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

Infertile men with obstructive azoospermia mainly due to congenital absence of the vas deferens (CAVD) now have the option of trying to father their own progeny. In fact, in the last five years epididymal sperm retrieval microsurgically have been successfully used for in vitro fertilisation of human oocytes. In this report the clinical results of 98 consecutive procedures of microsurgical epididymal sperm aspiration (MESA) combined with in vitro fertilisation (IVF) and tubal embryo transfer (TET) are described. An overall fertilisation rate of 17% and a pregnancy rate of 36% per transfer is reported. Five of the 18 pregnancies resulted in abortion (27%) and 13 were delivered at term. Additionally, extra embryos for freezing and potential use for future attempts were made available for 13 couples. Men with CAVD have also allowed the study of spermatogenesis, immunological response and sperm disposal mechanisms in condition of chronic obstruction.
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PMID:Epididymal sperm in assisted reproductive technology. 130 23

Gender-planned health services acknowledge the fact that women and men have different social roles and different medical needs. To date, most gender-specific health issues have been addressed to women's reproductive health needs, and women's groups have criticized maternal and child health services for their emphasis on child health. Justifications have made for adopting a broader reproductive health approach and redefining women's health care needs for the 1990s. Such an approach would improve access and quality in: 1) prenatal and maternity care, 2) family planning (FP) services, 3) legalized abortion, 4) special services for adolescent girls, 5) the area of nutrition, 6) treatment of sexually transmitted diseases (STDs), 7) treatment of infertility, and 8) information and medical services in cases of female genital mutilation. Access to FP has received the most donor support to date. All of these issues, however, are now a recognized part of a holistic approach to women's health, and more emphasis is being placed on prenatal care, abortion, and adolescent reproductive health needs. Women's "other" health needs include food security, access to water, ways to combat violence, treatment for drug abusers, and occupational health needs. Women's health status is related to the level of female education, the status of women in society, equal access to income activities or credit, and control over these resources. Men, too, need specific care, especially in areas related to risk-taking behavior. They need improved occupational health services that emphasize prevention; organized recreational activities, especially for adolescents; rehabilitation services for criminals; better health and sex education in schools; and strategies to avoid smoking, accidents, and STDs. Health programs can also change the attitudes of men toward women, including attitudes that are detrimental to women's health such as the belief that women are weak and that good women are quiet, subservient, and bear many children. Men should be knowledgeable about health services for women, because men are a source of information and financial support for women. Reproductive health strategies for men have been sidelined by the concern of feminists that women gain the right to control their fertility decisions. But FP groups do offer men information and education in an effort to increase men's responsibility for contraception. This has had mixed results because, in some areas, older female relatives have more influence over family fertility than men and may be a more appropriate audience. Since care givers have no prior experience in gender planning, clinical health problems must be assessed in terms of how they affect men and women as they function in their society.
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PMID:Gender-planned health services. 148 42

A prospective study was carried out on semen samples from 118 consecutive unselected men attending our infertility clinic to determine whether sperm motility may be affected by seminal plasma. The incidence of asthenozoospermia as defined by fewer than 50% of spermatozoa with forward progressive motility in the untreated semen was 37.4%. This value was significantly reduced to 23% after washing and removing seminal plasma. Men with asthenozoospermia in untreated semen but normal in the washed sample had a percentage of normal sperm morphology and a percentage of swollen tails in the HOS test similar to those of controls, and higher than those of asthenozoospermics in both the untreated and washed sample. Sperm velocity was also significantly improved after the washing procedure. Spermatozoa selected by swim-down procedure and applied to a seminal plasma medium reduced sperm motility affecting negatively the HOS test. Sperm motility should be assessed after a sperm washing procedure, since seminal plasma contains constituents that decrease sperm motility without affecting membrane integrity.
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PMID:Sperm motility should be assessed in fresh sperm and after a sperm washing procedure. 152 39

Seminal quality and levels of blood serotonin (5-HT) and serum prolactin (PRL) were determined in 60 men attending an infertility service. Subjects were grouped according to normal or abnormal accessory sex gland function. Subjects with normal accessory sex gland function were further subdivided into groups with asthenozoospermia, polyzoospermia, normozoospermia, oligozoospermia, or azoospermia. Blood 5-HT levels were significantly higher in oligozoospermics (115.9 +/- 23.7 ng ml-1, P less than 0.05), and asthenozoospermics (90.0 +/- 8.2 ng ml-1, P less than 0.05), than in normals (68.5 +/- 5.3 ng ml-1), whereas serum PRL levels were higher in azoospermics (44.2 +/- 4.7 ng ml-1) than in normozoospermics (15.9 +/- 1.6 ng ml-1, P less than 0.01). Subjects with abnormal accessory sex gland function were also subdivided according sperm count and sperm motility categories. None of these subgroups showed differences in serum PRL levels or blood 5-HT levels. Men with hyperserotoninaemia had higher serum PRL levels, low sperm count, and low motile sperm concentration. Moreover, higher 5-HT levels may be observed in men with normal PRL levels and also associated with normal PRL levels and with hyperprolactinaemia, and hyperprolactinaemia may be observed also associated with normal serotonin levels. Hyperserotoninaemia was related to both diminished sperm count and sperm motility, whereas hyperprolactinaemia was related to low sperm count. When hyperprolactinaemia and hyperserotoninaemia were both present, additive effects were observed.
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PMID:Hyperprolactinaemia and hyperserotoninaemia: their relationship to seminal quality. 160 4

