HLA sharing in Italian recurrent abortion couples

We performed HLA typing in 96 couples affected by recurrent abortion "sine causa". We matched these patients with 124 fertile couples and 204 individuals random paired. No significant difference in HLA sharing was demonstrated in the three study groups. The statistical analysis denoted significant differences in regard to HLA A3, A24, B12, and DR- comparing patients and normal members of fertile couples. The frequencies of HLA Cw5, Cw6 and DR2 were different in patients when compared with their partners.     

Subjective well-being in infertile couples

The subjective well-being of infertile couples is affected by numerous variables. One hundred and ten infertile couples were investigated using the von Zerssen symptom checklist. With the exception of sterile women of fertile men (group 1: female infertility), women and men in the overall randomized sample and the diagnostic groups (group 2: subfertility of the man; group 3: sterility of both partners; group 4: idiopathic sterility) report fewer general symptoms than the overall population of patients with somatic and psychiatric diseases. Subfertile men show lower rating in the symptom checklist than the norm. Involuntarily childless women express more symptoms than their partners.     

Subjective well-being in infertile couples

The subjective well-being of infertile couples is affected by numerous variables. One hundred and ten infertile couples were investigated using the von Zerssen symptom checklist. With the exception of sterile women of fertile men (group 1: female infertility), women and men in the overall randomized sample and the diagnostic groups (group 2: subfertility of the man; group 3: sterility of both partners; group 4: idiopathic sterility) report fewer general symptoms than the overall population of patients with somatic and psychiatric diseases. Subfertile men show lower rating in the symptom checklist than the norm. Involuntarily childless women express more symptoms than their partners.     

Personality traits of men with Klinefelter syndrome and their partners

The aim of the study was to find whether personality traits of men with Klinefelter syndrome and their partners (group 1-n = 17) differ from those of couples affected by idiopathic infertility (group 2; n = 16) and from those of fertile couples (group 3 n = 17). We further investigated the attitudes of the three groups towards pregnancy, labour and sexuality to find potential différences among the three groups. Besides, we verified the hypotheses of below average or low average intelligence of men with Klinefelter syndrome, and of inferior quality of social life in these men. The data were collected using the interview on medical history, the questionnaire on attitudes towards pregnancy, labour and sexuality (S-S-G), the personality questionnaire MMPI-2. The Raven progressive matrices were used only in group 1. The results show that men with Klinefelter syndrome and their partners do not differ significantly from the couples with idiopathic infertility (group 2), having some shizoide traits in their personality structure and mostly negative attitudes towards pregnancy, labour and sexuality. However, a significant difference has been found between the Klinefelter syndrome group and the fertile couples group. The hypothesis of below average intelligence has not been confirmed, but the quality of social life of men with Klinefelter syndrome has been found inférior. We may thus conclude that in the management of infertile couples in whom the man has been affected by Klinefelter syndrome, the personality structure, importantly affecting the outcome of treatment, should be taken into consideration.     

Coping with male infertility. Gender differences

Infertility is a stressor that affects the infertile couple. Coping of infertile couples with the unfulfilled desire for a child is affected by numerous variables. Depending on the diagnose is the patients were assigned to four groups: Group 1: female infertility (infertile women of fertile men), Group 2: infertility of the men, Group 3: infertility of both partners, Group 4: idiopathic sterility). One hundred and ten infertile couples were investigated with the Freiburg questionnaire of Coping with Illness. Compared to their partners, the women of infertile couples report a higher feature rating in the cales ”depressional coping” and ”self-distraction and self-stabilisation”. Women of infertile couples show lower feature ratings compared to the standardised collective of patients with chronic somatic disease only on the scale ”religiousness and search for meaning”. Involuntarily childless men activate all coping strategies to a smaller extent than the reference sample. The experience of infertility is greatly affected by gender and the associated role expectations. Received: 12 March 2001 / Accepted: 16 March 2001     

正常和不育男性血清及精浆Ig、补体水平的观察比较

IgG是精浆中正常存在的成份,而IgA并不常见。正常男性中精浆1gM和补体C_3、补体C_4的检出率很低或不能被检出。关于不育男性血清和精浆中Ig和补体的水平,以往报道不一。本文对循环抗精子抗体(A8Ab)阴性和阳性的不育男性以及正常男性血清和精浆中Ig、补体水平进行了观察,就循环抗精子抗体(简称精抗)的出现与精浆Ig、补体水平间的关系作了简要讨论。     

Quality of life and sexual functioning of Polish infertile couples

Objectives To evaluate the influence of infertility on the quality of life (QoL) and sexual functioning of infertile couples.

