Is BMI Sufficient to Evaluate the Association between Obesity and Ovarian Reserves?

Body fat content and distribution might have an effect on ovarian reserves. Here, we studied the effects of body fat distribution on the antral follicle count (AFC) of women who consulted for infertility. In this two-center study, the ovarian reserves of patients who came to the hospital for infertility treatment was evaluated based on their AFC and early follicular phase follicle-stimulating hormone (FSH) levels. In addition, adiposity was evaluated using their body mass index (BMI) and waist-to-hip ratios (WHRs), the subcutaneous tissue thickness of the bicipital and tricipital regions, and the body adiposity index (BAI). Body fat distribution was evaluated using bioelectrical impedance analysis (BIA). We evaluated 58 patients in this study. While we failed to show a relationship between BMI and WHR based on the AFC, there was a significant relationship between body fat percentage and the AFC. The AFC in patients with < 35% body fat and ≥ 35% body fat was 11.54 ± 4.27 and 9.00 ± 3.95, respectively (p = 0.029). There was no significant relationship between the AFC and the WHR, BAI, and bicipital and tricipital subcutaneous tissue thickness. BMI may not reflect the adiposity of every patient. When evaluating the ovarian reserves of patients, we must consider other measures of obesity that reflect body fatness. Further large studies must be conducted to investigate the relationship between body fat and infertility

Use of luteal estrogen supplementation in normal responder patients treated with fixed multidose GnRH antagonist: a prospective randomized controlled study

To evaluate the effect of luteal estrogen supplementation on pregnancy rates in normal responder IVF patients treated with recombinant FSH and fixed multidose GnRH antagonist, patients were randomized into two groups to receive vaginal 600 mg/d micronized progesterone for luteal phase supplementation with or without transdermal estrogen supplementation (100 µg/d). Because pregnancy rates and ongoing pregnancy rates were similar with and without estrogen supplementation (50.0% vs. 55.2% and 36.6% vs. 34.4%, respectively), we concluded that luteal estrogen supplementation in fixed multidose GnRH antagonist cycles did not change the pregnancy rates significantly. © 2008 American Society for Reproductive Medicine

Impact of Spinal Cord Injury

Although medical advances have greatly improved the prognosis for people who sustain spinal cord injury, it remains a major social and health-care problem. There are estimated 10,000–12,000 spinal cord injuries every year in the USA alone. More than a quarter of a million Americans are currently living with spinal cord injury, with many millions more worldwide. The cost of managing the care of patients with spinal cord injury is approximately $4 billion per year. The majority of spinal cord injury victims are young adults. Of them, more than 80% are men. As a result, young males constitute the largest part of this patient population. Reproductive function is essential for men with spinal cord injury, but unfortunately, less than 10% of them can father children without medical assistance. Infertility in male patients with spinal cord injury results from a combination of erectile dysfunction, ejaculatory dysfunction, and poor semen quality. As a result of advancements in assisted ejaculation techniques including electroejaculation and high-amplitude penile vibratory stimulation, semen can be safely obtained from nearly all men with spinal cord injury without resorting to surgical procedures; however, semen quality is poor in the majority of cases. Research indicates that inflammation contributes to this problem. Treating abnormal inflammatory processes may hold promise for improving semen quality in men with spinal cord injury