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

It is suggested that infertility may be distressing because it results in an inability to fulfil traditional roles and thus those individuals who adhere to traditional sex roles may be more distressed by the experience of infertility. In order to examine the relationship between sex role and emotional well-being in infertility patients, 58 women attending a clinic for assisted conception procedures and 31 of their male partners completed questionnaires assessing sex-role type (i.e. masculine, feminine, androgynous or undifferentiated) and emotional, marital and sexual functioning. Women with a traditional feminine sex-role type were more anxious than those with a masculine sex-role type but there were no differences in depression or marital or sexual functioning. Men with an undifferentiated sex-role type were more anxious and depressed than those with other sex-role types. The findings are discussed in terms of the relationship between sex role and infertility, previous research into sex differences in distress amongst infertility patients, and the problems associated with measuring distress.
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PMID:The relationship between sex role and emotional functioning in patients undergoing assisted conception. 835 21

Thirty-six infertile couples underwent treatment by in-vitro fertilization. In 16 couples (group 1) the male partner was positive for antisperm antibodies measured by direct mixed antiglobulin reaction, direct immunobead test, and serum and/or seminal plasma tray agglutination test. In 20 couples (group 2) the men had no such antibodies. Men with poor sperm motility were excluded. The female partners had no antisperm antibodies, and in the controls (group 2) infertility was due to a known female factor. The fertilization rate in couples without antisperm antibodies (group 2) was 72.7% compared to 50.5% when the men had antibodies. However, the pregnancy rate per embryo transfer was not significantly different in the two groups (46.1% in group 1, 33.3% in group 2). This indicates that antisperm antibodies in the male interfere with sperm--egg fusion and subsequent fertilization but once fertilization has occurred, the pregnancy rate remains the same.
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PMID:The effects on in-vitro fertilization of autoantibodies to spermatozoa in subfertile men. 840 91

For couples who want to have children, infertility is an undesirable situation. Certain emotions both obvious and hidden can emerge which could complicate the clinical picture and the couple's relationship. Fifteen infertile women between the ages of twenty five and forty were interviewed and invited to form workshops to identify the emotions evoked by infertility. The spontaneous expressed emotions were; fear, anxiety, frustration loneliness and sadness. The non expressed emotions were; rage and guilt. Women held themselves more responsible for the couple's infertility and generally protected their partners even when male factors were the evident cause. Men showed scant interest iin joining infertility workshops. Family orientated advice is vital in the management of the infertile couple both in the diagnosis and treatment.
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PMID:[Family counseling in infertility couples]. 855 92

Infertile men with Sertoli-cell-only syndrome (SCO) have highly elevated serum FSH immunoactivity related to the degree of histological damage. The activity that serum FSH exerts at the target site depends on its glycosylation pattern and FSH receptor (FSHR) function. Either could be impaired, leading to failure of spermatogenesis. The aim of the present investigation was to study bioactivity and the glycosylation pattern of serum FSH and the occurrence of mutations in the FSH receptor in infertile patients with SCO compared to normal men. Blood was taken from 19 patients with bilateral testicular focal or complete SCO and eight normozoospermic controls. FSH bioactivity in serum was measured using an in-vitro FSH bioassay based on recombinant rat FSHR. The glycosylation pattern of serum FSH was determined by concanavalin A chromatography. Inhibin B was determined in serum using a recently available assay. Genomic DNA extracted from blood lymphocytes was amplified by PCR using primers specific for the FSHR and screened by single-stranded conformation polymorphism gel electrophoresis. Men with SCO showed significantly higher FSH in-vitro bioactivity (34.9 +/- 5.0 IU/l) than controls (9.6 +/- 0.8 IU/l: p < 0.01), as well as significantly elevated FSH immunoactivity (14.9 +/- 1.7 IU/l) compared to controls (3.1 +/- 0.5; p < 0.01). Immunoactivity of serum FSH was correlated with in-vitro bioactivity (r = 0.9; p < 0.001) and was related to the degree of testicular damage (proportion of SCO-tubules) (ANOVA: p < 0.001) and total testicular volume (r = -0.76; p < 0.01). An inverse relationship between serum FSH and inhibin B levels (r = -0.93; p < 0.001) was found. In the serum of SCO patients a slight increase in less glycosylated FSH isoforms was found (6.7 +/- 0.6% versus 3.6 +/- 0.3%; p < 0.05). No mutations of the FSHR were observed in SCO patients. We conclude that the spermatogenic failure observed in infertile patients with SCO histology and elevated FSH serum levels can be explained neither by a change in FSH bioactivity nor by mutations in the FSHR. The slight change in the FSH glycosylation pattern is probably related to higher hormonal secretion rates in SCO patients. The inverse relationship between serum FSH and inhibin B points to an intact endocrine testicular-pituitary circuit responsible for the compensatory increase of FSH in SCO.
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PMID:Does the gonadotrophic axis play a role in the pathogenesis of Sertoli-cell-only syndrome? 920 88

