised to provide support and promote mental health,of which acceptance and commitment therapy(ACT)and cognitive behaviour therapy(CBT)were used most frequently.The interventions exhibited diversity in both content and composition,and addressed a wide range of issues.Conclusions:The review emphasizes that psycho-social interventions have a positive effect on psychological issues,relationships,and pregnancies among couples and can be incorporated into fertility-care practices.展开更多
Background: The pathologies causing male infertility are various (congenital or acquired) and concern several hormone-producing organs: the hypothalamus, pituitary gland, testes and adrenals. The hormonal dosage inclu...Background: The pathologies causing male infertility are various (congenital or acquired) and concern several hormone-producing organs: the hypothalamus, pituitary gland, testes and adrenals. The hormonal dosage includes systematically testosterone, FSH and LH. These analyses often highlight hypogonadism hypogonadotropic or hypergonadotropic. They can sometimes be normal. The present study aimed to establish the hormonal profile of infertile men residing in Brazzaville. Patients and Methods: It was a cross-sectional descriptive study during five years (from 2018 to 2023). It concerned 344 infertilemen with an abnormal spermogram and spermocytogram. The method was performed from the blood dosage of testosterone, FSH, and LH using the Elisa technique. Results: The hormonal assessment was not normal in 48.83% (168/344) of cases. Increased values of testosterone were noted in 6.10% of cases and decreased in 12.20%. Abnormal high values of FSH were observed in 14.24% of cases and decreased values in 8.13%. LH was elevated, i.e. 2.03% of cases and decreased in 6.10% of subjects. Conclusions: A hormonal disturbance was observed in almost half of the infertile men. It concerned the hypothalamus-pituitary and the testes axis and indicated mainly a state of hypogonadism with high FSH and low LH.展开更多
Background: The ovarian reserve, which is an important marker in the management of couple infertility, undergoes depletion over time. This depletion could accelerate in the presence of certain circumstances, such as o...Background: The ovarian reserve, which is an important marker in the management of couple infertility, undergoes depletion over time. This depletion could accelerate in the presence of certain circumstances, such as obesity. The contradictory results of studies on the impact of obesity on the ovarian reserve throughout the world accelerated ovarian ageing in infertile women from Kinshasa, as well as the high rate of obese women in this population, seemed necessary to undertake this study to find out if this obesity impacted the ovarian reserve of Kinshasa women. The objective of this study was to identify the profile of markers of ovarian reserve in obese infertile patients according to certain characteristics. Method: A case-control study with retrospective data collection on 439 obese infertile patients (cases) and 439 normal-weight infertile patients (controls) who had consulted for the desire to conceive at the University Hospital of Kinshasa and the Edith Medical Center between January 2016 and December 2021. Results: The average age of the patients was 33.6 years ± 4.3 years, with 47.8% of patients aged at least 35 years. Menarche and menstrual duration were correlated with AMH in linear regression (p = 0.043 and 0.021, respectively). Late menarche and irregular cycle were risk factors for ovarian ageing [OR: 4.6;95% CI: (1.052 - 20.636);p = 0.043 and OR: 4.8;95% CI: (1.633 - 14.566);p = 0.005] while PCO was a protective factor for ovarian ageing [OR: 0.109;95% CI: (0.182 - 0.652);p = 0.015]. Conclusion: Within the limits of our study, we found that the more obese the patients were, the faster the ovaries aged.展开更多
Background: Infertility is a complex disorder with significant psycho-social and economic consequences. It globally affects 10% - 15% of couples. In Cameroon, little is known about what women do to overcome the psycho...Background: Infertility is a complex disorder with significant psycho-social and economic consequences. It globally affects 10% - 15% of couples. In Cameroon, little is known about what women do to overcome the psychosocial aspects of the disease. Objectives: This study aimed to identify the support systems and coping strategies of infertile women attending the outpatient consultation unit of the Gynaecological Endoscopic Surgery and Reproductive Teaching Hospital (CHRACERH), Yaoundé, Cameroon. Methods: A hospital-based cross-sectional study was conducted from the 14th of March to the 6th of April 2023 at CHRACERH Yaoundé. A total of 190 participants were recruited using a convenience sampling method. Data regarding socio-demographic characteristics, support systems and coping strategies were collected using a pretested questionnaire. Descriptive and analytic statistics were conducted using SPSS version 25. Results: The mean age of participants was 39.52 ± 7.64 years. The majority 78.9% of participants were workers (public, private sector, or traders) and were Christians 95.8%. The most common source of psychological support was from family 76.8 and husbands 72.63%. Most of the participants 89.5% resorted to prayer and getting busy 48.4% as a coping strategy. There was no statistically significant relationship between coping strategies and psychological disorders p > 0.05. Conclusion: The main support system of participants was family, husband, and friends. Prayer, getting busy and adoption were the most common coping strategies. There is a need for the Ministry of Public Health and other stakeholders to put in place other support systems and coping strategies (FELICIA) used elsewhere and provide adequate health education and infection control to prevent infertility in Cameroon.展开更多
Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing ...Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing nations emphasis is placed on childbirth and inability to fulfill this role can be very distressing. There is an unmet need for assisted reproductive technology (ART) in many developing countries and where facilities exist, they are mostly privately owned, expensive and concentrated in urban areas. To bridge this gap, public fertility clinics have been established to provide subsidized care. Evaluating the characteristics and peculiarities of clientele presenting at these public facilities will aid planning and prioritization of care. Methodology: A descriptive retrospective study of 116 infertile patients presenting to the fertility clinic of the University College Hospital, Ibadan, Nigeria from inception on the 14<sup>th</sup> of February 2019 and 31<sup>st</sup> of December 2022.Data was analyzed using the Statical Package for Social Sciences (IBM, SPSS, New York) version 23. Descriptive statistics were used to summarize the results which were presented with the aid of bar charts and frequency tables. Result: The mean age of the patients was 40.70 ± 6.62 years. Post-menopausal patients accounted for about one-fifth of the study population while 80.2% (93 women) were older than 35 years. The mean duration of infertility was 9.39 ± 6.11years and nine patients (7.8%) had a duration greater than 2 decades. Secondary infertility occurred in 67.2% of the women. Twenty-nine women (25%) had undergone myomectomy prior to presentation. Hypertension (11.2%) was the most prevalent comorbidity. Nineteen patients (16.4%) had used contraceptives in the past with the male condom (36.8%)being the most preponderant. Sixty-seven patients had experienced pregnancy losses before 28 weeks of gestation while just 16 patients (13.8%) had undergone ART, and none was successful. Conclusion: Secondary infertility was the prevalent type of infertility and may not be unconnected with the low contraceptive usage and high risk of sexually transmitted infection. Late presentation coupled with a large proportion of post-menopausal clientele suggests delayed health-seeking behavior most probably due to the prohibitive cost of ART. The need to streamline services offered in public fertility clinics is paramount in low-income countries grappling with scarce resources. A pragmatic approach will involve the provision of low-cost ART, while enhancing gamete donation programs through the implementation of gamete sharing policies. This will invariably bridge the unmet need and skewed access to ART in developing countries.展开更多