Several antibiotics of choice for the treatment of Gonorrhoea have proved to be effective in the acute forms of this disease. Men infected with gonococci may not develop or may not notice any symptoms at all: thus, complications of gonococcal infection can cause semen inadequacy and infertility. We are not aware of any previous paper on the treatment of chronic asymptomatic gonorrhoea (IUGC) and the cytotoxic effects in sperm maturation (so called "stress pattern tubular syndrome") and/or motility possibly mediated by some antigonococcal agents after prolonged period of administration. In IUGC the aims of therapy should be both the bactericidal activity and the improvement in the seminal quality. One-hundred eleven out of 785 male partners of infertile marriages were studied. They had negative post coital test and culture positive for N. Gonorrhoea in their semen. They were subdivided in six random groups and were treated with Ceftazidime (CFZ = 20 cases), Cefonicid (CFN = 20 cases) Spectinomycin (SPM = 15 cases), Aztreonam (AZT = 20 cases), Piperacillin (PP = 18 cases) and Doxycycline (DXC = 18 cases) respectively. After 7 days of treatment (C1) seminal cultures became negative in 25 cases (22.5%) and no seminal parameter showed significant variation among groups. When the treatment was repeated other twice (C3. = 1 week every month for 3 months) the antigonococcal efficacy was complete (100%), but various effects on seminal quality (Density, D; Motility, M, Oval forms, O; Sperm precursors, Sp; nemaspermic penetration depth in bovine cervical mucus PN; rate of pregnancies) were observed.
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PMID:[Antibiotic therapy in infertile subjects with chronic gonococcal infections: measurement of sperm output]. 183 42

Men who appear normal and live a normal life, may have a 46,XX karyotype and present with the typical features of infertility and end organ (testicular) failure. They are azoospermic and their small testicles show specific patterns on light and electron microscopy. Recent advances in genetics (1) favor the "X-Y interchange" theory to explain this phenomenon; (2) hypothesize about the roles of the H-Y antigen and testis determining factor (TDF) in determining "maleness"; and (3) allow mapping of the relative positions of H-Y and TDF loci on the Y chromosome.
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PMID:Sex reversal syndrome (XX male). 221 11

This study of 103 couples in treatment for infertility suggests that spouses are generally similar in the way they perceive their marital adjustment, but that they arrive at their views by different routes. Acceptance of a childless lifestyle is consistently associated with greater marital adjustment for men, but greater stress associated with infertility undermines marital adjustment for both husbands and wives. Men adjust better to an involuntarily childless marriage if their wives are employed or have high earnings. Wife's marital adjustment diminishes with the length of the marriage and the course of treatment for infertility. The stress women experience as a result of infertility influences their perception of their marriage and may undermine their ability to get the support they need during the transition to nonparenthood.
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PMID:Involuntary childlessness and marital adjustment: his and hers. 224 92

In a retrospective study of 153 testis cancer survivors, we examined the sociodemographic and clinical determinants of attitudes and behaviors toward illness-induced infertility. Five fertility adjustment responses were identified: sperm-banking awareness (SBA); adoption awareness (AA); fertility testing (FT); trying to father children (TFC); and fertility distress (FD). Although responses to infertility are multidetermined, these data demonstrate there is a distinct sociodemographic and clinical profile for the subgroups of men who engage in different fertility-related behaviors. Multivariate analysis results show that men most likely to be concerned with banking sperm are those who at diagnosis are younger (less than 35 years), childless, college educated, and whose relationships have become strained. Men who sought fertility tests were childless, college graduates, and able to ejaculate. The only factor predicting adoption was childlessness. Those married men attempting to father children were also less than 35 years of age at diagnosis and without ejaculatory dysfunction. The men at greatest risk for continued distress about infertility were those who remained childless and had posttreatment ejaculatory dysfunction. Residual infertility distress also was significantly associated with treatments that included extensive retroperitoneal lymph node dissection (RPLND) surgery, indicating that the latter is a "risk factor" in survivors' long-term distress. These data, while not definitive, show that the prerogative to have children is very important to men and that losing it sets into motion a range of both adverse emotions and adaptive responses. Adjustment to infertility is a complex process that begins at diagnosis and extends long after treatment is completed.
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PMID:Adaptive behavioral responses to potential infertility among survivors of testis cancer. 229 74

The purpose of this descriptive study was to investigate gender differences in decision making about infertility treatment. The sample included 40 male and 107 female RESOLVE members. A questionnaire was used with which subjects rank ordered the importance of 14 factors that could influence the decision to undergo various infertility treatments. Gender differences in the importance of factors considered when making decisions about medical and surgical treatment options were explored. Men accorded more importance to the potential side effects when making decisions to pursue medical or surgical options than did women. Women, on the other hand, viewed the probability that the medical-surgical regimens or procedures would be effective as a more important factor in influencing their decisions about these options than did men. The author suggests that women may place more emphasis on treatment outcome than do men. Instead, men may focus on each individual treatment step involved in the process of becoming pregnant.
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PMID:Gender differences in decision making about infertility treatment. 235 73

A questionnaire on sexual function and fertility was completed by 54 men and 36 women, at an average of 3 years after successful renal transplant. Sexual desire increased significantly compared to reports of levels 6 months pretransplant. Men also had improved erectile function and ability to reach noncoital orgasms. About a quarter of men and women remained sexually dysfunctional, however. The frequency of sexual activity and overall sexual satisfaction did not improve significantly. Marital status and satisfaction were in the normal range for this group, except that those who became ill before adulthood were less likely to have married or have had children. Infertility was a major concern for 10% of the sample. Regular menstrual cycles were present in 64% of women under age 50, representing a significant improvement after transplantation. Three men fathered a child and two women became pregnant after transplantation. Most patients wanted more information on sexuality, fertility, and renal disease.
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PMID:Sexuality, fertility, and renal transplantation: a survey of survivors. 237 Jun 72


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