Psychosocial interventions for infertile couples:A scoping review

Objective:To bring out current evidence regarding psycho-social interventions for infertility care,and identify the best practices in clinical care.Methods:An in-depth literature review on infertility care intervention was conducted using data from multiple databases:PubMed,EMBASE,Google Scholar,and PsycINFO.The relevant articles selected were between 2008 and 2022.Results:A literature search turned up 1798 citations,of which 25 studies were included after rigorous analysis.Various intervention categories have been constantly utilised to provide support and promote mental health,of which acceptance and commitment therapy(ACT)and cognitive behaviour therapy(CBT)were used most frequently.The interventions exhibited diversity in both content and composition,and addressed a wide range of issues.Conclusions:The review emphasizes that psycho-social interventions have a positive effect on psychological issues,relationships,and pregnancies among couples and can be incorporated into fertility-care practices.

Hormonal Status Assessment of Infertile Congolese Men

Background: The pathologies causing male infertility are various (congenital or acquired) and concern several hormone-producing organs: the hypothalamus, pituitary gland, testes and adrenals. The hormonal dosage includes systematically testosterone, FSH and LH. These analyses often highlight hypogonadism hypogonadotropic or hypergonadotropic. They can sometimes be normal. The present study aimed to establish the hormonal profile of infertile men residing in Brazzaville. Patients and Methods: It was a cross-sectional descriptive study during five years (from 2018 to 2023). It concerned 344 infertilemen with an abnormal spermogram and spermocytogram. The method was performed from the blood dosage of testosterone, FSH, and LH using the Elisa technique. Results: The hormonal assessment was not normal in 48.83% (168/344) of cases. Increased values of testosterone were noted in 6.10% of cases and decreased in 12.20%. Abnormal high values of FSH were observed in 14.24% of cases and decreased values in 8.13%. LH was elevated, i.e. 2.03% of cases and decreased in 6.10% of subjects. Conclusions: A hormonal disturbance was observed in almost half of the infertile men. It concerned the hypothalamus-pituitary and the testes axis and indicated mainly a state of hypogonadism with high FSH and low LH.

Characteristics of Infertile Clientele Attending a Public in Vitro Fertilization Clinic: Appraising Priorities in a Low-Income Country

Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing nations emphasis is placed on childbirth and inability to fulfill this role can be very distressing. There is an unmet need for assisted reproductive technology (ART) in many developing countries and where facilities exist, they are mostly privately owned, expensive and concentrated in urban areas. To bridge this gap, public fertility clinics have been established to provide subsidized care. Evaluating the characteristics and peculiarities of clientele presenting at these public facilities will aid planning and prioritization of care. Methodology: A descriptive retrospective study of 116 infertile patients presenting to the fertility clinic of the University College Hospital, Ibadan, Nigeria from inception on the 14th of February 2019 and 31st of December 2022.Data was analyzed using the Statical Package for Social Sciences (IBM, SPSS, New York) version 23. Descriptive statistics were used to summarize the results which were presented with the aid of bar charts and frequency tables. Result: The mean age of the patients was 40.70 ± 6.62 years. Post-menopausal patients accounted for about one-fifth of the study population while 80.2% (93 women) were older than 35 years. The mean duration of infertility was 9.39 ± 6.11years and nine patients (7.8%) had a duration greater than 2 decades. Secondary infertility occurred in 67.2% of the women. Twenty-nine women (25%) had undergone myomectomy prior to presentation. Hypertension (11.2%) was the most prevalent comorbidity. Nineteen patients (16.4%) had used contraceptives in the past with the male condom (36.8%)being the most preponderant. Sixty-seven patients had experienced pregnancy losses before 28 weeks of gestation while just 16 patients (13.8%) had undergone ART, and none was successful. Conclusion: Secondary infertility was the prevalent type of infertility and may not be unconnected with the low contraceptive usage and high risk of sexually transmitted infection. Late presentation coupled with a large proportion of post-menopausal clientele suggests delayed health-seeking behavior most probably due to the prohibitive cost of ART. The need to streamline services offered in public fertility clinics is paramount in low-income countries grappling with scarce resources. A pragmatic approach will involve the provision of low-cost ART, while enhancing gamete donation programs through the implementation of gamete sharing policies. This will invariably bridge the unmet need and skewed access to ART in developing countries.

