Defective spermatogenesis: Martin et al. respond

This is an Open Access article - Copyright @ National Institute of Environmental Health Science.BACKGROUND: Male reproductive tract abnormalities such as hypospadias and cryptorchidism, and testicular cancer have been proposed to comprise a common syndrome together with impaired spermatogenesis with a common etiology resulting from the disruption of gonadal development during fetal life, the testicular dysgenesis syndrome (TDS). The hypothesis that in utero exposure to estrogenic agents could induce these disorders was first proposed in 1993. The only quantitative summary estimate of the association between prenatal exposure to estrogenic agents and testicular cancer was published over 10 years ago, and other systematic reviews of the association between estrogenic compounds, other than the potent pharmaceutical estrogen diethylstilbestrol (DES), and TDS end points have remained inconclusive. OBJECTIVES: We conducted a quantitative meta-analysis of the association between the end points related to TDS and prenatal exposure to estrogenic agents. Inclusion in this analysis was based on mechanistic criteria, and the plausibility of an estrogen receptor (ER)-α–mediated mode of action was specifically explored. RESULTS: We included in this meta-analysis eight studies investigating the etiology of hypospadias and/or cryptorchidism that had not been identified in previous systematic reviews. Four additional studies of pharmaceutical estrogens yielded a statistically significant updated summary estimate for testicular cancer. CONCLUSIONS: The doubling of the risk ratios for all three end points investigated after DES exposure is consistent with a shared etiology and the TDS hypothesis but does not constitute evidence of an estrogenic mode of action. Results of the subset analyses point to the existence of unidentified sources of heterogeneity between studies or within the study population

The male to female ratio at birth following the Scottish Independence Referendum, September 2014

Human male live births exceed female live births by approximately 3%. This sex ratio is conventionally expressed as M/F (male divided by total live births). Many factors have been implicated as influencing this ratio, such as stress. This phenomenon occurred following the Quebec sovereignty referendum of 1995. This study was carried out in order to ascertain whether the Scottish referendum of September 2014 had any effect on the M/F ratio in Scotland. Monthly live births by gender for Scotland were obtained from Scottish Office of National Records for the period January 2004 to July 2015. They were analysed for any significant period changes as witnessed in Quebec in 1995. There were 661166 total births (338850 male and 322316 female births), with an overall M/F of 0.5125 (95% CI: 0.5113-0.5137). There were no changes in M/F in the first five months after the referendum. However, there was a non-significant rise in M/F toward the end of 2014 which continued during much of 2015. The rise in M/F reached its peak in May-June 2015, 8-9 months after the referendum (M/F 0.5199 compared to M/F of 0.5124 for aggregated May-June values 2004-14). There was no significant drop in M/F in the Scottish population in relation to the Scottish referendum. This may be due to a type 2 error since this study was less powered (12 times smaller) than the Quebec study. The non-significant rise may have potentially been caused by increased coital rates as observed after the birth of Prince William in 1982 and for Hong Kong in relation to Dragon years. It will be interesting to analyse the rest of the UK data when this becomes officially available.peer-reviewe

Contraceptive Methods and the Subsequent Search for a Pregnancy

Many women are concerned about their future fertility, about pregnancy complications and about the health of their future child when choosing a contraceptive method and sometimes women want to interrupt the contraception – maybe after years of use – in order to attempt pregnancy. Return to fertility, has been thoroughly analyzed in the literature. This chapter provides evidence-based information and discusses the potential doubts of women. Return to fertility has been consistently found to be sure, albeit sometimes slightly slow in the short term: pregnancy rates after 1 year of contraceptive interruption are 79–95% for oral contraceptives, 79–96% for levonorgestrel IUD, 71–91% for copper IUDs, around 80% for implants and 75–80% for injectable contraceptives. About 50% women are pregnant 3–6 months after contraceptive discontinuation; around 90–95% of women had achieved pregnancy 2 years after stopping their contraceptive method. Some studies have found associated risks of fetal malformations when women take oral contraceptive pills after conception (though other studies disputed these results). However the offspring of women who used oral contraceptives before conception does not show an increased risk of fetal death, miscarriage, gestational hypertension, major newborn structural defects or hypospadias. The effect on birth weight seems small and inconclusive

Advanced paternal age and vulnerability to psychotic-like experiences in the offspring

AbstractObjectiveTo investigate whether advanced paternal age is associated with increased psychotic-like experiences (PLEs) and increased sensitivity to Cannabis in the offspring.MethodsA cross-sectional population-based study in 1684 participants aged 18 to 25.ResultsWe found no association of paternal age with PLEs. Only the positive dimension subscale was associated to paternal age, but that could be largely contributed to outliers. Also no increased sensitivity to Cannabis smoking was apparent.ConclusionIn the general population, we did not find robust support for an association between paternal age and vulnerability to PLEs in 18–25year old offspring

