Male Infertility is a Women\u27s Health Issue-Research and Clinical Evaluation of Male Infertility Is Needed

Infertility is a devastating experience for both partners as they try to conceive. Historically, when a couple could not conceive, the woman has carried the stigma of infertility; however, men and women are just as likely to contribute to the couple\u27s infertility. With the development of assisted reproductive technology (ART), the treatment burden for male and unexplained infertility has fallen mainly on women. Equalizing this burden requires reviving research on male infertility to both improve treatment options and enable natural conception. Despite many scientific efforts, infertility in men due to sperm dysfunction is mainly diagnosed by a semen analysis. The semen analysis is limited as it only examines general sperm properties such as concentration, motility, and morphology. A diagnosis of male infertility rarely includes an assessment of internal sperm components such as DNA, which is well documented to have an impact on infertility, or other components such as RNA and centrioles, which are beginning to be adopted. Assessment of these components is not typically included in current diagnostic testing because available treatments are limited. Recent research has expanded our understanding of sperm biology and suggests that these components may also contribute to the failure to achieve pregnancy. Understanding the sperm\u27s internal components, and how they contribute to male infertility, would provide avenues for new therapies that are based on treating men directly for male infertility, which may enable less invasive treatments and even natural conception

Understanding the relationship between the Centers for Medicare and Medicaid Services’ Hospital Compare star rating, surgical case volume, and short‐term outcomes after major cancer surgery

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138844/1/cncr30866.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138844/2/cncr30866_am.pd

The Use of HCG‐Based Combination Therapy for Recovery of Spermatogenesis after Testosterone Use

Introduction and AimAbout 3 million men take testosterone in the United States with many reproductive‐age men unaware of the negative impact of testosterone supplementation on fertility. Addressing this population, we provide an early report on the use of human chorionic gonadotropin (HCG)‐based combination therapy in the treatment of a series of men with likely testosterone‐related azoospermia or severe oligospermia. MethodsWe retrospectively reviewed charts from two tertiary care infertility clinics to identify men presenting with azoospermia or severe oligospermia (<1 million sperm/mL) while taking exogenous testosterone. All were noted to have been placed on combination therapy, which included 3,000 units HCG subcutaneously every other day supplemented with clomiphene citrate, tamoxifen, anastrozole, or recombinant follicle‐stimulating hormone (or combination) according to physician preference.Main Outcome MeasureClinical outcomes, including hormone values, semen analyses, and clinical pregnancies, were tracked. ResultsForty‐nine men were included in this case series. Return of spermatogenesis for azoospermic men or improved counts for men with severe oligospermia was documented in 47 men (95.9%), with one additional man (2.1%) having a documented pregnancy without follow‐up semen analysis. The average time to return of spermatogenesis was 4.6 months with a mean first density of 22.6 million/mL. There was no significant difference in recovery by type of testosterone administered or supplemental therapy. No men stopped HCG or supplemental medications because of adverse events. ConclusionsWe here provide an early report of the feasibility of using combination therapy with HCG and supplemental medications in treating men with testosterone‐related infertility. Future discussion and studies are needed to further characterize this therapeutic approach and document the presumed improved tolerability and speed of recovery compared with unaided withdrawal of exogenous testosterone. Wenker EP, Dupree JM, Langille GM, Kovac J, Ramasamy R, Lamb D, Mills JN, and Lipshultz LI. The use of HCG‐based combination therapy for recovery of spermatogenesis after testosterone use. J Sex Med 2015;12:1334–1337.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111925/1/jsm12890.pd

Sperm centriole assessment identifies male factor infertility in couples with unexplained infertility - a pilot study