Profile of the Infertile Man at the University Hospital of Conakry (Guinea)

Introduction: Male infertility is defined as the inability of a man to impregnate a woman after 12 months of regular sexual intercourse without contraception. Objective: To improve the state of knowledge on the profile of the infertile man in Guinea. Methodology: We conducted a prospective, descriptive study over a period of 6 months from October 1st, 2020 to March 31st, 2021. Results: We collected an overall number of 71 patients seen onroutine consultation for infertility. They had a mean age of 36.4 years. More than half of our patients were monogamous (79% of cases). Civil servants were the most affected with 38.02% of cases. Primary infertility was dominant in 65% (n = 46) of cases. On clinical examination, varicocele was the most remarkable abnormality with 88.73% (n = 63) followed by testicular hypotrophy with 59.15% (n = 42). Azoospermia was the most frequent sperm abnormality with 22.54% (n = 16) followed by oligospermia with 15.49% (n = 11). Hormonal assessment based on FSH and LH was performed in 16 patients with azoospermia (22.53%). FSH elevation was associated with azoospermia in 6 patients, i.e. 8.45%, azoospermia associated with a normal FSH level accounting for 14.08% in our series. Conclusion: In our practice, male infertility is becoming more and more of a concern due to the increasing number of patients seeking treatment. The scarcity of a medical assistance for procreation unit alongside with more efficient diagnostic means constitutes a handicap for its management.

Effect of cognitive behavioral therapy on anxiety and depression of infertile women: A meta-analysis

Objective:To investigate the effect of cognitive behavioral therapy on anxiety and depression in infertile women.Methods:This study was performed in 2019 by searching Google Scholar,Scopus,PubMed/MEDLINE,Cochrane library,EMBASE,Proquest,ISI Web of Science,MagIran,SID and IranMedex.Eligible studies were selected by two reviewers and outcomes of interest were extracted.The meta-analysis was performed using the random effect models.Ⅰ-square statistic test was used for heterogeneity analysis.Presence of publication bias was also checked.Results:Eleven studies were included in this review.Between-group differences(cognitive behavioral therapy and control groups)in risk ratio for infertile women's depression was d=-1.36;95%CI=-1.81,-0.90;P<0.001.For infertile women's anxiety,between-group differences in risk ratio wasd=-0.83;95%CI=-1.18,-0.47;P<0.001.Conclusions:Cognitive behavioral therapy is effective in the reduction of depression and anxiety in patients with or withoutin vitro fertilization/intracytoplasmic sperm injection treatment.However,the lack of high-quality studies makes it challenging to make a solid and precise conclusion.Well-designed studies should be undertaken in the future to confirm these results.

Intrafollicular Soluble RAGE Benefits Embryo Development and Predicts Clinical Pregnancy in Infertile Patients of Advanced Maternal Age Undergoing In Vitro Fertilization

Soluble receptor for advanced glycation end products（s RAGE） can decoy the toxic AGEs and is considered to be a protective factor.This study aimed to evaluate the correlation between intrafollicular s RAGE levels and clinical outcomes in infertile women of young or advanced maternal age（AMA） undergoing in vitro fertilization（IVF）.A total of 62 young women and 62 AMA women who would undergo IVF were included in this prospective study.The intrafollicular s RAGE concentration was measured to determine its association with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy in young and AMA women,respectively.Besides,correlations between sR AGE and age or follicle-stimulating hormone（FSH） were examined.We found that the intrafollicular s RAGE levels were higher in young patients than those in AMA patients,suggesting that the s RAGE levels were inversely correlated with age.In young patients,sR AGE showed no correlation with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy.But it was found that AMA patients with more retrieved oocytes,fertilized oocytes and high-quality embryos demonstrated higher sR AGE levels,which were a prognostic factor for getting clinical pregnancy independent of age or FSH level.In conclusion,the s RAGE levels decrease with age.Elevated intrafollicular s RAGE levels indicate good follicular growth,fertilization and embryonic development,and successful clinical pregnancy in AMA women,while in young women,the role of s RAGE may not be so predominant.

