In The Name Of God
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L. Simon1, K. Murphy1, M.B. Shamsi1, L. Liu1, B. Emery1, K.I. Aston1, J. Hotaling1 and D.T. Carrell1,2,3,*1Andrology and IVF Laboratory, Department of Surgery (Urology), University of Utah, Salt Lake City, UT 84108, USA 2Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84108, USA 3Department of Human Genetics, University of Utah, Salt Lake City, UT 84108, USA /July 18, 2014.
STUDY QUESTION Does sperm DNA damage affect early embryonic development?
SUMMARY ANSWER Increased sperm DNA damage adversely affects embryo quality starting at Day 2 of early embryonic development and continuing after embryo transfer, resulting in reduced implantation rates and pregnancy outcomes.
WHAT IS KNOWN ALREADY Abnormalities in the sperm DNA in the form of single and double strand breaks can be assessed by an alkaline Comet assay. Some prior studies have shown a strong paternal effect of sperm DNA damage on IVF outcome, including reduced fertilization, reduced embryo quality and cleavage rates, reduced numbers of embryos developing into blastocysts, increased percentage of embryos undergoing developmental arrest, and reduced implantation and pregnancy rates.
STUDY DESIGN, SIZE, DURATION A cross-sectional study of 215 men from infertile couples undergoing assisted reproduction techniques at the University of Utah Center for Reproductive Medicine.
PARTICIPANTS/MATERIALS, SETTING, METHODS Sperm from men undergoing ART were analyzed for DNA damage using an alkaline Comet assay and classified into three groups: ‘low damage’ (0–30%), ‘intermediate damage’ (31–70%) and ‘high damage’ (71–100%). The cause of couples' infertility was categorized into one of the three types (male, female or unexplained). Each embryo was categorized as ‘good’, ‘fair’ or ‘poor’ quality, based on the number and grade of blastomeres. The influence of sperm DNA damage on early embryonic development was observed and classified into four stages: peri-fertilization effect (fertilization rate), early paternal effect (embryonic days 1–2), late paternal effect (embryonic days 3–5) and implantation stage effect.
MAIN RESULTS AND THE ROLE OF CHANCE The paternal effect of sperm DNA damage was observed at each stage of early embryonic development. The peri-fertilization effect was higher in oocytes from patients with female infertility (20.85%) compared with male (8.22%; P < 0.001) and unexplained (7.30%; P < 0.001) infertility factors. In both the early and late paternal effect stages, the low DNA damage group had a higher percentage of good quality embryos (P < 0.05) and lower percentage of poor quality embryos (P < 0.05) compared with the high DNA damage group. Implantation was lower in the high DNA damage (33.33%) compared with intermediate DNA damage (55.26%; P < 0.001) and low DNA damage (65.00%; P < 0.001) groups. The implantation rate was higher following blastocyst transfer (58.33%), when compared with early stage blastocyst (53.85%; P = 0.554) and cavitating morula transfers (34.40%; P < 0.001). Implantation was higher when the female partner age was ≤35 years when compared with >35 year age group (52.75 versus 35.44%; P = 0.008).
LIMITATIONS, REASONS FOR CAUTION A potential limitation of this study is that it is cross-sectional. Generally in such studies more than one variable could affect the outcome. Analyzing sperm is one part of the equation but a number of environmental and female factors also have the potential to influence embryo development and implantation. Furthermore, the selection of morphologically normal and physiologically motile sperm may result in isolation of sperm with reduced DNA damage. Therefore, selecting the best available sperm for ICSI may lead to experimental bias, as the selected sperm do not represent the overall sperm population in which the DNA damage is measured. Similar studies on selected sperm and with a larger sample size are now required.
WIDER IMPLICATIONS OF THE FINDINGS The paternal influence of damaged chromatin is more prominent after zygotic transcriptional activation. A prolonged paternal effect on the developing embryo may be due to the active repair mechanism present in oocytes that tends to overcome the damaged paternal chromatin. The probability of eliminating an embryo fertilized by a sperm with damaged DNA is higher at the blastocyst stage than the cleavage stage; therefore blastocyst transfer could be recommended for better implantation success. Finally, we recommend ICSI treatment for patients with a higher percentage of sperm with DNA damage as well as additional studies with a larger sample size aimed at assessing DNA damage analysis as a diagnostic tool for IVF.
STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the University of Utah internal funds. The authors declare no competing interests.
Source:Human Reproduction 2014
STUDY QUESTION How are protamine deficiencies associated with sperm head morphology in subfertile men?
SUMMARY ANSWER The prevalence of morphological variations and large nuclear vacuoles was slightly higher in protamine-deficient spermatozoa than in non-deficient spermatozoa.