Methods The research group consisted of 206 infertile couples and the control group of 190 fertile couples. A specific questionnaire was used as a research tool. It gathered information about socio-demographic features and infertility status, and included validated scales: Short Form-36 Health Survey, Female Sexual Function Index and International Index of Erectile Function.

Results The QoL parameters in all categories were generally lower for infertile women than for those of the control group. Clinical sexual dysfunctions were not significantly more common among infertile than fertile women (17.5% versus 12.1%, p = 0.13). Clinically relevant erectile dysfunctions were diagnosed in 23.9% of infertile men and in 13.7% of the controls. Male infertility had the most significant negative effect on men's sexual functioning.

Conclusions The risk groups for decreased QoL are infertile women and older subjects with lower education and occupationally inactive. Clinically relevant sexual disorders in the infertile population most frequently affect older men, with a lower educational level and with previously diagnosed male infertility.     

The prevalence, risks, and management of Chlamydia trachomatis infections in fertile and infertile patients from the high socioeconomic bracket of the South African population

OBJECTIVE: The main objective of the study was to evaluate the prevalence of Chlamydia trachomatis endocervicitis in an infertile population. DESIGN: Forty consecutive patients were enrolled in the study group and 41 in the control group. SETTING: The study was undertaken in the Department of Obstetrics and Gynaecology of the University of the Orange Free State, Bloemfontein, Republic of South Africa. PATIENTS: Infertile white females, visiting an infertility clinic in an academic hospital and fertile white female patients visiting an antenatal clinic. INTERVENTIONS: Endocervical swabs were taken, and monoclonal direct immunofluorescence for C. Trachomatis were done on each. MAIN OUTCOME MEASURES: A difference was expected between the prevalence of C. trachomatis infection in the fertile and infertile population. RESULTS: In the study group, 14(35.9%) positive, 25(64.1%) negative, and 1 fallout were obtained. In the control group, 3 patients (7.32%) tested positive. CONCLUSION: Although no correlation was found between C. trachomatis infection of the female genital tract and the clinical history, it showed a significant correlation with infertility. This justifies routine screening tests and antibiotic treatment of positive infertile couples. Analysis of cost-effectiveness showed that empirical treatment of new infertile couples is justified in some populations.     

Histological dating of timed endometrial biopsy tissue is not related to fertility status

OBJECTIVE: To assess the ability of histological dating to discriminate between women of fertile and infertile couples. The utility of histological dating of endometrium in the evaluation of infertile couples is uncertain. DESIGN: Prospective multicenter study, with subjects randomly assigned to biopsy timing. Criterion standard for infertility was 12 months of unprotected, regular intercourse without conception and for fertility at least one live birth within 2 years. SETTING: University-based infertility practices. PATIENT(S): Volunteer subjects (847) recruited at 12 clinical sites participating in the National Institutes of Health-funded Reproductive Medicine Network. Inclusion criteria included ages 20-39 years, regular menstrual cycles, and no hormonal treatment or contraceptive use for 1 month before the study. Fertile controls were excluded if they had a history of infertility, recurrent pregnancy loss, or recent breastfeeding. INTERVENTION(S): Subjects underwent daily urinary LH testing. After detection of the LH surge, subjects were randomized to biopsy in the mid (days 21-22) or the late (days 26-27) luteal phase. Pathologists at each site estimated the cycle day based on standard criteria. For the primary analysis, an out-of-phase biopsy was defined as a greater than 2-day delay in the histological maturation of the endometrium. MAIN OUTCOME MEASURE(S): The proportion of out-of-phase biopsies in fertile and infertile women was compared using logistic regression models with age at randomization as a covariate. Comparisons were also made between fertile vs. infertile at the midluteal or late luteal phase time points. RESULT(S): Biopsies were evaluated (301 mid and 318 late; N = 619). Out-of-phase biopsy results poorly discriminated between women from fertile and infertile couples in either the midluteal (fertile: 49.4%, infertile: 43.2%) or late luteal phase (fertile: 35.3%, infertile 23.0%). Results did not substantially differ using alternative definitions of "out-of-phase" or standardized cycle day. CONCLUSION(S): Histological dating of the endometrium does not discriminate between women of fertile and infertile couples and should not be used in the routine evaluation of infertility.     