It is reported that a clinical left varicocele is associated with loss of ipsilateral testicular volume. We have examined the loss of left testicular volume in infertile men with clinical left varicocele using ultrasound-derived measurements of testicular volume. We have reviewed the testicular volumes, maximum internal spermatic vein diameters, and the clinical reports of 404 men presenting for infertility evaluation at our institution between 1992 and 1996. Men with bilateral or subclinical varicoceles were excluded from the study. Subclinical varicoceles were diagnosed by the ultrasonographic demonstration of one or more veins having a maximal diameter of more than 3 mm. In men with clinical left varicocele, mean left testicular volume was less than right testicular volume (12.7 vs. 13.8 mL, P < .001). This finding was not observed in men without varicocele (12.3 vs. 12.6 mL, P > .05). In men with left varicocele, the difference between right and left testicular volume (right minus left) increased with increasing varicocele grade. Our data demonstrate that a left varicocele is associated with loss of left testicular volume. The results also show that the degree of left testicular hypotrophy is proportional to the clinical grade of the varicocele.
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PMID:Loss of left testicular volume in men with clinical left varicocele: correlation with grade of varicocele. 964 59

A major international male reproductive health research project (the International Study of Semen Quality in Partners of Pregnant Women) will assess geographic variation in semen parameters (concentration, volume, morphology, motility) and male sex hormones; examine environmental estrogens as possible explanatory factors in such variation; and establish a registry of fertile couples. This research focus is being accompanied, on a clinical level, by increased emphasis on the role of the male partner in infertility. Men are advised to quit smoking, maintain normal weight, avoid excessive heat to the testicles, drink less alcohol and caffeinated beverages, and avoid dehydroepiandrosterone and other supplements that may be converted to testosterone. As research evidence emerges, practices in fertility clinics can be refined.
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PMID:Male reproductive health: a hotbed of research. 971 70

The aim of this study was to obtain evidence for the genetic basis of polycystic ovaries (PCO) and premature male pattern baldness (PMPB) by screening first-degree relatives of women affected by polycystic ovary syndrome (PCOS). Because of the high prevalence of PCO in the general population, we also studied first-degree relatives of ten asymptomatic control volunteers of reproductive age. The probands were recruited prospectively from infertility and endocrine clinics, where they presented with various clinical symptoms of PCOS. Each had PCO, on transvaginal ultrasound scan. The families of 29 probands and 10 volunteers agreed to take part in the study. Clinical, ultrasound, and biochemical parameters were used to define PCO/PCOS. All female relatives had an ovarian ultrasound scan and hormone profile performed. History was used to assign status in postmenopausal women. All male relatives were assessed for early onset (<30 yr old) male pattern baldness, by photographs. All relatives were assigned affected (PCO/PMPB) or nonaffected status, and segregation analysis was performed. Of the relatives of 29 PCOS probands, 15 of 29 mothers (52%), 6 of 28 fathers (21%), 35 of 53 sisters (66%), and 4 of 18 brothers (22%) were assigned affected status. First-degree female relatives of affected individuals had a 61% chance of being affected. Of the first-degree male relatives, 22% were affected. Of a total of 71 siblings of PCOS probands, 39 were affected, giving a segregation ratio of 39/32 (55%), which is consistent with autosomal dominant inheritance for PCO/PMPB. In the control families, 1 of 10 probands (10%), 1 of 10 mothers (10%), no fathers, 2 of 13 sisters (15%), and 1 of 11 brothers (9%) were affected. Of a total of 24 siblings, 3 were affected (13%), giving a segregation ratio (observed/expected) of 3/12, which was significantly different from autosomal dominant inheritance. The inheritance of PCO and PMPB is consistent with an autosomal dominant inheritance pattern in PCOS families, perhaps caused by the same gene. There was no such genetic influence in families of women without PCOS. Sisters of PCOS probands with polycystic ovarian morphology were more likely to have menstrual irregularity and had larger ovaries and higher serum androstenedione and dehydroepiandrosterone-sulfate levels than sisters without PCO. This suggests a spectrum of clinical phenotype in PCOS families. Men with PMPB had higher serum testosterone than those without. Collectively, these data are consistent with a role for genetic differences in androgen synthesis, metabolism, or action in the pathogenesis of PCOS.
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PMID:Polycystic ovaries are inherited as an autosomal dominant trait: analysis of 29 polycystic ovary syndrome and 10 control families. 992 59