WHAT IS KNOWN ALREADY A protamine deficiency was previously reported to be associated with an abnormal sperm morphology; however, how they are related to each other remains unclear. This is further confounded by a number of protamine-deficient spermatozoa having a normal head morphology.
STUDY DESIGN, SIZE, DURATION This is a cross-sectional study, including 36 men diagnosed with male factor infertility or participating in an assisted reproduction program. To assess sperm head morphology, this study analyzed 2400 spermatozoa with a protamine deficiency and 2400 spermatozoa with a normal protamine status. An additional 21 men were analyzed to examine DNA fragmentation and its relationship with protamine deficiencies and sperm head morphologies.
PARTICIPANTS/MATERIALS, SETTING, METHODS The morphology of the sperm head was evaluated based on its shape, size and nuclear vacuoles at a magnification of >6000×. Using elliptic Fourier analysis, the shape was summarized into four numeric variables. The protamine status was evaluated with chromomycin A3 (CMA3). Sperm head size, vacuoles and shape were compared between protamine-deficient and non-deficient spermatozoa. DNA fragmentation was evaluated with the terminal deoxynucleotidyltransferase-mediated dUTP nick-end labeling (TUNEL) assay. The percentages of protamine-deficient spermatozoa and DNA fragmentation were compared between spermatozoa with morphologically normal heads and those with abnormal heads.
MAIN RESULTS AND THE ROLE OF CHANCE Variations in head size (P < 0.0001) and shape (P < 0.0001) were significantly higher, with narrower (P < 0.001), more fan-shaped (P < 0.01) and more square-shaped forms (P < 0.001) in protamine-deficient spermatozoa than in non-deficient spermatozoa; however, the distribution of morphological variations markedly overlapped. Protamine deficiencies were more frequently observed in spermatozoa with large nuclear vacuoles than in those without them (32.0 ± 3.1 versus 39.4 ± 2.9%, P < 0.001). The percentage of protamine-deficient spermatozoa was significantly lower in spermatozoa with a normal head morphology than in those with an abnormal head morphology (25.4 ± 2.6 versus 38.0 ± 2.5%, P < 0.001). The percentage of DNA fragmentation was significantly higher in protamine-deficient spermatozoa than in non-deficient spermatozoa (11.3 ± 2.1 versus 1.6 ± 0.6%, P < 0.001), and was lower in spermatozoa with a normal head morphology than in those with an abnormal head morphology (2.6 ± 0.7 versus 6.4 ± 0.2%, P < 0.001).
LIMITATIONS, REASONS FOR CAUTION We were unable to discriminate the kind of protamines or quantify the extent of the protamine deficiency in spermatozoa using the CMA3 staining method.
WIDER IMPLICATIONS OF THE FINDINGS This study provided a novel insight into how abnormal protamination affects sperm head morphology as well as the relationship between sperm head morphology and its own molecular integrity. Our results will contribute to a deeper understanding of the benefits and limitations of the morphological selection of spermatozoa for ICSI.
STUDY FUNDING/COMPETING INTEREST(S) This study was supported by a JSPS Grant-in-Aid for the Encouragement of Scientists (25931009, 26931010). All authors have no conflicts of interest to disclose.
Source:Human Reproduction 2014
4 Direct comparison of targeted MRI-guided biopsy with systematic transrectal ultrasound-guided biopsy in patients with previous negative prostate biopsies Urologia Internationalis, September 19, 2014
7 Correlation of quantitative diffusion-weighted and dynamic contrast-enhanced MRI parameters with prognostic factors in prostate cancer Journal of Medical Imaging and Radiation Oncology, September 19, 2014
Rebecca Smith-Bindman, M.D., Chandra Aubin, M.D., R.D.M.S., John Bailitz, M.D., Rimon N. Bengiamin, M.D., R.D.M.S., Carlos A. Camargo, Jr., M.D., Dr.P.H., Jill Corbo, M.D., R.D.M.S., Anthony J. Dean, M.D., Ruth B. Goldstein, M.D., Richard T. Griffey, M.D., M.P.H., Gregory D. Jay, M.D., Ph.D., Tarina L. Kang, M.D., Dana R. Kriesel, M.P.H., M.S., O. John Ma, M.D., Michael Mallin, M.D., William Manson, M.D., Joy Melnikow, M.D., M.P.H., Diana L. Miglioretti, Ph.D., Sara K. Miller, M.D., R.D.M.S., Lisa D. Mills, M.D., James R. Miner, M.D., Michelle Moghadassi, M.P.H., Vicki E. Noble, M.D., Gregory M. Press, M.D., Marshall L. Stoller, M.D., Victoria E. Valencia, M.P.H., Jessica Wang, M.D., Ralph C. Wang, M.D., and Steven R. Cummings, M.D.