Depression and anxiety among Polish infertile couples – an evaluative prevalence study

Aim. The aim of this study was to evaluate the influence of infertility on the severity of anxiety and depression in infertile couples.

Material and methods. This was a cross-sectional study of differences between infertile couples (206 women and 188 men) and fertile couples (n = 190) with symptoms of depression and anxiety, as measured by the Beck Depression Inventory and Beck Anxiety Inventory.

Results. Infertile women (35.44%) scored above the cut-off for severe symptoms of depression, compared with 19.47% of fertile women. In the case of anxiety evaluation there was significant total prevalence among infertile women (15.53%). In the male groups there was a comparable frequency of negative results for depression and anxiety and their intensity. Among Female Infertile, depression occurred most frequently in combined infertility, whilst among Male Infertile in male infertility, with a time-frame of 3–6 years causing the creation and severity of depressive symptoms.

Conclusion. The risk factors of depression and anxiety in infertility include: female sex, age over 30, lower level of education, lack of occupational activity, diagnosed male infertility and infertility duration of 3–6 years.     

Effects of seminal constituents in leucocyte migration tests on infertile couples

Leucocyte migration tests were performed with cells from both partners of infertile couples in the presence of seminal constituents from the male partners. Leucocytes from fertile women were used as controls. Homogenized spermatozoa inhibited leucocyte migration in 36.1% of women and 20.7% of men from infertile couples and in 18.4% of control women. In all groups, occasional stimulation of leucocyte migration was observed (8.3%, 3.4% and 2.6% respectively). Although both types of changes in migration when considered together were statistically more frequent in the group of infertile women it was not possible to distinguish, on the basis of this test, between fertile and supposedly infertile individual women. It is suggested, however, that an inhibitory effect induced by spermatozoa on the men's own leucocytes may be of diagnostic significance. In contrast to spermatozoa, seminal plasma caused inhibition of leucocyte migration in the majority of cases — 88% of women and 71.9% of men from infertile couples and 77.8% of fertile women. Those patients whose semen lacked this inhibitory property are deserving of further study.     

Sperm antibodies and human leukocyte antigens in couples with early spontaneous abortions

Twenty-six couples with two or more early spontaneous abortions and 53 couples with recently proven fertility (control group) were typed for human leukocyte antigens (HLA) of A and B loci and screened for the presence of cytotoxic and hemagglutinating antibodies to sperm. Eighteen other couples with two or more abortions were tested for sperm antibodies alone. Both partners in 24 of 44 (54%) aborting couples were positive (titers of greater than or equal to 32), whereas the control group had sperm antibodies in the negative range (titers of 0 to 16; P less than .0001). Thirty-one husbands (70%) and 24 wives (54%) were positive for sperm antibodies in the study group. Sharing of HLA-A and/or -B antigens between partners was similar in the control and study groups. Fourteen of 26 (54%) couples with two or more abortions did not share HLA-A and/or -B antigens, in contrast to 14 of 53 (26%) in the control fertile group (P less than .02). Antigenic frequencies of HLA-B7 singly and in combination with HLA-B35 were increased in females in the aborting but not in the fertile control group (P less than .001). The combined incidence of HLA-B7, -B8, and -B35 in both partners was significantly higher in the aborting couples as contrasted with the control group. It is suggested that the presence of sperm antibodies is associated with early pregnancy wastage. Histocompatibility antigens B7 and B35 may play a role through their association with sperm antibodies and early spontaneous abortions.     