Backgrounds: While there’s developing proof aimed toward improving embryo implantation thru a focal point on great development, restrained studies have been performed on enhancing endometrial receptivity. Intrauterin...Backgrounds: While there’s developing proof aimed toward improving embryo implantation thru a focal point on great development, restrained studies have been performed on enhancing endometrial receptivity. Intrauterine Laser Therapy (LT) can be powerful in selling endometrial cell proliferation, therefore enhancing the achievement of assisted reproductive techniques (ART). The contemporary look at aimed to research the effectiveness of effective intrauterine lasers in growing endometrial thickness and the achievement of being pregnant rate. Materials and Methods: In the current clinical randomized trial (RTC) study, the infertile women (20 - 42 years old) referred to the infertility clinic in 2023-2024 who were candidates for IVF treatment with recurrent implantation failure (RIF) history were included. The patients were divided into two main groups: the intervention group;low level laser therapy (LLLT) after hormone administration) (n = 52) and the control group (hormone administration without LT) (n = 52). The IVF success rate and change in endometrial thickness before and after the LT were compared in groups. Results: There was a significant difference between groups (p Conclusion: It appears that the incorporation of Intrauterine LT in the realm of infertility could significantly impact as a novel supplementary treatment in improving endometrial receptivity and pregnancy rate.展开更多
Introduction: Male infertility is defined as the inability of a man to impregnate a woman after 12 months of regular sexual intercourse without contraception. Objective: To improve the state of knowledge on the profil...Introduction: Male infertility is defined as the inability of a man to impregnate a woman after 12 months of regular sexual intercourse without contraception. Objective: To improve the state of knowledge on the profile of the infertile man in Guinea. Methodology: We conducted a prospective, descriptive study over a period of 6 months from October 1st, 2020 to March 31st, 2021. Results: We collected an overall number of 71 patients seen onroutine consultation for infertility. They had a mean age of 36.4 years. More than half of our patients were monogamous (79% of cases). Civil servants were the most affected with 38.02% of cases. Primary infertility was dominant in 65% (n = 46) of cases. On clinical examination, varicocele was the most remarkable abnormality with 88.73% (n = 63) followed by testicular hypotrophy with 59.15% (n = 42). Azoospermia was the most frequent sperm abnormality with 22.54% (n = 16) followed by oligospermia with 15.49% (n = 11). Hormonal assessment based on FSH and LH was performed in 16 patients with azoospermia (22.53%). FSH elevation was associated with azoospermia in 6 patients, i.e. 8.45%, azoospermia associated with a normal FSH level accounting for 14.08% in our series. Conclusion: In our practice, male infertility is becoming more and more of a concern due to the increasing number of patients seeking treatment. The scarcity of a medical assistance for procreation unit alongside with more efficient diagnostic means constitutes a handicap for its management.展开更多
Field experiments on the decomposition of organic materials and the accumulation of organic carbon ininfertile red soils were conducted at the Ecological Experimental Station of Red Soil, the Chinese Academyof Science...Field experiments on the decomposition of organic materials and the accumulation of organic carbon ininfertile red soils were conducted at the Ecological Experimental Station of Red Soil, the Chinese Academyof Sciences, and the potential of CO2 sequestration by reclamation and improving the fertility of these soils was estimated. Results showed that in infertile red soils, the humification coefficients of organic materials were rather high, ranging from 0.28 to 0.63 with an average of 0.43, which was 41% higher than those incorresponding red soils with medium fertility. This was mainly attributed to the high clay content, highacidity and low native organic matter content of infertile red soils. Compared to those in correspondingnormal red soils, the decomposition rates of organic materials were significantly lower in infertile red soilsin the first 2 yearst thereafter no significant difference was observed between those in the two kinds of soils.Depending on the kind and amount of organic manure applied, the soil properties and the rotation systems,annual application of organic manure with a rate of 4500 to 9000 kg ha-1 increased the organic carboncontent in surface 20 cm of infertile red soils by 2.1~7.5 g kg-1 with an average of 4.7 g kg-1 within the first5 years. The organic carbon content in infertile red soils which received organic manure annually increasedlinearly in the first 10 years, thereafter it slowed down, implying that the fertility of the infertile red soilscould reach middle or high level in 1O years if the soil was managed properly It was estimated that throughexploitation of wastelands, re-establishment of fuel forests and improvement of soil fertility, soils in red soilregion of China could sequester an extra 1.50 × 1015 g of atmospheric CO2.展开更多
No previous study has evaluated systematically the relationship between metabolic syndrome （MetS） and prostate-related symptoms and signs in young infertile men. We studied 171 （36.5 ±8.3-years-old） males of ...No previous study has evaluated systematically the relationship between metabolic syndrome （MetS） and prostate-related symptoms and signs in young infertile men. We studied 171 （36.5 ±8.3-years-old） males of infertile couples. MetS was defined based on the National Cholesterol Education Program Third Adult Treatment Panel. All men underwent hormonal （including total testosterone （TT） and insulin）, seminal （including interleukin-8 （IL-8）, seminal plasma IL-8 （sIL-8））, scrotal and transrectal ultrasound evaluations. Because we have previously assessed correlations between MetS and scrotal parameters in a larger cohort of infertile men, here, we focused on transrectal features. Prostate-related symptoms were assessed using the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI） and the International Prostate Symptom Score （IPSS）. Twenty-two subjects fulfilled MetS criteria. In an age-adjusted logistic ordinal model, insulin levels increased as a function of MetS components （Wald = 29.5, P〈 0.0001） and showed an inverse correlation with TT （adjusted r = -0.359, P 〈 0.0001）. No association between MetS and NIH-CPSI or IPSS scores was observed. In an age-, TT-, insulin-adjusted logistic ordinal model, an increase in number of MetS components correlated negatively with normal sperm morphology （Wald -- 5.59, P〈 0.02） and positively with slL-8 levels （Wald = 4.32, P〈 0.05）, which is a marker of prostate inflammation, with prostate total and transitional zone volume assessed using ultrasound （Wald = 17.6 and 12.5, both P〈 0.0001）, with arterial peak systolic velocity （Wald = 9.57, P= 0.002）, with texture nonhomogeneity （hazard ratio （HR） = 1.87 （1.05-3.33）, P 〈 0.05）, with calcification size （Wald = 3.11, P 〈 0.05）, but not with parameters of seminal vesicle size or function. In conclusion, in males of infertile couples, MetS is positively associated with prostate enlargement, biochemical （slL8） and ultrasound-derived signs of prostate inflammation but not with prostate-related symptoms, which suggests that MetS is a trigger for a subclinical, early-onset form of benign prostatic hyperplasia.展开更多