N Engl J Med 2014; 371:1100-1110September 18, 2014DOI: 10.1056/NEJMoa1404446
In this multicenter, pragmatic, comparative effectiveness trial, we randomly assigned patients 18 to 76 years of age who presented to the emergency department with suspected nephrolithiasis to undergo initial diagnostic ultrasonography performed by an emergency physician (point-of-care ultrasonography), ultrasonography performed by a radiologist (radiology ultrasonography), or abdominal CT. Subsequent management, including additional imaging, was at the discretion of the physician. We compared the three groups with respect to the 30-day incidence of high-risk diagnoses with complications that could be related to missed or delayed diagnosis and the 6-month cumulative radiation exposure. Secondary outcomes were serious adverse events, related serious adverse events (deemed attributable to study participation), pain (assessed on an 11-point visual-analogue scale, with higher scores indicating more severe pain), return emergency department visits, hospitalizations, and diagnostic accuracy.
A total of 2759 patients underwent randomization: 908 to point-of-care ultrasonography, 893 to radiology ultrasonography, and 958 to CT. The incidence of high-risk diagnoses with complications in the first 30 days was low (0.4%) and did not vary according to imaging method. The mean 6-month cumulative radiation exposure was significantly lower in the ultrasonography groups than in the CT group (P<0.001). Serious adverse events occurred in 12.4% of the patients assigned to point-of-care ultrasonography, 10.8% of those assigned to radiology ultrasonography, and 11.2% of those assigned to CT (P=0.50). Related adverse events were infrequent (incidence, 0.4%) and similar across groups. By 7 days, the average pain score was 2.0 in each group (P=0.84). Return emergency department visits, hospitalizations, and diagnostic accuracy did not differ significantly among the groups.
Initial ultrasonography was associated with lower cumulative radiation exposure than initial CT, without significant differences in high-risk diagnoses with complications, serious adverse events, pain scores, return emergency department visits, or hospitalizations. (Funded by the Agency for Healthcare Research and Quality.)
Source:The New England Journal of Medicine Sep.18,2014
Urology news Sep.18,2014
R. Boguen1, P. Uribe1, F. Treulen1 andJ. V. Villegas1,2,*30 SEP2014/DOI: 10.1111/and.12167AndrologiaVolume 46, Issue 8, pages 943–947, October 2014
Sperm motility and vitality are decreased in male genital tract infection. Uropathogenic Escherichia coli (UPEC) are frequently associated with sperm parameter loss, but there are no reports to date regarding the effects of different E. coli isolates on human spermatozoa.
The aim of this work was to compare the effect in vitro of different E. coli isolates on human sperm parameters. Normal spermatozoa were incubated with E. coli isolated from nine men with urinary tract infection. After 1 h of incubation, sperm motility, vitality and mitochondrial membrane potential (ΔΨm) were measured.
The E. coli isolates were serotyped with specific antisera. Sperm motility was decreased with five of nine E. coli isolates. Two UPEC were typed as O6 strains, and they did not decrease sperm motility in the same experimental conditions as the other five isolates, despite the described high pathogenicity of the O6 strain in urogenital infections. Neither UPEC analysed affected vitality or ΔΨm.
UPEC isolates were shown to be heterogeneous in their effects, suggesting the need to characterise the pattern defining the pathogenicity of E. coli on human spermatozoa.
رابطه بین غلظت سرب وکادمیم با کیفیت اسپرم
N. Pant1,*, G. Kumar2, A. D. Upadhyay3, Y. K. Gupta2 andP. K. Chaturvedi1/16 SEP 2014DOI: 10.1111/and.12342© 2014 Blackwell Verlag GmbH/Andrologia
There are contrary reports of association of lead and cadmium with the decline in semen quality. This study evaluates whether seminal lead (Pb) and cadmium (Cd) at environmental concentration are associated with altered semen quality.
We conducted a study of healthy fertile and infertile men 20–43 years of age attending the Andrology Laboratory of Reproductive Biology Department for semen analysis. The semen analysis was carried out according to the WHO 2010 guidelines. Seminal lead and cadmium were estimated by ICP-AES. The lead and cadmium values were significantly higher in infertile subjects. A negative association between seminal lead or cadmium concentration and sperm concentration, sperm motility and per cent abnormal spermatozoa was found.
This study shows that exposure to Pb (5.29–7.25 μg dl−1) and cadmium (4.07–5.92 μg dl−1) might affect semen profile in men. Age, diet, smoking and tobacco chewing habits may have an influence on the increase in exposure to Pb and Cd in the individual subjects.
