Controversy and consensus on the management of elevated sperm DNA fragmentation in male infertility: A global survey, current guidelines, and expert recommendations

Purpose Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. Materials and Methods An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method. Results A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4–6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated. Conclusions This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians

Search for a standard model-like Higgs boson in the mu(+)mu(-) and e(+)e(-) decay channels at the LHC

A search is presented for a standard model-like Higgs boson decaying to the mu(+)mu(-) or e(+)e(-) final states based on proton-proton collisions recorded by the CMS experiment at the CERN LHC. The data correspond to integrated luminosities of 5.0 fb(-1) at a centre-of-mass energy of 7 TeV and 19.7 fb(-1) at 8 TeV for the mu(+)mu(-) search, and of 19.7 fb(-1) at 8 TeV for the e(+)e(-) search. Upper limits on the production cross section times branching fraction at the 95% confidence level are reported for Higgs boson masses in the range from 120 to 150 GeV. For a Higgs boson with a mass of 125 GeV decaying to mu(+)mu(-), the observed (expected) upper limit on the production rate is found to be 7.4 (6.5(-1.9)(+2.8)) times the standard model value. This corresponds to an upper limit on the branching fraction of 0.0016. Similarly, for e(+)e(-), an upper limit of 0.0019 is placed on the branching fraction, which is approximate to 3.7 x 10(5) times the standard model value. These results, together with recent evidence of the 125 GeV boson coupling to tau-leptons with a larger branching fraction consistent with the standard model, confirm that the leptonic couplings of the new boson are not flavour-universal

Searches for supersymmetry based on events with b jets and four W bosons in pp collisions at 8 TeV

Five mutually exclusive searches for supersymmetry are presented based on events in which b jets and four W bosons are produced in proton-proton collisions at root s = 8TeV. The data, corresponding to an integrated luminosity of 19.5 fb(-1), were collected with the CMS experiment at the CERN LHC in 2012. The five studies differ in the leptonic signature from the W boson decays, and correspond to all-hadronic, single-lepton, opposite-sign dilepton, same-sign dilepton, and >= 3 lepton final states. The results of the five studies are combined to yield 95% confidence level limits for the gluino and bottom-squark masses in the context of gluino and bottom-squark pair production, respectively. In the limit when the lightest supersymmetric particle is light, gluino and bottom squark masses are excluded below 1280 and 570 GeV, respectively

Performance of the CMS missing transverse momentum reconstruction in pp data at √s= 8 TeV

The performance of missing transverse energy reconstruction algorithms is presented using root s = 8 TeV proton-proton (pp) data collected with the CMS detector. Events with anomalous missing transverse energy are studied, and the performance of algorithms used to identify and remove these events is presented. The scale and resolution for missing transverse energy, including the effects of multiple pp interactions (pileup), are measured using events with an identified Z boson or isolated photon, and are found to be well described by the simulation. Novel missing transverse energy reconstruction algorithms developed specifically to mitigate the effects of large numbers of pileup interactions on the missing transverse energy resolution are presented. These algorithms significantly reduce the dependence of the missing transverse energy resolution on pileup interactions. Finally, an algorithm that provides an estimate of the significance of the missing transverse energy is presented, which is used to estimate the compatibility of the reconstructed missing transverse energy with a zero nominal value

Constraints on the Higgs boson width from off-shell production and decay to Z-boson pairs

Constraints are presented on the total width of the recently discovered Higgs boson, Gamma(H), using its relative on-shell and off-shell production and decay rates to a pair of Z bosons, where one Z boson decays to an electron or muon pair, and the other to an electron, muon, or neutrino pair. The analysis is based on the data collected by the CMS experiment at the LHC in 2011 and 2012, corresponding to integrated luminosities of 5.1 fb(-1) at a center-of-mass energy root s = 7 TeV and 19.7 fb(-1) at root s = 8 TeV. A simultaneous maximum likelihood fit to the measured kinematic distributions near the resonance peak and above the Z-boson pair production threshold leads to an upper limit on the Higgs boson width of Gamma(H) < 22 MeV at a 95% confidence level, which is 5.4 times the expected value in the standard model at the measured mass of m(H) = 125.6 GeV

Search for pair production of third-generation scalar leptoquarks and top squarks in proton-proton collisions at v root s=8 TeV

A search for pair production of third-generation scalar leptoquarks and supersymmetric top quark partners, top squarks, in final states involving tau leptons and bottom quarks is presented. The search uses events from a data sample of proton-proton collisions corresponding to an integrated luminosity of 19.7 fb(-1), collected with the CMS detector at the LHC with root s = 8 TeV. The number of observed events is found to be in agreement with the expected standard model background. Third-generation scalar leptoquarks with masses below 740 GeV are excluded at 95% confidence level, assuming a 100% branching fraction for the leptoquark decay to a tau lepton and a bottom quark. In addition, this mass limit applies directly to top squarks decaying via an R-parity violating coupling. lambda(') (333). The search also considers a similar signature from top squarks undergoing a chargino-mediated decay involving the Rparity violating coupling. lambda(')(3jk). Each top squark decays to a tau lepton, a bottom quark, and two light quarks. Top squarks in this model with masses below 580 GeV are excluded at 95% confidence level. The constraint on the leptoquark mass is the most stringent to date, and this is the first search for top squarks decaying via. lambda(')(3jk)