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Query: UMLS:C0021359 (infertility)
 26,075 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

250 women selected at random from outpatients of the Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Nigeria, were interviewed about their attitudes toward female sterilization by nurses with a standard questionnaire. Factors affecting attitudes toward sterilization were multiple and results are reported as percentages. The study population excluded women with infertility, a common problem, and further differed from the general population because the women were older and more highly educated. The number of living children was 3 or more in 59%; the ideal family size was at least 5 in 48%. 48% had used some type of contraception. 87.6% had heard of female sterilization, most often from medical personnel. Factors reported as affecting attitudes included: number of living children (59.6%); age of patient (52%); experience with complications of pregnancy and labor (45.2%); other medical disorders (36%); effect on reincarnation (17.6%); sex of living children (17.2%); fear of impotence (7.2%); and religion or culture (3.2%). The average age for female sterilization is 40 in Nigeria. A more extensive study of resistance to sterilization is indicated.
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PMID:The attitude of fertile Nigerian women to sterilization. 1228 95

Suggestions are made on how best to integrate sexually transmitted disease (STD) screening and education within family planning (FP) programs in the UK. FP programs are in a good position to advise about HIV infections and STDs because most clients are in a vulnerable age group (women aged 15-50 years) and because health personnel are experienced in discussing sexual issues. When FP clinics do not provide STD services, the options are to collaborate on joint referral and training efforts with STD clinics and to train staff to recognize and talk about STDs. Information about STDs can be clearly displayed in the clinics. Health personnel can talk about STD transmission to clients, explain the role of condoms in infection prevention, and demonstrate how to use condoms properly. Examples are given of integrated HIV and STD and FP programs in the US, Gambia, Zambia, and Mexico. In the US, Planned Parenthood of New York City trains staff in prevention and counseling skills and supervises staff until a level of comfort is reached. HIV and AIDS education and risk assessment are part of the initial and annual follow-up visits. The Gambia FP Association helps staff learn to counsel clients about the problems with sexual satisfaction between men and women and with communication between partners, impotence, painful intercourse from female circumcision, STDs and AIDS, infertility, and contraceptive side effects. In Zambia, a women's organization helps women prepare educational skits on condom use for males and helps women learn to talk with spouses about condom use without suffering rejection or charges of infidelity. The Ghana Planned Parenthood Association has a Daddy's Club where men learn about HIV and safe sex with condoms and meet for private counseling. Mexfam in Mexico educates for female farm laborers on sex education, FP, reproductive health and pregnancy, child health, water and sanitation, and energy-saving methods.
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PMID:Making good connections. 1228 38

Much information has been gathered on the role of human prolactin in both physiological and pathological lactation since it was identified in 1971. Although estrogens increase the number and activity of the prolactin-secreting cells, they block the action of prolactin on the breast. As a result, circulating prolactin levels rise 20-50 fold during pregnancy, but lactation does not start until estrogen levels have fallen after delivery. Prolonged breast feeding maintains high serum prolactin levels. After suckling there is an additional rise. These high serum prolactin levels act to impair fertility by several mechanisms: the ovaries are resistant to gonadotropin stimulation; the frequency of pulsatile pituitary gonadotropin secretion is reduced, and there is suppression of the normal pre-ovulatory gonadotrophin surge in response to rising estradiol levels. The contraceptive effect of lactation has proved unreliable in individual women. Small amounts of prolactin circulate in males and non-pregnant females but have no identified function. Sustained hyperprolactinemia causes galactorrhea and hypogonadism in both sexes: amenorrhea or infertility in females and relative or absolute impotence in males. Sustained hyperprolactinemia is most often the result of a prolactin-secreting pituitary tumor. The management of hyperprolactinemic patients calls for consideration of the endocrine abnormalities and of the pituitary tumor if 1 has been found.
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PMID:Prolactin and gonadal function. 1231 Sep 75