Antibodies to A19 and Bw35 complexes of human leukocyte antigens are present in infertile subjects with sperm antibodies

Sera and secretions from 100 couples with unexplained infertility were tested for sperm antibodies by cytotoxicity and passive hemagglutination and also for antibodies to human leukocyte antigen (HLA) by cytotoxicity assays. Lymphocytes of the study subjects were typed for 61 HLA-A and B alleles. Thirteen of 30 (43%) men with sperm autoimmunity also had HLA antibodies in their serum and/or seminal plasma samples, in contrast to 2 of 35 (6%) nonautoimmune males (P = 0.0003). Twenty-five of 35 (71%) sperm antibody-positive infertile women had HLA antibodies in their sera and/or secretions, while only 7 of 31 (23%) women without sperm antibodies were positive (P = 0.00007). Antibodies to HLA-A19 (A26, A29, AW30, AW31, AW32, AW33, and AW34) and Bw35 (B5, B15, B17, and B18) complexes were present in 19 of 22 (86%) infertile men and 44 of 48 (92%) infertile women positive for HLA antibodies (P less than 0.01). The presence of antibodies to HLA-A19 and/or Bw35 in the infertile subjects did not correlate with the presence of HLA-A19 and/or Bw35 in the husbands. The presence of antibodies to HLA-A19 and/or Bw35 in the cervical mucus of the infertile women correlated with their presence in the seminal plasma of their husbands. It is suggested that antibodies to sperm antigens cross-reactive with HLA-A19 and/or Bw35 may be relevant to infertility.     

Atopy in couples with unexplained infertility

In an initial exploratory study, proneness to atopy was measured by specific allergen history, allergen skin testing and plasma IgE in couples with unexplained infertility and in a comparison group of couples who had recently had a child. At least one of the assessments was positive in 29 out of 47 infertile couples and in 52 out of 103 controls, but only five of the infertile group and two of the fertile group had all three assessments positive. Raised IgE levels occurred significantly more often in the infertile couples than in the comparison group.     

Effects of infertility on gender differences in marital relationship and quality of life: a case-control study of Turkish couples

Objectives

Although there are many studies trying to evaluate the effect of infertility on marital relations (MR) and quality of life (QoL) in developed counties, there have been no studies in Turkey. As in many societies around the world, lack of pregnancy and the resulting childlessness are often highly stigmatized, leading to profound social suffering for infertile couples in Turkey.

Study Design

This study was planned as a case–control study in order to investigate the effects of infertility on MR and QoL. It was conducted among 58 primary infertile and 51 fertile couples. The Dyadic Adjustment Scale (DAS) and the World Health Organization QoL Scale (WHOQOL-BREF) were applied at the infertility department of the Istanbul University's faculty of medicine. The t-test, Mann–Whitney U, ANOVA and Pearson's correlation coefficient were used.

Results

The socio-demographic properties were similar for both groups. The QoL average score was higher for the infertile group. There were no gender differences in QoL for infertile couples. The total DAS score was higher than the cut-off score for both groups (114.44 ± 18.53 for infertile, 110.29 ± 18.28 for fertile couples; p > 0.05). Infertile women's DAS and QoL scores were higher than the fertile women's (p < 0.05). Other than in the social domain, all QoL scores were higher for infertile men than fertile men (p < 0.05). There was a positive correlation between the DAS and QoL scores.

Conclusions

It was determined that infertility did not have a negative impact on MR and QoL measurements. There were no gender differences.     

Atopy in couples with unexplained infertility

Summary. In an initial exploratory study, proneness to atopy was measured by specific allergen history, allergen skin testing and plasma IgE in couples with unexplained infertility and in a comparison group of couples who had recently had a child. At least one of the assessments was positive in 29 out of 47 infertile couples and in 52 out of 103 controls, but only five of the infertile group and two of the fertile group had all three assessments positive. Raised IgE levels occurred significantly more often in the infertile couples than in the comparison group.     