Genome-wide identification of gene expression in the epididymis of infertile rat induced by alpha-chlorohydrin using oligonucleotide microarray

Objective To establish a rat model of sterility associated with epididymis and epididymal gene expression profiles relation to fertility by alpha-chlorohydrin.Methods Rats were treated with 10 mg·kg-1·d-1.alpha-chlorohydrin for 10 consecutive days.Sperm maturation and other fertility parameters were analyzed.The sperm motility and morphology were evaluated by computer-assisted sperm analysis(CASA);sperm survival rate was assessed by SYBR-14 and propidium iodide(PI)fluorescent staining;the weights of testes,epididymides,prostates and seminal vesicles were determined by electronic balance;histological examination of above tissues were evaluated by HE staining;and serumal dihydrotestosterone(DHT)and testosterone(T)of rats were detected by enzyme-labeled immunoassay.Each male rat was paired with 2 female rats in proestrus.Female rats were examined the next morning for the presence of sperm in vaginal smears and underwent a cesarean section on day 12 of gestation.Finally the reproductive indices were calculated as follows:copulation index(number of sperm positive females /number of pairings),pregnancy index(number of pregnancies /number of sperm positive females),and fertility index(number of pregnancies /number of pairings).After that we used Affymetrix Rat 230 2.0 oligo-microarray to identify epididymal special genes associated with fertility.Finally,we validated some of these genes by Real-Time quantitative polymerase chain reaction.Results The motility of spermatozoa from the cauda epididymidis of treated rats showed a significant decrease in percentage of motile,progressively motile sperm,and sperm survival rate.At the same time,the morphology of cauda epididymal spermatozoa was also adversely affected by the treatment.In addition,the serumal androgen levels of treated animals weren't changed compared with the control group.Accordingly,matings with treated males resulted in no successful pregnancy.Then,we classified general functions of the down or up regulated epididymal genes by chlorhydrin with the GeneSpring gene ontology(GO)analysis,which are involved in macromolecular metabolism and transport,primary metabolism process,cell metabolism,biological process regulation,immunology regulation,ion combination,hydratase and oxidoreductase activity.Among all the different expressed genes,we analyzed and screened the down-regulated genes associated with glucose,lipid,protein and other energy metabolism,which are considered as the major ACH action targets.Simultaneously,the up-regulated genes by chlorhydrin were detected and their characters of negative regulated sperm maturation and fertility analyzed,which are apoptosis and immune-related genes and not reported before.Conclusions We established male infertile rat model with ACH(10 mg·kg-1·d-1,po,10 days)through evaluating changes of sperm motility and morphology,mating index,fertility index and pregnancy index.Simultaneously,the ACH didn't affect the major androgen(T and DHT)metabolism and sexual ability,which is considered as the best way for male contraception.Then we determined the down-regulated epididymal genes relation to substance metabolism,which can affect the epididymal sperm maturation and presumed the major antifertility targets by ACH.Further more,we found and analyzed the epididymal up-regulated genes associated with apoptosis and immune functions,which maybe the new possible sites of action by ACH and other male antifertility agents.