Objective:To investigate the effect of cognitive behavioral therapy on anxiety and depression in infertile women.Methods:This study was performed in 2019 by searching Google Scholar,Scopus,PubMed/MEDLINE,Cochrane libr...Objective:To investigate the effect of cognitive behavioral therapy on anxiety and depression in infertile women.Methods:This study was performed in 2019 by searching Google Scholar,Scopus,PubMed/MEDLINE,Cochrane library,EMBASE,Proquest,ISI Web of Science,MagIran,SID and IranMedex.Eligible studies were selected by two reviewers and outcomes of interest were extracted.The meta-analysis was performed using the random effect models.Ⅰ-square statistic test was used for heterogeneity analysis.Presence of publication bias was also checked.Results:Eleven studies were included in this review.Between-group differences(cognitive behavioral therapy and control groups)in risk ratio for infertile women's depression was d=-1.36;95%CI=-1.81,-0.90;P<0.001.For infertile women's anxiety,between-group differences in risk ratio wasd=-0.83;95%CI=-1.18,-0.47;P<0.001.Conclusions:Cognitive behavioral therapy is effective in the reduction of depression and anxiety in patients with or withoutin vitro fertilization/intracytoplasmic sperm injection treatment.However,the lack of high-quality studies makes it challenging to make a solid and precise conclusion.Well-designed studies should be undertaken in the future to confirm these results.展开更多
Soluble receptor for advanced glycation end products（s RAGE） can decoy the toxic AGEs and is considered to be a protective factor.This study aimed to evaluate the correlation between intrafollicular s RAGE levels an...Soluble receptor for advanced glycation end products（s RAGE） can decoy the toxic AGEs and is considered to be a protective factor.This study aimed to evaluate the correlation between intrafollicular s RAGE levels and clinical outcomes in infertile women of young or advanced maternal age（AMA） undergoing in vitro fertilization（IVF）.A total of 62 young women and 62 AMA women who would undergo IVF were included in this prospective study.The intrafollicular s RAGE concentration was measured to determine its association with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy in young and AMA women,respectively.Besides,correlations between sR AGE and age or follicle-stimulating hormone（FSH） were examined.We found that the intrafollicular s RAGE levels were higher in young patients than those in AMA patients,suggesting that the s RAGE levels were inversely correlated with age.In young patients,sR AGE showed no correlation with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy.But it was found that AMA patients with more retrieved oocytes,fertilized oocytes and high-quality embryos demonstrated higher sR AGE levels,which were a prognostic factor for getting clinical pregnancy independent of age or FSH level.In conclusion,the s RAGE levels decrease with age.Elevated intrafollicular s RAGE levels indicate good follicular growth,fertilization and embryonic development,and successful clinical pregnancy in AMA women,while in young women,the role of s RAGE may not be so predominant.展开更多
Objective To establish a rat model of sterility associated with epididymis and epididymal gene expression profiles relation to fertility by alpha-chlorohydrin.Methods Rats were treated with 10 mg·kg-1·d-1.al...Objective To establish a rat model of sterility associated with epididymis and epididymal gene expression profiles relation to fertility by alpha-chlorohydrin.Methods Rats were treated with 10 mg·kg-1·d-1.alpha-chlorohydrin for 10 consecutive days.Sperm maturation and other fertility parameters were analyzed.The sperm motility and morphology were evaluated by computer-assisted sperm analysis(CASA);sperm survival rate was assessed by SYBR-14 and propidium iodide(PI)fluorescent staining;the weights of testes,epididymides,prostates and seminal vesicles were determined by electronic balance;histological examination of above tissues were evaluated by HE staining;and serumal dihydrotestosterone(DHT)and testosterone(T)of rats were detected by enzyme-labeled immunoassay.Each male rat was paired with 2 female rats in proestrus.Female rats were examined the next morning for the presence of sperm in vaginal smears and underwent a cesarean section on day 12 of gestation.Finally the reproductive indices were calculated as follows:copulation index(number of sperm positive females /number of pairings),pregnancy index(number of pregnancies /number of sperm positive females),and fertility index(number of pregnancies /number of pairings).After that we used Affymetrix Rat 230 2.0 oligo-microarray to identify epididymal special genes associated with fertility.Finally,we validated some of these genes by Real-Time quantitative polymerase chain reaction.Results The motility of spermatozoa from the cauda epididymidis of treated rats showed a significant decrease in percentage of motile,progressively motile sperm,and sperm survival rate.At the same time,the morphology of cauda epididymal spermatozoa was also adversely affected by the treatment.In addition,the serumal androgen levels of treated animals weren't changed compared with the control group.Accordingly,matings with treated males resulted in no successful pregnancy.Then,we classified general functions of the down or up regulated epididymal genes by chlorhydrin with the GeneSpring gene ontology(GO)analysis,which are involved in macromolecular metabolism and transport,primary metabolism process,cell metabolism,biological process regulation,immunology regulation,ion combination,hydratase and oxidoreductase activity.Among all the different expressed genes,we analyzed and screened the down-regulated genes associated with glucose,lipid,protein and other energy metabolism,which are considered as the major ACH action targets.Simultaneously,the up-regulated genes by chlorhydrin were detected and their characters of negative regulated sperm maturation and fertility analyzed,which are apoptosis and immune-related genes and not reported before.Conclusions We established male infertile rat model with ACH(10 mg·kg-1·d-1,po,10 days)through evaluating changes of sperm motility and morphology,mating index,fertility index and pregnancy index.Simultaneously,the ACH didn't affect the major androgen(T and DHT)metabolism and sexual ability,which is considered as the best way for male contraception.Then we determined the down-regulated epididymal genes relation to substance metabolism,which can affect the epididymal sperm maturation and presumed the major antifertility targets by ACH.Further more,we found and analyzed the epididymal up-regulated genes associated with apoptosis and immune functions,which maybe the new possible sites of action by ACH and other male antifertility agents.展开更多
Objective:To compare the prolactin, progesterone, luteinizing hormone, follicle stimulating hormone, estradiol, antisperm antibodies, tumor necrosis factorα, total antioxidant capacity, prostaglandin E2 and F2α betw...Objective:To compare the prolactin, progesterone, luteinizing hormone, follicle stimulating hormone, estradiol, antisperm antibodies, tumor necrosis factorα, total antioxidant capacity, prostaglandin E2 and F2α between primary and secondary infertile women in Calabar.Methods:One hundred and two volunteers infertile women (test group), aged 20-45 years attending the infertility clinic in the University of Calabar Teaching Hospital (UCTH) were recruited. Fourteen of the women had primary infertility while 88 of them had secondary infertility. Sixty apparently healthy, age matched women served as the control group. Five millilitres of blood was collected, allowed to clot and serum was obtained from the subjects and Enzyme Linked Immunosorbent Assay method was used for prolactin, progesterone, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH), prostaglandin E2and F2α, human TNF-α,Chlamydia trachomatis IgG, antisperm antibodies assay, while serum total antioxidant capacity was assessed spectrophotometrically.Results:The result shows on comparison that primary infertile women has a significantly higher level of progesterone than those with secondary infertility (P>0.05). There was a significant difference in the levels of prolactin and total antioxidant capacity in the primary and secondary infertility when compare to the control group atP>0.05. Their mean ages were (31.10±5.37) years and (33.10±4.91) years respectively. There was a positive correlation between TAC and FSH, TNF and anti-sperm anti-bodies in the test group ofr=0.207 andr=0.632;P>0.05 respectively.Conclusions: These findings suggest no alterations in levels of prostaglandin F2α, TNF and anti-oxidant between primary and secondary infertile females.展开更多
