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Query: UMLS:C0021359 (infertility)
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Men attending the Andrology Laboratory for the first time were asked to complete questionnaires regarding their employment, lifestyle, diet and infancy for the Chemicals and Pregnancy Study UK (CHAPS-UK) research study. CHAPS-UK is a multi-centre study investigating reasons for male infertility. During one interview, a patient expressed concerns about his sexual relationship with his wife. Initially, he described his concerns about infertility but as the nurse used her counselling skills, the patient was able to voice his psychosexual difficulties. This was the first time in 5 years of marriage the patient talked about his situation to another person. The research nurse was able to combine good communication and counselling skills to facilitate the patient's need to face his problem, which enabled him to make a constructive decision about his need for further help. This case highlights the difficult situation in which fertility nurses can find themselves and reinforces the need for nurses involved in the care of infertile couples to have training in counselling skills and the ability to make appropriate referral to an infertility counsellor when required.
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PMID:Unexpected application of counselling skills by a fertility research nurse. 1219 96

Men, as well as women, were interviewed in the Haiti National Contraceptive Prevalence Survey (NCPS) in 1989. THe inclusion of males allowed the survey to: 1) attain information on fertility, contraceptive use and supply sources, method mix, and unplanned pregnancies; 2) explain the difference between the number used; 3) examine the role of men in family planning; and investigate barriers to contraceptive usage. The preliminary report of the survey found that the use of family planning among women in union (WIU) has gone up to 10%; use of traditional contraceptive methods is less than 1%. The pill is the most frequently used method (4% of all WIU); followed by female sterilization (2.5%), and the "injection" (16%). Less than 1% of WIU use condoms. Among men in union (MIU), 11% use family planning. Condoms are the most commonly used method (3.4% of MIU). Women may underreport condom use. MIU may report use of condoms with partners outside of their current union. Among all men, 8.5% use family planning; 6% of single men, mostly in urban areas, report using condoms. Most men say that they use condoms to prevent pregnancy; 13% use them for protection against sexually transmitted diseases, including the acquired immunodeficiency syndrome. Another 20% give both reasons. Among women and men in union who are using family planning, 2.3 gave reasons of infertility, sexual activity, or pregnancy. 37% of the nonusers are breastfeeding or pregnant; another 10% would like a pregnancy (18%); 16% of men believe their partner is menopausal. Among women who gave birth in the 5 years previous tot he survey, more than 2/3 has at least 1 antenatal care visit; 22% had more than 6 visits. 3 in 10 of these birth were not planned.
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PMID:Survey report: Haiti. 1228 4

At least 8 new male contraceptives have emerged and most can be used now, but little promotion of these new methods has occurred. No-scalpel vasectomy developed in China consists of a small puncture instead of an incision through which the health worker either cuts or blocks the vas deferens. This technique is safer and heals faster than the conventional technique. The Association for Voluntary Surgical Contraception has a list of US physicians trained in this technique. Another new male contraceptive is injection of chemicals in the vas deferens thereby blocking sperm movement. It is permanent. Research in China shows the injectable plug in the vas deferens to be an effective, potentially reversible method. Similarly the surgically implanted "shug" performs the same purpose as the injectable plug and has the same potential to be reversible. Another method is injection of a spermicide into the vas deferens which temporarily brings about infertility. Animal trials indicate it is safe and effective. Human trials are now going on in India and will soon be underway in the US. The wet heat method has been known since the 4th century B.C. It involves placing the testes in hot water (116 degrees Fahrenheit) for 45 minutes every night for 3 weeks. This provides protection for 6 months. A similar method is artificial cryptorchidism where men wear special underwear during the day to keep the testes inside the inguinal canal which increases their temperature. Applying ultrasound to the testes for 10 minutes once every 6 months also brings about azoospermia. Ultrasonography requires physician intervention but wet heat and artificial cryptorchidism do not. Funding agencies have not provided monies to male contraception research, claiming men are not committed to contraception, yet vasectomies comprise 12% of global contraceptive use. Another excuse is that new male contraceptives do not prevent HIV transmission but neither does Norplant. Men should familiarize themselves with the new male contraceptives and then pressure authorities to sponsor their research and development.
Chang Men
PMID:New nonhormonal contraceptive methods for men. 1228 17