Comparison of serum reproductive hormones, antioxidants, PGE2 and PGF2-α between primary and secondary infertile women in Calabar

Objective:To compare the prolactin, progesterone, luteinizing hormone, follicle stimulating hormone, estradiol, antisperm antibodies, tumor necrosis factorα, total antioxidant capacity, prostaglandin E2 and F2α between primary and secondary infertile women in Calabar.Methods:One hundred and two volunteers infertile women (test group), aged 20-45 years attending the infertility clinic in the University of Calabar Teaching Hospital (UCTH) were recruited. Fourteen of the women had primary infertility while 88 of them had secondary infertility. Sixty apparently healthy, age matched women served as the control group. Five millilitres of blood was collected, allowed to clot and serum was obtained from the subjects and Enzyme Linked Immunosorbent Assay method was used for prolactin, progesterone, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH), prostaglandin E2and F2α, human TNF-α,Chlamydia trachomatis IgG, antisperm antibodies assay, while serum total antioxidant capacity was assessed spectrophotometrically.Results:The result shows on comparison that primary infertile women has a significantly higher level of progesterone than those with secondary infertility (P>0.05). There was a significant difference in the levels of prolactin and total antioxidant capacity in the primary and secondary infertility when compare to the control group atP>0.05. Their mean ages were (31.10±5.37) years and (33.10±4.91) years respectively. There was a positive correlation between TAC and FSH, TNF and anti-sperm anti-bodies in the test group ofr=0.207 andr=0.632;P>0.05 respectively.Conclusions: These findings suggest no alterations in levels of prostaglandin F2α, TNF and anti-oxidant between primary and secondary infertile females.

Evaluation of infertile women: Mini-review

Evaluation of infertility indicated for women failed to conceive after one year of unprotected intercourse and for women over 35 years failed to conceive after 6 mo of unprotected intercourse, because the fertility decline as women approach 40 years. Evaluation of infertile couple should begin with semen analysis of male partner. If the semen analysis is within normal range, evaluation then move on to female partner. Evaluation of the infertile woman should be carried in cost-effective manner to identify the causes of infertility using the least invasive methods. Methods of evaluation of infertile women include: 1) history and physical examination;2) evaluation of the male partner;3) documentation of ovulation;4) evaluation of the ovarian reserve;5) evaluation of cervical causes of infertility;6) evaluation of uterine causes of infertility;7) documentation of the tubal patency;and 8) exclusion of peritoneal causes of infertility. Evaluation of infertile couple should include evaluation of both partners. Semen analysis for the male partner, followed by documentation of ovulation and evaluation of genital tract patency. PCT is not used as routine evaluation of infertile women. Laparoscopy is not used as routine evaluation of infertile women unless there is suspected peritoneal factors of infertility or endometriosis or tubal occlusion. Ovarian reserve should only be done for infertile women with diminished response to external gonadotropins (not routine).

A Fertility Assessment of Infertile Men with Varicocele by Means of Doppler Ultrasound

The diameters of spermatic veins and blood reflux in sixty-two male patients with infertility caused by varicocele were assessed with Doppler ultrasound in this study. Scrotal thermograph, testes volume and semen analysis were also applied to analysis of these patients. Among sixty-two patients, thirty-one received high ligation of internal spermatic vein. The results showed: 1. The diameter of spermatic veins was negatively correlated with fertility index and positively correlated with Doppler grading of blood reflux. 2. In operative patients, the effect of surgery was better in patients with blood reflux than in those without blood reflux. It was suggested the diameter of spermatic veins probably reflects the duration and serious degree of blood reflux in spermatic vein, and may be used for assessment of severity of male infertility in combination with semen analysis.

Happiness for Infertile Couples： An Introduction to Zhangzhou Medical Centre for Treatment of Infertility

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Obesity leads to higher risk of sperm DNA damage in infertile patients

There has been a growing interest over the past few years in the impact of male nutrition on fertility. Infertility has been linked to male overweight or obesity, and conventional semen parameter values seem to be altered in case of high body mass index （BMI）. A few studies assessing the impact of BMI on sperm DNA integrity have been published, but they did not lead to a strong consensus. Our objective was to explore further the relationship between sperm DNA integrity and BMI, through a 3-year multicentre study. Three hundred and thirty male partners in subfertile couples were included. Using the terminal uridine nick-end labelling （TUNEL） assay, we observed an increased rate of sDerm DNA damage in obese men （odds ratio （95% confidence interval）： 2.5 （1.2-5.1））.