Evaluation of infertility indicated for women failed to conceive after one year of unprotected intercourse and for women over 35 years failed to conceive after 6 mo of unprotected intercourse, because the fertility de...Evaluation of infertility indicated for women failed to conceive after one year of unprotected intercourse and for women over 35 years failed to conceive after 6 mo of unprotected intercourse, because the fertility decline as women approach 40 years. Evaluation of infertile couple should begin with semen analysis of male partner. If the semen analysis is within normal range, evaluation then move on to female partner. Evaluation of the infertile woman should be carried in cost-effective manner to identify the causes of infertility using the least invasive methods. Methods of evaluation of infertile women include: 1) history and physical examination;2) evaluation of the male partner;3) documentation of ovulation;4) evaluation of the ovarian reserve;5) evaluation of cervical causes of infertility;6) evaluation of uterine causes of infertility;7) documentation of the tubal patency;and 8) exclusion of peritoneal causes of infertility. Evaluation of infertile couple should include evaluation of both partners. Semen analysis for the male partner, followed by documentation of ovulation and evaluation of genital tract patency. PCT is not used as routine evaluation of infertile women. Laparoscopy is not used as routine evaluation of infertile women unless there is suspected peritoneal factors of infertility or endometriosis or tubal occlusion. Ovarian reserve should only be done for infertile women with diminished response to external gonadotropins (not routine).展开更多
The diameters of spermatic veins and blood reflux in sixty-two male patients with infertility caused by varicocele were assessed with Doppler ultrasound in this study. Scrotal thermograph, testes volume and semen anal...The diameters of spermatic veins and blood reflux in sixty-two male patients with infertility caused by varicocele were assessed with Doppler ultrasound in this study. Scrotal thermograph, testes volume and semen analysis were also applied to analysis of these patients. Among sixty-two patients, thirty-one received high ligation of internal spermatic vein. The results showed: 1. The diameter of spermatic veins was negatively correlated with fertility index and positively correlated with Doppler grading of blood reflux. 2. In operative patients, the effect of surgery was better in patients with blood reflux than in those without blood reflux. It was suggested the diameter of spermatic veins probably reflects the duration and serious degree of blood reflux in spermatic vein, and may be used for assessment of severity of male infertility in combination with semen analysis.展开更多
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 alt...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 sDerm DNA damage in obese men （odds ratio （95% confidence interval）： 2.5 （1.2-5.1））.展开更多
Aim： To investigate the prevalence of high levels of sperm DNA damage among men from infertile couples with both normal and abnormal standard semen parameters. Methods： A total of 350 men from infertile couples were...Aim： To investigate the prevalence of high levels of sperm DNA damage among men from infertile couples with both normal and abnormal standard semen parameters. Methods： A total of 350 men from infertile couples were assessed. Standard semen analysis and sperm chromatin structure assay （SCSA） were carried out. Results： Ninety-seven men （28% of the whole study group） had a DNA fragmentation index （DFI） 〉 20%, and 43 men （12%） had a DFI 〉 30%. In the group of men with abnormal semen parameters （n = 224）, 35% had a DFI 〉 20%, and 16% had a DFI 〉 30%, whereas these numbers were 15% and 5%, respectively, in the group of men with normal semen parameters （n = 126）. Men with low sperm motility and abnormal morphology had significantly higher odds ratios （ORs） for having a DFI 〉 20% （4.0 for motility and 1.9 for morphology） and DFI 〉 30% （6.2 for motility and 2.8 for morphology） compared with men with normal sperm motility and morphology. Conclusion： In almost one-third of unselected men from infertile couples, the DFI exceeded the level of 20% above which, according to previous studies, the in vivo fertility is reduced. A significant proportion of men with otherwise normal semen parameters also had high sperm DNA damage levels. Thus, the SCSA test could add to explaining causes of infertility in cases where semen analysis has not shown any deviation from the norm. We also recommend running the SCSA test to choose the appropriate assisted reproductive technique （ART）.展开更多
This study was carried out to analyze the vertical transmission of Yq AZFc microdeletions from father to son in infertile Han Chinese families to investigate genetic factors and family background affecting fertility s...This study was carried out to analyze the vertical transmission of Yq AZFc microdeletions from father to son in infertile Han Chinese families to investigate genetic factors and family background affecting fertility status.The peripheral blood of infertile males in 19 Han families was extracted and screened with modified multiplex polymerase chain reaction （PCR）. Family trees were drawn according to fertility status and clinical characteristics of the subjects. The vertical transmission of Yq AZFc microdeletions was detected in six cases of 19 investigated families （31.6%,6/19）. Although both fathers and sons showed a similar type of Yq AZFc deletion,the fathers were fertile,whereas the sons were infertile and showed severe oligozoospermia. The vertical transmission of Yq AZFc microdeletion from fertile fathers to infertile sons over generations is not rare. This has different effects on fertility status in fathers and sons in Han Chinese families. Both genetic factors and family background affect spermatogenetic phenotypes.展开更多
Aim： To investigate the possible causes of oligozoospermia and azoospermia in infertile Thai men, and to find the frequencies of Y chromosome microdeletions and cytogenetic abnormalities in this group. Methods： From...Aim： To investigate the possible causes of oligozoospermia and azoospermia in infertile Thai men, and to find the frequencies of Y chromosome microdeletions and cytogenetic abnormalities in this group. Methods： From June 2003 to November 2005, 50 azoospermic and 80 oligozoospermic men were enrolled in the study. A detailed history was taken for each man, followed by general and genital examinations. Y chromosome microdeletions were detected by multiplex polymerase chain reaction （PCR） using 11 gene-specific primers that covered all three regions of the azoospermic factor （AZFa, AZFb and AZFc）. Fifty men with normal semen analysis were also studied. Karyotyping was done with the standard G- and Q-banding. Serum concentrations of follicle stimulating hormone （FSH）, luteinizing hormone （LH）, prolactin （PRL） and testosterone were measured by electrochemiluminescence immunoassays （ECLIA）. Results： Azoospermia and oligozoospermia could be explained by previous orchitis in 22.3%, former bilateral cryptorchidism in 19.2%, abnormal karyotypes in 4.6% and Y chromosome microdeletions in 3.8% of the subjects. The most frequent deletions were in the AZFc region （50%）, followed by AZFb （33%） and AZFbc （17%）. No significant difference was detected in hormonal profiles of infertile men, with or without microdeletions. Conclusion： The frequencies of Y chromosome microdeletions and cytogenetic abnormalities in oligozoospermic and azoospermic Thai men are comparable with similarly infertile men from other Asian and Western countries.展开更多
基金funded by University Grants Commission,India under the JRF(Junior Research Fellowship)scheme for Ph.D.Scholars.
