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Chen M, Huang S, Song C, Chen X, Chen J, Bu G, Zhang H, Huang W, Fu J, Xu E. Value of painless transvaginal four-dimensional hysterosalpingo contrast sonography in reducing venous intravasation: a comparative study. J Ultrasound 2024; 27:511-517. [PMID: 38219240 PMCID: PMC11333643 DOI: 10.1007/s40477-023-00847-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/11/2023] [Indexed: 01/16/2024] Open
Abstract
OBJECTIVE To investigate the value of painless transvaginal four-dimensional hysterosalpingo contrast sonography (TV 4-D HyCoSy) in reducing venous intravasation and its influencing factors through a retrospective comparative study on conventional TV 4-D HyCoSy. MATERIALS AND METHODS A total of 451 patients were enrolled in this study from Jan. 2019 to Oct. 2021. There were 249 patients in the painless TV 4-D HyCoSy group and 202 patients in the conventional TV 4-D HyCoSy group. The incidence of venous intravasation and its related influencing factors were analyzed and compared between these two groups. The difficulty of image evaluation for the diagnosis was also compared. RESULTS There was no significant difference in the baseline characteristics between the painless group and the conventional group (p > 0.05). Compared with the conventional group, the painless group had a lower incidence of venous intravasation (16.9 vs. 24.8%; p = 0.039). Painless TV 4-D HyCoSy was more effective in reducing venous intravasation in patients with primary infertility (p = 0.032) without a history of pelvic surgery (p = 0.008) or ectopic pregnancy (p = 0.018). Logistic regression analysis demonstrated that painless TV 4-D HyCoSy and endometrial thickness > 5 mm were protective factors for venous intravasation. Moreover, the diagnostic procedure was easier in the painless group than in the conventional group (p = 0.002). CONCLUSIONS Painless TV 4D-HyCoSy may be an effective mode in reducing the incidence of venous intravasation and improving the diagnosis of patency of fallopian tubes.
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Affiliation(s)
- Mengjie Chen
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China
| | - Shiying Huang
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China
| | - Changlin Song
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China
| | - Xiaomin Chen
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China
| | - Jiajia Chen
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China
| | - Guojuan Bu
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China
| | - Huiying Zhang
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China
| | - Wanling Huang
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China
| | - Juan Fu
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China.
| | - Erjiao Xu
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China.
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Lee MC, Chien PS, Zhou Y, Yu T. Prevalence and help-seeking for infertility in a population with a low fertility rate. PLoS One 2024; 19:e0306572. [PMID: 39024399 PMCID: PMC11257226 DOI: 10.1371/journal.pone.0306572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND In Taiwan there has been limited research of epidemiological surveys on prevalence of infertility. This study aimed to provide the updated prevalence of primary infertility and of help-seeking among residents in Taiwan. METHODS Between February and March 2023, we conducted a cross-sectional population-based telephone survey of 1,297 men and women aged 20-49 years who were residing in Taiwan. We used computer-assisted telephone interviewing techniques to collect data regarding sociodemographic and reproductive characteristics. Using two approaches to defining infertility, we estimated the prevalence of infertility and the prevalence of help-seeking behaviors. Our analyses accounted for survey weighting. RESULTS The response rate was 27.9%. Among 1,297 respondents, 829 (63.9%) were married or cohabiting, including 404 men and 425 women. The prevalence of primary infertility using definition 1 was 5.6% (95% confidence interval [CI]: 4.2% - 7.4%); the prevalence of primary infertility using definition 2 was 6.7% (5.1% - 8.6%). Regarding professional help-seeking, 11.1% (9.2%-13.5%) had ever consulted a doctor about getting pregnant; 9.9% (8.1%-12.2%) had ever received diagnostic tests/treatment to help with conceiving; 2.6% (1.6% - 4.0%) were currently receiving diagnostic tests/treatment to help with conceiving. CONCLUSION Our nationwide survey of the prevalence of primary infertility in Taiwan suggests that the prevalence was not as high as what is often seen in the news reports (about 14%). These findings also suggest there may be a gap between those who are currently experiencing infertility and those who are currently being treated; hence, we call for raising awareness of infertility and improving access to infertility healthcare.
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Affiliation(s)
- Mei-Chuan Lee
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pharmacy, Chi Mei Medical Center, Tainan, Taiwan
| | - Pei-Shan Chien
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Chinese Medicine, Chi Mei Medical Center, Tainan, Liouying, Taiwan
| | - Yue Zhou
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Tong M, Lu H, Xu H, Fan X, Zhang JJ, Kelly FJ, Gong J, Han Y, Li P, Wang R, Li J, Zhu T, Xue T. Reduced human fecundity attributable to ambient fine particles in low- and middle-income countries. ENVIRONMENT INTERNATIONAL 2024; 189:108784. [PMID: 38852259 DOI: 10.1016/j.envint.2024.108784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/09/2024] [Accepted: 05/27/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Exposure to ambient fine particulate matter (PM2.5) has been associated with reduced human fecundity. However, the attributable burden has not been estimated for low- and middle-income countries (LMICs), where the exposure-response function between PM2.5 and the infertility rate has been insufficiently studied. OBJECTIVE This study examined the associations between long-term exposure to PM2.5 and human fecundity indicators, namely the expected time to pregnancy (TTP) and 12-month infertility rate (IR), and then estimated PM2.5-attributable burden of infertility in LMICs. METHODS We analyzed 164,593 eligible women from 100 Demographic and Health Surveys conducted in 49 LMICs between 1999 and 2021. We assessed PM2.5 exposures during the 12 months before a pregnancy attempt using the global satellite-derived PM2.5 estimates produced by Atmospheric Composition Analysis Group (ACAG). First, we created a series of pseudo-populations with balanced covariates, given different levels of PM2.5 exposure, using a matching approach based on the generalized propensity score. For each pseudo-population, we used 2-stage generalized Gamma models to derive TTP or IR from the probability distribution of the questionnaire-based duration time for the pregnancy attempt before the interview. Second, we used spline regressions to generate nonlinear PM2.5 exposure-response functions for each of the two fecundity indicators. Finally, we applied the exposure-response functions to estimate number of infertile couples attributable to PM2.5 exposure in 118 LMICs. RESULTS Based on the Gamma models, each 10 µg/m3 increment in PM2.5 exposure was associated with a TTP increase by 1.7 % (95 % confidence interval [CI]: -2.3 %-6.0 %) and an IR increase by 2.3 % (95 %CI: 0.6 %-3.9 %). The nonlinear exposure-response function suggested a robust effect of an increased IR for high-concentration PM2.5 exposure (>75 µg/m3). Based on the PM2.5-IR function, across the 118 LMICs, the number of infertile couples attributable to PM2.5 exposure exceeding 35 µg/m3 (the first-stage interim target recommended by the World Health Organization global air quality guidelines) was 0.66 million (95 %CI: 0.061-1.43), accounting for 2.25 % (95 %CI: 0.20 %-4.84 %) of all couples affected by infertility. Among the 0.66 million, 66.5 % were within the top 10 % high-exposure infertile couples, mainly from South Asia, East Asia, and West Africa. CONCLUSION PM2.5 contributes significantly to human infertility in places with high levels of air pollution. PM2.5-pollution control is imperative to protect human fecundity in LMICs.
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Affiliation(s)
- Mingkun Tong
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Center, Beijing, China
| | - Hong Lu
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Center, Beijing, China
| | - Huiyu Xu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Xinguang Fan
- Department of Sociology, Peking University, Beijing, China
| | - Junfeng Jim Zhang
- Nicholas School of the Environment, & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Frank J Kelly
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Jicheng Gong
- SKL-ESPC & SEPKL-AERM, College of Environmental Sciences and Engineering, Center for Environment and Health, Peking University, Beijing, China
| | - Yiqun Han
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Pengfei Li
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou, Zhejiang, China
| | - Ruohan Wang
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jiajianghui Li
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Center, Beijing, China
| | - Tong Zhu
- SKL-ESPC & SEPKL-AERM, College of Environmental Sciences and Engineering, Center for Environment and Health, Peking University, Beijing, China
| | - Tao Xue
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Center, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou, Zhejiang, China; Center for Environment and Health, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.
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Rama N, Lescay H, Raheem O. Male Factor Infertility: What Every OB/GYN Should Know. Obstet Gynecol Clin North Am 2023; 50:763-777. [PMID: 37914493 DOI: 10.1016/j.ogc.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Male factor infertility plays a role in approximately 30% of infertility cases. Various causes of male factor infertility exist including congenital, acquired, idiopathic, or environmental factors. Identifying the underlying etiology of male factor infertility is a key step toward providing appropriate counseling, effective treatment options, and improving outcomes for couples with infertility. Although the recent advances and developments in assisted reproductive technology have undoubtedly improved fertility outcomes, clinicians must understand the scope of reproductive urologists in the evaluation and treatment of male infertility to provide comprehensive counseling, appropriate referral, comprehensive evaluation, and correct surgical sperm retrieval techniques when needed.
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Affiliation(s)
- Nihar Rama
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Hernan Lescay
- Department of Surgery, Section of Urology, University of Chicago Medicine, Chicago, IL, USA
| | - Omer Raheem
- Department of Surgery, Section of Urology, University of Chicago Medicine, Chicago, IL, USA.
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5
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Ford J, Hince D, Lee E, Lo G. Intravasation complicating hysterosalpingo-foam sonography (HyFoSy) using ExEm® Foam. Aust N Z J Obstet Gynaecol 2023; 63:577-582. [PMID: 37185818 DOI: 10.1111/ajo.13682] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/26/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Transvaginal hysterosalpingo-foam sonography (HyFoSy) assesses tubal patency in an outpatient setting and without ionising radiation, unlike traditional hysterosalpingography (HSG) under fluoroscopy. Like HSG, HyFoSy may be complicated by uterine intramural contrast leak, leading to venous intravasation. Intravasation of particulate contrast agents risks pulmonary or cerebral emboli. AIMS We aimed to assess the intravasation rate of HyFoSy using ExEm® Foam and association with endometrial thickness, ExEm® Foam volume, uterine length, adenomyosis severity, uterine morphology or pain score. METHODS An ethics-approved retrospective study on all HyFoSy examinations between 23 January 2018 and 27 October 2021 on sub-fertile patients, trying to conceive. Initial transvaginal sonography confirmed anatomy, uterine morphology, adenomyosis severity and endometrial thickness. Subspecialist radiologists performed HyFoSy with sonographer assistance. Intravasation was identified in real time but also checked for afterwards. Patients were asked to rate instillation pain/discomfort from one to ten immediately afterward. RESULTS Four hundred and thirty-six (n = 436) patients met inclusion criteria. Thirty (6.9%) experienced intravasation. Endometrial thickness and pain score were associated with intravasation. For every millimetre increase in endometrial thickness, the odds of intravasation decreased by 26% (P = 0.010). For every point increase on the pain scale, the odds of intravasation increased by 22% (P = 0.032). There was no evidence of an association between instilled ExEm® Foam volume or the other previously published parameters with intravasation. CONCLUSION A 6.9% rate of intravasation was observed. Both endometrial thickness and pain score were significantly associated with intravasation. There was no evidence of an association between ExEm® Foam volume and intravasation.
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Affiliation(s)
- Jemma Ford
- Western Ultrasound For Women, Perth, Western Australia, Australia
- Sir Charles Gairdner Osborne Park Hospital Care Group, Perth, Western Australia, Australia
| | - Dana Hince
- Institute for Health Research, The University of Notre Dame, Fremantle, Western Australia, Australia
| | - Emmeline Lee
- Western Ultrasound For Women, Perth, Western Australia, Australia
- Sir Charles Gairdner Osborne Park Hospital Care Group, Perth, Western Australia, Australia
| | - Glen Lo
- Western Ultrasound For Women, Perth, Western Australia, Australia
- Sir Charles Gairdner Osborne Park Hospital Care Group, Perth, Western Australia, Australia
- Curtin University Medical School, Perth, Western Australia, Australia
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6
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Summers KM, Scherer A, Chasco EE, Ryan GL. Defining infertility: a qualitative interview study of patients and physicians. J Reprod Infant Psychol 2023:1-15. [PMID: 37288784 DOI: 10.1080/02646838.2023.2221277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE To investigate if infertility patients and physicians apply a traditional biomedical model of disease in their conceptualisation of infertility, examine any contradictions and conflicts in conceptualisations, and examine areas of concordance and discordance between physicians and patients. METHODS Semi-structured interviews were conducted with 20 infertility patients and 18 infertility physicians between September 2010 and April 2012. Interviews were analysed qualitatively to determine physician and patient conceptualisations of infertility, reactions to the definition of infertility as a disease, and potential benefits and concerns related to application of a disease label to the condition. RESULTS Most physicians (n = 14/18) and a minority of patients (n = 6/20) were supportive of defining infertility as a disease. Many of the patients who agreed with classifying infertility as a disease expressed that they had not personally defined it as such previously. Physicians (n = 14) and patients (n = 13) described potential benefits of a disease label, including increases in research funding, insurance coverage, and social acceptability. Some patients (n = 10) described potential stigma as a negative consequence. When describing appraisals of infertility, both physicians (n = 7) and patients (n = 8) invoked religious/spiritual concepts. The potential for religious/spiritual appraisal to contribute to stigmatising or de-stigmatising infertility was discussed. CONCLUSION Our findings contradict the assumption that infertility physicians and patients are fully supportive of defining infertility as a disease. While potential benefits of the disease label were recognised by both groups, caution against potential for stigmatisation and unsolicited invocation of religion/spirituality suggest a more holistic model may be appropriate.
