Differences in the Central Neural Activation under Emotional Stress across the Menstrual Cycle

The present study had several goals. First, we aimed to investigate the potential differences in the activation of the corticolimbic structures during emotional stress in healthy women across the menstrual cycle using stress imagery. Second, we searched for differences in the subjective anxiety under emotional stress across the menstrual cycle and tried to correlate the perceived level of anxiety to activation of the specific corticolimbic structures. Third, we attempted to compare central neural activation of women in follicular and in luteal phases of the menstrual cycle separately to that of men during emotional stress to investigate potential differences in neural response. We used perfusion based functional magnetic resonance imaging (MRI) and blood oxygen level dependent (BOLD) contrast to measure cerebral blood flow response to the emotional stress using stress imagery in 29 healthy volunteers (9 women in follicular phase, 10 women in luteal phase, and 10 men). Cycle-dependent comparison of the stress response in women revealed that women in the follicular phase had greater activation in the areas of the ventro-medial prefrontal cortex (VMPFC), with levels of activation comparable to those of men, and anterior insula, while women in the luteal phase of their menstrual cycle demonstrated increase blood flow in the areas of the anterior cingulate and hippocampus at P = 0.01. Males showed overall greater degree of corticolimbic activation, specifically in the bilateral hippocampi and right prefrontal cortex regardless of which group of women they were compared to. When compared to women in different phases of the menstrual cycle specifically, men showed greater cerebral blood flow in bilateral cingulate cortices and right hippocampus compared to women in the follicular phase, and bilateral striatum, amygdala, bilateral hippocampi when compared to women in the luteal phase. We did not observe different levels of self-reported anxiety during stress imagery across the menstrual cycle, however, women in their luteal phase showed a positive correlation of the self-reported anxiety levels and cerebral blood flow in the posterior insula at the threshold level of P = 0.05. The results of our study are consistent with the previously available information regarding the differences in the corticolimbic activation across the menstrual cycle in women and in women vs. men. In addition to that, our data supports the correlation of the levels of anxiety and insular activation in the luteal phase of the menstrual cycle and could represent an initial step in uncovering the mechanisms regulating stress response, anxiety and their relation to the hormonal status

Sperm DNA fragmentation: A new guideline for clinicians

Sperm DNA integrity is crucial for fertilization and development of healthy offspring. The spermatozoon undergoes extensive molecular remodeling of its nucleus during later phases of spermatogenesis, which imparts compaction and protects the genetic content. Testicular (defective maturation and abortive apoptosis) and post-testicular (oxidative stress) mechanisms are implicated in the etiology of sperm DNA fragmentation (SDF), which affects both natural and assisted reproduction. Several clinical and environmental factors are known to negatively impact sperm DNA integrity. An increasing number of reports emphasizes the direct relationship between sperm DNA damage and male infertility. Currently, several assays are available to assess sperm DNA damage, however, routine assessment of SDF in clinical practice is not recommended by professional organizations

Predictors of sperm recovery after cryopreservation in testicular cancer

Our objective was to identify predictors of improved postthaw semen quality in men with testicular cancer banking sperm for fertility preservation. We reviewed 173 individual semen samples provided by 67 men with testicular germ cell tumor (TGCT) who cryopreserved sperm before gonadotoxic treatment between 1994 and 2010 at our tertiary university medical center. Our main outcomes measures were independent predictors for the greater postthaw total motile count (TMC) in men with TGCT. Men with NSGCT were more likely to be younger (P median fresh TMC each had increased odds of a postthaw TMC greater than median postthaw TMC. Interestingly, age, advanced cancer stage (II or III), rapid freezing protocol, and motility enhancer did not show increased odds of improved postthaw TMC in our models. In conclusion, men with TGCT or poor fresh TMC should consider preserving additional vials (at least 15 vials) before oncologic treatment. Density gradient purification should be routinely used to optimize postthaw TMC in men with TGCT. Larger, randomized studies evaluating cancer stage and various cryopreservation techniques are needed to assist in counseling men with TGCT regarding fertility preservation and optimizing cryosurvival

Prevalence of low testosterone and predisposing risk factors in men with type 1 diabetes mellitus: Findings from the DCCT/EDIC

Conclusion: The men with T1DM in the EDIC cohort do not appear to have a high prevalence of androgen deficiency. Risk factors associated with low testosterone levels in this population are similar to the general population

Predictors of sperm recovery after cryopreservation in testicular cancer

Our objective was to identify predictors of improved postthaw semen quality in men with testicular cancer banking sperm for fertility preservation. We reviewed 173 individual semen samples provided by 67 men with testicular germ cell tumor (TGCT) who cryopreserved sperm before gonadotoxic treatment between 1994 and 2010 at our tertiary university medical center. Our main outcomes measures were independent predictors for the greater postthaw total motile count (TMC) in men with TGCT. Men with NSGCT were more likely to be younger (P median fresh TMC each had increased odds of a postthaw TMC greater than median postthaw TMC. Interestingly, age, advanced cancer stage (II or III), rapid freezing protocol, and motility enhancer did not show increased odds of improved postthaw TMC in our models. In conclusion, men with TGCT or poor fresh TMC should consider preserving additional vials (at least 15 vials) before oncologic treatment. Density gradient purification should be routinely used to optimize postthaw TMC in men with TGCT. Larger, randomized studies evaluating cancer stage and various cryopreservation techniques are needed to assist in counseling men with TGCT regarding fertility preservation and optimizing cryosurvival