文摘Objective:To bring out current evidence regarding psycho-social interventions for infertility care,and identify the best practices in clinical care.Methods:An in-depth literature review on infertility care intervention was conducted using data from multiple databases:PubMed,EMBASE,Google Scholar,and PsycINFO.The relevant articles selected were between 2008 and 2022.Results:A literature search turned up 1798 citations,of which 25 studies were included after rigorous analysis.Various intervention categories have been constantly utilised to provide support and promote mental health,of which acceptance and commitment therapy(ACT)and cognitive behaviour therapy(CBT)were used most frequently.The interventions exhibited diversity in both content and composition,and addressed a wide range of issues.Conclusions:The review emphasizes that psycho-social interventions have a positive effect on psychological issues,relationships,and pregnancies among couples and can be incorporated into fertility-care practices.
文摘Background: The pathologies causing male infertility are various (congenital or acquired) and concern several hormone-producing organs: the hypothalamus, pituitary gland, testes and adrenals. The hormonal dosage includes systematically testosterone, FSH and LH. These analyses often highlight hypogonadism hypogonadotropic or hypergonadotropic. They can sometimes be normal. The present study aimed to establish the hormonal profile of infertile men residing in Brazzaville. Patients and Methods: It was a cross-sectional descriptive study during five years (from 2018 to 2023). It concerned 344 infertilemen with an abnormal spermogram and spermocytogram. The method was performed from the blood dosage of testosterone, FSH, and LH using the Elisa technique. Results: The hormonal assessment was not normal in 48.83% (168/344) of cases. Increased values of testosterone were noted in 6.10% of cases and decreased in 12.20%. Abnormal high values of FSH were observed in 14.24% of cases and decreased values in 8.13%. LH was elevated, i.e. 2.03% of cases and decreased in 6.10% of subjects. Conclusions: A hormonal disturbance was observed in almost half of the infertile men. It concerned the hypothalamus-pituitary and the testes axis and indicated mainly a state of hypogonadism with high FSH and low LH.
文摘Background: The ovarian reserve, which is an important marker in the management of couple infertility, undergoes depletion over time. This depletion could accelerate in the presence of certain circumstances, such as obesity. The contradictory results of studies on the impact of obesity on the ovarian reserve throughout the world accelerated ovarian ageing in infertile women from Kinshasa, as well as the high rate of obese women in this population, seemed necessary to undertake this study to find out if this obesity impacted the ovarian reserve of Kinshasa women. The objective of this study was to identify the profile of markers of ovarian reserve in obese infertile patients according to certain characteristics. Method: A case-control study with retrospective data collection on 439 obese infertile patients (cases) and 439 normal-weight infertile patients (controls) who had consulted for the desire to conceive at the University Hospital of Kinshasa and the Edith Medical Center between January 2016 and December 2021. Results: The average age of the patients was 33.6 years ± 4.3 years, with 47.8% of patients aged at least 35 years. Menarche and menstrual duration were correlated with AMH in linear regression (p = 0.043 and 0.021, respectively). Late menarche and irregular cycle were risk factors for ovarian ageing [OR: 4.6;95% CI: (1.052 - 20.636);p = 0.043 and OR: 4.8;95% CI: (1.633 - 14.566);p = 0.005] while PCO was a protective factor for ovarian ageing [OR: 0.109;95% CI: (0.182 - 0.652);p = 0.015]. Conclusion: Within the limits of our study, we found that the more obese the patients were, the faster the ovaries aged.
文摘Background: Infertility is a complex disorder with significant psycho-social and economic consequences. It globally affects 10% - 15% of couples. In Cameroon, little is known about what women do to overcome the psychosocial aspects of the disease. Objectives: This study aimed to identify the support systems and coping strategies of infertile women attending the outpatient consultation unit of the Gynaecological Endoscopic Surgery and Reproductive Teaching Hospital (CHRACERH), Yaoundé, Cameroon. Methods: A hospital-based cross-sectional study was conducted from the 14th of March to the 6th of April 2023 at CHRACERH Yaoundé. A total of 190 participants were recruited using a convenience sampling method. Data regarding socio-demographic characteristics, support systems and coping strategies were collected using a pretested questionnaire. Descriptive and analytic statistics were conducted using SPSS version 25. Results: The mean age of participants was 39.52 ± 7.64 years. The majority 78.9% of participants were workers (public, private sector, or traders) and were Christians 95.8%. The most common source of psychological support was from family 76.8 and husbands 72.63%. Most of the participants 89.5% resorted to prayer and getting busy 48.4% as a coping strategy. There was no statistically significant relationship between coping strategies and psychological disorders p > 0.05. Conclusion: The main support system of participants was family, husband, and friends. Prayer, getting busy and adoption were the most common coping strategies. There is a need for the Ministry of Public Health and other stakeholders to put in place other support systems and coping strategies (FELICIA) used elsewhere and provide adequate health education and infection control to prevent infertility in Cameroon.
