Endometriosis may not be a chronic disease An alternative theory offering more optimistic prospects for our patients

Authors:
Michel Canis, M.D., Ph.D., Nicolas Bourdel, M.D., Céline Houlle, M.D., Anne Sophie Gremeau, M.D., Revaz Botchorishvili, M.D., Sachiko Matsuzaki, M.D.

Volume 105, Issue 1, Pages 32-34

Abstract:

For more than a century, endometriosis has been described as unexplained, poorly understood, or enigmatic. As a result treatments are not based on the pathophysiology of the disease, which consequently cannot be cured effectively, meaning that the symptoms, which have major consequences on women’s quality of life, will almost inevitably recur. Such pessimistic perspectives have devastating consequences, particularly on the results of treatments for chronic pelvic pain. All the mechanisms proposed, whether retrograde menstruation, metaplasia, lymphatic and vascular metastasis, embryology, stem cells, and müllerianosis, may occur in all women.

Relationship between sperm aneuploidy sperm DNA integrity chromatin packaging traditional semen parameters and recurrent pregnancy loss

Capsule:
The increase in abnormal sperm parameters, sperm DNA fragmentation, chromatin decondensation, and aneuploidy suggest possible causes of unexplained recurrent pregnancy loss, which encourage the screening of both partners simultaneously.

Authors:
Ines Zidi-Jrah, M.D., Amani Hajlaoui, M.Sc., Soumaya Mougou-Zrelli, M.D., Ph.D., Molka Kammoun, M.D., Imene Meniaoui, M.D., Amira Sallem, M.D., Sonia Brahem, Ph.D., Meriem Fekih, M.D., Mohammed Bibi, M.D., Ali Saad, M.D., Ph.D., Samira Ibala-Romdhane, M.D., Ph.D.

Volume 105, Issue 1, Pages 58-64

Abstract:

Objective:
To study the possible relationship between sperm aneuploidy, sperm DNA integrity, chromatin packaging, traditional semen parameters, and recurrent pregnancy loss (RPL).

Design:
Descriptive study.

Setting:
University-affiliated tertiary teaching hospital, cytogenetic and reproductive biology department.

Patient(s):
A total of 22 couples with history of RPL and 20 fertile men.

Intervention(s):
Semen samples from case and control men were examined for differences in semen parameters, DNA fragmentation, chromatin condensation, and sperm aneuploidy.

Main Outcome Measure(s):
Sperm DNA and chromatin integrity and sperm aneuploidy.

Result(s):
Sperm progressive motility (30.2% vs. 51.5%) was significantly lower and abnormal morphology (74.8% vs. 54.2%) was significantly higher in the RPL group versus the control group, respectively. The percentage of fragmented DNA was significantly increased in the RPL group (17.1% vs. 10.2%) as well as the rate of spermatozoa with nuclear chromatin decondensation (23.6% vs. 11.8%). There was a significantly higher sperm aneuploidy rate among the RPL group as well.

Conclusion(s):
The increase in abnormal sperm parameters, sperm DNA fragmentation, nuclear chromatin decondensation, and sperm aneuploidy suggest possible causes of unexplained RPL.

Microdose flare protocol with interrupted follicle stimulating hormone and added androgen for poor responders An observational pilot study

Capsule:
The androgen–interrupted follicle stimulating hormone protocol may improve follicular response during a microdose flare stimulation cycle in women with slow follicular growth or asynchronous follicular development.

Authors:
Frederic Mitri, M.D., Lucy Ann Behan, M.D., Courtney A. Murphy, B.H.Sc., Anat Hershko-Klement, M.D., Robert F. Casper, M.D., Yaakov Bentov, M.D., M.Sc.

Volume 105, Issue 1, Pages 100-105

Abstract:

Objective:
To investigate whether temporarily withholding FSH and adding androgen could improve follicular response during a microdose flare protocol in women with slow follicular growth or asynchronous follicular development.

Design:
Observational pilot study.

Setting:
University-affiliated private fertility center.

Patient(s):
Twenty-six women aged 34–47 years with poor response to stimulation or a previous cancelled IVF cycle and with slow or asynchronous follicular growth during a microdose flare cycle.

Intervention(s):
For 13 women, after initiation of ovarian stimulation using the microdose flare protocol, gonadotropin administration was interrupted and transdermal testosterone gel was added for several days (4.4 ± 1.2 d) starting after cycle day 7 (mean cycle day 10 ± 2.6).

Main Outcome Measure(s):
FSH, E2, follicular growth, and total number of mature oocytes retrieved were determined for all of the patients. Cycle cancellation rate as well as pregnancy rate following embryo transfer were also documented when applicable.

Result(s):
FSH levels declined (25.2 ± 6.5 to 6.8 ± 3.2 IU/L), E2 levels increased (896 ± 687 to 2,163 ± 1,667 pmol/L), and follicular growth improved significantly during gonadotropin interruption and were tracked for 2 days during this time frame. The average number of oocytes retrieved was 5.3 ± 2.6, and the ratio of mature to total oocytes was 4:5. Four of the 13 women in the interruption group became pregnant following frozen embryo transfer, whereas none in the control group did.

Conclusion(s):
The androgen–interrupted FSH protocol may improve follicular response to gonadotropins in cycles that might otherwise be cancelled.

Articles of Special Interest

Endometriosis may not be a chronic disease An alternative theory offering more optimistic prospects for our patients

Tuesday, December 29, 2015

Authors:
Michel Canis, M.D., Ph.D., Nicolas Bourdel, M.D., Céline Houlle, M.D., Anne Sophie Gremeau, M.D., Revaz Botchorishvili, M.D., Sachiko Matsuzaki, M.D.…

Relationship between sperm aneuploidy sperm DNA integrity chromatin packaging traditional semen parameters and recurrent pregnancy loss

Tuesday, December 29, 2015
The increase in abnormal sperm parameters, sperm DNA fragmentation, chromatin decondensation, and aneuploidy suggest possible causes of unexplained recurrent pregnancy loss, which encourage the screening of both partners simultaneously.

Microdose flare protocol with interrupted follicle stimulating hormone and added androgen for poor responders An observational pilot study

Tuesday, December 29, 2015
The androgen–interrupted follicle stimulating hormone protocol may improve follicular response during a microdose flare stimulation cycle in women with slow follicular growth or asynchronous follicular development.

Spontaneous fertility and IVF outcome The new evidence of HPV sperm infection

Tuesday, December 29, 2015
This clinical study demonstrates a significant association between HPV sperm infection, reduced pregnancy rates, and higher miscarriage rates in couples undergoing assisted reproduction.
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