Advanced paternal age is a risk factor for schizophrenia in Iranians

<p>Abstract</p> <p>Background</p> <p>Since 1958 many, but not all studies have demonstrated that paternal age is a risk factor for schizophrenia. There may be many different explanations for differences between studies, including study design, sample size, collection criteria, heterogeneity and the confounding effects of environmental factors that can for example perturb epigenetic programming and lead to an increase in disease risk. The small number of children in Western families makes risk comparisons between siblings born at different paternal ages difficult. In contrast, more Eastern families have children both at early and later periods of life. In the present study, a cross-sectional population study in an Iranian population was performed to compare frequency of schizophrenia in younger offspring (that is, older paternal age) versus older offspring.</p> <p>Methods</p> <p>A total of 220 patients with the diagnosis of schizophrenia (cases) from both psychiatric hospitals and private clinics and 220 individuals from other hospital wards (controls), matched for sex and age were recruited for this study. Patients with neurological problem, substance abuse, mental retardation and mood disorder were excluded from both groups.</p> <p>Results</p> <p>Birth rank comparisons revealed that 35% vs 24% of the cases vs the controls were in the third or upper birth rank (<it>P </it>= 0.01). Also, the mean age of fathers at birth in case group (30 ± 6.26 years) was significantly more than the control group (26.45 ± 5.64 years; <it>P </it>= 0.0001). The age of 76 fathers at birth in case group was over 32 versus 33 fathers in control group. Individuals whose fathers' age was more than 32 (at birth) were at higher risk (2.77 times) for schizophrenia versus others (<it>P </it>< 0.0001, 95% CI 1.80 to 4.27). The maternal age at parturition of the case versus controls groups was 26.1 ± 5.41 vs 25.07 ± 4.47 (<it>P </it>= 0.02). Logistic regression analysis suggests that maternal age is less likely to be involved in the higher risk of schizophrenia than advanced parental age.</p> <p>Discussion</p> <p>This study demonstrates a relationship between paternal age and schizophrenia in large families of an Iranian population. Arguments have been put forth that DNA bases changes or epigenetic changes in sperm account for the increased risk associated with older fathers. However, it would not be surprising that both <it>de novo </it>germline mutations and epigenetic changes contribute to disease occurrence because DNA replication and DNA methylation are closely linked at both the macromolecular level (that is, methylation closely follows replication), and at the metabolic level (both processes require folate), and susceptible to modulation by the environment. Further research on samples such as those collected here are needed to sort out the contributions of de novo mutations versus epigenetic changes to schizophrenia.</p

Dvadesettrogodišnji dugoročni ishod na zdravlje djece rođene tijekom rata u Vukovaru