文摘Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing nations emphasis is placed on childbirth and inability to fulfill this role can be very distressing. There is an unmet need for assisted reproductive technology (ART) in many developing countries and where facilities exist, they are mostly privately owned, expensive and concentrated in urban areas. To bridge this gap, public fertility clinics have been established to provide subsidized care. Evaluating the characteristics and peculiarities of clientele presenting at these public facilities will aid planning and prioritization of care. Methodology: A descriptive retrospective study of 116 infertile patients presenting to the fertility clinic of the University College Hospital, Ibadan, Nigeria from inception on the 14<sup>th</sup> of February 2019 and 31<sup>st</sup> of December 2022.Data was analyzed using the Statical Package for Social Sciences (IBM, SPSS, New York) version 23. Descriptive statistics were used to summarize the results which were presented with the aid of bar charts and frequency tables. Result: The mean age of the patients was 40.70 ± 6.62 years. Post-menopausal patients accounted for about one-fifth of the study population while 80.2% (93 women) were older than 35 years. The mean duration of infertility was 9.39 ± 6.11years and nine patients (7.8%) had a duration greater than 2 decades. Secondary infertility occurred in 67.2% of the women. Twenty-nine women (25%) had undergone myomectomy prior to presentation. Hypertension (11.2%) was the most prevalent comorbidity. Nineteen patients (16.4%) had used contraceptives in the past with the male condom (36.8%)being the most preponderant. Sixty-seven patients had experienced pregnancy losses before 28 weeks of gestation while just 16 patients (13.8%) had undergone ART, and none was successful. Conclusion: Secondary infertility was the prevalent type of infertility and may not be unconnected with the low contraceptive usage and high risk of sexually transmitted infection. Late presentation coupled with a large proportion of post-menopausal clientele suggests delayed health-seeking behavior most probably due to the prohibitive cost of ART. The need to streamline services offered in public fertility clinics is paramount in low-income countries grappling with scarce resources. A pragmatic approach will involve the provision of low-cost ART, while enhancing gamete donation programs through the implementation of gamete sharing policies. This will invariably bridge the unmet need and skewed access to ART in developing countries.
文摘Backgrounds: While there’s developing proof aimed toward improving embryo implantation thru a focal point on great development, restrained studies have been performed on enhancing endometrial receptivity. Intrauterine Laser Therapy (LT) can be powerful in selling endometrial cell proliferation, therefore enhancing the achievement of assisted reproductive techniques (ART). The contemporary look at aimed to research the effectiveness of effective intrauterine lasers in growing endometrial thickness and the achievement of being pregnant rate. Materials and Methods: In the current clinical randomized trial (RTC) study, the infertile women (20 - 42 years old) referred to the infertility clinic in 2023-2024 who were candidates for IVF treatment with recurrent implantation failure (RIF) history were included. The patients were divided into two main groups: the intervention group;low level laser therapy (LLLT) after hormone administration) (n = 52) and the control group (hormone administration without LT) (n = 52). The IVF success rate and change in endometrial thickness before and after the LT were compared in groups. Results: There was a significant difference between groups (p Conclusion: It appears that the incorporation of Intrauterine LT in the realm of infertility could significantly impact as a novel supplementary treatment in improving endometrial receptivity and pregnancy rate.
文摘Introduction: Male infertility is defined as the inability of a man to impregnate a woman after 12 months of regular sexual intercourse without contraception. Objective: To improve the state of knowledge on the profile of the infertile man in Guinea. Methodology: We conducted a prospective, descriptive study over a period of 6 months from October 1st, 2020 to March 31st, 2021. Results: We collected an overall number of 71 patients seen onroutine consultation for infertility. They had a mean age of 36.4 years. More than half of our patients were monogamous (79% of cases). Civil servants were the most affected with 38.02% of cases. Primary infertility was dominant in 65% (n = 46) of cases. On clinical examination, varicocele was the most remarkable abnormality with 88.73% (n = 63) followed by testicular hypotrophy with 59.15% (n = 42). Azoospermia was the most frequent sperm abnormality with 22.54% (n = 16) followed by oligospermia with 15.49% (n = 11). Hormonal assessment based on FSH and LH was performed in 16 patients with azoospermia (22.53%). FSH elevation was associated with azoospermia in 6 patients, i.e. 8.45%, azoospermia associated with a normal FSH level accounting for 14.08% in our series. Conclusion: In our practice, male infertility is becoming more and more of a concern due to the increasing number of patients seeking treatment. The scarcity of a medical assistance for procreation unit alongside with more efficient diagnostic means constitutes a handicap for its management.
文摘Field experiments on the decomposition of organic materials and the accumulation of organic carbon ininfertile red soils were conducted at the Ecological Experimental Station of Red Soil, the Chinese Academyof Sciences, and the potential of CO2 sequestration by reclamation and improving the fertility of these soils was estimated. Results showed that in infertile red soils, the humification coefficients of organic materials were rather high, ranging from 0.28 to 0.63 with an average of 0.43, which was 41% higher than those incorresponding red soils with medium fertility. This was mainly attributed to the high clay content, highacidity and low native organic matter content of infertile red soils. Compared to those in correspondingnormal red soils, the decomposition rates of organic materials were significantly lower in infertile red soilsin the first 2 yearst thereafter no significant difference was observed between those in the two kinds of soils.Depending on the kind and amount of organic manure applied, the soil properties and the rotation systems,annual application of organic manure with a rate of 4500 to 9000 kg ha-1 increased the organic carboncontent in surface 20 cm of infertile red soils by 2.1~7.5 g kg-1 with an average of 4.7 g kg-1 within the first5 years. The organic carbon content in infertile red soils which received organic manure annually increasedlinearly in the first 10 years, thereafter it slowed down, implying that the fertility of the infertile red soilscould reach middle or high level in 1O years if the soil was managed properly It was estimated that throughexploitation of wastelands, re-establishment of fuel forests and improvement of soil fertility, soils in red soilregion of China could sequester an extra 1.50 × 1015 g of atmospheric CO2.
文摘No previous study has evaluated systematically the relationship between metabolic syndrome （MetS） and prostate-related symptoms and signs in young infertile men. We studied 171 （36.5 ±8.3-years-old） males of infertile couples. MetS was defined based on the National Cholesterol Education Program Third Adult Treatment Panel. All men underwent hormonal （including total testosterone （TT） and insulin）, seminal （including interleukin-8 （IL-8）, seminal plasma IL-8 （sIL-8））, scrotal and transrectal ultrasound evaluations. Because we have previously assessed correlations between MetS and scrotal parameters in a larger cohort of infertile men, here, we focused on transrectal features. Prostate-related symptoms were assessed using the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI） and the International Prostate Symptom Score （IPSS）. Twenty-two subjects fulfilled MetS criteria. In an age-adjusted logistic ordinal model, insulin levels increased as a function of MetS components （Wald = 29.5, P〈 0.0001） and showed an inverse correlation with TT （adjusted r = -0.359, P 〈 0.0001）. No association between MetS and NIH-CPSI or IPSS scores was observed. In an age-, TT-, insulin-adjusted logistic ordinal model, an increase in number of MetS components correlated negatively with normal sperm morphology （Wald -- 5.59, P〈 0.02） and positively with slL-8 levels （Wald = 4.32, P〈 0.05）, which is a marker of prostate inflammation, with prostate total and transitional zone volume assessed using ultrasound （Wald = 17.6 and 12.5, both P〈 0.0001）, with arterial peak systolic velocity （Wald = 9.57, P= 0.002）, with texture nonhomogeneity （hazard ratio （HR） = 1.87 （1.05-3.33）, P 〈 0.05）, with calcification size （Wald = 3.11, P 〈 0.05）, but not with parameters of seminal vesicle size or function. In conclusion, in males of infertile couples, MetS is positively associated with prostate enlargement, biochemical （slL8） and ultrasound-derived signs of prostate inflammation but not with prostate-related symptoms, which suggests that MetS is a trigger for a subclinical, early-onset form of benign prostatic hyperplasia.