Karyotype analysis in large-sample infertile couples living in Central China: a study of 14965 couples

Objective

To explore that it is necessary to routinely detect chromosomes in fertile couples, we detected peripheral blood lymphocyte karyotype in 14965 infertile couples living in Central China and analyzed the incidence and type of chromosomal anomaly.

Methods

G-banding karyotype analysis of peripheral blood lymphocytes was performed in 14965 couples who went to the outpatient department of our reproductive medical center for counseling on infertility between January 2004 and December 2011. Semen analysis was performed three times in all the men from the 14965 couples.

Results

The rate of chromosomal anomaly in the 14965 infertile couples was 3.84 % (1150/29930). The rate of chromosomal anomaly in the men from 14965 couples was 6.84 % (1024/14965) and in the women 0.84 % (126/14965). The rates of chromosomal anomaly were 1.69 % in normal semen group, 11.82 % in light oligo-astheno-spermis group, 6.58 % in moderate to severe olig-astheno-spermia group and 17.26 % in azoospermia group.

Conclusion

Since the rates of chromosomal anomaly are 1.69 % and 11.82 % even in normal semen group and light oligo-astheno-spermia group, respectively, it is necessary to detect peripheral blood lymphocyte karyotype in all infertile couples.     

Sexual,Marital, and Social Impact of a Man's Perceived Infertility Diagnosis

IntroductionMale factor infertility is a relatively common problem. This diagnosis may increase sexual, marital, and relationship strain in male partners of infertile couples.AimTo measure the personal, social, sexual, and marital impacts of a male factor infertility diagnosis among men in couples evaluated for infertility.MethodsCross-sectional analysis of 357 men in infertile couples from eight academic and community-based fertility clinics. Participants completed written surveys and face-to-face and telephone interviews at study enrollment. This interview queried each participant's perception of their infertility etiology to determine the primary study exposure (i.e., male factor only, male and female factors, female factor only, unknown).Main Outcome MeasuresPersonal Impact, Social Impact, Marital Impact, and Sexual Impact scales.ResultsAmong the 357 men, no male factor was reported in 47%, isolated male factor was present in 12%, combined male and female factors were present in 16%, and unexplained infertility was present in 25% of couples. Male factor infertility was independently associated with worse Sexual (mean 39 vs. 30, standard deviation [SD] 2.7, P = 0.004) and Personal (mean 37 vs. 29, SD 3.8, P = 0.04) Impact scores relative to men in couples without male factor infertility. These differences remained statistically significant after controlling for male age, partner age, race, religion, educational level, employment status, prior pregnancy, duration of infertility, and prior paternity.ConclusionsMale partners in couples who perceive isolated male factor infertility have a lower sexual and personal quality of life compared with male partners of couples without perceived male factor infertility. Social strain is highest among couples without a clear etiology for infertility. These findings highlight the clinically significant negative sexual, personal, and social strains of a perceived infertility diagnosis for men. Smith JF, Walsh TJ, Shindel AW, Turek PJ, Wing H, Pasch L, Katz PP, and The Infertility Outcomes Program Project Group. Sexual, marital, and social impact of a man's perceived infertility diagnosis. J Sex Med 2009;6:2505–2515.     

Comparison of gonadal function between fertile and infertile men with varicoceles

The high prevalence of men with varicoceles who by history are fertile has led some to question the suggested causal relationship between a varicocele and male infertility. However, testicular function in these fertile men has not previously been studied in detail. Fifty-five normal fertile men, 42 fertile men with varicoceles, and 24 infertile men with varicoceles and normal female partners were studied. Semen analyses were done, baseline serum testosterone and gonadotropin levels tested and the gonadotropin response to luteinizing hormone-releasing hormone (LH-RH) measured. The infertile men with varicoceles exhibited lower sperm counts, abnormal sperm morphologic features, increased baseline serum gonadotropins, and increased gonadotropin responses to LH-RH, compared with the normal fertile men. The fertile men with varicoceles showed similar abnormalities, although this was not statistically significant in all cases. That semen and hormone abnormalities were observed in both the fertile and infertile men with varicoceles suggests that the presence of a varicocele is associated with some degree of primary testicular dysfunction, regardless of present fertility status.