Unexplained infertility affects about one-third of infertile couples and is defined as the failure to identify the cause of infertility despite extensive evaluation of the male and female partners. Therefore, there is a need for a multiparametric approach to study sperm function. Recently, we developed a Fluorescence-Based Ratiometric Analysis of Sperm Centrioles (FRAC) assay to determine sperm centriole quality. Here, we perform a pilot study of sperm from 10 fertile men and 10 men in couples with unexplained infertility, using three centriolar biomarkers measured at three sperm locations from two sperm fractions, representing high and low sperm quality. We found that FRAC can identify men from couples with unexplained infertility as the likely source of infertility. Higher quality fractions from 10 fertile individuals were the reference population. All 180 studied FRAC values in the 10 fertile individuals fell within the reference population range. Eleven of the 180 studied FRAC values in the 10 infertile patients were outliers beyond the 95% confidence intervals (P = 0.0008). Three men with unexplained infertility had outlier FRAC values in their higher quality sperm fraction, while four had outlier FRAC values in their lower quality sperm fraction (3/10 and 4/10, P = 0.060 and P = 0.025, respectively), suggesting that these four individuals are infertile due, in part, to centriolar defects. We propose that a larger scale study should be performed to determine the ability of FRAC to identify male factor infertility and its potential contribution to sperm multiparametric analysis

Plasma Dynamics

Contains research objectives and summary of research.U.S. Atomic Energy Commission (Contract AT(11-1)-3070)National Science Foundation (Grant GK-37979X)National Science Foundation (Grant GK-28282X1

Plasma Dynamics

Contains reports on ten research projects split into two sections.National Science Foundation (Grant ENG77-00340)U.S. Department of Energy (Contract EY-76-S-02-2766)U.S. Air Force - Office of Scientific Research (Grant AFOSR-77-3143)U.S. Department of Energy (Contract ET-78-C-01-3019)U.S. Department of Energy (Contract ET-78-S-02-4681)U.S. Department of Energy (Contract ET-78-S-02-4682)U.S. Department of Energy (Grant EG-77-G-01-4107)U.S. Department of Energy (Contract ET-78-S-02-4714)U.S. Department of Energy (Contract ET-78-S-02-4886)U.S. Department of Energy (Contract ET-78-S-02-4690

Plasma Dynamics

Contains reports on ten research projects divided into two sections.National Science Foundation (Grant ENG79-07047)U.S. Air Force - Office of Scientific Research (Grant AFOSR-77-3143)U.S. Department of Energy (Contract DE-ACO2-78ET51013)U.S. Department of Energy (Contract DE-ASO2-78ET53073.AO02)U.S. Department of Energy (Contract ET-78-S-02-4682)U.S. Department of Energy (Contract DE-AS02-78ET53074)U.S. Department of Energy (Contract DE-ASO2-78ET53050)U.S. Department of Energy (Contract DE-AS02-78ET51002)U.S. Department of Energy (Contract DE-ASO2-78ET53076

On Solving the Coronal Heating Problem

This article assesses the current state of understanding of coronal heating, outlines the key elements of a comprehensive strategy for solving the problem, and warns of obstacles that must be overcome along the way.Comment: Accepted by Solar Physics; Published by Solar Physic

Worsening Depressive Symptoms Are Associated With Adverse Clinical Outcomes in Patients With Heart Failure

To assess the impact of changes in symptoms of depression over a 1-year time period on subsequent clinical outcomes in heart failure (HF) patients

Multiple populations in globular clusters. Lessons learned from the Milky Way globular clusters

Recent progress in studies of globular clusters has shown that they are not simple stellar populations, being rather made of multiple generations. Evidence stems both from photometry and spectroscopy. A new paradigm is then arising for the formation of massive star clusters, which includes several episodes of star formation. While this provides an explanation for several features of globular clusters, including the second parameter problem, it also opens new perspectives about the relation between globular clusters and the halo of our Galaxy, and by extension of all populations with a high specific frequency of globular clusters, such as, e.g., giant elliptical galaxies. We review progress in this area, focusing on the most recent studies. Several points remain to be properly understood, in particular those concerning the nature of the polluters producing the abundance pattern in the clusters and the typical timescale, the range of cluster masses where this phenomenon is active, and the relation between globular clusters and other satellites of our Galaxy.Comment: In press (The Astronomy and Astrophysics Review