文摘Objective:To investigate the effect of cognitive behavioral therapy on anxiety and depression in infertile women.Methods:This study was performed in 2019 by searching Google Scholar,Scopus,PubMed/MEDLINE,Cochrane library,EMBASE,Proquest,ISI Web of Science,MagIran,SID and IranMedex.Eligible studies were selected by two reviewers and outcomes of interest were extracted.The meta-analysis was performed using the random effect models.Ⅰ-square statistic test was used for heterogeneity analysis.Presence of publication bias was also checked.Results:Eleven studies were included in this review.Between-group differences(cognitive behavioral therapy and control groups)in risk ratio for infertile women's depression was d=-1.36;95%CI=-1.81,-0.90;P<0.001.For infertile women's anxiety,between-group differences in risk ratio wasd=-0.83;95%CI=-1.18,-0.47;P<0.001.Conclusions:Cognitive behavioral therapy is effective in the reduction of depression and anxiety in patients with or withoutin vitro fertilization/intracytoplasmic sperm injection treatment.However,the lack of high-quality studies makes it challenging to make a solid and precise conclusion.Well-designed studies should be undertaken in the future to confirm these results.
基金supported by the National Natural Science Foundation of China(No.81471507)
文摘Soluble receptor for advanced glycation end products（s RAGE） can decoy the toxic AGEs and is considered to be a protective factor.This study aimed to evaluate the correlation between intrafollicular s RAGE levels and clinical outcomes in infertile women of young or advanced maternal age（AMA） undergoing in vitro fertilization（IVF）.A total of 62 young women and 62 AMA women who would undergo IVF were included in this prospective study.The intrafollicular s RAGE concentration was measured to determine its association with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy in young and AMA women,respectively.Besides,correlations between sR AGE and age or follicle-stimulating hormone（FSH） were examined.We found that the intrafollicular s RAGE levels were higher in young patients than those in AMA patients,suggesting that the s RAGE levels were inversely correlated with age.In young patients,sR AGE showed no correlation with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy.But it was found that AMA patients with more retrieved oocytes,fertilized oocytes and high-quality embryos demonstrated higher sR AGE levels,which were a prognostic factor for getting clinical pregnancy independent of age or FSH level.In conclusion,the s RAGE levels decrease with age.Elevated intrafollicular s RAGE levels indicate good follicular growth,fertilization and embryonic development,and successful clinical pregnancy in AMA women,while in young women,the role of s RAGE may not be so predominant.
文摘Objective To establish a rat model of sterility associated with epididymis and epididymal gene expression profiles relation to fertility by alpha-chlorohydrin.Methods Rats were treated with 10 mg·kg-1·d-1.alpha-chlorohydrin for 10 consecutive days.Sperm maturation and other fertility parameters were analyzed.The sperm motility and morphology were evaluated by computer-assisted sperm analysis(CASA);sperm survival rate was assessed by SYBR-14 and propidium iodide(PI)fluorescent staining;the weights of testes,epididymides,prostates and seminal vesicles were determined by electronic balance;histological examination of above tissues were evaluated by HE staining;and serumal dihydrotestosterone(DHT)and testosterone(T)of rats were detected by enzyme-labeled immunoassay.Each male rat was paired with 2 female rats in proestrus.Female rats were examined the next morning for the presence of sperm in vaginal smears and underwent a cesarean section on day 12 of gestation.Finally the reproductive indices were calculated as follows:copulation index(number of sperm positive females /number of pairings),pregnancy index(number of pregnancies /number of sperm positive females),and fertility index(number of pregnancies /number of pairings).After that we used Affymetrix Rat 230 2.0 oligo-microarray to identify epididymal special genes associated with fertility.Finally,we validated some of these genes by Real-Time quantitative polymerase chain reaction.Results The motility of spermatozoa from the cauda epididymidis of treated rats showed a significant decrease in percentage of motile,progressively motile sperm,and sperm survival rate.At the same time,the morphology of cauda epididymal spermatozoa was also adversely affected by the treatment.In addition,the serumal androgen levels of treated animals weren't changed compared with the control group.Accordingly,matings with treated males resulted in no successful pregnancy.Then,we classified general functions of the down or up regulated epididymal genes by chlorhydrin with the GeneSpring gene ontology(GO)analysis,which are involved in macromolecular metabolism and transport,primary metabolism process,cell metabolism,biological process regulation,immunology regulation,ion combination,hydratase and oxidoreductase activity.Among all the different expressed genes,we analyzed and screened the down-regulated genes associated with glucose,lipid,protein and other energy metabolism,which are considered as the major ACH action targets.Simultaneously,the up-regulated genes by chlorhydrin were detected and their characters of negative regulated sperm maturation and fertility analyzed,which are apoptosis and immune-related genes and not reported before.Conclusions We established male infertile rat model with ACH(10 mg·kg-1·d-1,po,10 days)through evaluating changes of sperm motility and morphology,mating index,fertility index and pregnancy index.Simultaneously,the ACH didn't affect the major androgen(T and DHT)metabolism and sexual ability,which is considered as the best way for male contraception.Then we determined the down-regulated epididymal genes relation to substance metabolism,which can affect the epididymal sperm maturation and presumed the major antifertility targets by ACH.Further more,we found and analyzed the epididymal up-regulated genes associated with apoptosis and immune functions,which maybe the new possible sites of action by ACH and other male antifertility agents.
