J. Daru

IS THERE A RELATIONSHIP BETWEEN CELL PHONE USE AND SEMEN QUALITY

This study was conducted to determine a possible relationship between regular cell phone use and different human semen attributes. The history-taking of men in our university clinic was supplemented with questions concerning cell phone use habits, including possession, daily standby position and daily transmission times. Semen analyses were performed by conventional methods. Statistics were calculated with SPSS statistical software. A total of 371 were included in the study. The duration of possession and the daily transmission time correlated negatively with the proportion of rapid progressive motile sperm (r = − 0.12 and r = − 0.19, respectively), and positively with the proportion of slow progressive motile sperm (r = 0.12 and r = 0.28, respectively). The low and high transmitter groups also differed in the proportion of rapid progressive motile sperm (48.7% vs. 40.6%). The prolonged use of cell phones may have negative effects on the sperm motility characteristics.

EFFECT OF BODY WEIGHT ON TESTOSTERONE/ESTRADIOL RATIO IN OLIGOZOOSPERMIC PATIENTS

To evaluate the effect of body mass on the hormonal and semen profiles of subfertile men with oligozoospemia, sperm concentration and reproductive hormone levels were compared in two body mass index (BMI) groups: underweight or normal weight patients (BMI ≤ 25 kg/m2) vs. overweight or obese patients (BMI > 25 kg/m2). The mean BMI was 27 ± 4.6 kg/m2. The testosterone/estradiol ratio was significantly reduced in the high BMI group as compared to the low BMI group (17 ± 4 vs. 12 ± 3; p < 0.05). A similar difference was found in the sperm concentration (11.2 ± 3.16 × 106/ml vs. 8.1 ± 2.6 × 106/ml). A nonsignificant difference was found in the LH/FSH ratio (1.41 ± 0.64 vs. 1.63 ± 0.72). We concluded that obesity and the consequent estrogen excess decrease the sperm concentration by influencing the hypothalamo-pituitary system.

Effect of Female Body Weight on Efficiency of Donor AI

A total of 1144 infertile women were treated by artificial donor insemination. Unsuccessful ovulation induction was found in 96 of these cases. The obese women (BMI: 28-36) had a relative risk of unsuccessful ovulation induction of 2.7 (95% confidence interval (CI)=2.1-3.4) compared with women lower or normal body weight (BMI: 20-24). The effect was smaller in women with a BMI 25-27 or <19 (relative risk (RR)=1.4, 95% CI=0.9-2.1 and 1.5, 95% CI=0.8-2.5), respectively. During the AID treatment 412 pregnancies occurred. Pregnancy rate achieved by insemination was 28% (50 pregnancies per 178 cases, BMI 16-19), 42% (251/599, BMI 20-24), 33% (92/286, BMI 25-27), and 21% (19/81, BMI 28-36), respectively, in the different BMI groups.

Hypothesis: Safety of Using Mobile Phones on Male Fertility

I. Fejes, Z. Z avaczki, S. Kolosz ar, J. Szöll} osi, J. Daru, L. Kov acs, and A. P al Department of Obstetrics and Gynaecology, University of Szeged, Szeged, Hungary A recent review paper from Derias et al. [3] described the growing concern over the safety of using mobile phones. Our own results lend support to their conclusions as we have observed relationships between the duration of possession of a cell phone and the spermatozoa motility characteristics and also between the duration of daily transmission and the spermatozoa motility characteristics [5]. Although rats are frequently used as laboratory animals for various studies, the results must be interpreted with caution, as the different species have different sensitivities to environmental effects and rats are famous for their ability to adapt. Conclusions may also be drawn of the harmful effects on fertility from studies on different human tissues. There have been publications concerning effects on the central nervous system, such as alterations in the electroencephalogram pattern, the sleeping pattern or even the neuroendocrine functions [1, 2, 7, 9]. de Seze et al. found no alterations in the levels of pituitary hormones in association with prolonged cell phone use [4], whereas Burch et al. demonstrated a reduced 6-hydroxymelatonin sulphate (6OHMS) level in the urine among those using a cell phone for over 25 minutes= day; 6-OHMS is the urinary metabolite reflecting the serum level of the pineal hormone melatonin [1]. Melatonin is known to be an antioxidant that protects against lipid peroxidation in the retina, brain, liver cells, and even human sperm [6]. The electromagnetic radiation emitted by cell phones may cause DNA breakage in cells in the male genital tract, as this can occur in a low-frequency electromagnetic field. In vitro studies appear justified to investigate the increased numbers of chromosome aberrations of the micronuclei in human leucocytes and DNA breaks [8, 10, 11]. Additionally, a recent pilot study has shown that proteomics may be an effective tool in the search for cell responses to weak stimuli, including cell phone radiation. Multiple cell phone radiation protein targets were found in endothelial cells that participate in basic physiological cell functions such as cell energy production, protein translation, and cytoskeleton-dependent processes. The most important finding from the aspect of spermatozoa movement could well be the decline in the expression of isocitrate-dehydrogenase 3 (NADþ)a, a subunit of the mitochondrial enzyme, which catalyses the conversion of Address correspondence to I. Fejes, Department of Obstetrics and Gynaecology, University of Szeged, H-6725 Szeged, Semmelweis u 1, Hungary. E-mail: fejesimi@yahoo.com Archives of Andrology, 53:105–106, 2007 Copyright # Informa Healthcare ISSN: 0148-5016 print=1521-0375 online DOI: 10.1080/01485010600915202

Pregnancy Rate after Controlled Ovarian Hyperstimulation and Intrauterine Insemination for the Treatment of Endometriosis following Surgery

