Infertility Clinic Research Articles

Inter-cycle variability of anti-Müllerian hormone: implications for predicting controlled ovarian stimulation cycle outcomes

BackgroundAnti-Müllerian hormone (AMH) is a widely used marker for estimating ovarian reserve, and it may predict response to ovarian stimulation. While AMH is considered a stable, cycle-independent marker, studies have shown it can exhibit significant fluctuations based on factors like age, reproductive stage, and menstrual cycle phase. The fluctuations in AMH levels can make it challenging to predict individual responses accurately, particularly when the AMH is not measured in the COS cycle. The aim of this study was to assess the inter-cycle variability of serum AMH levels in two consecutive menstrual cycles and their correlation with response to controlled ovarian stimulation outcome in the latter.MethodsIn this single-centre retrospective cohort study, data of normal and low responder patients who underwent intracytoplasmic sperm injection following a GnRH antagonist cycle at a university hospital infertility clinic between January 2022 and December 2023 were reviewed. Serum AMH levels were measured in the early follicular phase of two consecutive menstrual cycles with Elecsys-AMH Roche® system (Roche Diagnostics, Meylan, France). Correlations between AMH levels and controlled ovarian stimulation outcomes, including total oocyte and mature oocyte (MII) counts, were assessed. The study included normal and poor responder women to maintain data integrity.ResultsA total of 79 patients were included in the final analyses. Significant cycle-to-cycle variation in serum AMH levels was observed, with a median variation of 44.3%. Normal responders exhibited a mean change of 0.60 ± 0.46 ng/ml, while poor responders had a mean change of 0.28 ± 0.28 ng/ml. Approximately 20% of patients were reclassified between normal and poor responder categories based on the second AMH measurement. The controlled ovarian stimulation cycle AMH levels showed a stronger correlation with both total oocyte count (r = 0.871, P < 0.001) and MII oocyte count (r = 0.820, P < 0.001) compared to preceding cycle AMH levels.ConclusionAMH levels can exhibit significant variations between consecutive cycles, potentially leading to misclassification of patients. Measuring AMH in the early follicular phase of the COS cycle provides a more accurate prediction of the numbers of total and MII oocytes collected. Consistent and repeated AMH measurements can help clinical decision-making.

An exploratory study of perceptions and utilization of genetic information in the intended parent experience of oocyte donor selection.

Utilization of oocyte donation has become an increasingly common practice in assisted reproductive technology (ART). Since the introduction of larger carrier screening (CS) panels and extended family medical histories (EFMH), studies have not examined how this information factors into the oocyte donor selection process. This exploratory, qualitative study provides further insight into what role, if any, donors' available genetic information (e.g., larger CS panels and EFMH) plays in selecting an oocyte donor. An online screening survey was distributed to individuals who have undergone or are currently in the process of selecting an oocyte donor through the RESOLVE network and Mayo Clinic's Reproductive Endocrinology and Infertility clinic. From 13 survey respondents, six oocyte recipients subsequently participated in semi-structured telephone interviews and discussed their experiences as oocyte recipients including their perceptions of donors' available genetic information and process in choosing an oocyte donor. Genetic information was seen as valuable and reassuring for participants, particularly EFMH, but did not play a significant role in the selection process for these participants. Supplemental emergent themes provide context on the psychosocial complexities of the oocyte recipient experience and possible explanations for why genetic information is not a decisional priority. Participants indicated genetic information was not extensively discussed or fully explained by providers. Results demonstrate how genetic counselors can be more involved in the pre-selection process to discuss the utility and limitations of genetic information, as well as address psychosocial issues common to the oocyte recipient experience.

Sperm histone modifications may predict success in human assisted reproduction: a pilot study.

Currently, assisted reproduction clinics employ various sperm selection techniques to identify the best sperm for fertilization. However, these techniques may not assess crucial sperm traits that can substantially impact embryonic quality. To address this, we propose analyzing diverse histone modifications as potential markers of sperm functionality and success in assisted reproduction techniques. Cross-sectional pilot study including infertile male patients attending an infertility clinic in CABA, Argentina between April and August 2019 was performed. We used immunofluorescence techniques to evaluate post-translational modifications of histones in sperm and established correlations with in vitro fertilization outcome and embryo quality. Our findings indicate a negative correlation between H3K4me3 and H3K4me2 marks and fertilization rate and showed a positive correlation of this parameter with H3K9me mark. In addition, there was a positive correlation between H3K27me3 and good embryo quality. This pilot study proposes a non-invasive strategy to predict embryo quality by analyzing spermatozoa prior to fertilization. The assessment of histone post-translational modifications in sperm samples could provide useful information for the recognition of epigenetic marks that could predict the health of the embryo of an assisted fertilization treatment.

Postpartum Depression Levels in Women After the Application of Assisted Reproduction Techniques and Their Affecting Factors

Objective: This study was carried out to determine postpartum depression levels and their affecting factors in women who became women after the application of assisted reproductive techniques. Methods: The study is descriptive and cross-sectional and was conducted with mothers (n=93) who had babies as a result of treatment at the infertility clinic of Cukurova University Hospital. Research data were collected using the “Personal Information Form” and “Edinburgh Postpartum Depression Scale (EPDS)”. In the analysis of the research data, descriptive statistics, independent samples t-test, Kruskall Wallis and Mann Whitney U test were employed. Results: The EPDS mean score of the women in the study was determined to be 18.22± 3.22 and 94.6% of them were at risk for postpartum depression. Statistically significant differences were found between the EPDS mean score of the mothers and the gender of the baby they want to have, experiencing anxiety, and sharing problems with their spouse (p0.05). Conclusion: It was determined that mothers who have a baby as a result of infertility treatment are at risk for postpartum depression. Although a healthy outcome of pregnancies obtained as a result of treatment is eagerly awaited by the mothers, it also poses a risk for postpartum infertile mothers.