In 1985 the Colombian Family Planning Association PROFAMILIA realized that men did not want to come to its family planning centers simply because they felt intimidated by the feminine atmosphere there. Nor did they dare disclose their problems and sexual questions even to a female professional. The solution was to establish a family planning center, La Clinica del Hombre (Men's Clinic), providing services exclusively for men and staffed with men to provide the necessary privacy. Latin American men's attitudes are changing. In 1985 in Bogota, the majority of men were convinced that a vasectomy was equivalent to castration. In 1993, 300 vasectomies were performed in the clinic each month. The Colombian Family Planning Association is not only providing contraception, but also information on sexual and reproductive education to avoid misunderstanding of the available methods. PROFAMILIA has incorporated a sexuality consultation into its services, so they can deal with husbands and wives separately, without spoiling the couple's relationship. PROFAMILIA now has 7 family planning clinics for men and 48 for women, thanks to the contribution of international donors. The Challenge Grant for Men's Programs, given by an anonymous donor from the United States, helped with the fund-raising to open 3 clinics in the Atlantic Coast Region where needs were vital. The Clinica del Hombre will incorporate a program to treat infertility, in addition to the department of urology, general medicine, ambulatory surgery, and treatment of sexually transmitted diseases. In January, 1994, they will begin offering dental and plastic surgery services because, owing to the violence that exists in the country, there are many men whose faces are disfigured and who need to have corrective plastic surgery.
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PMID:For men only. 1228 23

A representative of the Naam movement, a grass-roots organization of women in Burkina Faso, Ramata Sawadogo, speaks about her work as a health educator. She had worked in the health system but became disillusioned because most health problems of her clients were related to poverty. Now she works with the Naam movement to help spread the acceptance of family planning. Within the last 1 or 2 generations, women are having twice as many children because the traditional birth-spacing customs are in decline. Ms. Sawadogo explains the effect of large families by analogy with the local custom of planting only 2 millet seeds per hill. She also emphasizes to people that family planning includes treatment for infertility, sexually transmitted diseases, and menstrual problems. Now even mothers-in-law are beginning to realize the need for family planning. Marked changes in attitudes are evident because people can discuss and even laugh at sexual issues, which were formerly taboo even between spouses. Men are helping women with their work to some extent, or lending them bicycles to go to market. Another dramatic success of the Naam movement is the soap-making enterprise, with soap sales totaling US$135/week, the equivalent of a civil servant's salary. Women are trading vegetables and their labor to pay back loans for soap-making equipment. Ms. Sawadogo urged clinic staff to treat local farmers with extreme courtesy, since their reception will influence whole villages about the motivation of those offering family planning.
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PMID:Empowering the women of the Sahel. 1231 80

Sexually transmitted diseases cause more problems for women, than AIDS causes for men, children, and women combined. Yet, the cure for this problem is simple contraceptive prevention. In developing countries women can be abandoned, abused, and even murdered for being infertile, yet 70% if female infertility is caused by the STDs they contracted from their husbands. Men are the agents that transmit STDs, not wives, not prostitutes. Men seeking commercial sex can infect a prostitute who then goes on to infect many other men who then infect their wives. In overview, STD rates are that same for men and women. STDs cause 750,000 deaths annually and 75 million illnesses among women yearly. By 2000, estimates are double.
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PMID:The other epidemic. 1231 26