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Affiliation(s)
- K M Summers
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Iowa Hospital and Clinics, Iowa City, IA, USA
| | - A Scherer
- Department of Internal Medicine, University of Iowa Hospital and Clinics, Iowa City, IA, USA
| | - E E Chasco
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA, USA
| | - G L Ryan
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Washington Medical Center Montlake, Seattle, WA, USA
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Creary S, Pecker LH, Quinn GP, Nahata L. Comment on: Infertility and treatment-seeking practices among females and males with sickle cell disease in the Sickle Cell Disease Implementation Consortium registry. Pediatr Blood Cancer 2023; 70:e30487. [PMID: 37288748 PMCID: PMC10959232 DOI: 10.1002/pbc.30487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Affiliation(s)
- Susan Creary
- Division of Heme/Onc/BMT and Center for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Lydia H. Pecker
- Division of Hematology, Department of Medicine and Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gwendolyn P. Quinn
- Department of OB-GYN, Division of Medical Ethics Grossman School of Medicine, New York University, New York, New York, USA
| | - Leena Nahata
- Division of Endocrinology and Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
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8
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Ribas-Maynou J, Novo S, Salas-Huetos A, Rovira S, Antich M, Yeste M. Condensation and protamination of sperm chromatin affect ICSI outcomes when gametes from healthy individuals are used. Hum Reprod 2023; 38:371-386. [PMID: 36539233 DOI: 10.1093/humrep/deac261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
STUDY QUESTION Do defects in sperm chromatin protamination and condensation have an impact on ICSI outcomes? SUMMARY ANSWER Sperm protamination is related to fertilization rates in healthy donors, and the in vitro capacity of sperm to condense their chromatin is linked to blastocyst rates, both associations being more apparent in women <33 years of age. WHAT IS KNOWN ALREADY Previous data on how sperm chromatin damage affects ICSI outcomes are inconsistent. Revealing which sperm factors influence embryo development is necessary to understand the male contribution to ICSI success and to develop novel sperm selection techniques or male-based treatments. Sperm chromatin is mainly condensed in protamines, which are cross-linked through disulphide bridges. This study aimed to determine whether sperm protamination and the integrity of disulphide bonds (condensation) are related to embryo development after ICSI. STUDY DESIGN, SIZE, DURATION The design was a retrospective study with a blind analysis of sperm chromatin. Gametes were divided into two groups: double donation (DD) cohort and single donation (SD) cohort. Samples from 45 semen donors used in 55 ICSI cycles with oocyte donors (age range 19-33 years), generating 491 embryos, were included in the DD cohort. The SD cohort consisted of samples from 34 semen donors used in 41 ICSI cycles with oocytes from healthy females (single-parent families or lesbian couples, age range 20-44 years), generating a total of 378 embryos. PARTICIPANTS/MATERIALS, SETTINGS, METHODS Donor sperm samples from DD and SD cohorts were used for standard ICSI, and embryo development was observed by time-lapse imaging. The incidence of thiol reduction (dibromobimane, DBB) and the degree of chromatin protamination (chromomycin A3, CMA3, indicating non-protaminated regions) in sperm were determined by flow cytometry at 0 and 4 h post-thawing. MAIN RESULTS AND THE ROLE OF CHANCE Percentages ± standard deviation of CMA3 were 21.08 ± 9.09 and 35.01 ± 14.68 at 0 and 4 h post-thawing, respectively, in the DD cohort and 22.57 ± 9.48 and 35.79 ± 12.58, at 0 and 4 h post-thawing, respectively, in the SD cohort. Percentages of DBB+ were 16.57 ± 11.10 and 10.51 ± 8.40 at 0 and 4 h post-thawing (P < 0.0001), respectively, in the DD cohort and 17.98 ± 10.19 and 12.72 ± 8.76 at 0 and 4 h post-thawing (P < 0.0001), respectively, in the SD cohort. Female age correlated with fertilization rates, and the relation between sperm chromatin and embryo development was determined through multiple linear regression. While CMA3 was associated with fertilization rates, with no influence of female age, in the DD cohort (β1 = -1.036, P < 0.001 for CMA3; β2 = 0.667, P = 0.304 for female age), this was not observed in the SD cohort, where female age had a significant effect, masking the effects of CMA3 (β1 = -0.066, P = 0.804 for CMA3; β 2 = -1.451, P = 0.003 for female age). The in vitro capacity of sperm to condense their chromatin after 4 h of incubation was associated with blastocyst rates, independent of female age (DD cohort: β1 = -0.238, P = 0.008 for %DBB+ variation; β2 = 0.404, P = 0.638 for female age; SD cohort: β1 = -0.278, P = 0.010 for %DBB+ variation; β2 = -0.292, P = 0.594 for female age). The in vitro capacity of sperm to condense their chromatin was also related to the time required for the embryo to reach blastocyst stage in the DD cohort (P = 0.007). Finally, multiple logistic regression showed that both chromatin protamination and condensation, together with the age of the oocyte donors and the embryo recipients, had an impact on pregnancy achievement (P < 0.01) and on live birth rates (P < 0.01). LIMITATIONS, REASONS FOR CAUTION The main limitation was the restrictive selection of couples, which led to a relatively small sample size and could influence the observed outcomes. For this reason, and to reduce Type I error, the level of significance was set at P ≤ 0.01. On the other hand, the use of cryopreserved samples could also be a limitation. WIDER IMPLICATIONS OF THE FINDINGS This research demonstrated that protamination and condensation of sperm chromatin are related to embryo development after ICSI, but female age could be a confounding factor when oocytes from older females are used. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the European Union's Horizon 2020 Research and Innovation scheme under the Marie Skłodowska-Curie grant agreement No 801342 (Tecniospring INDUSTRY; TECSPR-19-1-0003); La Marató de TV3 Foundation (214/857-202039); the Ministry of Science and Innovation, Spain (IJC2019-039615-I); the Catalan Agency for Management of University and Research Grants, Regional Government of Catalonia, Spain (2017-SGR-1229); and the Catalan Institution for Research and Advanced Studies, Spain (ICREA). The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Jordi Ribas-Maynou
- Unit of Cell Biology, Department of Biology, Faculty of Sciences, University of Girona, Girona, Spain.,Biotechnology of Animal and Human Reproduction (TechnoSperm), Institute of Food and Agricultural Technology, University of Girona, Girona, Spain
| | - Sergi Novo
- Fertilab-Institut Catala de Fertilitat SL, Barcelona, Spain.,Fertibank, Barcelona, Spain
| | - Albert Salas-Huetos
- Unit of Cell Biology, Department of Biology, Faculty of Sciences, University of Girona, Girona, Spain.,Biotechnology of Animal and Human Reproduction (TechnoSperm), Institute of Food and Agricultural Technology, University of Girona, Girona, Spain.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sergi Rovira
- Fertilab-Institut Catala de Fertilitat SL, Barcelona, Spain.,Fertibank, Barcelona, Spain
| | - Marta Antich
- Fertilab-Institut Catala de Fertilitat SL, Barcelona, Spain.,Fertibank, Barcelona, Spain
| | - Marc Yeste
- Unit of Cell Biology, Department of Biology, Faculty of Sciences, University of Girona, Girona, Spain.,Biotechnology of Animal and Human Reproduction (TechnoSperm), Institute of Food and Agricultural Technology, University of Girona, Girona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
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Freeman JR, Whitcomb BW, Bertone-Johnson ER, Balzer LB, O'Brien LM, Dunietz GL, Purdue-Smithe AC, Kim K, Silver RM, Schisterman EF, Mumford SL. Preconception sleep duration, sleep timing, and shift work in association with fecundability and live birth among women with a history of pregnancy loss. Fertil Steril 2023; 119:252-263. [PMID: 36586812 PMCID: PMC9899515 DOI: 10.1016/j.fertnstert.2022.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate the associations between preconception sleep characteristics and shift work with fecundability and live birth. DESIGN Secondary analysis of the Effects of Aspirin in Gestation and Reproduction study, a preconception cohort. SETTING Four US academic medical centers. PATIENT(S) Women aged 18-40 with a history of 1-2 pregnancy losses who were attempting to conceive again. INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURES(S) We evaluated baseline, self-reported sleep duration, sleep midpoint, social jetlag, and shift work among 1,228 women who were observed for ≤6 cycles of pregnancy attempts to ascertain fecundability. We ascertained live birth at the end of follow up via chart abstraction. We estimated fecundability odds ratios (FORs) using discrete, Cox proportional hazards models and risk ratios (RRs) for live birth using log-Poisson models. RESULT(S) Sleep duration ≥9 vs. 7 to <8 hours (FOR: 0.81, 95% confidence interval [CI], 0.61; 1.08), later sleep midpoints (3rd tertile vs. 2nd tertile: FOR: 0.85; 95% CI, 0.69, 1.04) and social jetlag (continuous per hour; FOR: 0.93, 95% CI: 0.86, 1.00) were not associated with reduced fecundability. In sensitivity analyses, excluding shift workers, sleep duration ≥9 vs. 7 to <8 hours (FOR: 0.62; 95% CI, 0.42; 0.93) was associated with low fecundability. Night shift work was not associated with fecundability (vs. non-night shift work FOR: 1.17, 95% CI, 0.96; 1.42). Preconception sleep was not associated with live birth. CONCLUSION(S) Overall, there does not appear to be a strong association between sleep characteristics, fecundability, and live birth. Although these findings may suggest weak and imprecise associations with some sleep characteristics, our findings should be evaluated in larger cohorts of women with extremes of sleep characteristics. CLINICAL TRIAL REGISTRATION NUMBER Clinicaltrials.gov NCT00467363.
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Affiliation(s)
- Joshua R Freeman
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts; Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
| | - Brian W Whitcomb
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Elizabeth R Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts; Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Laura B Balzer
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Louise M O'Brien
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan; Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Galit L Dunietz
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan
| | - Alexandra C Purdue-Smithe
- Division of Women's Health, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Keewan Kim
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Robert M Silver
- Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Enrique F Schisterman
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sunni L Mumford
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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10
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Özmen S, Tola EN, Karahasanoğlu A. Intracytoplasmic sperm injection cycle success in patients under 35 years old with diminished ovarian reserve plus severe male factor. J Obstet Gynaecol Res 2023; 49:265-272. [PMID: 36257622 DOI: 10.1111/jog.15470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE We aimed to evaluate intracytoplasmic sperm injection (ICSI) outcomes in young patients with diminished ovarian reserve (DOR) plus severe male factor (SMF) compared with age-matched controls with DOR. STUDY DESIGN A total of 189 infertile women under 35 years with DOR undergoing ICSI procedures were included retrospectively. Participants whose partners' sperm analysis was normal considered as the DOR group (n = 154) and whose partners' had SMF considered as the DOR + SMF group (n = 35). The two groups were compared regarding cycle characteristics and pregnancy outcomes. RESULTS Demographic features except infertility duration were similar between two groups. The duration of infertility was significantly longer in the DOR + SMF group compared to the DOR group (p = 0.02). Ovarian stimulation characteristics, oocyte retrieval parameters, fertilization rate, quality of embryos, embryo cancellation rate, and development up to blastocyst stage were found similar between two groups. Implantation, clinical pregnancy, abortion, and live birth rate, multiple pregnancy rate per cycle were distributed homogenously between the DOR and DOR + SMF groups. Regarding perinatal and neonatal outcomes of groups, fetal height and weight were significantly lower in DOR + SMF group than in DOR group (p = 0.001 and 0.01, respectively). Gestational week at delivery was lower in the DOR + SMF group compared to the DOR group (p < 0.0001). CONCLUSION Fetal anthropometric measures were lower regarding to preterm delivery in the DOR + SMF group than the DOR group. Large sample-sized studies should be performed to explain the decreased gestational week at the time of delivery in the DOR + SMF group.
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Affiliation(s)
- Sevinc Özmen
- Istanbul Medipol University Medipol Mega Hospital, In Vitro Fertilization Unit, Istanbul, Turkey
| | - Esra Nur Tola
- Department of Obstetrics and Gynaecology, Istanbul Medipol University Faculty of Medicine, Medipol Pendik Hospital, Istanbul, Turkey
| | - Ayse Karahasanoğlu
- Istanbul Medipol University Medipol Mega Hospital, In Vitro Fertilization Unit, Istanbul, Turkey
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11
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Garcia-Grau E, Lleberia J, Costa L, Guitart M, Yeste M, Benet J, Amengual MJ, Ribas-Maynou J. Decline of Sperm Quality over the Last Two Decades in the South of Europe: A Retrospective Study in Infertile Patients. BIOLOGY 2022; 12:biology12010070. [PMID: 36671762 PMCID: PMC9856056 DOI: 10.3390/biology12010070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023]
Abstract
Semen quality has a direct relation to male fertility. Whether sperm variables in humans have decreased over the last years is still uncertain, with some studies showing a decline and others reporting no changes. In this regard, previous research has suggested that lifestyle and environmental conditions may contribute to this variability, calling for regional studies. The present work is a retrospective, unicentric study that includes semen samples analyzed between 1997 and 2017 at the Parc Taulí Hospital (Barcelona metropolitan area). First, a multivariate analysis including the age as a confounding factor showed a statistically significant decrease in semen volume, pH, progressive motility, morphology and total motile sperm over time. Contrarily, no significant variation in sperm count or concentration was observed. Mean reductions per year were -0.02 mL for volume, -0.57% for progressively motile sperm and -0.72% for sperm with normal morphology. Interestingly, the average annual temperature registered by the Spanish Meteorology Agency negatively correlated to sperm morphology and sperm count (Rs = -0.642; p = 0.002 and Rs = -0.435; p = 0.049, respectively). In conclusion, the present study based on infertile patients from the Barcelona area found a decline in sperm motility and morphology, without effects on sperm count. Changes in temperature appeared to be associated to this decline, but further studies are needed to address the mechanisms linked to the observed variations.
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Affiliation(s)
- Emma Garcia-Grau
- Departament of Obstetrics and Gynecology, Parc Taulí Health Corporation, ES-08208 Sabadell, Spain
- Unit of Obstetrics and Gynecology, Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine and Public Health, Faculty of Medicine, Autonomous University of Barcelona, Bellaterra, (Cerdanyola del Vallès), ES-08193 Barcelona, Spain
| | - Judith Lleberia
- Departament of Obstetrics and Gynecology, Parc Taulí Health Corporation, ES-08208 Sabadell, Spain
| | - Laura Costa
- Departament of Obstetrics and Gynecology, Parc Taulí Health Corporation, ES-08208 Sabadell, Spain
| | - Miriam Guitart
- UDIAT Diagnostic Center, Parc Taulí Health Corporation, ES-08208 Sabadell, Spain
| | - Marc Yeste
- Biotechnology of Animal and Human Reproduction (TechnoSperm), Institute of Food and Agricultural Technology, University of Girona, ES-17003 Girona, Spain
- Unit of Cell Biology, Department of Biology, Faculty of Sciences, University of Girona, ES-17003 Girona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), ES-08010 Barcelona, Spain
- Correspondence:
| | - Jordi Benet
- Unit of Cell Biology and Medical Genetics, Department of Cell Biology, Physiology and Immunology, Faculty of Medicine, Autonomous University of Barcelona, Bellaterra (Cerdanyola del Vallès), ES-08193 Barcelona, Spain
| | - María José Amengual
- UDIAT Diagnostic Center, Parc Taulí Health Corporation, ES-08208 Sabadell, Spain
| | - Jordi Ribas-Maynou
- Biotechnology of Animal and Human Reproduction (TechnoSperm), Institute of Food and Agricultural Technology, University of Girona, ES-17003 Girona, Spain
- Unit of Cell Biology, Department of Biology, Faculty of Sciences, University of Girona, ES-17003 Girona, Spain
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12
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Sun X, Sun C, Meng M, Liu L. Association of ABO blood groups with ovarian reserve: a retrospective cohort study in Chinese Han women younger than 40 years with infertility. J Ovarian Res 2022; 15:132. [PMID: 36539903 PMCID: PMC9769009 DOI: 10.1186/s13048-022-01075-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Ovarian reserve reflects both the quantity and quality of oocytes available for procreation and is affected by many known and unknown factors. ABO blood type is related to several infertility processes, but it is unclear whether and how ABO blood type affects ovarian reserve. OBJECTIVE The purpose of the study was to explore the correlation between ABO blood types and ovarian reserve in infertile Chinese Han women under 40 years of age undergoing the in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI)-embryo transfer (IVF/ICSI-ET) treatment. METHODS Women aged < 40 years who underwent IVF/ICSI-ET at our institution and had a documented ABO blood type were eligible for this study. In this study, patients were divided into two groups according to the diminished ovarian reserve (DOR) group (AMH < 1.1 ng/mL, AFC < 6) and the non-diminished ovarian reserve (non-DOR) group (AMH ≥ 1.1 ng/mL, AFC ≥ 6). The relationship between ovarian reserve and ABO blood group was determined by correlation analysis. RESULTS In this retrospective cohort study, clinical data were collected from 1690 Chinese Han women treated with IVF/ ICSI-ET in hospital records between April 2019 and March 2020 in the affiliated hospital of Southwest Medical University, located in Luzhou, China. The differences in age, duration of infertility, BMI, FSH, FSH / LH, and p (DOR vs non-DOR) for each parameter (DOR vs non-DOR) were statistically significant, and the differences in LH and E2 were not statistically significant. ABO blood groups were most prevalent in the DOR group with O (143, 34.8%) and A (122, 29.7%) and in the non-DOR group with A (428, 33.5%) and O (419, 32.8%). ABO blood groups were most prevalent in the DOR group with O (n = 57, 30.5%) and A (n = 54, 28.9%) and in the non-DOR group with A (n = 335, 34.0%) and O (n = 323, 32.8%) were the most frequent in the non-DOR group. CONCLUSIONS In this retrospective cohort study, we confirmed the lack of a significant association between ABO blood type and ovarian reserve. Further studies are needed to clarify whether there is any prognostic correlation between ABO blood group and ovarian reserve in women undergoing IVF/ICSI-ET.