Sperm DNA damage in men from infertile couples

Aim： To investigate the prevalence of high levels of sperm DNA damage among men from infertile couples with both normal and abnormal standard semen parameters. Methods： A total of 350 men from infertile couples were assessed. Standard semen analysis and sperm chromatin structure assay （SCSA） were carried out. Results： Ninety-seven men （28% of the whole study group） had a DNA fragmentation index （DFI） 〉 20%, and 43 men （12%） had a DFI 〉 30%. In the group of men with abnormal semen parameters （n = 224）, 35% had a DFI 〉 20%, and 16% had a DFI 〉 30%, whereas these numbers were 15% and 5%, respectively, in the group of men with normal semen parameters （n = 126）. Men with low sperm motility and abnormal morphology had significantly higher odds ratios （ORs） for having a DFI 〉 20% （4.0 for motility and 1.9 for morphology） and DFI 〉 30% （6.2 for motility and 2.8 for morphology） compared with men with normal sperm motility and morphology. Conclusion： In almost one-third of unselected men from infertile couples, the DFI exceeded the level of 20% above which, according to previous studies, the in vivo fertility is reduced. A significant proportion of men with otherwise normal semen parameters also had high sperm DNA damage levels. Thus, the SCSA test could add to explaining causes of infertility in cases where semen analysis has not shown any deviation from the norm. We also recommend running the SCSA test to choose the appropriate assisted reproductive technique （ART）.

Frequency of Y chromosome microdeletions and chromosomal abnormalities in infertile Thai men with oligozoospermia and azoospermia

Aim： To investigate the possible causes of oligozoospermia and azoospermia in infertile Thai men, and to find the frequencies of Y chromosome microdeletions and cytogenetic abnormalities in this group. Methods： From June 2003 to November 2005, 50 azoospermic and 80 oligozoospermic men were enrolled in the study. A detailed history was taken for each man, followed by general and genital examinations. Y chromosome microdeletions were detected by multiplex polymerase chain reaction （PCR） using 11 gene-specific primers that covered all three regions of the azoospermic factor （AZFa, AZFb and AZFc）. Fifty men with normal semen analysis were also studied. Karyotyping was done with the standard G- and Q-banding. Serum concentrations of follicle stimulating hormone （FSH）, luteinizing hormone （LH）, prolactin （PRL） and testosterone were measured by electrochemiluminescence immunoassays （ECLIA）. Results： Azoospermia and oligozoospermia could be explained by previous orchitis in 22.3%, former bilateral cryptorchidism in 19.2%, abnormal karyotypes in 4.6% and Y chromosome microdeletions in 3.8% of the subjects. The most frequent deletions were in the AZFc region （50%）, followed by AZFb （33%） and AZFbc （17%）. No significant difference was detected in hormonal profiles of infertile men, with or without microdeletions. Conclusion： The frequencies of Y chromosome microdeletions and cytogenetic abnormalities in oligozoospermic and azoospermic Thai men are comparable with similarly infertile men from other Asian and Western countries.

The prevalence of azoospermia factor microdeletion on the Y chromosome of Chinese infertile men detected by multi-analyte suspension array technology