In untreated congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21OHDS) the presence of adrenal and testicular tumors had been described; however little is known about the effect of the enzymatic defect on fertility in males. We studied a male adult patient affected by 21OHDS for infertility, after a long period of discontinuation of glucocorticoid therapy and then during resumption of treatment and 8 months after monoadrenalectomy. The initial spermatic count revealed azoospermia and testicular needle aspiration showed a cytological picture consistent with prepuberty. The morphofunctional study revealed a right adrenal mass with reduced uptake at radioscan. Treatment was resumed with onset of impotency, which improved after reduction of the dose of glucocorticoids. The patient was monoadrenalectomised and his spermatic count increased. The patient shows that corticosteroid therapy in 21OHDS should be continued lifelong to avoid adrenal hyperplasia with possible areas of autonomy and to allow regular fertility. Impotence during treatment is probably due to a decrease of excessive adrenal androgens while testicular androgen production is still suppressed.
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PMID:Unilateral adrenal tumor, erectile dysfunction and infertility in a patient with 21-hydroxylase deficiency: effects of glucocorticoid treatment and surgery. 1260 49

With the assumption that infertility and related diagnostic and therapeutic processes are stressful, an uncontrolled pilot study was designed to evaluate the effect of sildenafil citrate on sexual compliance and reproductive outcome. A group of sexually healthy men were studied after the administration of 50 mg sildenafil before semen collection for intrauterine artificial insemination (n = 25) or planned intercourse for a postcoital test (n = 12). We demonstrated that sexual dysfunction is highly prevalent in patients undergoing diagnostic procedures for infertility, and that sildenafil is effective in reversing stress-induced transitory impotence. Furthermore, sildenafil improved some seminal parameters, such as the percentage of spermatozoa with linear progressive motility, as well as the number of spermatozoa penetrating the cervical mucus. Two pregnancies were obtained after sildenafil administration.
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PMID:Treatment of sexual dysfunctions secondary to male infertility with sildenafil citrate. 1274 29

There is growing concern about the health of men in the developed West. Compared with women they have higher rates of morbidity and mortality and are less likely to seek out and employ medical services. Several authors have drawn on social constructionist models, such as the concept of hegemonic masculinity, to account for these gender differences in risk and behaviour. One might anticipate that certain conditions, such as male infertility, would be perceived as posing a particular threat to conventional views of masculinity. There is some support for this, although there is little research into the social construction of male infertility. In this study Discourse Analysis was employed to analyse newspaper accounts of a reported decline in sperm counts in order to study the way in which infertility and masculinity were represented and constructed in the media. The results indicate a construction of fertility as being in crisis and of male infertility as conflated with impotence. Men were positioned as vulnerable and threatened by forces outside their control. The accounts drew on a range of stereotypically masculine reference points, such as warfare and mechanical analogies. These results are consistent with concepts of hegemonic masculinity and suggest that men are offered a highly restricted set of options in terms of perceiving and representing their bodies and their health.
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PMID:Masculinity, infertility, stigma and media reports. 1521 89

The problem of the interference of celiac disease (CD) with the male reproductive system is made evident both by the recognized adverse effects on female reproduction and by the multifactorial nature of the disease. It is important to consider CD as a multifactorial condition since its diverse effects can be modulated, besides gluten, by different concurrent genetic and environmental factors. The male CD patient has a greater risk of infertility and other reproductive disturbances, as well as a greater incidence of hypoandrogenism. In this paper the problems of CD associated to endocrine disorders and to deficiencies of micronutrients are discussed. Affected males show a picture of tissue resistance to androgens. Moreover, attention should be paid to increases of FSH and prolactin; these are not associated to infertility and/or impotence, but they may indicate an imbalance at hypothalamus-pituitary level, with general effects on health: an example is the increased risk of male osteoporosis in CD patients. Hormone alterations are reversible upon start of the gluten-free diet, emphasizing the importance of early diagnosis; this should be performed in the case of clinical suspicion, e.g., unexplained hypoandrogenism. As regards nutritional aspects, the folic acid deficiency of CD can affect rapidly proliferating tissues, such as the embryo and the seminiferous epithelium. More attention should be paid to deficiencies of fat-soluble vitamins, such as A and E, observed in CD. Vitamin A is important for Sertoli cell function as well as for early spermatogenetic phases. Vitamin E supports the correct differentiation and function of epidydimal epithelium, spermatid maturation and secretion of proteins by the prostate. Therefore, CD male patients should be considered as vulnerable subjects; thus, the detection of early biomarkers of andrological or endocrinological dysfunctions should trigger timely strategies for prevention and treatment.
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PMID:[Celiac disease and its endocrine and nutritional implications on male reproduction]. 1528 52