N. Pant, G. Kumar, A. D. Upadhyay, Y. K. Gupta and P. K. Chaturvedi
Article first published online: 16 SEP 2014 | DOI: 10.1111/and.12342
N. delli Muti, G. Tirabassi, G. R. Lamonica, A. Lenzi and G. Balercia
Article first published online: 16 SEP 2014 | DOI: 10.1111/and.12339
J. Krebs, K. Göcking and J. Pannek
Article first published online: 16 SEP 2014 | DOI: 10.1111/and.12334
R. B. Abdellatief, D. A. Elgamal and E. E. M. Mohamed
Article first published online: 16 SEP 2014 | DOI: 10.1111/and.12316
F. Boitrelle, M. Pagnier, Y. Athiel, N. Swierkowski-Blanchard, A. Torre, L. Alter, C. Muratorio, F. Vialard, M. Albert and J. Selva
Article first published online: 15 SEP 2014 | DOI: 10.1111/and.12341
J. R. Kovac, J. Scovell, R. Ramasamy, S. Rajanahally, R. M. Coward, R. P. Smith and L. I. Lipshultz
Article first published online: 15 SEP 2014 | DOI: 10.1111/and.12340
M. Zubair, M. Ahmad and H. Jamil
Article first published online: 15 SEP 2014 | DOI: 10.1111/and.12335
M. E. Asker, W. A. Hassan and A. M. El-Kashlan
Article first published online: 13 SEP 2014 | DOI: 10.1111/and.12312
J. Chen, Z. Hu, L. Zhuan, H. Xiao, Y. Zhang and J. Yang
Article first published online: 13 SEP 2014 | DOI: 10.1111/and.12323
A. D. Esterhuizen, D. R. Franken, E. Bosman, F. A. Rodrigues, J. H. Van Rensburg, J. A. M. Van Schouwenburg and C. Lombaard
Article first published online: 13 SEP 2014 | DOI: 10.1111/and.12326
W.-J. Zhu and J. Li
Article first published online: 13 SEP 2014 | DOI: 10.1111/and.12328
K. Kaya, O. Ciftci, A. Cetin, H. Doğan and N. Başak
Article first published online: 13 SEP 2014 | DOI: 10.1111/and.12332
T. Degheidy, H. Abdelfattah, A. Seif, F. K. Albuz, S. Gazi and S. Abbas
Article first published online: 11 SEP 2014 | DOI: 10.1111/and.12343
E. Filipiak, K. Marchlewska, E. Oszukowska, R. Walczak-Jedrzejowska, A. Swierczynska-Cieplucha, K. Kula and J. Slowikowska-Hilczer
Article first published online: 11 SEP 2014 | DOI: 10.1111/and.12338
T. Mirzapour, M. Movahedin, M. Koruji and M. R. Nowroozi
Article first published online: 11 SEP 2014 | DOI: 10.1111/and.12310
3 Adult physical, sexual, and emotional abuse and postpartum depression, a population based, prospective study of 53,065 women in the Norwegian Mother and Child Cohort Study Full Text BMC Pregnancy and Childbirth, September 18, 2014
5 Socioeconomic disparities in prepregnancy BMI and impact on maternal and neonatal outcomes and postpartum weight retention: The EFHL longitudinal birth cohort study Full Text BMC Pregnancy and Childbirth, September 18, 2014
8 Hemodynamic and metabolic effects of estrogen plus progestin therapy in hypertensive postmenopausal women treated with an ACE-inhibitor or a diuretic Clinical Research in Cardiology, September 18, 2014
11 Improving women's diet quality preconceptionally and during gestation: effects on birth weight and prevalence of low birth weight—a randomized controlled efficacy trial in India (Mumbai Maternal Nutrition Project) American Journal of Clinical Nutrition, September 18, 2014
Sep. 17, 2014 — 23 new regions of the genome have been discovered that influence the risk for developing prostate cancer, according to a study. Prostate cancer is the most common non-skin cancer in American men. ..
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Sep. 16, 2014 — A comparison of five-year sexual function outcomes, as reported by patients treated with external beam radiotherapy (EBRT) versus combination EBRT plus brachytherapy, indicates that the utilization ...
Sep. 16, 2014 — Prostate cancer patients who receive high-dose radiation therapy (HDRT) followed by a longer period of hormone suppression therapy, or androgen deprivation therapy (ADT), have higher five-year ...
Sep. 15, 2014 — A new, large cohort analysis from the prospective Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, indicates that men who had moderate baldness affecting both the front and the ...
Sep. 15, 2014 — High-risk prostate cancer patients who receive radiation therapy (RT) and an 18-month course of androgen deprivation therapy (ADT) recover a normal testosterone level in a shorter amount of time ...