Aim： To develop a high-throughput multiplex, fast and simple assay to scan azoospermia factor （AZF） region microdeletions on the Y chromosome and establish the prevalence of Y chromosomal microdeletions in Chinese infertile males with azoospermia or oligozoospermia. Methods： In total, 178 infertile patients with azoospermia （nonobstructed）, 134 infertile patients with oligozoospermia as well as 40 fertile man controls were included in the present study. The samples were screened for AZF microdeletion using optimized multi-analyte suspension array （MASA） technology. Results： Of the 312 patients, 36 （11.5%） were found to have deletions in the AZF region. The rnicrodeletion frequency was 14% （25/178） in the azoospermia group and 8.2% （11/134） in the oligospermia group. Among 36 patients with microdeletions, 19 had deletions in the AZFc region, seven had deletions in AZFa and six had deletions in AZFb. In addition, four patients had both AZFb and AZFc deletions. No deletion in the AZF region was found in the 40 fertile controls. Conclusion： There is a high prevalence of Y chromosomal microdeletions in Chinese infertile males with azoospermia or oligozoospermia. The MASA technology, which has been established in the present study, provides a sensitive and high-throughput method for detecting the deletion of the Y chromosome. And the results suggest that genetic screening should be advised to infertile men before starting assisted reproductive treatments.

Testicular expression of survivin and human telomerase reverse transcriptase(hTERT)associated with spermatogenic function in infertile patients

Aim： To characterize the coexpression of survivin, an inhibitor of apoptosis （IAF）, and human telomerase reverse transcriptase （hTERT） in human testes with varying spermatogenic function. Methods： Transcript levels of survivin mRNA and hTERT mRNA were determined in normal testes （n = 11） and testes with defective spermatogenesis （n = 28） using real-time reverse-transcription polymerase chain reaction （RT-PCR）. The histological work-up was performed according to a modified Johnsen score. Results： Expressions of both survivin and hTERT were highest at median levels of 96.8 and 709 in normal spermatogenesis and dropped to 53.3 and 534 in testes with postmeiotic spermatogenic arrest （n = 10）. In severe spermatogenic failure （n = 18）, survivin expression was lacking in most specimens （n = 16）, whereas at least low levels of testicular hTERT expression were largely detectable with a normalized expression of 73 in premeiotic spermatogenic arrest （n = 7） and 45 in patients with Sertoli cell-only syndrome （SCOS） （n = 3）. Both survivin and hTERT expressions increased with a progressing Johnsen score （P for trend = 0.001）. Conclusion： Although both survivin and hTERT are correlated with spermatogenic function, they show different expression patterns in testes of infertile patients. These findings substantiate results from studies in the rodent testis suggesting a predominant expression of survivin in meiotically dividing germ cells. （Asian J Andro12006 Jan; 8： 95-100）

Evaluation of germ-cell kinetics in infertile patients with proliferating cell nuclear antigen proliferating index

Aim: To explore the usefulness of proliferating cell nuclear antigen proliferating index (PCNA PI) in the pathologicaldiagnosis and treatment of male infertility. Methods: Testicular biopsy specimen obtained from 48 cases of male in-fertility and 2 normal controls were fixed and embedded. The sections were stained with anti-PCNA monoclonal anti-bodies or haematoxylin/eosin. Proliferating index (PI), expressed as the percentage of germ-cell nuclei positivelystained with PCNA antibody, was assessed from more than 20 seminiferous tubules or 600 germ-cells. Results: Theinfertile patients were divided into 4 groups: Group 1, normal spermatogenesis (14 cases); Group 2, hypospermato-genesis (16 cases); Group 3, germinal arrest (10 cases); Group 4, Sertoli cell only syndrome (8 cases). The PCNAPI of normal control testis was 86.5 % (mean value). Group 3 had a significantly lower PCNA PI (29.8 %) than nor-mal testis; Group 1 and 2 had similar Pis (82.3% and 82.3%, respectively) as the control testis. PI of the negativecontrol (Group 4) was 0 as no germ-cells were found. Conclusion: PCNA PI is useful for assessing germ-cell ki-netics, especially for pathological diagnosis of germinal arrest which is difficult to differentiate by routine HE stainingtechnique. In germinal arrest, there is a significantly lowered PCNA PI, which is an indication of DNA synthesis dete-rioration, suggesting the use of therapies be different from those for hypospermatogenesis. (Asian J Androl 2001 Mar;3: 63-66)

Genetic polymorphisms in glutathione S-transferase T1 affect the surgical outcome of varicocelectomies in infertile patients