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Affiliation(s)
- Xingyu Sun
- grid.488387.8Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000 Sichuan China ,grid.488387.8Department of Reproductive Medicine Center, the Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Luzhou, China
| | - Chenyu Sun
- grid.488798.20000 0004 7535 783XAMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL 60657 USA
| | - Muzi Meng
- UK Program Site, American University of the Caribbean School of Medicine, Vernon Building Room 64, Sizer St, Preston, PR1 1JQ UK ,Bronxcare Health System, 1650 Grand Concourse, The Bronx, NY 10457 USA
| | - Ling Liu
- grid.488387.8Department of Reproductive Medicine Center, the Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Luzhou, China
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13
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Jimbo M, Kunisaki J, Ghaed M, Yu V, Flores HA, Hotaling JM. Fertility in the aging male: a systematic review. Fertil Steril 2022; 118:1022-1034. [PMID: 36509505 PMCID: PMC10914128 DOI: 10.1016/j.fertnstert.2022.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 12/14/2022]
Abstract
The negative effect of advanced female age on fertility and offspring health is well understood. In comparison, much less is known about the implications of male age on fertility, with many studies showing conflicting results. Nevertheless, increasing evidence suggests that advanced paternal age has negative effects on sperm parameters, reproductive success, and offspring health. Herein, we summarize the current body of knowledge on this controversial topic, with the belief that this review will serve as a resource for the clinicians providing fertility counseling to couples with older male partners.
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Affiliation(s)
- Masaya Jimbo
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Jason Kunisaki
- Department of Human Genetics, University of Utah, Salt Lake City, Utah
| | - Mohammadali Ghaed
- Urology Department, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Victor Yu
- University of Nevada Reno School of Medicine, Reno, Nevada
| | - Hunter A Flores
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
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14
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Arora UP, Dumont BL. Meiotic drive in house mice: mechanisms, consequences, and insights for human biology. Chromosome Res 2022; 30:165-186. [PMID: 35829972 PMCID: PMC9509409 DOI: 10.1007/s10577-022-09697-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/20/2022] [Accepted: 04/27/2022] [Indexed: 11/27/2022]
Abstract
Meiotic drive occurs when one allele at a heterozygous site cheats its way into a disproportionate share of functional gametes, violating Mendel's law of equal segregation. This genetic conflict typically imposes a fitness cost to individuals, often by disrupting the process of gametogenesis. The evolutionary impact of meiotic drive is substantial, and the phenomenon has been associated with infertility and reproductive isolation in a wide range of organisms. However, cases of meiotic drive in humans remain elusive, a finding that likely reflects the inherent challenges of detecting drive in our species rather than unique features of human genome biology. Here, we make the case that house mice (Mus musculus) present a powerful model system to investigate the mechanisms and consequences of meiotic drive and facilitate translational inferences about the scope and potential mechanisms of drive in humans. We first detail how different house mouse resources have been harnessed to identify cases of meiotic drive and the underlying mechanisms utilized to override Mendel's rules of inheritance. We then summarize the current state of knowledge of meiotic drive in the mouse genome. We profile known mechanisms leading to transmission bias at several established drive elements. We discuss how a detailed understanding of meiotic drive in mice can steer the search for drive elements in our own species. Lastly, we conclude with a prospective look into how new technologies and molecular tools can help resolve lingering mysteries about the prevalence and mechanisms of selfish DNA transmission in mammals.
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Affiliation(s)
- Uma P Arora
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME, 04609, USA
- Graduate School of Biomedical Sciences, Tufts University, 136 Harrison Ave, Boston, MA, 02111, USA
| | - Beth L Dumont
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME, 04609, USA.
- Graduate School of Biomedical Sciences, Tufts University, 136 Harrison Ave, Boston, MA, 02111, USA.
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15
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Lee Y, Bohlin J, Page CM, Nustad HE, Harris JR, Magnus P, Jugessur A, Magnus MC, Håberg SE, Hanevik HI. Associations between epigenetic age acceleration and infertility. Hum Reprod 2022; 37:2063-2074. [PMID: 35771672 PMCID: PMC9433848 DOI: 10.1093/humrep/deac147] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/12/2022] [Indexed: 12/17/2022] Open
Abstract
STUDY QUESTION Is the use of ART, a proxy for infertility, associated with epigenetic age acceleration? SUMMARY ANSWER The epigenetic age acceleration measured by Dunedin Pace of Aging methylation (DunedinPoAm) differed significantly between non-ART and ART mothers. WHAT IS KNOWN ALREADY Among mothers who used ART, epigenetic age acceleration may be associated with low oocyte yield and poor ovarian response. However, the difference in epigenetic age acceleration between non-ART and ART mothers (or even fathers) has not been examined. STUDY DESIGN, SIZE, DURATION The Norwegian Mother, Father and Child Cohort Study (MoBa) recruited pregnant women and their partners across Norway at around 18 gestational weeks between 1999 and 2008. Approximately 95 000 mothers, 75 000 fathers and 114 000 children were included. Peripheral blood samples were taken from mothers and fathers at ultrasound appointments or from mothers at childbirth, and umbilical cord blood samples were collected from the newborns at birth. PARTICIPANTS/MATERIALS, SETTING, METHODS Among the MoBa participants, we selected 1000 couples who conceived by coitus and 894 couples who conceived by IVF (n = 525) or ICSI (n = 369). We measured their DNA methylation (DNAm) levels using the Illumina MethylationEPIC array and calculated epigenetic age acceleration. A linear mixed model was used to examine the differences in five different epigenetic age accelerations between non-ART and ART parents. MAIN RESULTS AND THE ROLE OF CHANCE We found a significant difference in the epigenetic age acceleration calculated by DunedinPoAm between IVF and non-ART mothers (0.021 years, P-value = 2.89E-06) after adjustment for potential confounders. Further, we detected elevated DunedinPoAm in mothers with tubal factor infertility (0.030 years, P-value = 1.34E-05), ovulation factor (0.023 years, P-value = 0.0018) and unexplained infertility (0.023 years, P-value = 1.39E-04) compared with non-ART mothers. No differences in epigenetic age accelerations between non-ART and ICSI fathers were found. DunedinPoAm also showed stronger associations with smoking, education and parity than the other four epigenetic age accelerations. LIMITATIONS, REASONS FOR CAUTION We were not able to determine the directionality of the causal pathway between the epigenetic age accelerations and infertility. Since parents' peripheral blood samples were collected after conception, we cannot rule out the possibility that the epigenetic profile of ART mothers was influenced by the ART treatment. Hence, the results should be interpreted with caution, and our results might not be generalizable to non-pregnant women. WIDER IMPLICATIONS OF THE FINDINGS A plausible biological mechanism behind the reported association is that IVF mothers could be closer to menopause than non-ART mothers. The pace of decline of the ovarian reserve that eventually leads to menopause varies between females yet, in general, accelerates after the age of 30, and some studies show an increased risk of infertility in females with low ovarian reserve. STUDY FUNDING/COMPETING INTEREST(S) This study was partly funded by the Research Council of Norway (Women's fertility, project no. 320656) and through its Centres of Excellence Funding Scheme (project no. 262700). M.C.M. has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement number 947684). The authors declare no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Yunsung Lee
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jon Bohlin
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Christian M Page
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Mathematics, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Haakon E Nustad
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Deepinsight, Oslo, Norway
| | - Jennifer R Harris
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Astanand Jugessur
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Hans I Hanevik
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Fertility Department Sør, Telemark Hospital Trust, Porsgrunn, Norway
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16
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Li YD, Ren ZJ, Gao L, Ma JH, Gou YQ, Tan W, Liu C. Association between male infertility and the risk of hypertension: A meta-analysis and literature review. Andrologia 2022; 54:e14535. [PMID: 35838446 DOI: 10.1111/and.14535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 06/06/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022] Open
Abstract
To explore the association between male infertility and hypertension risk, a meta-analysis and systematic review was conducted. Observational studies were sought in Medline, PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure up to April 30, 2021. Two independent reviewers selected available studies and extracted the data. The association between male infertility and hypertension risk was estimated by calculating the relative risk (RR) and 95% confidence interval (95% CI) using Stata12.0 statistical software. A total of seven studies were included in this meta-analysis, including 102,152 patients and 636,645 healthy individuals. The results demonstrated that male infertility was significantly associated with increased hypertension incidence (RR = 1.08; 95% CI 1.02-1.14; p = 0.004), with moderate-quality evidence. A subgroup analysis based on region showed that a positive association was observed in Europe but not the United States or Asia. This positive association was further confirmed in a cohort study, but not in a case-control study. After adjusting for potential confounders, male infertility was still significantly associated with hypertension risk (RR = 1.06, 95% CI 1.03-1.09). In conclusion, our findings suggest that male infertility increases the risk of hypertension incidence. However, further studies are needed to provide more conclusive evidence.
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Affiliation(s)
- Ya-Dong Li
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Zheng-Ju Ren
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Liang Gao
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jun-Hao Ma
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yuan-Qing Gou
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Wei Tan
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Chuan Liu
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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17
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Combined Trifocal and Microsurgical Testicular Sperm Extraction Enhances Sperm Retrieval Rate in Low-Chance Retrieval Non-Obstructive Azoospermia. J Clin Med 2022; 11:jcm11144058. [PMID: 35887821 PMCID: PMC9317803 DOI: 10.3390/jcm11144058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Low-chance retrieval non-obstructive azoospermic (NOA) patients are a subpopulation of NOA patients. The objective of this study is to compare the surgical outcome of microsurgical-assisted testicular sperm extraction (M-TeSE) and combined trifocal/M-TeSE in low-chance retrieval NOA patients. Material and Methods: A single-center retrospective analysis of NOA patients who underwent testicular sperm extraction was performed. Low-chance retrieval NOA (testicular volume < 10 cc and FSH > 12.4 UI/L) was set as the inclusion criteria. Re-do TeSE procedures were excluded from the current analysis. Data were extrapolated from clinical records and operative notes. We compared data from patients who underwent classic M-TeSE (group A) with that from patients submitted to combined trifocal/M-TeSE (group B). Sperm retrieval rate (SRr) was the primary outcome of the study. Surgical outcomes and postoperative complications were evaluated. A multivariate analysis was conducted to investigate predictive factors for positive SR. Results: Overall, 80 patients (60 patients in Group A and 20 patients in Group B) fulfilled the inclusion criteria. The average (SD) age was 35 (8.2) years. The average preoperative FSH was 27.5 (13) UI/L. The average testicular volume was 6.3 (3) cc on the left side and 6.8 (2.5) cc on the right. Groups were similar in terms of preoperative parameters. The overall SRr was 28%. Patients in group B had higher SRr than those in group A (29.4% vs. 26.9%, p < 0.03). We identified a significant association between testicular histopathology and positive SR (hypospermatogenesis 100%, spermatogenic arrest 32%, and Sertoli cell-only syndrome 22%). The histopathology report was the only significant predicting factor for SR in the multivariate analysis. Conclusion: The combined trifocal and M-TeSE approach is safe and may represent a valuable approach to enhance the SRr in low-chance retrieval NOA. The histopathology report is confirmed to be the only valuable predicting factor for a positive SR.
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18
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Pre- and Postnatal Dietary Exposure to a Pesticide Cocktail Disrupts Ovarian Functions in 8-Week-Old Female Mice. Int J Mol Sci 2022; 23:ijms23147525. [PMID: 35886873 PMCID: PMC9317375 DOI: 10.3390/ijms23147525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 11/21/2022] Open
Abstract
Female infertility has a multifactorial origin, and exposure to contaminants, including pesticides, with endocrine-disrupting properties is considered to be involved in this reproductive disorder, especially when it occurs during early life. Pesticides are present in various facets of the environment, and consumers are exposed to a combination of multiple pesticide residues through food intake. The consequences of such exposure with respect to female fertility are not well known. Therefore, we aimed to assess the impact of pre- and postnatal dietary exposure to a pesticide mixture on folliculogenesis, a crucial process in female reproduction. Mice were exposed to the acceptable daily intake levels of six pesticides in a mixture (boscalid, captan, chlorpyrifos, thiacloprid, thiophanate and ziram) from foetal development until 8 weeks old. Female offspring presented with decreased body weight at weaning, which was maintained at 8 weeks old. This was accompanied by an abnormal ovarian ultrastructure, a drastic decrease in the number of corpora lutea and progesterone levels and an increase in ovary cell proliferation. In conclusion, this study shows that this pesticide mixture that can be commonly found in fruits in Europe, causing endocrine disruption in female mice with pre- and postnatal exposure by disturbing folliculogenesis, mainly in the luteinisation process.
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19
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Zhang S, Mo F, Chang Y, Wu S, Ma Q, Jin F, Xing L. Effects of mobile phone use on semen parameters: a cross-sectional study of 1634 men in China. Reprod Fertil Dev 2022; 34:669-678. [PMID: 35436442 DOI: 10.1071/rd21234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 02/11/2022] [Indexed: 12/18/2022] Open
Abstract
Mobile phones play an irreplaceable role in modern people's lives. However, the radiofrequency electromagnetic radiation produced by mobile phones has also caused increasing concern. A cross-sectional study was conducted to investigate the effect of radiofrequency electromagnetic radiation produced by mobile phones on semen parameters in 1634 men who underwent semen examination at the Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, China. Analysis of variance and multivariate linear regression were used to explore differences among different groups. A P <0.05 was considered statistically significant. The results showed significant associations among different groups of daily mobile phone use time and daily duration of phone calls in the percentage of progressively motile spermatozoa (P =0.004 and P =0.007), rapid progressively motile spermatozoa (P =0.012 and P =0.006) and total motile spermatozoa (P =0.004 and P =0.046). After adjustments for the confounding effects of age and body mass index by multiple linear regression, the results showed that the daily duration of mobile phone use had a negative effect on sperm motility. However, there was no statistically significant correlation between daily phone call duration and sperm motility. Therefore, the daily duration of mobile phone use may negatively affect sperm motility and impair male fertility.
