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

The effects of a single administration of ethane dimethane sulphonate (EDS), which has a direct cytotoxic effect on Leydig cells, was assessed for its spermatogenic damage and intratubular androgen level in SD male adult rats. The protective effect of human chorionic gonadotropins (hCG) (s.c.), testosterone propionate (TP) (s.c.) and intratesticular administration of testosterone microcrystal suspension (Tmcs) against the spermatogenic damage in rats EDS given was also evaluated. EDS caused a decrease of the seminiferous tubular diameter and impaired spermatogenesis remarkably; moreover, it also caused significant decreases in intratubular androgen levels. These results suggest that EDS-treated SD male adult rats may be suitable as a model for hormone dependent infertility. The administration of hCG and intratesticular Tmcs prevented tubular damage and increased the intratubular T level. On the other hand, the administration of TP prevented tubular damage while remarkably decreasing intratubular androgen level. In this connection, it was inferred that priming of rats with TP caused an increase in intratubular androgen binding protein, which would stimulate spermatogenesis. The fact that a single injection of Tmcs caused no tubular damage suggests that intratubular T level is one of the factors playing an important role in spermatogenesis and that an intratesticular injection of Tmcs may be useful for the treatment of some cases of idiopathic male infertility.
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PMID:[Study on ethane dimethane sulphonate (EDS)-induced spermatogenic damage and protective drugs against this damage in the rat]. 132 40

Cumulative conception and livebirth rates related to age and cause of infertility provide the most useful estimate of success after in-vitro fertilisation (IVF), but limited data are available. It is also uncertain whether the probability of pregnancy, livebirth, and pregnancy failure changes with repeated treatment cycles. To assess the effects of patients' age and cause of infertility on these outcomes, we studied the results of 5055 consecutive IVF cycles (773 clinical pregnancies, 518 livebirths) undertaken on 2735 patients in a single IVF unit. Cumulative conception and livebirth rates were analysed by the life-table approach and differences in rates between age-groups and between causes of infertility were measured by the log-rank test and logistic regression modelling. Both conception and livebirth rates per cycle declined with age (p less than 0.001), and cumulative conception and livebirth rates after five treatment cycles were about 54% and 45%, respectively, at 20-34 years, compared with 38.7% and 28.9% at 35-39 years and 20.2% and 14.4% at greater than or equal to 40 years. The two rates were significantly different between causal groups (p less than 0.001 and p = 0.02, respectively) and were lowest in patients with male infertility or multiple infertility factors. The pregnancy failure rate was higher (p = 0.006) in women over the age of 34 years and there was a significant decline in the chances of pregnancy and livebirth per cycle with successive treatment cycles.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cumulative conception and livebirth rates after in-vitro fertilisation. 135 83

Recent advances in micromanipulation and biopsy of gametes and embryos have made it possible to develop new approaches for early genetic diagnosis and prevention of genetic disease and for treatment of severe male-factor infertility. Preimplantation diagnosis of a number of X-linked and autosomal recessive disorders has been performed, using polar body sampling and blastomere biopsy, coupled with polymerase chain reaction. Blastocyst biopsy has also been performed in human embryos; however, there has been no clinical application so far. Existing data have not shown any detrimental effect of micromanipulation and biopsy involved in the preimplantation development of the human embryo. The existing experience on micromanipulation of gametes (zona-opening procedures, subzonal sperm insertion, and sperm microinjection into the ooplasm) has also demonstrated the clinical usefulness in assisted fertilization, suggesting a possible selective application of various micromanipulation techniques and their combinations in male infertility.
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PMID:Micromanipulation of gametes and embryos in preimplantation genetic diagnosis and assisted fertilization. 139 44

Ultrasound (US) has become crucial in the assessment of infertility of couples, in 50% of whom the male partner is responsible. Male infertility is caused by many diverse conditions, from reparable obstructive disorders to noncorrectable intrinsic testicular failure. During the past 4 years, a select group of 70 young infertile men with azoospermia or oligospermia and low ejaculate volume were examined with transrectal US. Twenty-six patients had congenital bilateral absence of the vas deferens, 11 had congenital unilateral absence of the vas deferens and contralateral obstructive pathology, 15 had additional abnormalities thought to be directly related to semen deficiencies, and 18 patients with other causes for semen deficiency and infertility had findings that were either normal or showed minor abnormalities. The delineation of congenital and obstructive abnormalities of the distal urogenital tract with transrectal US enables an accurate diagnosis of certain cases of male infertility and helps guide appropriate clinical and surgical management.
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PMID:Male infertility: role of transrectal US in diagnosis and management. 141 Mar 38

Over the past decade, in vitro fertilization (IVF) has become a routine and acceptable tool in the treatment of infertility. However, major limitations in solving certain infertility problems still remain. Male infertility is one area in which only a small fraction of patients have benefited from IVF. Union of male and female gametes, either in vivo or in vitro, requires sperm penetration through the cumulus oophorus and the zona pellucida. Failure of fertilization despite the increased number of spermatozoa introduced into the oocyte's vicinity by IVF, has been shown to be directly related to abnormalities in sperm cell morphology and motility. The improved technology for micromanipulation of gametes has made it possible to circumvent the oocyte barriers to sperm penetration, thereby greatly reducing the number of normal sperm cells needed to achieve fertilization. This paper reviews the three major micromanipulative strategies which have been developed over the past five years, patient selection for the different procedures and the methods of sperm preparation to improve the yield of the applied technique.
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PMID:Treatment of male infertility by gamete micromanipulation. 144 71