文摘Objective:To compare the prolactin, progesterone, luteinizing hormone, follicle stimulating hormone, estradiol, antisperm antibodies, tumor necrosis factorα, total antioxidant capacity, prostaglandin E2 and F2α between primary and secondary infertile women in Calabar.Methods:One hundred and two volunteers infertile women (test group), aged 20-45 years attending the infertility clinic in the University of Calabar Teaching Hospital (UCTH) were recruited. Fourteen of the women had primary infertility while 88 of them had secondary infertility. Sixty apparently healthy, age matched women served as the control group. Five millilitres of blood was collected, allowed to clot and serum was obtained from the subjects and Enzyme Linked Immunosorbent Assay method was used for prolactin, progesterone, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH), prostaglandin E2and F2α, human TNF-α,Chlamydia trachomatis IgG, antisperm antibodies assay, while serum total antioxidant capacity was assessed spectrophotometrically.Results:The result shows on comparison that primary infertile women has a significantly higher level of progesterone than those with secondary infertility (P>0.05). There was a significant difference in the levels of prolactin and total antioxidant capacity in the primary and secondary infertility when compare to the control group atP>0.05. Their mean ages were (31.10±5.37) years and (33.10±4.91) years respectively. There was a positive correlation between TAC and FSH, TNF and anti-sperm anti-bodies in the test group ofr=0.207 andr=0.632;P>0.05 respectively.Conclusions: These findings suggest no alterations in levels of prostaglandin F2α, TNF and anti-oxidant between primary and secondary infertile females.
文摘Evaluation of infertility indicated for women failed to conceive after one year of unprotected intercourse and for women over 35 years failed to conceive after 6 mo of unprotected intercourse, because the fertility decline as women approach 40 years. Evaluation of infertile couple should begin with semen analysis of male partner. If the semen analysis is within normal range, evaluation then move on to female partner. Evaluation of the infertile woman should be carried in cost-effective manner to identify the causes of infertility using the least invasive methods. Methods of evaluation of infertile women include: 1) history and physical examination;2) evaluation of the male partner;3) documentation of ovulation;4) evaluation of the ovarian reserve;5) evaluation of cervical causes of infertility;6) evaluation of uterine causes of infertility;7) documentation of the tubal patency;and 8) exclusion of peritoneal causes of infertility. Evaluation of infertile couple should include evaluation of both partners. Semen analysis for the male partner, followed by documentation of ovulation and evaluation of genital tract patency. PCT is not used as routine evaluation of infertile women. Laparoscopy is not used as routine evaluation of infertile women unless there is suspected peritoneal factors of infertility or endometriosis or tubal occlusion. Ovarian reserve should only be done for infertile women with diminished response to external gonadotropins (not routine).
文摘The diameters of spermatic veins and blood reflux in sixty-two male patients with infertility caused by varicocele were assessed with Doppler ultrasound in this study. Scrotal thermograph, testes volume and semen analysis were also applied to analysis of these patients. Among sixty-two patients, thirty-one received high ligation of internal spermatic vein. The results showed: 1. The diameter of spermatic veins was negatively correlated with fertility index and positively correlated with Doppler grading of blood reflux. 2. In operative patients, the effect of surgery was better in patients with blood reflux than in those without blood reflux. It was suggested the diameter of spermatic veins probably reflects the duration and serious degree of blood reflux in spermatic vein, and may be used for assessment of severity of male infertility in combination with semen analysis.
文摘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 sDerm DNA damage in obese men （odds ratio （95% confidence interval）： 2.5 （1.2-5.1））.
文摘Aim： To investigate the prevalence of high levels of sperm DNA damage among men from infertile couples with both normal and abnormal standard semen parameters. Methods： A total of 350 men from infertile couples were assessed. Standard semen analysis and sperm chromatin structure assay （SCSA） were carried out. Results： Ninety-seven men （28% of the whole study group） had a DNA fragmentation index （DFI） 〉 20%, and 43 men （12%） had a DFI 〉 30%. In the group of men with abnormal semen parameters （n = 224）, 35% had a DFI 〉 20%, and 16% had a DFI 〉 30%, whereas these numbers were 15% and 5%, respectively, in the group of men with normal semen parameters （n = 126）. Men with low sperm motility and abnormal morphology had significantly higher odds ratios （ORs） for having a DFI 〉 20% （4.0 for motility and 1.9 for morphology） and DFI 〉 30% （6.2 for motility and 2.8 for morphology） compared with men with normal sperm motility and morphology. Conclusion： In almost one-third of unselected men from infertile couples, the DFI exceeded the level of 20% above which, according to previous studies, the in vivo fertility is reduced. A significant proportion of men with otherwise normal semen parameters also had high sperm DNA damage levels. Thus, the SCSA test could add to explaining causes of infertility in cases where semen analysis has not shown any deviation from the norm. We also recommend running the SCSA test to choose the appropriate assisted reproductive technique （ART）.
文摘This study was carried out to analyze the vertical transmission of Yq AZFc microdeletions from father to son in infertile Han Chinese families to investigate genetic factors and family background affecting fertility status.The peripheral blood of infertile males in 19 Han families was extracted and screened with modified multiplex polymerase chain reaction （PCR）. Family trees were drawn according to fertility status and clinical characteristics of the subjects. The vertical transmission of Yq AZFc microdeletions was detected in six cases of 19 investigated families （31.6%,6/19）. Although both fathers and sons showed a similar type of Yq AZFc deletion,the fathers were fertile,whereas the sons were infertile and showed severe oligozoospermia. The vertical transmission of Yq AZFc microdeletion from fertile fathers to infertile sons over generations is not rare. This has different effects on fertility status in fathers and sons in Han Chinese families. Both genetic factors and family background affect spermatogenetic phenotypes.
文摘Aim： To investigate the possible causes of oligozoospermia and azoospermia in infertile Thai men, and to find the frequencies of Y chromosome microdeletions and cytogenetic abnormalities in this group. Methods： From June 2003 to November 2005, 50 azoospermic and 80 oligozoospermic men were enrolled in the study. A detailed history was taken for each man, followed by general and genital examinations. Y chromosome microdeletions were detected by multiplex polymerase chain reaction （PCR） using 11 gene-specific primers that covered all three regions of the azoospermic factor （AZFa, AZFb and AZFc）. Fifty men with normal semen analysis were also studied. Karyotyping was done with the standard G- and Q-banding. Serum concentrations of follicle stimulating hormone （FSH）, luteinizing hormone （LH）, prolactin （PRL） and testosterone were measured by electrochemiluminescence immunoassays （ECLIA）. Results： Azoospermia and oligozoospermia could be explained by previous orchitis in 22.3%, former bilateral cryptorchidism in 19.2%, abnormal karyotypes in 4.6% and Y chromosome microdeletions in 3.8% of the subjects. The most frequent deletions were in the AZFc region （50%）, followed by AZFb （33%） and AZFbc （17%）. No significant difference was detected in hormonal profiles of infertile men, with or without microdeletions. Conclusion： The frequencies of Y chromosome microdeletions and cytogenetic abnormalities in oligozoospermic and azoospermic Thai men are comparable with similarly infertile men from other Asian and Western countries.