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Affiliation(s)
- Shanshan Zhang
- School of Medicine, Zhejiang University, Hangzhou, 310012 Zhejiang Province, People's Republic of China; and Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006 Zhejiang Province, People's Republic of China
| | - Fengyi Mo
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006 Zhejiang Province, People's Republic of China
| | - Yali Chang
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006 Zhejiang Province, People's Republic of China
| | - Shufang Wu
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006 Zhejiang Province, People's Republic of China
| | - Qing Ma
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006 Zhejiang Province, People's Republic of China
| | - Fan Jin
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006 Zhejiang Province, People's Republic of China
| | - Lanfeng Xing
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006 Zhejiang Province, People's Republic of China
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20
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Hærvig KK, Petersen KU, Giwercman A, Hougaard KS, Høyer BB, Lindh C, Ramlau-Hansen CH, Nybo Andersen AM, Toft G, Bonde JP, Tøttenborg SS. Fetal exposure to maternal cigarette smoking and male reproductive function in young adulthood. Eur J Epidemiol 2022; 37:525-538. [PMID: 35476275 DOI: 10.1007/s10654-022-00869-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 04/04/2022] [Indexed: 11/03/2022]
Abstract
Maternal smoking during pregnancy constitutes a potential, major risk factor for adult male reproductive function. In the hitherto largest longitudinal cohort, we examined biomarkers of reproductive function according to maternal smoking during the first trimester and investigated whether associations were mitigated by smoking cessation prior to the fetal masculinization programming window. Associations between exposure to maternal smoking and semen characteristics, testicular volume and reproductive hormones were assessed among 984 young men from the Fetal Programming of Semen Quality (FEPOS) cohort. Maternal smoking was assessed through interview data and measured plasma cotinine levels during pregnancy. We applied negative binomial, logistic and linear regression models to estimate differences in outcomes according to levels of maternal smoking. Sons of light smokers (≤ 10 cigarettes/day) had a 19% (95% CI - 29%, - 6%) lower sperm concentration and a 24% (95% CI - 35%, - 11%) lower total sperm count than sons of non-smokers. These estimates were 38% (95% CI - 52%, - 22%) and 33% (95% CI - 51%, - 8%), respectively, for sons of heavy smokers (> 10 cigarettes/day). The latter group also had a 25% (95% CI 1%, 54%) higher follitropin level. Similarly, sons exposed to maternal cotinine levels of > 10 ng/mL had lower sperm concentration and total sperm count. Smoking cessation prior to gestational week seven was not associated with a higher reproductive capacity. We observed substantial and consistent exposure-response associations, providing strong support for the hypothesis that maternal smoking impairs male reproductive function. This association persisted regardless of smoking cessation in early pregnancy.
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Affiliation(s)
- Katia Keglberg Hærvig
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark. .,Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Bispebjerg Bakke 23F, entrance 20F, 1st floor, 2400, Copenhagen, NV, Denmark.
| | - Kajsa Ugelvig Petersen
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Karin Sørig Hougaard
- Department of Public Health, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Birgit Bjerre Høyer
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Department of Regional Development, Region of Southern Denmark, Vejle, Denmark
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | | | - Anne-Marie Nybo Andersen
- Department of Public Health, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gunnar Toft
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Department of Public Health, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Department of Public Health, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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21
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Azonbakin S, Gahou U, Gangbo F, Dangbemey P, Adovoekpe D. [Gamete intrafallopian transfer in the treatment of infertility: knowledge, attitude and perception of students at the Faculty of Health and Medical Sciences in Cotonou- Benin]. Pan Afr Med J 2022; 41:147. [PMID: 35519155 PMCID: PMC9046854 DOI: 10.11604/pamj.2022.41.147.26430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/04/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction infertility is a real public health problem. Medically Assisted Procreation (MAP) with donor gametes is one of the possible solutions. In Benin, despite a well-defined legislative framework (children´s code), MAP using donated gametes has not been studied. The purpose of this study was to assess knowledge, attitudes and perceptions of students at the Faculty of Health and Medical Sciences in Cotonou about the donation of gametes. Methods we conducted a cross-sectional and descriptive study among second or third-year medical students at the Faculty of Health and Medical Sciences (FHMS) in Cotonou. Results the surveyed sample consisted of 236 students, of whom 54% (n=127) were male and 46% (n=109) were female; the representative age range was between 18 and 24 years (87%). The knowledge of MAP using donated gametes was 90.6% (n=214). The possibility that this treatment might be performed in Benin was known to be 55.6% (n=131). More that eighty-eight percent (n=209) of respondents were unaware of the existence of legislation in force since 2015 on this matter and 69.5% (n=164) refused to donate gametes. Among the reasons mentioned, the ethical reason dominated. Conclusion in Benin, students´ knowledge about MAP using donated gametes is adequate but there is a widespread refusal to donate their gametes among them, mainly because of ethical issues.
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Affiliation(s)
- Simon Azonbakin
- Unité de Biologie Humaine, Faculté des Sciences de la Santé, Cotonou, Benin
| | - Ulrich Gahou
- Unité de Biologie Humaine, Faculté des Sciences de la Santé, Cotonou, Benin
| | - Flore Gangbo
- Unité de Biologie Humaine, Faculté des Sciences de la Santé, Cotonou, Benin
| | - Patrice Dangbemey
- Centre Mère-Enfant, Faculté des Sciences de la Santé, Université d´Abomey-Calavi, Cotonou, Benin
| | - Diane Adovoekpe
- Unité de Biologie Humaine, Faculté des Sciences de la Santé, Cotonou, Benin
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22
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Yland JJ, Chiu YH, Rinaudo P, Hsu J, Hernán MA, Hernández-Díaz S. Emulating a target trial of the comparative effectiveness of clomiphene citrate and letrozole for ovulation induction. Hum Reprod 2022; 37:793-805. [PMID: 35048945 PMCID: PMC8971650 DOI: 10.1093/humrep/deac005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/01/2021] [Indexed: 01/22/2023] Open
Abstract
STUDY QUESTION What are the comparative pregnancy outcomes in women who receive up to six consecutive cycles of ovulation induction with letrozole versus clomiphene citrate? SUMMARY ANSWER The risks of pregnancy, livebirth, multiple gestation, preterm birth, neonatal intensive care unit (NICU) admission and congenital malformations were higher for letrozole compared with clomiphene in participants with polycystic ovarian syndrome (PCOS), though no treatment differences were observed in those with unexplained infertility. WHAT IS KNOWN ALREADY Randomized trials have reported higher pregnancy and livebirth rates for letrozole versus clomiphene among individuals with PCOS, but no differences among those with unexplained infertility. None of these trials were designed to study maternal or neonatal complications. STUDY DESIGN, SIZE, DURATION We emulated a hypothetical trial of the comparative effectiveness of letrozole versus clomiphene citrate for ovulation induction among all women, then stratified by PCOS and unexplained infertility status. We used real-world data from a large healthcare claims database in the USA (2011-2015). PARTICIPANTS/MATERIALS, SETTING, METHODS We analyzed data from 18 120 women who initiated letrozole and 49 647 women who initiated clomiphene during 2011-2014, and who were aged 18-45 years with no history of diabetes, thyroid disease, liver disease or breast cancer and had no fertility treatments for 3 months before trial initiation. The treatment strategies were clomiphene citrate or letrozole for six consecutive cycles. The outcomes were pregnancy, livebirth, multiple gestation, preterm birth, small for gestational age (SGA), NICU admission and major congenital malformations. We estimated the probability of each outcome under each strategy via pooled logistic regression and used standardization to adjust for confounding and selection bias due to loss to follow-up. MAIN RESULTS AND THE ROLE OF CHANCE The estimated probabilities of pregnancy, livebirth and neonatal outcomes were similar under each strategy, both overall and among individuals with unexplained infertility. Among women with PCOS, the probability of pregnancy was 43% for letrozole vs 37% for clomiphene (risk difference [RD] = 6.0%; 95% CI: 4.4, 7.7) in the intention-to-treat analyses. The corresponding probability of livebirth was 32% vs 29% (RD = 3.1%; 95% CI: 1.5, 4.8). In per protocol analyses, the risk of multiple gestation was 19% vs 9%, the risk of preterm birth was 20% vs 15%, the risk of SGA was 5% vs 3%, the risk of NICU admission was 22% vs 16% and the risk of congenital malformation was 8% vs 2% among those with a livebirth. LIMITATIONS, REASONS FOR CAUTION We cannot completely rule out the possibility of residual confounding by body mass index or duration of infertility. However, we adjusted for proxies identified in administrative data and results did not change. WIDER IMPLICATIONS OF THE FINDINGS Our findings suggest that for women with unexplained infertility, the two treatments result in comparable probabilities of a livebirth. For women with PCOS, letrozole appears slightly more effective for attaining a livebirth. Neonatal outcomes were similar for the two treatments among women with unexplained infertility; we did not confirm the hypothesized higher risk of adverse neonatal outcomes for clomiphene versus letrozole. The risks of adverse neonatal outcomes were slightly greater among women with PCOS who were treated with letrozole versus clomiphene. It is likely that these effects are partially mediated through an increased risk of multiple gestation among women who received letrozole. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Institute of Child Health and Human Development (R01HD088393). Y.-H.C. reports grants from the American Heart Association (834106) and NIH (R01HD097778). P.R. reports grants from the National Institutes of Health. J.H. reports grants from the National Institutes of Health, the Agency for Healthcare Research and Quality, and the California Health Care Foundation during the conduct of the study; and consulting for several health care delivery organizations including Cambridge Health Alliance, Columbia University, University of Southern California, Community Servings, and the Delta Health Alliance. S.H.-D. reports grants from the National Institutes of Health and the US Food and Drug Administration during the conduct of the study; grants to her institution from Takeda outside the submitted work; consulting for UCB (biopharmaceutical company) and Roche; and being an adviser for the Antipsychotics Pregnancy Registry and epidemiologist for the North American Antiepileptics Pregnancy Registry, both at Massachusetts General Hospital. M.A.H. reports grants from the National Institutes of Health and the U.S. Veterans Administration during the conduct of the study; being a consultant for Cytel; and being an adviser for ProPublica. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Jennifer J Yland
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA,Correspondence address. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA. E-mail: https://orcid.org/0000-0001-7870-8971
| | - Yu-Han Chiu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA,CAUSALab, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paolo Rinaudo
- Center for Reproductive Health, University of California San Francisco, San Francisco, CA, USA
| | - John Hsu
- Mongan Institute, Massachusetts General Hospital, Boston, MA, USA,Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Miguel A Hernán
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA,CAUSALab, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sonia Hernández-Díaz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA,CAUSALab, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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23
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Dutta S, Sengupta P, Chakravarthi S. Oxidant-Sensitive Inflammatory Pathways and Male Reproductive Functions. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1358:165-180. [DOI: 10.1007/978-3-030-89340-8_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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24
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Sengupta P, Dutta S, Alahmar AT. Reductive Stress and Male Infertility. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1391:311-321. [PMID: 36472829 DOI: 10.1007/978-3-031-12966-7_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Male infertility research and clinical advances had vast progress in the last few decades. Strong research evidence underpinned the concepts of oxidative stress (OS)-mediated male reproductive disruptions, which bear answers to several cases of idiopathic male infertility. Antioxidant treatment held the prime solution for OS-mediated male infertility. But excess use of antioxidants is challenged by the research breakthrough that reductive stress also predisposes to male infertility, resolutely instituting that any biological extremes of the redox spectrum are deleterious to male fertility. Superfluity of reducing agents may hinder essential oxidation mechanisms, affecting physiological homeostasis. These mechanisms need to be explicated and updated time and again to identify the fine thread between OS-mediated male infertility treatment and induction of reductive stress. This chapter thus presents the evidence-based concepts pertaining to the antioxidants actions to combat OS-induced male infertility, the mechanism of induction of reductive stress and its impact on male reproduction.
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Affiliation(s)
- Pallav Sengupta
- Physiology Unit, Department of Biomedical Sciences, College of Medicine, Gulf Medical University, Ajman, UAE.
| | - Sulagna Dutta
- School of Medical Sciences, Bharath Institute of Higher Education and Research (BIHER), Chennai, India
| | - Ahmed T Alahmar
- Department of Medical Physiology, College of Medicine, University of Babylon, Hillah, Iraq
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25
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Riccetto L, Vieira TP, Viguetti-Campos NL, Mazzola TN, Guaragna MS, Fabbri-Scallet H, de Mello MP, Marques-de-Faria AP, Maciel-Guerra AT, Guerra G. Clinical and laboratory differences between chromosomal and undefined causes of non-obstructive azoospermia: A retrospective study. SAO PAULO MED J 2022; 141:e2022281. [PMID: 36449967 PMCID: PMC10065101 DOI: 10.1590/1516-3180.2022.0281.r1.30082022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/30/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Knowledge of clinical and laboratory differences between chromosomal and undefined causes aids etiological research on non-obstructive azoospermia. OBJECTIVE Compare clinical and laboratory differences between men with non-obstructive azoospermia due to chromosomal anomalies versus undefined causes. DESIGN AND SETTING A cross-sectional retrospective study conducted at a public university hospital in Campinas (Brazil). METHODS All men aged 20-40 years with non-obstructive azoospermia were included in the analysis. RESULTS The 107 cases included 14 with Klinefelter syndrome (KS) (13%), 1 with mosaic KS, 4 with sex development disorders (2 testicular XX, 1 NR5A1 gene mutation, and 1 mild androgen insensitivity syndrome) (4%), 9 with other non-obstructive azoospermia etiologies (8%), and 79 with undefined causes. The 22 chromosomal anomaly cases (14 KS, 1 mosaic KS, 2 testicular XX, 4 sex chromosome anomalies, and 1 autosomal anomaly) were compared with the 79 undefined cause cases. The KS group had lower average testicular volume, shorter penile length, and lower total testosterone levels but greater height, arm span, serum luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, and gynecomastia frequency (absent in the undefined group and affecting more than half of the KS group). Patients with testicular XX DSD had LH, FSH, and penile length data intermediate between the KS and undefined cause groups, testicular volume similar to the KS group, and other data similar to the undefined group. CONCLUSION Clinical and laboratory data differentiate men with non-obstructive azoospermia and chromosomal anomalies, particularly KS and testicular XX, from those with undefined causes or other chromosomal anomalies.