Results of the first research of this kind on the 23-year long-term outcome in children born during the war in Vukovar are presented. This retrospective clinical study surveyed the potential 23-year long-term consequences and morbidity of children born between May 1, 1991 and November 19, 1991, during the siege and occupation of Vukovar. Data were obtained from women having delivered their babies in that period and from delivery protocols of the Department of Gynecology and Obstetrics, Vukovar County Hospital. According to the survey and the data collected, there were 9 (3.98%) preterm deliveries, 60 (81%) of the total of 77 subjects were breastfed, 14 (19%) were not breastfed, while three babies died in the postpartum period. However, the breastfeeding period was evidently shorter, as only 10 women breastfed for a period longer than 6 months, while the mean length of the breastfeeding period was 9.9 weeks, i.e. 2.5 months. Allergyrelated illnesses and proneness to infections in childhood and preschool age were found in 27.3% and 16.9% of children, respectively, while two children developed diabetes type 1. One child had atopic diathesis, two started speaking after the age of two, one child started walking late (after 20 months) and started speaking after the age of two, one child had loud sound phobia, and one used to overreact and express anger in inconvenient situations, all of them being of female gender and born prematurely. Cognitive and attention disorders and stress reactions were found in 6.5% of the children. Regular elementary school education was completed by 74 (96%) children, while three (3.8%) children experienced failure at school due bad behavior, i.e. delinquency. At the age of 23, 34 (46%) children had developed bad habits, i.e. 33 of them smoked, 2 were addicted to alcohol, whereas one was addicted to both smoking and alcohol. Forty (54%) subjects did not use any harmful substances. Psychiatric disorders related to anxiety, depression or other illnesses were not found in this research. In conclusion, it should be noted that pregnant women who gave birth during the study period spent the first trimester of their pregnancy in a relatively peaceful pre-war period without acute stressors, so the long-term results and morbidity actually did not differ from those in the general population. The most important isolated risk factor was premature delivery with the known short-term and long-term consequences typical for premature delivery (perinatal mortality, slow neuromotor and cognitive development).U ovom prvom istraživačkom radu prikazuju se rezultati 23-godišnjega dugoročnog ishoda na zdravlje djece koja su rođena u ratnim uvjetima tijekom okupacije grada Vukovara. U istraživanju je sudjelovalo 77 (34%) žena koje su rodile prema protokolu Ginekološko-porođajnoga odjela vukovarske bolnice od 1. svibnja do 19. studenoga 1991. Od ostalih 149 žena sudbina njih 118 nije poznata (mahom prognanici, izbjeglice, logoraši ili nestali) s nepoznatim boravištima, dok 31 žena nije željela sudjelovati u istraživanju iz osobnih razloga. Prijevremenih porođaja prema anketi i podatcima bilo je 9 (3,98%), od čega je troje djece umrlo nakon porođaja zbog vrlo niske porođajne težine. Dojilo je 60 (81%) žena, 14 (19%) nije dojilo, od kojih tri zbog smrti djeteta u postpartalnom razdoblju. No, duljina dojenja evidentno je bila skraćena, jer je svega 10 žena dojilo >6 mjeseci, a prosječna duljina dojenja bila je 9,9 tjedana, odnosno 2,5 mjeseca. Alergijskih bolesti i sklonosti infekcijama u dječjoj i predškolskoj dobi bilo je u 27,3% odnosno 16,9% djece, dok je dijabetes tipa 1 razvilo dvoje djece. Kognitivne, poremećaje pažnje i reakcije na stres imalo je 6,5% djece ispitanica. Uredno osnovnoškolsko obrazovanje završilo je njih 74 (96%), dok je troje (3,8%) djece imalo školski neuspjeh zbog lošeg ponašanja, odnosno delinkvencije. Štetne navike u 23. godini života imalo je njih 34 (46%) i to pušenje 33, alkohol 2, a pušenje i alkohol jedno, dok 40 (54%) ispitanih nije konzumiralo nikakve štetne tvari. Psihijatrijskih poremećaja u vidu anksioznosti, depresije ili drugih bolesti nije u ovom istraživanju pronađeno. U zaključku, valja naglasiti da su trudnice koje su rodile u ovom razdoblju I. tromjesečje trudnoće provele u relativno predratnom mirnom razdoblju bez akutnih stresora pa dugoročni rezultati i pobol zapravo ne odstupaju od onih u općoj populaciji. Kao najznačajniji izolirani čimbenik rizika bio je prijevremeni porođaj s poznatim kratkoročnim i dugoročnim posljedicama uobičajenim za uranjeno rađanje (perinatalna smrtnost, usporeni neuromotorni i kognitivni razvoj)

The GOAL study: a prospective examination of the impact of factor V Leiden and ABO(H) blood groups on haemorrhagic and thrombotic pregnancy outcomes

Factor V Leiden (FVL) and ABO(H) blood groups are the common influences on haemostasis and retrospective studies have linked FVL with pregnancy complications. However, only one sizeable prospective examination has taken place. As a result, neither the impact of FVL in unselected subjects, any interaction with ABO(H) in pregnancy, nor the utility of screening for FVL is defined. A prospective study of 4250 unselected pregnancies was carried out. A venous thromboembolism (VTE) rate of 1·23/1000 was observed, but no significant association between FVL and pre-eclampsia, intra-uterine growth restriction or pregnancy loss was seen. No influence of FVL and/or ABO(H) on ante-natal bleeding or intra-partum or postpartum haemorrhage was observed. However, FVL was associated with birth-weights &gt;90th centile [odds ratio (OR) 1·81; 95% confidence interval (CI&lt;sub&gt;95&lt;/sub&gt;) 1·04–3·31] and neonatal death (OR 14·79; CI&lt;sub&gt;95&lt;/sub&gt; 2·71–80·74). No association with ABO(H) alone, or any interaction between ABO(H) and FVL was observed. We neither confirmed the protective effect of FVL on pregnancy-related blood loss reported in previous smaller studies, nor did we find the increased risk of some vascular complications reported in retrospective studies

Sexual Dimorphism in Stature (SDS), jealousy and mate retention

Previous research has investigated the manner in which absolute height impacts on jealousy and mate retention. Although relative height is also important, little information exists about the potential influence of sexual dimorphism in stature (SDS) within established relationships. The current study investigated the relationship between SDS and the satisfaction, jealousy and mate retention behaviors reported by men and women. Heterosexual men ( n = 98) and women ( n = 102) completed a questionnaire. Men in high SDS relationships reported the lowest levels of cognitive and behavioral jealousy, although the impact of SDS on relationship satisfaction was less clear. SDS was not associated with the overall use of mate retention strategies; SDS did however affect the use of three specific strategies (vigilance, monopolization of time, love and care). SDS did not affect women's relationship satisfaction, jealousy (cognitive, behavioral, or emotional) or the use of mate retention strategies (with the exception of resource display)