Intracytoplasmatic sperm injection (ICSI) has improved the success rate in treating severe male infertility. The method may now be used with sperm from the epididymis and testis. This article summarizes our knowledge on genetic factors affecting male gamete formation or function. Infertile men with severe impairment of spermatogenesis showed a higher than normal incidence of chromosomal abnormalities and 10-20% had microdeletion, in the Y-chromosome. About 75% of males with congenital bilateral absence of vas deferens (CBAVD) have mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. In conclusion, we recommend genetic counselling to all couples with a diagnosis of male infertility prior to ICSI. Men with severe oligozoospermia or non-obstructive azoospermia should have karyotype analysis performed and with establishment of diagnostic tools to reveal Y-chromosome deletions, this should be offered to the same group of men. Men with obstructive azoospermia and congenital albilateral absence of vas deferens as well as their wives should be screened for cystic fibrosis mutations.
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PMID:[Severe male infertility. Genetic investigation and counseling prior to intracytoplasmic sperm injection]. 1023 38

After a chemo- and/or radiotherapy not only acute side effects but also longterm side effects do occur. The following longterm side effects are observed: irregularities in the menstrual cycle, early onset of menopause and infertility. They are of special importance to children, teenagers and young adults having survived a malignancy. For young women experiencing a premature menopause a hormone replacement therapy is indicated. The degree of gonadal failure depends on the total dose of cytotoxics, radiation or the combination of both. Alkylating substances are responsible for gonadal failure whereas other cytotoxic agents lead to reversible gonadal dysfunction. An important risk factor for the development of ovarian failure is the woman's age at the time of treatment. A pregnancy in patients with a history of malignancy always is a high risk pregnancy and needs a close follow up. The offspring of cancer survivors do not show a higher rate of chromosomal abnormalities or neoplasms. Before starting a chemo- and/or radiotherapy the patient should be informed about acute and late effects. Men and adolescent boys should be given the opportunity for sperm cryopreservation. It is unclear whether a fertility reserve can be achieved by cryopreservation also in women.
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PMID:[Desire for children in tumor patients]. 1040 3

Since increased levels of soluble CD23 (sCD23) were demonstrated in patients with autoimmune diseases, seminal plasma sCD23 levels were examined in 110 men divided into seven groups according to etiological diagnosis of infertility and two groups on the basis of normal or abnormal spermiogram. sCD23 was absent in the seminal plasma of normal men: According to the ANOVA results, all measurements were significantly different between the groups of patients examined (p<.01). Specifically, patients with idiopathic testicular lesion have a significantly higher mean value of sCD23 than all other patients. A statistically significant difference was noted in the sCD23 levels between men with normal and those with abnormal spermiograms, although with wide overlapping of the individual values. Men with idiopathic testicular lesion may be immunologically more active than other groups with subfertility.
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PMID:Enhancement of soluble CD23 levels in the seminal plasma of infertile men with idiopathic testicular lesion. 1054 72


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