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Affiliation(s)
- Luísa Riccetto
- Undergraduate Medicine Student, Pontifícia Universidade Católica de Campinas (PUCCAMP), Campinas (SP), Brazil; and Member, Grupo Interdisciplinar de Estudos da Determinação e Diferenciação do Sexo (GIEDDS), Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Tarsis Paiva Vieira
- PhD. Professor, Department of Translational Medicine, School of Medical Sciences, Laboratory of Human Cytogenetics, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Nilma Lucia Viguetti-Campos
- PhD. Laboratory Worker, Department of Medical Genetics Genomics, School of Medical Sciences, Laboratory of Cytogenetics, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Tais Nitsch Mazzola
- PhD. Laboratory Worker, Laboratory of Human Molecular Genetics, Center of Molecular Biology and Genetic Engineering, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Mara Sanches Guaragna
- PhD. Researcher, Laboratory Worker, Laboratory of Human Molecular Genetics, Center of Molecular Biology and Genetic Engineering, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Helena Fabbri-Scallet
- PhD Researcher, Laboratory Worker, Laboratory of Human Molecular Genetics, Center of Molecular Biology and Genetic Engineering, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Maricilda Palandi de Mello
- PhD. Professor, Laboratory of Human Molecular Genetics, Center of Molecular Biology and Genetic Engineering, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Antonia Paula Marques-de-Faria
- PhD. Professor, Department of Medical Genetics and Genomics Medicine, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP); and Member, Grupo Interdisciplinar de Estudos da Determinação e Diferenciação do Sexo (GIEDDS), Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Andrea Trevas Maciel-Guerra
- PhD. Professor, Department of Medical Genetics and Genomics Medicine, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP); and Member, Grupo Interdisciplinar de Estudos da Determinação e Diferenciação do Sexo (GIEDDS) Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Gil Guerra
- PhD. Professor, Department of Pediatrics, School of Medical Sciences Universidade Estadual de Campinas (UNICAMP); and Member, Grupo Interdisciplinar de Estudos da Determinação e Diferenciação do Sexo (GIEDDS), Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
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26
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The Association study of eNOS 4a/b and G1190T variant with Iranian male infertility: A case-control study and computational analysis. Meta Gene 2021. [DOI: 10.1016/j.mgene.2021.100971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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27
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Nassan FL, Priskorn L, Salas-Huetos A, Halldorsson TI, Jensen TK, Jørgensen N, Chavarro JE. Association between intake of soft drinks and testicular function in young men. Hum Reprod 2021; 36:3036-3048. [PMID: 34585250 DOI: 10.1093/humrep/deab179] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 06/24/2021] [Indexed: 01/05/2023] Open
Abstract
STUDY QUESTION Is intake of sugar-sweetened beverages (SSB) or artificially sweetened beverages (ASB) associated with testicular function in young men? SUMMARY ANSWER Among young men unaware of their semen quality and reproductive hormone levels, intake of SSBs was associated with lower sperm concentration, lower total sperm count, and a lower ratio of serum inhibin-B/FSH. WHAT IS KNOWN ALREADY SSBs may adversely impact testicular function, but results are not consistent across studies. Moreover, the associations of ASB, energy-drinks or fruit juices with testicular function are unclear. STUDY DESIGN, SIZE, DURATION Young healthy men and unselected for fertility status men enrolled in a cross-sectional study between 2008 and 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 2935 young (median age: 19 years) men enrolled in the study. Intake of SSBs, ASBs, fruit juices, and energy-drinks was assessed with a validated food frequency questionnaire. Testicular function was assessed through conventional semen quality parameters (semen volume, sperm concentration, total count, motility and morphology), testicular volume assessed with ultrasound, and serum reproductive hormone concentrations (total testosterone, free testosterone, E2, inhibin-B, LH, FSH, sex hormone-binding globulin) were measured. MAIN RESULTS AND THE ROLE OF CHANCE In multivariable-adjusted analyses, men in the highest category of SSB intake (median: 1.1 servings (∼220 ml)/day) had a 13.2 million/ml lower median sperm concentration (95% CI: -21.0, -5.5) than non-consumers. A similar pattern was observed with total sperm count (-28 million (95% CI: -48, -9)), serum inhibin-B (-12 pg/ml (95% CI: -21, -4)), and inhibin-B/FSH ratio (-9 (95% CI: -18, 0)). The adjusted median difference in sperm concentration and inhibin-B associated with increasing SSB intake by 1 serving (∼200ml)/day at the expense of water was -3.4 million sperm/ml (95% CI: -5.8, -1.0) and -7 pg/ml (95% CI: -11, -3), respectively. LIMITATIONS, REASONS FOR CAUTION Inferring causality is limited owing to the cross-sectional design. We adjusted for a number of potential confounders but cannot exclude that unmeasured lifestyle and behavior associated with soft drink intake is associated with testicular function in these young men. WIDER IMPLICATIONS OF THE FINDINGS In the largest study to date, intake of SSBs was associated with lower sperm concentration, total sperm count, and serum inhibin-B/FSH ratio, consistent with a direct suppressive effect of SSB intake on testicular function among otherwise healthy men, potentially affecting fertility. However, the observed association between higher SSB intake and lower semen quality does not necessarily imply a decrease in fertility. STUDY FUNDING/COMPETING INTEREST(S) Supported by research from the Danish Council for Strategic Research (2101-08-0058), Independent Research Fund Denmark (8020-00218B), European Union (212844), the Kirsten and Freddy Johansen's Foundation (95-103-72087), the Research Fund of the Capital Region of Denmark (A6176), and the NIH (P30DK046200). The authors report no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- F L Nassan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - L Priskorn
- Department of Growth and Reproduction, and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - A Salas-Huetos
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - T I Halldorsson
- Department of Epidemiology Research, Centre for Foetal Programming, Statens Serum Institut, Copenhagen, Denmark.,Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - T K Jensen
- Department of Growth and Reproduction, and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.,Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - N Jørgensen
- Department of Growth and Reproduction, and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - J E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
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28
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Perry MJ, Arrington S, Freisthler MS, Ibe IN, McCray NL, Neumann LM, Tajanlangit P, Trejo Rosas BM. Pervasive structural racism in environmental epidemiology. Environ Health 2021; 20:119. [PMID: 34784917 PMCID: PMC8595076 DOI: 10.1186/s12940-021-00801-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 10/22/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Epistemological biases in environmental epidemiology prevent the full understanding of how racism's societal impacts directly influence health outcomes. With the ability to focus on "place" and the totality of environmental exposures, environmental epidemiologists have an important opportunity to advance the field by proactively investigating the structural racist forces that drive disparities in health. OBJECTIVE This commentary illustrates how environmental epidemiology has ignored racism for too long. Some examples from environmental health and male infertility are used to illustrate how failing to address racism neglects the health of entire populations. DISCUSSION While research on environmental justice has attended to the structural sources of environmental racism, this work has not been fully integrated into the mainstream of environmental epidemiology. Epidemiology's dominant paradigm that reduces race to a mere data point avoids the social dimensions of health and thus fails to improve population health for all. Failing to include populations who are Black, Indigenous, and people of color (BIPOC) in health research means researchers actually know very little about the effect of environmental contaminants on a range of population health outcomes. This commentary offers different practical solutions, such as naming racism in research, including BIPOC in leadership positions, mandating requirements for discussing "race", conducting far more holistic analyses, increasing community participation in research, and improving racism training, to address the myriad of ways in which structural racism permeates environmental epidemiology questions, methods, results and impacts.
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Affiliation(s)
- Melissa J Perry
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA.
| | - Suzanne Arrington
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Marlaina S Freisthler
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Ifeoma N Ibe
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Nathan L McCray
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Laura M Neumann
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Patrick Tajanlangit
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Brenda M Trejo Rosas
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
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Khampang S, Cho IK, Punyawai K, Gill B, Langmo JN, Nath S, Greeson KW, Symosko KM, Fowler KL, Tian S, Statz JP, Steves AN, Parnpai R, White MA, Hennebold JD, Orwig KE, Simerly CR, Schatten G, Easley CA. Blastocyst development after fertilization with in vitro spermatids derived from nonhuman primate embryonic stem cells. F&S SCIENCE 2021; 2:365-375. [PMID: 34970648 PMCID: PMC8716017 DOI: 10.1016/j.xfss.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To demonstrate that functional spermatids can be derived in vitro from nonhuman primate pluripotent stem cells. DESIGN Green fluorescent protein-labeled, rhesus macaque nonhuman primate embryonic stem cells (nhpESCs) were differentiated into advanced male germ cell lineages using a modified serum-free spermatogonial stem cell culture medium. In vitro-derived round spermatid-like cells (rSLCs) from differentiated nhpESCs were assessed for their ability to fertilize rhesus oocytes by intracytoplasmic sperm(atid) injection. SETTING Multiple academic laboratory settings. PATIENTS Not applicable. INTERVENTIONS Intracytoplasmic sperm(atid) injection of in vitro-derived spermatids from nhpESCs into rhesus macaque oocytes. MAIN OUTCOME MEASURES Differentiation into spermatogenic cell lineages was measured through multiple assessments including ribonucleic acid sequencing and immunocytochemistry for various spermatogenic markers. In vitro spermatids were assessed for their ability to fertilize oocytes by intracytoplasmic sperm(atid) injection by assessing early fertilization events such as spermatid deoxyribonucleic acid decondensation and pronucleus formation/apposition. Preimplantation embryo development from the one-cell zygote stage to the blastocyst stage was also assessed. RESULTS Nonhuman primate embryonic stem cells can be differentiated into advanced germ cell lineages, including haploid rSLCs. These rSLCs undergo deoxyribonucleic acid decondensation and pronucleus formation/apposition when microinjected into rhesus macaque mature oocytes, which, after artificial activation and coinjection of ten-eleven translocation 3 protein, undergo embryonic divisions with approximately 12% developing successfully into expanded blastocysts. CONCLUSIONS This work demonstrates that rSLCs, generated in vitro from primate pluripotent stem cells, mimic many of the capabilities of in vivo round spermatids and perform events essential for preimplantation development. To our knowledge, this work represents, for the first time, that functional spermatid-like cells can be derived in vitro from primate pluripotent stem cells.
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Affiliation(s)
- Sujittra Khampang
- Division of Neuropharmacology and Neurologic Diseases; Yerkes National Primate Research Center; Atlanta, Georgia.,Embryo Technology and Stem Cell Research Center, School of Biotechnology, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - In Ki Cho
- Division of Neuropharmacology and Neurologic Diseases; Yerkes National Primate Research Center; Atlanta, Georgia.,Department of Environmental Health Science, College of Public Health, University of Georgia; Athens, Georgia.,Regenerative Bioscience Center; University of Georgia; Athens, Georgia
| | - Kanchana Punyawai
- Division of Neuropharmacology and Neurologic Diseases; Yerkes National Primate Research Center; Atlanta, Georgia
| | - Brittany Gill
- Department of Environmental Health Science, College of Public Health, University of Georgia; Athens, Georgia.,Regenerative Bioscience Center; University of Georgia; Athens, Georgia
| | - Jacqueline N Langmo
- Department of Environmental Health Science, College of Public Health, University of Georgia; Athens, Georgia.,Regenerative Bioscience Center; University of Georgia; Athens, Georgia
| | - Shivangi Nath
- Department of Genetics, University of Georgia, Athens, Georgia
| | - Katherine W Greeson
- Department of Environmental Health Science, College of Public Health, University of Georgia; Athens, Georgia.,Regenerative Bioscience Center; University of Georgia; Athens, Georgia
| | - Krista M Symosko
- Department of Environmental Health Science, College of Public Health, University of Georgia; Athens, Georgia.,Regenerative Bioscience Center; University of Georgia; Athens, Georgia
| | - Kristen L Fowler
- Department of Environmental Health Science, College of Public Health, University of Georgia; Athens, Georgia.,Regenerative Bioscience Center; University of Georgia; Athens, Georgia
| | - Siran Tian
- Division of Neuropharmacology and Neurologic Diseases; Yerkes National Primate Research Center; Atlanta, Georgia
| | - John P Statz
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon.,Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Alyse N Steves
- Division of Neuropharmacology and Neurologic Diseases; Yerkes National Primate Research Center; Atlanta, Georgia.,Regenerative Bioscience Center; University of Georgia; Athens, Georgia
| | - Rangsun Parnpai
- Embryo Technology and Stem Cell Research Center, School of Biotechnology, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Michael A White
- Department of Genetics, University of Georgia, Athens, Georgia
| | - Jon D Hennebold
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon.,Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Kyle E Orwig
- Magee-Womens Research Institute and Departments of Obstetrics, Gynecology, and Reproductive Sciences, Cell Biology and Bioengineering; University of Pittsburgh; Pittsburgh, Pennsylvania
| | - Calvin R Simerly
- Magee-Womens Research Institute and Departments of Obstetrics, Gynecology, and Reproductive Sciences, Cell Biology and Bioengineering; University of Pittsburgh; Pittsburgh, Pennsylvania
| | - Gerald Schatten
- Magee-Womens Research Institute and Departments of Obstetrics, Gynecology, and Reproductive Sciences, Cell Biology and Bioengineering; University of Pittsburgh; Pittsburgh, Pennsylvania
| | - Charles A Easley
- Division of Neuropharmacology and Neurologic Diseases; Yerkes National Primate Research Center; Atlanta, Georgia.,Department of Environmental Health Science, College of Public Health, University of Georgia; Athens, Georgia.,Regenerative Bioscience Center; University of Georgia; Athens, Georgia
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30
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Priskorn L, Tøttenborg SS, Almstrup K, Andersson AM, Axelsson J, Bräuner EV, Elenkov A, Freiesleben NLC, Giwercman YL, Grøndahl ML, Hansen AH, Hansen LS, Henic E, Kitlinski ML, Landersoe SK, Lindh C, Løkkegaard EL, Malm J, Olsen KW, Petersen KU, Schmidt L, Stormlund S, Svendsen PF, Vassard D, Wang NF, Zedeler A, Bhasin S, Chavarro J, Eisenberg ML, Hauser R, Huhtaniemi I, Krawetz SA, Marko-Varga G, Salonia A, Toppari J, Juul A, Jørgensen N, Nielsen HS, Pinborg A, Rylander L, Giwercman A. RUBIC (ReproUnion Biobank and Infertility Cohort): A binational clinical foundation to study risk factors, life course, and treatment of infertility and infertility-related morbidity. Andrology 2021; 9:1828-1842. [PMID: 34114375 PMCID: PMC10015988 DOI: 10.1111/andr.13063] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Infertility affects 15%-25% of all couples during their reproductive life span. It is a significant societal and public health problem with potential psychological, social, and economic consequences. Furthermore, infertility has been linked to adverse long-term health outcomes. Despite the advanced diagnostic and therapeutic techniques available, approximately 30% of infertile couples do not obtain a live birth after fertility treatment. For these couples, there are no further options to increase their chances of a successful pregnancy and live birth. OBJECTIVES Three overall questions will be studied: (1) What are the risk factors and natural life courses of infertility, early embryonic loss, and adverse pregnancy outcomes? (2) Can we develop new diagnostic and prognostic biomarkers for fecundity and treatment success? And (3) what are the health characteristics of women and men in infertile couples at the time of fertility treatment and during long-term follow-up? MATERIAL AND METHODS ReproUnion Biobank and Infertility Cohort (RUBIC) is established as an add-on to the routine fertility management at Copenhagen University Hospital Departments in the Capital Region of Denmark and Reproductive Medicine Centre at Skåne University Hospital in Sweden. The aim is to include a total of 5000 couples equally distributed between Denmark and Sweden. The first patients were enrolled in June 2020. All eligible infertile couples are prospectively asked to participate in the project. Participants complete an extensive questionnaire and undergo a physical examination and collection of biospecimens (blood, urine, hair, saliva, rectal swabs, feces, semen, endometrial biopsies, and vaginal swabs). After the cohort is established, the couples will be linked to the Danish and Swedish national registers to obtain information on parental, perinatal, childhood, and adult life histories, including disease and medication history. This will enable us to understand the causes of infertility and identify novel therapeutic options for this important societal problem.