The present study was designed to determine the response of human epididymis, seminal vesicles and prostate function after a 5-day course of clomiphene citrate in men attending an infertility service. In 45 men, the secretions of the epididymis, seminal vesicles and prostate were assessed by measurements of seminal alpha-glucosidase, fructose and acid phosphatase, respectively. Subjects were classified as normal or abnormal: abnormal men were defined as those who either had history of a sexually transmitted disease (STD), leukocytospermia, hypoandrogenism, or a low response of Leydig cells to clomiphene stimulation; and normal subjects were those who did not have these conditions. Mean serum testosterone luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels were significantly increased after the short course with clomiphene citrate. After clomiphene citrate stimulation, the men in the normal group showed significantly increased marker levels of the seminal vesicles (P < 0.02) and prostate (P < 0.05), but not of the epididymis (P : NS). Men classified as abnormal showed no response according to the markers of the seminal vesicles and epididymis. Men with history of STD and abnormal basal values of acid phosphatase did not respond to the treatment. Men with history of STD but normal basal values of seminal acid phosphatase increased significantly in their levels of seminal acid phosphatase after clomiphene stimulation (P < 0.02). Multivariate analysis showed that the basal serum testosterone level was the only variable in predicting the probability of response to the clomiphene in terms of true-corrected seminal fructose, seminal acid phosphatase and seminal alpha-glucosidase levels. In fact, a high response of the seminal vesicles was observed in men with the highest basal serum testosterone levels (0.45 +/- 0.17; coefficient of regression +/- standard error; P < 0.018). However, a high response in terms of seminal acid phosphatase (P < 0.004) or alpha-glucosidase (P < 0.037) was observed in men with low basal serum testosterone levels. In conclusion, in the normal men, true-corrected fructose and acid phosphatase but not alpha-glucosidase in semen increased after duplicate androgen stimulation. An absence of response was observed in cases with history of STD/leukocytospermia or hypoandrogenism.
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PMID:Basal serum testosterone as an indicator of response to clomiphene treatment in human epididymis, seminal vesicles and prostate. 1239 89

Marriage is universal, and pair bonding is found in other species too with highly dependent young. So marriage functions as a reproductive social arrangement that traditionally involved the extended family. The sexes are not identical in their biological contributions to children's survival, so they seek somewhat different attributes in a mate. Men seek a young, attractive, sexually faithful bride. Women seek a man who is older, taller, and (as in many other species) socially dominant. Both sexes prefer a kind, healthy, attractive, similar mate who is emotionally attached to them. A spouse who fails to maintain sufficiently high mate value is vulnerable to divorce. Infertility and sexual dissatisfaction predict divorce, as does death of a child, but the more children, the stabler the marriage. Cross-cultural data suggest that cruel or subdominant men (e.g., poor providers) and unfaithful women are prone to divorce. Marriages in which the wife dominates the husband in economic contributions, nonverbal behavior, and decision making tend to be less satisfying. In societies in which wives are economically independent of husbands, divorce rates are high. As women's economic power has risen with industrialization, divorce rates have climbed. Economic and fitness considerations also help explain cultural differences in polygyny, age at marriage, arranged marriage, concern with the bride's sexual chastity, and marriage ceremonies. Other factors also affect marital dynamics, such as state subsidies to families, the sex ratio, and influence of the couple's parents.
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PMID:Marriage: an evolutionary perspective. 1249 35

This study investigated the relationship between variation in the polymorphic CAG trinucleotide repeat (TNR) region of the human androgen receptor (AR) gene and semen quality in a Caucasian sample population. These men were patients attending the New Zealand Centre for Reproductive Medicine in Christchurch. The AR TNR region was amplified by polymerase chain reaction and then DNA sequenced to determine exact numbers of CAG repeats for each sample. In addition, the samples were screened for microdeletions within the AZFc region of the Y-chromosome. A total of 105 men with poor semen quality were compared with a group of 93 men with normal semen quality. Men with poor semen quality had similar CAG repeat number to men with normal semen quality (21.46 +/- 0.30 vs. 20.99 +/- 0.28, p = 0.126). Y-chromosome microdeletions were only detected in men with suboptimal semen parameters (7.4%). However, the presence of a deletion was not related to CAG repeat number. The CAG repeat number in the men with normal semen quality in the present study is similar to the Australian and German samples, but lower than those reported for the Swedes, Dutch and Danes. These results are contrary to the hypothesis that higher CAG repeats are associated with infertility in men, but strongly suggest that different populations may show different numbers of CAG repeats in addition to racial variation reported in previous studies.
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PMID:Absence of association of androgen receptor trinucleotide expansion and poor semen quality. 1253 37

We report report a case of a man with azoospermia who was studied because of infertility. Between the causes of azoospermia and severe oligospermia, in male patients with infertility evaluations, small deletions in regions of the Y chromosome must be considered, as in our case. Regions for spermatogenesis in the Yq chromosome can be evidenced using PCR analysis. Men with azoospermia are at high risk to have small deletions in that regions. Yq chromosome deletions could be transmitted when ICSI (intracytoplasmic sperm injection) is applied. Thereafter, study of microdeletions would be included in severe infertile men.
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PMID:[Infertility caused by AZF microdeletions. A new case of azoospermia]. 1264 77


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