Objective. To compare pregnancy rate after controlled ovarian hyperstimulation and intrauterine insemination (COH-IUI) with no treatment in patients with endometriosis-associated infertility treated with laparoscopy. Design. A clinical cohort study. Setting. University-level tertiary care center. Patients. 238 women with various stages of endometriosis after laparoscopic treatment. Interventions. Either COH-IUI or follow-up for 12 months. Main Outcome Measures. The primary outcome measures were clinical pregnancy and live birth rate. Predictive factors evaluated were female age, maternal BMI, and duration of infertility. Results. The pregnancy rate attained after the integrated laparoscopy–COH-IUI approach was 53.4%, while it was significantly lower (38.5%) in the control group. Similarly, a significant difference was observed in live births (48.3% versus 34.2%). Patients with severe endometriosis were less likely to achieve pregnancy (38%) and live birth (35%) than their counterparts with milder forms (57% and 53%). Conclusions. In patients with endometriosis-based infertility, surgery followed by COH-IUI is more effective than surgery alone.

Magnetic resonance vs. sonographic imaging: diagnostics of a large congenital pulmonary airway malformation.

Sonographic scan revealed a homogenously hyperechogenic lesion in the right fetal lung with microcystic pattern by a primigravid women at 22nd weeks of gestation. A large congenital pulmonary airway malformation (CPAM) was suspected with a lesion-to-lung ratio over 90%. The microcystic image of this thoracic anomaly was moderately visible on magnetic resonance imaging (MRI) at that early stage of the pregnancy. Fetopsy confirmed the diagnosis as a pure microcystic CPAM following termination of pregnancy. A controlled prospective study could be performed to compare ultrasound as a diagnostic modality to the MRI, focusing on volumetry, signal characteristics, and follow-up/regression of fetal pulmonary malformations.

Effects of aromatase inhibitor on menopausal hyperplasia in a case of obesity

The aromatase inhibitor anastrazole proved effective in the treatment of endometrial hyperplasia and postmenopausal bleeding in an obese 65-year-old woman with high operative risk. During anastrazole administration for 12 months, the endometrial thickness decreased from 9.8 mm to 2.4 mm and the control endometrial histology showed an atrophic endometrium. Uterine bleeding did not occur in the post-treatment, 3-year follow-up period. The endometrial thicknesses measured yearly by ultrasonography were 2.9, 3.5 and 3.3 mm. The plasma estradiol levels increased from < 73 pmol/l post-treatment to 112, 98 and 103 pmol/l. This case demonstrates that long-term aromatase inhibitor treatment can result in a refractory status of the endometrium and the estradiol produced in the adipose tissue does not exert a proliferative effect.

Results of insemination (AIH) following GnRH treatment of endometriosis.

Endometriosis is one of the most frequent benign diseases in gynecology. It is the cause of the pelvic pain and infertility in more than 35% of women of reproductive age. The most appropriate treatment for endometriosis is the combination of surgery and adjuvant medical therapy with GnRH agonists. The authors demonstrate the results of 33 artificial intrauterine homolog inseminations after a 6-month GnRH analog therapy.

The Role of Endoscopy in Management of Infertility

Laparoscopy is used world-wide to investigate infertility. It is a minimally invasive surgical technique used in infertility diagnosis and treatment and generally accepted that diagnostic laparoscopy is the gold standard in diagnosing tubal pathology and other intra abdominal causes of infertility. Laparoscopic surgery has revolutionized gynecological surgery. In a female, the uterus, fallopian tubes and ovaries are located in the pelvis which is at the very bottom of the abdomen. Laparoscopy allows seeing abnormalities that might interfere with a womans ability to conceive a pregnancy. Infertility diagnostic and operative laparoscopy help evaluate gynecological problems such as uterine fibroids, structural abnormalities of the uterus, endometriosis, ovarian cysts and adhesions. A large number of procedures can be performed laparoscopically. Most commonly it is used to inspect the pelvic organs (diagnostic laparoscopy), and often to perform surgical procedures (operative laparoscopy) at the same time. Complicated endometriosis, pelvic adhesions, removal of large ovarian cysts and fibroids should only be performed by highly skilled laparoscopic surgeons. The fiber-optic camera on the laparoscope is very small. It is inserted into the body, through an incision made in the nave, another incision may be made near the upper pubic region.

The role of intrauterine insemination in the therapy of infertile women with endometriosis

Purpose Laparoscopy is considered the gold standard for the diagnosis and treatment of endometriosis. Controlled ovarian hyperstimulation-intrauterine insemination (COH-IUI) is often used to treat women with infertility associated with endometriosis. The objective of the study was to assess the pregnancy rate following surgery, and 6 month GnRH analogue (GnRH-a) therapy, and to assess whether a combined approach with laparoscopic surgery and GnRH-a followed by COH-IUI can improve the overall pregnancy rate. Methods A prospective study was performed on 119 infertile patients who underwent laparoscopic surgery and GnRH-a therapy for endometriosis and returned for a follow-up for a period of time between one and 10 years. Results The pregnancy rate attained after the integrated laparoscopy–GnRH-a–COH-IUI approach was 51.6%. The pregnancy rate after surgery and GnRH-a therapy was significantly lower (41.8%). The fecundity rate for spontaneous conception within 6 months of laparoscopy and GnRH-a treatment (27%) was significantly higher (P<.05) than for the following intervals. Cumulative fecundity in women aged older than 35 was significantly lower than in younger women. Conclusions In patients with endometriosis-associated infertility, surgery and GnRH-a therapy followed by COH-IUI is more effective than surgery and GnRH-a therapy. When patients fail to conceive spontaneously, after a maximum of one year following laparoscopic surgery and GnRH-a, COH-IUI or In Vitro Fertilization Embryo Transfer (IVF-ET) should be recommended.