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Affiliation(s)
- Laerke Priskorn
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Health, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Kristian Almstrup
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jonatan Axelsson
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden
| | - Elvira Vaclavik Bräuner
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Angel Elenkov
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden
| | - Nina la Cour Freiesleben
- The Fertility Clinic, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Marie Louise Grøndahl
- Fertility Clinic, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Ann Holm Hansen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Laura Smidt Hansen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Emir Henic
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden
| | | | - Selma Kloeve Landersoe
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Obstetrics and Gynecology, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Ellen Leth Løkkegaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics and Gynecology, Copenhagen University Hospital - North Zealand, Copenhagen, Denmark
| | - Johan Malm
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | | | - Kajsa Uglevig Petersen
- Department of Occupational and Environmental Health, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sacha Stormlund
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Pernille Fog Svendsen
- Fertility Clinic, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Ditte Vassard
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Nathalie Friis Wang
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anne Zedeler
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Shalender Bhasin
- Research Program in Men's Health: Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jorge Chavarro
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michael L Eisenberg
- Department of Urology and Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Russ Hauser
- Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ilpo Huhtaniemi
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology, Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | | | - Andrea Salonia
- Graduate School of Urology, University Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Jorma Toppari
- Institute of Biomedicine, Research Centre for Integrated Physiology and Pharmacology, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Henriette Svarre Nielsen
- The Fertility Clinic, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anja Pinborg
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Aleksander Giwercman
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden.,Department of Translational Medicine, Lund University, Malmö, Sweden
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31
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Branch FM, Perry MJ, Chen Z, Louis GMB. Metal(loid)s and human semen quality: The LIFE Study. Reprod Toxicol 2021; 106:94-102. [PMID: 34637914 DOI: 10.1016/j.reprotox.2021.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/06/2021] [Accepted: 10/07/2021] [Indexed: 11/24/2022]
Abstract
Multiple studies have demonstrated a global population-wide decline in semen quality, with sperm concentrations having fallen 50 % over the past 50 years. Several metal and metalloid ("metal(loid)") compounds are known to have testicular toxicity, raising concerns about their contribution to rising infertility. In the male reproductive tract, metal(loid)s can reduce semen quality and disturb function both directly, by inducing tissue damage, and indirectly, by disrupting hormone production and secretion. This study assessed associations between 15 creatinine-adjusted metal(loid)s and 7 measures of semen quality among 413 reproductive-aged men recruited from 16 U.S. counties between 2005-2009. Multi-metal(loid) multivariable linear regression models estimated associations between semen quality endpoints and urinary concentrations of chromium, cobalt, copper, molybdenum, selenium, zinc, antimony, arsenic, barium, cadmium, lead, thallium, tin, tungsten, and uranium. LASSO regression was employed to select model variables and account for multicollinearity of the metal(loid)s. A positive association was observed between tin and sperm morphology (β = 4.92 p = 0.045). Chromium (β = 1.87, p = 0.003) and copper (β= -1.30, p = 0.028) were positively and negatively associated with total sperm count, respectively. With respect to DNA fragmentation, cadmium (β = 12.73, p = 0.036) was positively associated and chromium was negatively associated (β = -5.08, p = 0.001). In this cohort of U.S. population-based men, there was evidence of both positive and negative associations between specific metal(loid)s and semen quality. Additional research is needed to determine interactions between metal(loid)s within a mixture, consistent with typical human exposure, and identify sperm effects resulting from cumulative metal(loid) exposures.
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Affiliation(s)
- Francesca M Branch
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave. NW, Washington, DC, 20037, United States.
| | - Melissa J Perry
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave. NW, Washington, DC, 20037, United States.
| | - Zhen Chen
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive Executive Boulevard, Bethesda, MD 20892, United States.
| | - Germaine M Buck Louis
- College of Health and Human Services, George Mason University, 4400 University Drive, MS 2G7, Fairfax, VA 22030, United States.
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32
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Liu X, Wang H, Liu B, Qi Z, Li J, Xu B, Liu W, Xu Z, Deng Y. The Latest Research Progress of m 6A Modification and Its Writers, Erasers, Readers in Infertility: A Review. Front Cell Dev Biol 2021; 9:681238. [PMID: 34568313 PMCID: PMC8461070 DOI: 10.3389/fcell.2021.681238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/06/2021] [Indexed: 01/22/2023] Open
Abstract
Eukaryotic messenger mRNAs contain many RNA methyl chemical modifications, in which N6-methyladenosine (m6A) plays a very important role. The modification process of RNA methylation is a dynamic reversible regulatory process that is mainly catalyzed by "Writer" m6A methyltransferase, removed by "Eraser" m6A demethylase, and recognized by the m6A binding protein, thereby, linking m6A modification with other mRNA pathways. At various stages of the life cycle, m6A modification plays an extremely important role in regulating mRNA splicing, processing, translation, as well as degradation, and is associated with gametogenesis and fertility for both sexes. Normal gametogenesis is a basic guarantee of fertility. Infertility leads to trauma, affects harmony in the family and seriously affects the quality of life. We review the roles and mechanisms of RNA m6A methylation modification in infertility and provide a potential target for infertility treatment, which can be used for drug development.
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Affiliation(s)
- Xuda Liu
- Department of Public Health, China Medical University, Shenyang, China
| | - Haiying Wang
- Department of Public Health, China Medical University, Shenyang, China
| | - Bingchen Liu
- Department of Public Health, China Medical University, Shenyang, China
| | - Zhipeng Qi
- Department of Public Health, China Medical University, Shenyang, China
| | - Jiashuo Li
- Department of Public Health, China Medical University, Shenyang, China
| | - Bin Xu
- Department of Public Health, China Medical University, Shenyang, China
| | - Wei Liu
- Department of Public Health, China Medical University, Shenyang, China
| | - Zhaofa Xu
- Department of Public Health, China Medical University, Shenyang, China
| | - Yu Deng
- Department of Public Health, China Medical University, Shenyang, China
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33
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Giulioni C, Maurizi V, Scarcella S, Di Biase M, Iacovelli V, Galosi AB, Castellani D. Do environmental and occupational exposure to pyrethroids and organophosphates affect human semen parameters? Results of a systematic review and meta-analysis. Andrologia 2021; 53:e14215. [PMID: 34410018 DOI: 10.1111/and.14215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/25/2021] [Accepted: 07/29/2021] [Indexed: 11/30/2022] Open
Abstract
Our purpose was to review and analyse the impact of pyrethroids and organophosphates exposure on human semen parameters. A comprehensive literature search was performed through MEDLINE via PubMed, Scopus and Webscience. Only cohort studies examining semen parameters in workers or general populations exposed to pyrethroids or organophosphates were included. Ejaculate volume, sperm count, concentration, motility, viability, normal morphology and seminal pH alterations were pooled using the Cochran-Mantel-Haenszel Method with the random effect model and expressed as weighted mean difference, risk ratios, 95% confidence intervals and p-values. Seven cross-sectional studies regarding pyrethroids were included. Four of them were eligible for meta-analysis. The only parameter affected by pyrethroid exposure was normal sperm morphology (WMD-7,61%, 95%CI -11,92 to -3,30;p = 0,0,005). Nine studies were selected to evaluate the impact of organophosphates on semen parameters with six of them eligible for meta-analysis. A significant reduction was detected for the following: ejaculate volume (WMD -0,47ml, 95%CI -0,69 to -0,25; p < 0,0001), sperm count (WMD-40,03, 95%CI -66,81 to -13,25;p = 0,003), concentration (WMD-13,69 x10⁶/mL, 95%CI -23, 27 to-4,12;p = 0,005) and motility (WMD -5,70%, 95%CI -12,89 to 1,50;p = 0,12). Despite the increase in sperm abnormality, it has been shown that pyrethroids are unrelated to reduced sperm quality. However, the negative association of organophosphates with spermatogenesis is noteworthy.
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Affiliation(s)
- Carlo Giulioni
- Department of Urology, Ospedali Riuniti" University Hospital, Ancona, Italy
| | - Valentina Maurizi
- Department of Clinical and Molecular Sciences, "Polytechnic University of Marche Region, Ospedali Riuniti" University Hospital, Ancona, Italy
| | - Simone Scarcella
- Department of Urology, Ospedali Riuniti" University Hospital, Ancona, Italy
| | | | - Valerio Iacovelli
- Urology Unit, "San Carlo di Nancy" General Hospital - GVM Care and Research, Rome, Italy
| | | | - Daniele Castellani
- Department of Urology, Ospedali Riuniti" University Hospital, Ancona, Italy
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34
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Eisenberg ML, Thoma ME, Li S, McLain AC. Trends in time-to-pregnancy in the USA: 2002 to 2017. Hum Reprod 2021; 36:2331-2338. [PMID: 34021350 DOI: 10.1093/humrep/deab107] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 03/30/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Has there been there a temporal change in time-to-pregnancy (TTP) in the USA. SUMMARY ANSWER Overall, TTP was stable over time, but a longer TTP for women over 30 and parous women was identified. WHAT IS KNOWN ALREADY Fertility rates in the USA have declined over the past several years. Although these trends have been attributed to changing reproductive intentions, it is unclear whether declining fecundity (the biologic ability to reproduce measured by TTP in the current report) may also play a role. Indeed, trends based on declining sperm quality and higher utilisation of infertility treatment suggest fecundity may be falling. STUDY DESIGN, SIZE, DURATION This cross-sectional survey data from the National Survey of Family Growth was administered from 2002 to 2017. The surveys are based on nationally representative samples of reproductive-aged women in the USA. Interviews were conducted in person or through computer-assisted self-administration of sensitive questions. PARTICIPANTS/MATERIALS, SETTING, METHODS The study included women who self-reported time spent trying to become pregnant allowing utilisation of the current duration approach to estimate the total duration of pregnancy attempt (i.e. TTP). In all, 1202 participants were analysed over each study period. To estimate a TTP distribution overall and by parity, we used a piecewise constant proportional hazards model that accounts for digit preference. Accelerated-failure-time regression models, which were weighted to account for the sampling design, were used to estimate time ratios (TRs). Models were adjusted for age, BMI, race, education, relationship status, parity, pelvic inflammatory disease treatment and any reproductive problems. MAIN RESULTS AND THE ROLE OF CHANCE Of the participants analysed, the average age was 31.8 and BMI was 28.6, which was similar across the survey periods. Relationship status was the only demographic characteristic that changed over time. All other variables remained constant across the study periods. Overall, TRs comparing TTP between 2002 and 2017 increased slightly (TR: 1.02, 95% CI: 0.99, 1.04). When stratified by parity, parous women had a longer TTP over the later years of the study (TR: 1.04, 95% CI: 1.01, 1.06). TTP remained constant for nulliparous women. Similarly, TTP also increased over time for women over age thirty (TR: 1.02, 1.00, 1.05) but not for women under age thirty. LIMITATIONS, REASONS FOR CAUTION Small changes in data collection over time may have impacted the findings. We accounted for this in sensitivity analyses using imputed data. Overall, TRs were slightly attenuated using the imputed data, but represented similar patterns to the original data. Results for parous women and women over 30 remained consistent in the sensitivity analyses. WIDER IMPLICATIONS OF THE FINDINGS Consistent with reports of falling fertility rates and sperm counts, this study suggests parous and older couples in the USA may be taking longer to become pregnant. Although trends were suggestive of a small overall increase in TTP, particularly for parous women and women over age thirty, additional data are needed to attempt to understand these trends given the societal, economic and public health implications related to fecundity. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by National Institutes of Health grant R03HD097287 to A.C.M. There are no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Michael L Eisenberg
- Male Reproductive Medicine and Surgery, Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Marie E Thoma
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - Shufeng Li
- Male Reproductive Medicine and Surgery, Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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35
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Objective sleep duration and timing predicts completion of in vitro fertilization cycle. J Assist Reprod Genet 2021; 38:2687-2696. [PMID: 34374922 DOI: 10.1007/s10815-021-02260-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/10/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To examine associations between objectively measured sleep duration and sleep timing with odds of completion of an in vitro fertilization (IVF) cycle. METHODS This prospective cohort study enrolled 48 women undergoing IVF at a large tertiary medical center between 2015 and 2017. Sleep was assessed by wrist-worn actigraphy, 1-2 weeks prior to initiation of the IVF cycle. Reproductive and IVF cycle data and demographic and health information were obtained from medical charts. Sleep duration, midpoint, and bedtime were examined in relation to IVF cycle completion using logistic regression models, adjusted for age and anti-Müllerian hormone levels. A sub-analysis excluded women who worked non-day shifts to control for circadian misalignment. RESULTS The median age of all participants was 33 years, with 29% of women >35 years. Ten women had an IVF cycle cancelation prior to embryo transfer. These women had shorter sleep duration, more nocturnal awakenings, lower sleep efficiency, and later sleep timing relative to those who completed their cycle. Longer sleep duration was associated with lower odds of uncompleted IVF cycle (OR = 0.88; 95%CI 0.78, 1.00, per 20-min increment of increased sleep duration). Women with later sleep midpoint and later bedtime had higher odds of uncompleted cycle relative to those with earlier midpoint and earlier bedtime; OR = 1.24; 95%CI 1.09, 1.40 and OR = 1.33; 95%CI 1.17, 1.53 respectively, for 20-min increments. These results were independent of age, anti-Müllerian hormone levels, or sleep duration, and remained significant after exclusion of shift-working women. CONCLUSIONS Shorter sleep duration and later sleep timing increase the odds of uncompleted cycles prior to embryo transfer.
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36
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One size does not fit all: variations by ethnicity in demographic characteristics of men seeking fertility treatment across North America. Fertil Steril 2021; 116:1287-1294. [PMID: 34325919 DOI: 10.1016/j.fertnstert.2021.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare racial differences in male fertility history and treatment. DESIGN Retrospective review of prospectively collected data. SETTING North American reproductive urology centers. PATIENT(S) Males undergoing urologist fertility evaluation. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Demographic and reproductive Andrology Research Consortium data. RESULT(S) The racial breakdown of 6,462 men was: 51% White, 20% Asian/Indo-Canadian/Indo-American, 6% Black, 1% Indian/Native, <1% Native Hawaiian/Other Pacific Islander, and 21% "Other". White males sought evaluation sooner (3.5 ± 4.7 vs. 3.8 ± 4.2 years), had older partners (33.3 ± 4.9 vs. 32.9 ± 5.2 years), and more had undergone vasectomy (8.4% vs. 2.9%) vs. all other races. Black males were older (38.0 ± 8.1 vs. 36.5 ± 7.4 years), sought fertility evaluation later (4.8 ± 5.1 vs. 3.6 ± 4.4 years), fewer had undergone vasectomy (3.3% vs. 5.9%), and fewer had partners who underwent intrauterine insemination (8.2% vs. 12.6%) compared with all other races. Asian/Indo-Canadian/Indo-American patients were younger (36.1 ± 7.2 vs. 36.7 ± 7.6 years), fewer had undergone vasectomy (1.2% vs. 6.9%), and more had partners who underwent intrauterine insemination (14.2% vs. 11.9%). Indian/Native males sought evaluation later (5.1 ± 6.8 vs. 3.6 ± 4.4 years) and more had undergone vasectomy (13.4% vs. 5.7%). CONCLUSION(S) Racial differences exist for males undergoing fertility evaluation by a reproductive urologist. Better understanding of these differences in history in conjunction with societal and biologic factors can guide personalized care, as well as help to better understand and address disparities in access to fertility evaluation and treatment.
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Stanford JB, Carpentier PA, Meier BL, Rollo M, Tingey B. Restorative reproductive medicine for infertility in two family medicine clinics in New England, an observational study. BMC Pregnancy Childbirth 2021; 21:495. [PMID: 34233646 PMCID: PMC8265110 DOI: 10.1186/s12884-021-03946-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 06/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Restorative reproductive medicine (RRM) seeks to identify and correct underlying causes and factors contributing to infertility and reproductive dysfunction. Many components of RRM are highly suitable for primary care practice. We studied the outcomes amongst couples who received restorative reproductive medicine treatment for infertility in a primary care setting. METHODS Two family physicians in Massachusetts trained in a systematic approach to RRM (natural procreative technology, or NaProTechnology) treated couples with infertility. We retrospectively reviewed the characteristics, diagnoses, treatments, and outcomes for all couples treated during the years 1989 to 2014. We compared pregnancy and live birth by clinical characteristics using Kaplan-Meier analysis. We employed the Fleming-Harrington weighted Renyi test or the logrank test to compare the cumulative proportion with pregnancy or with live birth. RESULTS Among 370 couples beginning treatment for infertility, the mean age was 34.8 years, the mean prior time trying to conceive was 2.7 years, and 27% had a prior live birth. The mean number of diagnoses per couple was 4.9. Treatment components included fertility tracking with the Creighton Model FertilityCare System (80%); medications to enhance cervical mucus production (81%), to stimulate ovulation (62%), or to support the luteal phase (75%); and referral to female laparoscopy by a surgeon specializing in endometriosis (46%). The cumulative live birth rate at 2 years was 29% overall; this was significantly higher for women under age 35 (34%), and for women with body mass index < 25 (40%). There were 2 sets of twins and no higher-order multiple gestations. Of the 63 births with data available, 58 (92%) occurred at term. CONCLUSIONS Family physicians can provide a RRM approach for infertility to identify underlying causes and promote healthy term live births. Younger women and women with body mass index < 25 are more likely to have a live birth.
