[Hypoplasia adrenal congenita of anencephalic type: two cases with pituitary abnormalities and review of literature]

Hypoplasia adrenal congenita is an extremely uncommon disease of early onset. This condition can be lethal in the absence of treatment. Some forms are due to the congenital adrenal hypoplasia of anencephalic type whose origin is even unknown. Here, we present two cases of congenital adrenal hypoplasia of anencephalic type with pituitary abnormalities. The two male newborns died because adrenal insufficiency in the neonatal period. The adrenal glands were hypoplastic with a histological structure of anencephalic type Immunocytochemical study of the pituitary revealed an absence of the gonadotrophs. No mutation of DAX 1 and SF-1 was found.

[Consequences of cigarette smoking on male fertility]

The different studies conducted over the last fifteen years on the consequences of cigarette smoking on male fertility have shown a decrease of sperm quality in smokers. In fact, the components of cigarette smoke pass through the blood-testis barrier and thus induce an alteration of sperm parameters and nucleus quality of the spermatozoa. Beyond this decrease of sperm quality, cigarette smoking also appears to have an impact on the smoker's offspring: lower embryo quality, increased risks to develop a childhood cancer. The pathophysiologic mechanisms are not yet clearly understood, but one of the most likely hypotheses is the production of an oxidative stress which is responsible for DNA fragmentation compromising the chances of pregnancy. In addition to the spermogram, further tests available in specialized laboratories can be prescribed to evaluate spermatozoal DNA fragmentation (TUNEL Assay, SCSA...). Antioxidant treatment can be administrated to reduce DNA fragmentation and increase the chances of pregnancy.

Impact négatif du tabac sur la fertilité masculine : des spermatozoïdes à la descendance

Cigarette smoking has negative effects on male fertility. Recent studies showed an active transfer of several components of cigarettes through the blood-testis barrier. The presence of these components in the seminal plasma may induce a degradation of sperm parameters and nuclear quality of spermatozoa, and compromise the chances of pregnancy. Moreover, smoking may have a negative impact on the smokers'offspring: poor quality embryos, development of childhood cancers. Oxidative stress-induced DNA damage seems to be one of the major causes of sperm quality alteration. Several methods are now available to analyze the degree of DNA fragmentation. In order to optimize the success rate of assisted reproduction technologies, the deleterious effects of smoking on male fertility and the necessity of cessation have to be explained in detail to these patients.