Glutathione S-transferases （GSTs）, superoxide dismutase 2 （SOD2） and NAD（P）H：quinone oxidoreductase 1 （NQO1） are anti-oxidant enzyme genes. Polymorphisms of GSTs, SOD2 and NQO1 have been reported to influence individual susceptibility to various diseases. In an earlier study, we obtained preliminary findings that a subset of glutathione S-transferase 7：1 （GSTT1）-wt patients with varicocele may exhibit good response to varicocelectomy. In this study, we extended the earlier study to determine the distribution of genotype of each gene in the infertile population and to evaluate whether polymorphism of these genes affects the results of surgical treatment of varicocele. We analyzed 72 infertile varicocele patients, 202 infertile patients without varicocele and 101 male controls. Genotypes of GSTs were determined by polymerase chain reaction （PCR）. Genotyping of SOD2 and NQO1 was performed using the PCR-restriction fragment length polymorphism （PCR-RFLP） method. A significantly better response to varicocelectomy was found in patients with the GSTTI-wt genotype （63.2%） and NQO1-Ser/Ser genotype （80.0%） than in those with GSTTI-null genotype （35.3%） and NQO1-Pro/Pro or NQO1- Pro/Ser genotype （45.2%）, respectively. The frequencies of glutathione S-transferase M1/T1, SOD2 and NQO1 genotypes did not differ significantly among the varicocele patients, idiopathic infertile patients and male controls. GSTT1 genotype is associated with improvement of semen parameters after varicocelectomy. As the number of patients with NQO1-Ser/Ser genotype was not sufficient to reach definite conclusions, the association of NQO1 genotype with varicocelectomy requires further investigation.

Untreated Prior Pulmonary Tuberculosis Adversely Affects Pregnancy Outcomes in Infertile Women Undergoing in vitro Fertilization and Embryo Transfer: A Large Retrospective Cohort Study

Objective Prior pulmonary tuberculosis(PTB) on chest X-ray(CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer(IVF-ET). It was unclear whether untreated PTB would affect pregnancy outcomes after IVF-ET.Method We conducted a retrospective cohort study of 14,254 infertile patients who had received IVFET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth,clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.Results The untreated PTB group had significantly lower clinical pregnancy(31.7% vs. 38.1%) and live birth(23.8% vs. 30.6%) rates than the non-PTB group(both P < 0.001). Multivariate analysis revealed that untreated PTB was a risk factor for decreased live birth rate [odds ratio(OR), 0.80;95% confidence interval(CI), 0.66–0.98;P = 0.028] in all patients and for increased miscarriage(OR, 4.19;95% CI,1.69–10.39;P = 0.002) and decreased live birth(OR, 0.45;95% CI, 0.24–0.83;P = 0.011) rates in patients with unexplained infertility.Conclusions Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.

Effect of smoking on semen quality of infertile men in Shandong, China

Aim: To study the effect of smoking on the semen quality in infertile men in Shandong Province, China. Methods:Adult non-drinker males attending the infertility clinic, including 110 non-smokers and 191 smokers, were recruited forthe study. Sixty-one fertile, non-smoker and non-drinker males, who had one or more children, served as the controls.The smokers were divided into subgroups according to the amount and duration of smoking. Semen parameters (semenvolume and sperm density, viability, motility, and morphology) were examined and seminal plasma contents of Zn,Cu and superoxide dismutase (SOD) determined. Results: The semen volume and acidity, and the sperm density,viability and forward progression, as well as the seminal plasma contents of Zn, Cu and SOD were much lower in themedium, heavy and long-term smokers than in the non-smokers ( P < 0.01). The sperm density, viability and forwardprogression, and the seminal plasma Zn, Cu and SOD levels were negatively correlated with the amount and duration ofcigarette smoking (P < 0.01). Conclusion: Medium, heavy and long-term smoking adversely affected the semenquality in a population of men visiting the infertility clinic in Shandong, China.