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Affiliation(s)
- Joseph B Stanford
- Office of Cooperative Reproductive Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA. .,International Institute for Restorative Reproductive Medicine, London, UK.
| | - Paul A Carpentier
- International Institute for Restorative Reproductive Medicine, London, UK.,Gianna of Long Island Center for Women's Health and Fertility, New York, USA.,In His Image Family Medicine, Gardner, MA, USA
| | - Barbara L Meier
- International Institute for Restorative Reproductive Medicine, London, UK.,Gianna of Long Island Center for Women's Health and Fertility, New York, USA.,In His Image Family Medicine, Gardner, MA, USA.,Reliant Medical Group, Fitchburg, MA, USA
| | - Mark Rollo
- International Institute for Restorative Reproductive Medicine, London, UK.,Reliant Medical Group, Fitchburg, MA, USA
| | - Benjamin Tingey
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
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Cannarella R, Crafa A, Condorelli RA, Mongioì LM, La Vignera S, Calogero AE. Relevance of sperm imprinted gene methylation on assisted reproductive technique outcomes and pregnancy loss: a systematic review. Syst Biol Reprod Med 2021; 67:251-259. [PMID: 34080930 DOI: 10.1080/19396368.2021.1909667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Recent evidence suggests that gamete-imprinted genes play a role in embryo and placenta development and growth. This systematic review aimed to evaluate whether altered methylation of sperm-imprinted genes associates with sperm DNA fragmentation (SDF), pregnancy loss rate and assisted reproductive technique (ART) outcome. To accomplish this, Pubmed, MEDLINE, Cochrane, Academic One Files, Google Scholar, and Scopus databases were used for search strategy from each database inception until December 2020. Specific keywords were used. Studies satisfying the PECOS (Population, Exposure, Comparison/Comparator, Outcomes, Study design) model were retrieved. Ten studies could be included in the qualitative analysis. A significant association was reported between increased SDF rate and aberrant methylation of H19/IGF2 and KCNQ1 genes by two studies. A significantly lower H19 methylation was found in patients with idiopathic recurrent pregnancy loss (RPL) and in infertile patients compared to fertile men. Methylation of GLT2, PEG1/MEST, and ZAC/PLACL1 were similar in patients with RPL and controls. The ART outcome was similar in patients with aberrant and normal methylation of H19, SNRPN, KCNQ1OT1, PEG1/MEST, LIT1, PEG3, NESPAS, and GLT2. By contrast, a study showed an association between altered GLT2 methylation and more inferior ART results. If further confirmed by well-sized studies, these data might be helpful to identify possible epigenetic predictors of ART outcome. Particularly, aberrant methylation of H19/IGF2 and KCNQ1 genes might represent interesting targets that deserve further investigation.
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Affiliation(s)
- Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Laura M Mongioì
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Ngai FW, Lam W. Perception of family sense of coherence among Chinese couples with infertility. J Clin Nurs 2021; 30:3259-3267. [PMID: 33963632 DOI: 10.1111/jocn.15833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore perceptions of family sense of coherence among infertile couples and to provide a theoretical interpretation of the comprehensibility, manageability and meaningfulness of couples' experiences coping with infertility. BACKGROUND Infertility is a devastating experience for many couples and can have long-lasting psychosocial consequences. Family sense of coherence has the potential to facilitate a couple's adjustment to the life crisis of infertility and may provide a useful conceptual lens to understand experiences of infertility. METHODS Sixty-four couples with infertility participated in semi-structured interviews at subfertility clinics. Data were analysed using the constant comparative approach of grounded theory. COREQ guidelines were followed in reporting the study. RESULTS Three major themes related to infertility emerged from the interviews: comprehensibility, manageability and meaningfulness. The couples experienced psychological strain while making cognitive sense of infertility. The significance of children, which is embedded in traditional Chinese culture, created a sense of meaning and purpose in couples' lives and motivated them to mobilise both internal and external resources to cope with the demands of infertility and its treatment. CONCLUSIONS The findings indicate that the salutogenic model of family sense of coherence can contribute to our understanding of the experiences of infertility among Chinese couples. RELEVANCE TO CLINICAL PRACTICE The results offer a theoretical framework that healthcare professionals can use to help couples cope with the life crisis of infertility by strengthening their sense of family coherence.
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Affiliation(s)
- Fei Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
| | - Winsome Lam
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
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Rosati AJ, Whitcomb BW, Brandon N, Buck Louis GM, Mumford SL, Schisterman EF, Pilsner JR. Sperm mitochondrial DNA biomarkers and couple fecundity. Hum Reprod 2021; 35:2619-2625. [PMID: 33021643 DOI: 10.1093/humrep/deaa191] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/26/2020] [Indexed: 01/28/2023] Open
Abstract
STUDY QUESTION Do sperm mitochondrial DNA measures predict probability of pregnancy among couples in the general population? SUMMARY ANSWER Those with high sperm mitochondrial DNA copy number (mtDNAcn) had as much as 50% lower odds of cycle-specific pregnancy, and 18% lower probability of pregnancy within 12 months. WHAT IS KNOWN ALREADY Semen parameters have been found to poorly predict reproductive success yet are the most prevalent diagnostic tool for male infertility. Increased sperm mtDNAcn and mitochondrial DNA deletions (mtDNAdel) have been associated with decreased semen quality and lower odds of fertilization in men seeking fertility treatment. STUDY DESIGN, SIZE, DURATION A population-based prospective cohort study of couples discontinuing contraception to become pregnant recruited from 16 US counties from 2005 to 2009 followed for up to 16 months. PARTICIPANTS/MATERIALS, SETTING, METHODS Sperm mtDNAcn and mtDNAdel from 384 semen samples were assessed via triplex probe-based quantitative PCR. Probability of pregnancy within 1 year was compared by mitochondrial DNA, and discrete-time proportional hazards models were used to evaluate the relations with time-to-pregnancy (TTP) with adjustment for covariates. MAIN RESULTS AND THE ROLE OF CHANCE Higher sperm mtDNAcn was associated with lower pregnancy probability within 12 months and longer TTP. In unadjusted comparisons by quartile (Q), those in Q4 had a pregnancy probability of 63.5% (95% CI: 53.1% to 73.1%) compared to 82.3% (95% CI: 73.2% to 89.9%) for Q1 (P = 0.002). Similar results were observed in survival analyses adjusting for covariates to estimate fecundability odds ratios (FORs) comparing mtDNAcn in quartiles. Relative to those in Q1 of mtDNAcn, FORs (95% CI) were for Q2 of 0.78 (0.52 to 1.16), Q3 of 0.65 (0.44 to 0.96) and Q4 of 0.55 (0.37 to 0.81), and this trend of decreasing fecundability with increasing mtDNAcn quartile was statistically significant (FOR per log mtDNAcn = 0.37; P < 0.001). Sperm mtDNAdel was not associated with TTP. LIMITATIONS, REASONS FOR CAUTION This prospective cohort study consisted primarily of Caucasian men and women and thus large diverse cohorts are necessary to confirm the associations between sperm mtDNAcn and couple pregnancy success in other races/ethnicities. WIDER IMPLICATIONS OF THE FINDINGS Our results demonstrate that sperm mtDNAcn has utility as a biomarker of male reproductive health and probability of pregnancy success in the general population. STUDY FUNDING/COMPETING INTEREST(S) This work was funded in part by the National Institute of Environmental Health Sciences, National Institutes of Health (R01-ES028298; PI: J.R.P.) and the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland (Contracts N01-HD-3-3355, N01-HD-3-3356 and N01-HD-3-3358). The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Allyson J Rosati
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Brian W Whitcomb
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Nicole Brandon
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Germaine M Buck Louis
- Dean's Office of the College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Sunni L Mumford
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, Bethesda, MD, USA
| | - Enrique F Schisterman
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, Bethesda, MD, USA
| | - J Richard Pilsner
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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Righarts A, Dickson NP, Ekeroma A, Gray AR, Parkin L, Gillett WR. The burden of infertility in New Zealand: A baseline survey of prevalence and service use. Aust N Z J Obstet Gynaecol 2021; 61:439-447. [PMID: 33644852 DOI: 10.1111/ajo.13323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Studies in southern New Zealand indicate that up to a quarter of women experienced infertility, likely due to delay in childbearing. However, these findings may not be generalisable to the whole population. AIMS To assess the lifetime prevalence of infertility and evidence for disparities for New Zealand men and women in a nationally representative sample. MATERIALS AND METHODS In 2014/15 a general health survey with a module on sexual and reproductive health was conducted among New Zealand residents aged 16-74 years; 3792 men and 5222 women provided information on infertility. RESULT(S) There were 8.2% (95% CI 7.1-9.4%) of men and 12.5% (11.3-13.8%) of women who had experienced infertility; among fertility-tested women this was 15.4% (14.0-16.9%). Prevalence peaked in the 35-44 year age group (14.3% for men, 19.1% for women and 20.8% for fertility-tested women). Estimates for European, Māori and Asian ethnicities were similar. Pacific men and women had higher relative risks: 2.37 (95% CI 1.51-3.71) and 1.76 (1.27-2.44), respectively, compared with Europeans. Medical help was sought by 69.3% (95% CI 62.4-75.5%) of infertile men and 68.2% (63.1-72.9%) of women; this was significantly lower for Māori and Pacific. CONCLUSIONS Infertility levels for those of European ethnicity were similar to studies in southern New Zealand, and in other high-income countries. However, infertility levels were just as high for Māori, and higher for Pacific people, despite experiencing fertility at younger ages. Focusing on reducing causes of infertility other than delayed childbearing would likely contribute to addressing this health disparity.
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Affiliation(s)
- Antoinette Righarts
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Nigel P Dickson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Andrew R Gray
- Centre for Biostatistics, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Lianne Parkin
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Wayne R Gillett
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
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Ngai FW, Loke AY. Relationships between infertility-related stress, family sense of coherence and quality of life of couples with infertility. HUM FERTIL 2021; 25:540-547. [PMID: 33432870 DOI: 10.1080/14647273.2021.1871781] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This is a cross-sectional study with the objective to examine the relationships between infertility-related stress, family sense of coherence and quality of life of Chinese couples with infertility in Hong Kong. A convenience sample of 135 Chinese couples were recruited at the subfertility clinics of the Family Planning Association of Hong Kong. Data were collected using the Fertility Problem Inventory, Family Sense of Coherence Scale and Fertility Quality of Life. Path analysis was used for data analysis. The results showed that infertility-related stress had a negative association with the quality of life of infertile couples and family sense of coherence mediated the effect of infertility-related stress on quality of life for both partners. The infertility-related stress of women had a negative association with their husbands' quality of life. Infertile women had more infertility-related stress and a lower quality of life than their husbands. The findings provide new insights into the importance of family sense of coherence in facilitating couples' adjustment to infertility. Culturally competent heath care interventions should be developed to strengthen family sense of coherence among Chinese couples with infertility and help them reduce their infertility-related stress, thus improving their quality of life.
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Affiliation(s)
- Fei-Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Chang WF, Peng M, Hsu J, Xu J, Cho HC, Hsieh-Li HM, Liu JL, Lu CH, Sung LY. Effects of Survival Motor Neuron Protein on Germ Cell Development in Mouse and Human. Int J Mol Sci 2021; 22:ijms22020661. [PMID: 33440839 PMCID: PMC7827477 DOI: 10.3390/ijms22020661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/29/2020] [Accepted: 01/03/2021] [Indexed: 11/24/2022] Open
Abstract
Survival motor neuron (SMN) is ubiquitously expressed in many cell types and its encoding gene, survival motor neuron 1 gene (SMN1), is highly conserved in various species. SMN is involved in the assembly of RNA spliceosomes, which are important for pre-mRNA splicing. A severe neurogenic disease, spinal muscular atrophy (SMA), is caused by the loss or mutation of SMN1 that specifically occurred in humans. We previously reported that SMN plays roles in stem cell biology in addition to its roles in neuron development. In this study, we investigated whether SMN can improve the propagation of spermatogonia stem cells (SSCs) and facilitate the spermatogenesis process. In in vitro culture, SSCs obtained from SMA model mice showed decreased growth rate accompanied by significantly reduced expression of spermatogonia marker promyelocytic leukemia zinc finger (PLZF) compared to those from heterozygous and wild-type littermates; whereas SMN overexpressed SSCs showed enhanced cell proliferation and improved potency. In vivo, the superior ability of homing and complete performance in differentiating progeny was shown in SMN overexpressed SSCs in host seminiferous tubule of transplant experiments compared to control groups. To gain insights into the roles of SMN in clinical infertility, we derived human induced pluripotent stem cells (hiPSCs) from azoospermia patients (AZ-hiPSCs) and from healthy control (ct-hiPSCs). Despite the otherwise comparable levels of hallmark iPCS markers, lower expression level of SMN1 was found in AZ-hiPSCs compared with control hiPSCs during in vitro primordial germ cell like cells (PGCLCs) differentiation. On the other hand, overexpressing hSMN1 in AZ-hiPSCs led to increased level of pluripotent markers such as OCT4 and KLF4 during PGCLC differentiation. Our work reveal novel roles of SMN in mammalian spermatogenesis and suggest new therapeutic targets for azoospermia treatment.
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Affiliation(s)
- Wei-Fang Chang
- Institute of Biotechnology, National Taiwan University, Taipei 106, Taiwan; (W.-F.C.); (M.P.); (J.H.)
| | - Min Peng
- Institute of Biotechnology, National Taiwan University, Taipei 106, Taiwan; (W.-F.C.); (M.P.); (J.H.)
| | - Jing Hsu
- Institute of Biotechnology, National Taiwan University, Taipei 106, Taiwan; (W.-F.C.); (M.P.); (J.H.)
| | - Jie Xu
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, Ann Arbor, MI 48109, USA;
| | - Huan-Chieh Cho
- Animal Resource Center, National Taiwan University, Taipei 106, Taiwan;
| | - Hsiu-Mei Hsieh-Li
- Department of Life Science, National Taiwan Normal University, Taipei 116, Taiwan;
| | - Ji-Long Liu
- MRC Functional Genomics Unit, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK;
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Chung-Hao Lu
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 105, Taiwan
- Correspondence: (C.-H.L.); (L.-Y.S.)
| | - Li-Ying Sung
- Institute of Biotechnology, National Taiwan University, Taipei 106, Taiwan; (W.-F.C.); (M.P.); (J.H.)
- Animal Resource Center, National Taiwan University, Taipei 106, Taiwan;
- Agricultural Biotechnology Research Center, Academia Sinica, Taipei 115, Taiwan
- Correspondence: (C.-H.L.); (L.-Y.S.)
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Kiani Z, Simbar M, Hajian S, Zayeri F. Quality of life among infertile women living in a paradox of concerns and dealing strategies: A qualitative study. Nurs Open 2021; 8:251-261. [PMID: 33318833 PMCID: PMC7729776 DOI: 10.1002/nop2.624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/06/2020] [Accepted: 08/21/2020] [Indexed: 12/12/2022] Open
Abstract
Aim The current work investigated the issues that cause apprehension in infertile women, the effects of this disquiet on their quality of life and the strategies that they adopt in dealing with their concerns. Design The qualitative research. Method This qualitative research sampled participants from a training centre in Mazandaran University of Medical Sciences and a privately owned infertility centre in Mazandaran Province, north of Iran. Purposive sampling continued until data saturation was reached. We conducted a conventional content analysis of the responses of 30 individuals (15 women with female infertility and 15 key informants) to in-depth and semi-structured in-person interviews on May to November 2019 . Results The results uncovered two themes subsuming four categories of issues: The first theme revolves around "infertility concerns," under which "concerns" and "the difficulty and vagueness of treatment" belonged. The second theme was "dealing with infertility," which covered "adaptive strategies" and "inhibitors of reconciliation with perceived infertility."