Erectile dysfunction (ED) is a common and often distressing side effect of renal failure. Uremic men of different ages report a high variety of sexual problems, including sexual hormonal pattern alterations, reduced or loss of libido, infertility, and impotence, thereby influencing their well-being. The pathogenic mechanisms include physiologic, psychologic, and organic causes. To determine the contribution of morphologic factors to impotence we studied the ultrastructure of the corpora cavernosa in 20 patients with end-stage renal disease who were treated with chronic dialysis and compared the findings with 6 individuals with no clinical history of impotence. Our results indicated that in male uremic patients with sexual disturbances there were major changes in smooth muscle cells. This was characterized by reduction of dense bodies in the cytoplasm, thick basement membranes, and increased interstitial collagen fibers with resultant reduction of cell-to-cell contact. In addition, there was thickening and lamination of basement membranes of endothelial cells and increased accumulation of collagen between nerve fibers. These alterations were more evident in patients with longer time on dialysis and were independent of type of primary renal disease. We hypothesize that ED in dialysis patients is not related to the primary disease but to the uremic state.
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PMID:Ultrastructural changes of corpora cavernosa in men with erectile dysfunction and chronic renal failure. 1549 Apr 17

The male reproductive system consists of the hypothalamus, the anterior pituitary gland, and the testes. Alcohol can interfere with the function of each of these components, thereby causing impotence, infertility, and reduced male secondary sexual characteristics. In the testes, alcohol can adversely affect the Leydig cells, which produce and secrete the hormone testosterone. Studies found that heavy alcohol consumption results in reduced testosterone levels in the blood. Alcohol also impairs the function of the testicular Sertoli cells that play an important role in sperm maturation. In the pituitary gland, alcohol can decrease the production, release, and/or activity of two hormones with critical reproductive functions, luteinizing hormone and follicle-stimulating hormone. Finally, alcohol can interfere with hormone production in the hypothalamus.
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PMID:Alcohol's effects on male reproduction. 1570 96

Many extravagant physical traits are selected because they are used as cues for mate choice (sexual selection). Why is mate choice driven by costly ornaments? A theory of sexual selection posits that extravagant traits are preferred because are reliable indicators of superior (heritable) phenotypic quality. In particular, the preferred traits can be expressed only in individuals with superior conditions because are handicaps which impose a high cost to the carrier. The human penis achieves its reproductive function by the complex neuro-vascular mechanisms that controls erection. Surprisingly, erectile dysfunction and infertility, two condition which nearly annihilate fitness, are widespread medical conditions which affect millions of people of any age worldwide. The very high incidence of erectile dysfunction appears as an evolutionary paradox. Impotence is associated with all major systemic diseases as well depression and stress. Stress is also one of the causes of infertility. Therefore, male reproduction appears to be extremely sensitive to internal and external stressors. Moreover, erectile dysfunction is a predictor of myocardial infarction and stroke, whereas men with regular sexual activity have lower risk of death due to coronary disease. This large body of medical literature makes erection the best case for a fitness indicator in the human male. We suggest that the fragility of male sexual physiology observed in modern society is the specific consequence of an evolutionary process driven by the handicap principle.
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PMID:Male reproductive physiology as a sexually selected handicap? Erectile dysfunction is correlated with general health and health prognosis and may have evolved as a marker of poor phenotypic quality. 1589 37


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