In this randomized prospective study, we determined the conception rate following intra-uterine insemination with washed and prepared sperm, or with the first portion of a split ejaculate, in couples with longstanding male (n = 27, 70 treatment cycles) or cervical infertility (n = 14, 29 treatment cycles). Folliculogenesis and ovulation were induced by human menopausal gonadotropin and human chorionic gonadotropin. Significantly more couples conceived in the male infertility group following intra-uterine insemination with washed sperm, than after intra-uterine insemination with split ejaculate (9 vs. 2; P less than 0.05), while no difference in pregnancy rate (2 vs. 2) was found by the two intra-uterine insemination methods in the cervical infertility group.
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PMID:Intra-uterine insemination with prepared sperm vs. unprepared first split ejaculates. A randomized study. 150 50

Approximately one in six married couples find themselves involuntarily infertile. This ratio translates to between two and four million U.S. couples. Although numerous tests are available for diagnosing infertility problems, 5-10 percent of all couples who seek medical treatment are diagnosed with unexplained infertility. Several tests are presently available for diagnosing male infertility; however, none of the present procedures test for activation of the sperm nucleus following entry into the fertilized egg, a series of events critical for the entry of the zygote into the developmental program. We have developed an in vitro human sperm activation assay, using Xenopus laevis frog egg extract. When normal human sperm is permeabilized and then mixed with frog egg extract, the sperm nuclei decondense, synthesize DNA, and recondense during a three-hour time course. We have tested this assay's utility in diagnosing previously unexplained infertility. We found that 20 percent of the male infertility patients produced sperm that responded abnormally in the assay (95 percent confidence interval, 4-48 percent; n = 15), while sperm samples from 15 fertile males showed no abnormal responses (p = 0.0112). These preliminary results indicate that the human sperm activation assay may be a useful tool for diagnosing some cases of human infertility.
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PMID:Use of Xenopus laevis frog egg extract in diagnosing human male unexplained infertility. 150 82

Retrograde ejaculation is an uncommon form of male infertility. It may occur in diabetics from neuropathy involving the sympathetic fibers innervating the bladder neck. Treatment of infertility in these cases is with artificial homologous insemination. Several techniques for semen recovery from the bladder have been proposed. This paper describes a case of twin pregnancy following direct intraperitoneal insemination (DIPI) of semen retrieved from a diabetic man with retrograde ejaculation. Retrieval of semen was performed in this case by spontaneous voiding of urine after the introduction of a suitable medium into the bladder and before ejaculation. The quality of the semen was examined after spontaneous urination before DIPI. The poor quality of the spermatozoa induced us to introduce into the bladder a suitable medium before ejaculation and sperm recovery.
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PMID:Sperm retrieval for direct intraperitoneal insemination in a diabetic with retrograde ejaculation. A case report. 156 5

The in-vitro fertilization and embryo transfer (IVF-ET) procedure was compared in 175 couples with male infertility and 480 couples with tubal infertility. In cases of male infertility, more oocytes were recovered but fewer oocytes were fertilized. Although the cleavage rate was decreased, no difference in embryo quality was found. In male infertility, fewer transfers were performed and the average number of embryos per transfer was lower. The total pregnancy rate was also lower per cycle (12.8 versus 22.9%), but not per transfer (25.4 versus 25.7%). The further obstetrical outcome was similar in both groups. We conclude that male infertility can be treated by IVF-ET but results are still disappointing when compared to a control group with normal spermatozoa.
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PMID:Comparison of in-vitro fertilization in male and tubal infertility: a 3 year survey. 157 34

The role of the nurse needs to be expanded to include protection of women's reproductive potential. Nursing has adjusted to the change in medical care through assistance in regaining of health in acute and extended care facilities, in health maintenance, and in acting as primary care providers in providing information on prevention. Infertility increases with age. The impact of contraceptive choices on fertility is reviewed for barrier contraception, oral contraception, IUDs, sterilization, and new contraceptive methods. At different stages in the life cycle there are methods of contraception that are more appropriate than others. The environmental effects on fertility are noted for diethylstilbestrol (DES), which may result in cell carcinoma and changes in the cervical ectropion, uterine, and tubal anomalies; these effects in turn may lead to decreased fertility or fetal loss. DES may also affect male fertility. Chemicals in the workplace such as lead, ionizing radiation, ethylene oxide, and dibromochloropropane are Federally regulated because of deleterious effects on reproduction. Other metals and chemicals that may affect fertility are indicated. The prevention of sexually transmitted diseases has a significant impact on preservation of fertility. Life style choices and counseling at early stages of disease are important considerations. Women who smoke have an earlier menopause, have reduced estrogen levels, and increased vaginal bleeding. Infant mortality is higher among women who smoke. Fetal alcohol syndrome is known, but alcohol's effect on fertility is not well documented. Adolescent drug use may lead to later dysfunction. Marijuana use in adults has been related to decreased levels of follicle stimulating hormone, luteinizing hormone, and prolactin, which appears to be reversible in adults. Exposure to high levels of heat is related to male infertility (sperm quality and number); increased scrotal temperature may be caused by febrile illness, varicocele, hot tub usage, and tight jockey shorts. Fertility impairment may be related to a previous medical or surgical intervention. Options are available for organ preservation rather than outright removal. General health conditions related to infertility are identified. The nurse practitioner as a preconception counselor may screen for potential infertility and collect a routine history and physical examination including testing.
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PMID:The role of the expanded function nurse in fertility preservation. 159 37


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