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Affiliation(s)
- Zahra Kiani
- Student Research CommitteeDepartment of Midwifery and Reproductive HealthSchool of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research CenterDepartment of Midwifery and Reproductive HealthSchool of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Sepideh Hajian
- Midwifery and Reproductive Health Research CenterDepartment of Midwifery and Reproductive HealthSchool of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Farid Zayeri
- Proteomics Research Center and Department of BiostatisticsFaculty of Allied Medical SciencesShahid Beheshti University of Medical SciencesTehranIran
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Keiding N, Ali MM, Eriksson F, Matsaseng T, Toskin I, Kiarie J. The Use of Time to Pregnancy for Estimating and Monitoring Human Fecundity From Demographic and Health Surveys. Epidemiology 2021; 32:27-35. [PMID: 33259462 PMCID: PMC7707157 DOI: 10.1097/ede.0000000000001296] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 09/24/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Available studies on the prevalence of infertility have proved to have certain limitations, with a scarcity of population-based studies and inconsistent reporting from surveys in countries at all income levels. We wanted to test the applicability of the current duration approach to data from the important Demographic and Health Surveys (DHS) program, funded by USAID since its inception in 1985, https://dhsprogram.com/. METHODS The current duration approach assumes that there is a well-defined time of initiation of attempts to get pregnant and defines the current duration of a still ongoing pregnancy attempt as the time interval from initiation to interview. The DHS interviews do not have an explicit question about initiation. We focused on nullipari and substituted date of "establishment of relationship with current partner" for initiation. Our study used the current duration approach on 15 datasets from DHS during 2002-2016 in eight different countries from sub-Saharan Africa, Asia, and Latin America. RESULTS Well-established statistical techniques for current duration data yielded results that for some countries postulated surprisingly long median times to pregnancy and surprisingly high estimates of infertility prevalence. Further study of the data structures revealed serious deviations from expected patterns, in contrast to our earlier experience from surveys in France and the United States where participants were asked explicitly about time of initiation of attempts to become pregnant. CONCLUSIONS Using cohabitation as a proxy for the initiation of attempts to get pregnant is too crude. Using the current duration approach with DHS data will require more explicit questions during the DHS interviews about initiation of pregnancy attempt.
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Affiliation(s)
- Niels Keiding
- From the Section of Biostatistics, Department of Public Health, Faculty of Health Sciences, University of Copenhagen. Copenhagen K, Denmark
| | - Mohamed M. Ali
- Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland
| | - Frank Eriksson
- From the Section of Biostatistics, Department of Public Health, Faculty of Health Sciences, University of Copenhagen. Copenhagen K, Denmark
| | - Thabo Matsaseng
- Reproductive Medicine Unit, Stellenbosch University/Tygerberg Academic Hospital, Cape Town, South Africa
| | - Igor Toskin
- Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland
| | - James Kiarie
- Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland
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Kasman A, Del Giudice F, Shkolyar E, Porreca A, Busetto GM, Lu Y, Eisenberg ML. Modeling the contribution of the obesity epidemic to the temporal decline in sperm counts. ACTA ACUST UNITED AC 2020; 92. [PMID: 33348967 DOI: 10.4081/aiua.2020.4.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/15/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Total sperm count (TSC) has been declining worldwide over the last several decades due to unknown etiologies. Our aim was to model the contribution that the obesity epidemic may have on declining TSC. MATERIALS AND METHODS Obesity rates were determined since 1973 using the WHO's Global Health Observatory data. A literature review was performed to determine the association between TSC and obesity. Using the measured obesity rates and published TSC since 1973, a model was created to evaluate the association between temporal trends in obesity/temperature and sperm count. RESULTS Since 1973, obesity prevalence in the United States was increased from 41% to 67.9%. A review of the literature showed that body mass index (BMI) categories 2, 3, and 4 were associated with TSC (millions) of 164.27, 155.71, and 142.29, respectively. The contribution to change over time for obesity from 1974 to 2011 was modeled at 1.8%. When the model was changed to represent the most extreme possible contribution to obesity reported, the modeled change over time rose to 7.2%. When stratified according to fertility status, the contribution that BMI had to falling sperm counts for all comers was 1.7%, while those presenting for fertility evaluation was 2.1%. CONCLUSIONS While the decline in TSC may be partially due to rising obesity rates, these contributions are minimal which highlights the complexity of this problem.
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Affiliation(s)
- Alex Kasman
- Department of Urology, Stanford University School of Medicine, Stanford, California.
| | - Francesco Del Giudice
- Department of Urology, "Sapienza" University of Rome; Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome.
| | - Eugene Shkolyar
- Department of Urology, Stanford University School of Medicine, Stanford, California.
| | - Angelo Porreca
- Department of Urology, Policlinico Abano Terme, Abano Terme (PD).
| | - Gian Maria Busetto
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome.
| | - Ying Lu
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford.
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California.
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Freitag N, Pour SJ, Fehm TN, Toth B, Markert UR, Weber M, Togawa R, Kruessel JS, Baston-Buest DM, Bielfeld AP. Are uterine natural killer and plasma cells in infertility patients associated with endometriosis, repeated implantation failure, or recurrent pregnancy loss? Arch Gynecol Obstet 2020; 302:1487-1494. [PMID: 32666129 PMCID: PMC7584523 DOI: 10.1007/s00404-020-05679-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/03/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Infertility is a debilitating situation that millions of women around the world suffer from, but the causal relationship between infertility and endometriosis is still unclear. We hypothesize that the immune cell populations of uterine natural killer cells (uNK) and plasma cells (PC) which define chronic endometritis could differ in patients with or without endometriosis and therefore be the link to endometriosis-associated infertility. METHODS Our retrospective study includes 173 patients that underwent an endometrial scratching in the secretory phase of the menstrual cycle and subsequently immunohistochemical examination for uNK cells and PC. Sixty-seven patients were diagnosed with endometriosis, 106 served as the control cohort. RESULTS The risk for an elevated number of uNK cells in women with endometriosis is not increased as compared to the control group. Our findings suggest that patients with endometriosis are 1.3 times more likely to have chronic endometritis (CE) as compared to those without and that the treatment with doxycycline might increase pregnancy rates. Endometriosis and an increased number of uNK cells seem to be unrelated. CONCLUSIONS In contrast to the lately published connection between endometriosis, infertility and increased uNK cells, we could not find any evidence that patients with endometriosis are more prone to elevated uterine uNK cells. Counting of PC in endometrial biopsies might be a new approach in the search of biomarkers for the nonsurgical diagnosis of endometriosis since our findings suggest a connection.
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Affiliation(s)
- Nadine Freitag
- Department of Obstetrics, Gynecology and REI (UniKiD), Medical Faculty, Medical Center University of Düsseldorf, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Sarah J Pour
- Department of Obstetrics, Gynecology and REI (UniKiD), Medical Faculty, Medical Center University of Düsseldorf, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Tanja N Fehm
- Department of Obstetrics and Gynecology, Medical Center University of Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Bettina Toth
- Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Udo R Markert
- Placenta Lab, Department of Obstetrics, Jena University Hospital, Am Klinikum 1, 07740, Jena, Germany
| | - Maja Weber
- Placenta Lab, Department of Obstetrics, Jena University Hospital, Am Klinikum 1, 07740, Jena, Germany
| | - Riku Togawa
- Department of Gynecological Endocrinology and Fertility Disorders, Karls-Ruprecht University, Heidelberg, Germany
| | - Jan-Steffen Kruessel
- Department of Obstetrics, Gynecology and REI (UniKiD), Medical Faculty, Medical Center University of Düsseldorf, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Dunja M Baston-Buest
- Department of Obstetrics, Gynecology and REI (UniKiD), Medical Faculty, Medical Center University of Düsseldorf, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Alexandra P Bielfeld
- Department of Obstetrics, Gynecology and REI (UniKiD), Medical Faculty, Medical Center University of Düsseldorf, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
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Ribas‐Maynou J, Abad C, García‐Segura S, Oliver‐Bonet M, Prada E, Amengual MJ, Navarro J, Benet J. Sperm chromatin condensation and single‐ and double‐stranded DNA damage as important parameters to define male factor related recurrent miscarriage. Mol Reprod Dev 2020; 87:1126-1132. [DOI: 10.1002/mrd.23424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Jordi Ribas‐Maynou
- Departament de Biologia Cel·lular, Fisiologia i Immunologia Universitat Autònoma de Barcelona Bellaterra Spain
| | - Carlos Abad
- Servei d'Urologia, Corporació Sanitària Parc Taulí Institut Universitari Parc Taulí – UAB Sabadell Spain
| | - Sergio García‐Segura
- Departament de Biologia Cel·lular, Fisiologia i Immunologia Universitat Autònoma de Barcelona Bellaterra Spain
| | - Maria Oliver‐Bonet
- Departament de Biologia Cel·lular, Fisiologia i Immunologia Universitat Autònoma de Barcelona Bellaterra Spain
| | - Elena Prada
- Servei de Ginecologia. Hospital Universitari Mútua de Terrassa Terrassa Spain
| | - Maria José Amengual
- UDIAT, Centre Diagnòstic, Corporació Sanitària Parc Taulí Institut Universitari Parc Taulí – UAB Sabadell Spain
| | - Joaquima Navarro
- Departament de Biologia Cel·lular, Fisiologia i Immunologia Universitat Autònoma de Barcelona Bellaterra Spain
| | - Jordi Benet
- Departament de Biologia Cel·lular, Fisiologia i Immunologia Universitat Autònoma de Barcelona Bellaterra Spain
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Kelly-Hedrick M, Gross MS. HIV-, HBV-, and HCV-Related Information on U.S. Fertility Clinic Websites: A Content Analysis. Health Equity 2020; 4:345-352. [PMID: 32908955 PMCID: PMC7473042 DOI: 10.1089/heq.2019.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose: People living with human immunodeficiency virus, hepatitis B virus, or hepatitis C virus (PLHIV/HBV/HCV) face barriers to assisted reproductive technologies (ART), in part, due to laws and professional regulations mandating dedicated laboratory facilities and storage tanks for reproductive tissue to minimize theoretical risk of cross-contamination. These guidelines greatly increase the expense of providing equal care, however, fertility clinics are neither required to treat nor disclose whether they treat PLHIV/HBV/HCV. Clinics' websites are an important source of information regarding available services for prospective patients and referring providers. We assessed whether clinic websites disclose availability of ART for PLHIV/HBV/HCV. Methods: Websites for Society for Assisted Reproductive Technology-accredited clinics in Northeast and South Atlantic United States were searched systematically for HIV-, HBV-, or HCV-specific content. Qualitative and thematic analysis was performed. Clinic characteristics (annual volume, practice setting) were collected. Results: Of 136 websites, nine (6.6%) had information relevant to PLHIV seeking infertility treatment, and seven (5.1%) offered at least some treatments. Three clinics (2.2%) also mentioned treatment information relevant for PLHBV/HCV, one of which offered treatment. Information was often difficult to find or interpret. By contrast, 77/136 (56.6%) of clinics mentioned universally screening patients for HIV and 77/136 (56.6%) mentioned screening for HBV/HCV before ART. Conclusion: Given economic disincentives to providing ART to PLHIV/HBV/HCV under current guidelines, the paucity of clinics openly offering treatment suggests a troubling lack of transparency or, possibly, a lack of available care. Further research should examine the impact of current guidelines and whether dedicated facilities and storage are medically indicated.
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Affiliation(s)
- Margot Kelly-Hedrick
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Marielle S Gross
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
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50
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Nassan FL, Arvizu M, Mínguez-Alarcón L, Gaskins AJ, Williams PL, Petrozza JC, Hauser R, Chavarro JE. Marijuana smoking and outcomes of infertility treatment with assisted reproductive technologies. Hum Reprod 2020; 34:1818-1829. [PMID: 31505640 PMCID: PMC6736415 DOI: 10.1093/humrep/dez098] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/10/2019] [Indexed: 12/15/2022] Open
Abstract
STUDY QUESTION What is the association of female and male partner marijuana smoking with infertility treatment outcomes with ART? SUMMARY ANSWER Women who were marijuana smokers at enrollment had a significantly higher adjusted probability of pregnancy loss during infertility treatment with ART whereas, unexpectedly, there was a suggestion of more favorable treatment outcomes in couples where the man was a marijuana smoker at enrollment. WHAT IS KNOWN ALREADY Data on the relation of female and male partner marijuana use with outcomes of infertility treatment is scarce despite increased use and legalization worldwide. STUDY DESIGN, SIZE, DURATION We followed 421 women who underwent 730 ART cycles while participating in a prospective cohort (the Environment and Reproductive Health Study) at a fertility center between 2004 and 2017. Among them, 200 women (368 cycles) were part of a couple in which their male partner also enrolled in the study. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants self-reported marijuana smoking at baseline. Clinical endpoints were abstracted from electronic medical records. We used generalized linear mixed models with empirical standard errors to evaluate the association of baseline marijuana smoking with ART outcomes adjusting for participants' age, race, BMI, tobacco smoking, coffee and alcohol consumption, and cocaine use. We estimated the adjusted probability of implantation, clinical pregnancy, and live birth per ART cycle, as well as the probability of pregnancy loss among those with a positive B-hCG. MAIN RESULTS AND THE ROLE OF CHANCE The 44% of the women and 61% of the men had ever smoked marijuana; 3% and 12% were marijuana smokers at enrollment, respectively. Among 317 women (395 cycles) with a positive B-hCG, those who were marijuana smokers at enrollment (N = 9, cycles = 16) had more than double the adjusted probability of pregnancy loss than those who were past marijuana smokers or had never smoked marijuana (N = 308, 379 cycles) (54% vs 26%; P = 0.0003). This estimate was based on sparse data. However, couples in which the male partner was a marijuana smoker at enrollment (N = 23, 41 cycles) had a significantly higher adjusted probability of live birth than couples in which the male partner was a past marijuana smoker or had never smoked marijuana (N= 177, 327 cycles) (48% vs 29%; P = 0.04), independently of the women's marijuana smoking status. Treatment outcomes of past marijuana smokers, male and female, did not differ significantly from those who had never smoked marijuana. LIMITATIONS, REASONS FOR CAUTION Marijuana smoking was self-reported with possible exposure misclassification. Chance findings cannot be excluded due to the small number of exposed cases. The results may not be generalizable to couples from the general population. WIDER IMPLICATIONS OF THE FINDINGS Even though marijuana smoking has not been found in past studies to impact the ability to become pregnant among pregnancy planners in the general population, it may increase the risk of pregnancy loss among couples undergoing infertility treatment. Marijuana smoking by females and males may have opposing effects on outcomes of infertility treatment with ART. STUDY FUNDING/COMPETING INTEREST(S) The project was financed by grants R01ES009718, P30ES000002, and K99ES026648 from the National Institute of Environmental Health Sciences (NIEHS). None of the authors has any conflicts of interest to declare.
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Affiliation(s)
- Feiby L Nassan
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Mariel Arvizu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Audrey J Gaskins
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Paige L Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - John C Petrozza
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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