Information Regarding Male Infertility in the Nordic Countries’ Fertility Clinics’ Websites: An Evaluation of Readability, Suitability, and Quality

Background There is a shortage of information on infertility targeted at men on the Internet, and the quality of websites on fertility-related information varies. This may lead men to seek information on the Internet, as the anonymity of online forums may appeal to some men. However, this information is not a substitute for proper diagnosis and treatment. Aim To examine whether online information on male infertility on private or university infertility clinics in Finland, Denmark, Norway, and Sweden is readable, suitable, and of good quality. Methods A cross-sectional design was used to evaluate 83 fertility clinics’ websites focusing on male infertility by using the Suitability Assessment of Materials (SAM), and the DISCERN instrument. Results The results indicated that information pertaining to male infertility was scarce but had an “adequate” readability and was easy to comprehend. The findings also pinpoint several elements on websites that necessitate enhancement, notably updated evidence-based information. Conclusions The conclusion was that the information on the websites must be reliable, so that men can base their choices concerning their fertility issues on trustworthy facts. It is crucial that healthcare professionals develop high-quality sources of information regarding male infertility.

Effects of Obesity in Male Fertility in Khartoum State

Obesity is a severe medical condition causing health issues and reducing life expectancy, affecting 400 million adults and 1.6 million overweight individuals, is a severe medical condition affecting fertility, with extreme obesity causing fertility issues. This study aimed to investigate the effect of obesity on male fertility in Khartoum state; it is a cross-sectional facility-based study studying All males of Infertile couples who come to the infertility clinic. The study discussed patient demographics, past medical and surgical history, and self-reported male sexual dysfunction in addition to the factors that affect male infertility, Body Mass Index (BMI), and spermatic parameters (motility, morphology, concentration) by seminal analysis. The statistical package SPSS 23.0 was used for analysis. The study revealed that 40 men (20.5) were of age &lt;30 years old, 57 men (29.9%) of age 30 – 40 years old, and 98 men (50.3%) were of age &gt;40 years old. “One hundred five men (53.8%) were from North Sudan”, “58 men (29.7%) were from Eastern Sudan,30 men (15.35%) were from Western Sudan overweight, and 2 men (1.15%) were from Southern Sedan, 56 men (28.7%) have BMI &lt;25,81(41.5%) had BMI 25 -30 and 58(29.8%) have BMI of &gt;30, 110 men (56.4%) have normal sperm counts and 85 (43.6) have abnormal sperm counts, 105 men (53.8%) have normal sperm morphology”. In contrast, 90 (46.2) have abnormal morphology. Eighty-eight men (45.1%) have progressive motility, while 107 men (54.9%) have impaired motility. Fifty-six men (28.8%) of participants have erectile dysfunction, while 139 (71.2%) have not. It concluded that increasing the age of the male partner increases the risk of infertility, and ethnicity has an unclear effect on infertility and still needs further studies to prove it. Obesity rates are increasing among men in Khartoum, impacting seminal parameters like motility and erectile dysfunction, as highlighted in a study.

Machine learning-based classification of varicocoele grading: A promising approach for diagnosis and treatment optimization.

Varicocoele is a correctable cause of male infertility. Although physical examination is still being used in diagnosis and grading, it gives conflicting results when compared to ultrasonography-based varicocoele grading. We aimed to develop a multi-class machine learning model for the grading of varicocoeles based on ultrasonographic measurements. Between January and May 2024, we enrolled unilateral varicocoele patients at an infertility clinic, assessing their varicocoele stages using the Dubin and Amelar system. We measured vascular diameter and reflux time at the testicular apex and the subinguinal region ultrasonography in both the supine and standing positions. Using these measurements, we developed four multi-class machine learning models, evaluating their performance metrics and determining which patient position and projection were most influential in varicocoele grading. We included 248 patients with unilateral varicocoele in the study, their average age was 26.61±4.95 years old. Of these, 212 had left-sided and 36 had right-sided varicocoeles. According to the Dubin and Amelar system, there were 66 grade I, 96 grade II, and 86 grade III varicocoeles. Among the models we created, the random forest (RF) model performed best, with an overall accuracy of 0.81±0.06, an F1 score of 0.79±0.02, a sensitivity of 0.69±0.02, and a specificity of 0.8±0.03. Vascular diameter measurement at the testicular apex in the supine position had the most impact on grading across all models. In support vector machine and multi-layer perceptron models, reflux time measurements from the subinguinal projection in the standing position contributed the most, while in RF and k-nearest neighbors models, measurements from the subinguinal projection in the supine position were the most influential. Machine learning methods have demonstrated superior accuracy in predicting disease compared to traditional statistical regressions and nomograms. These advancements hold promise for clinically automated prediction of varicocoele grades in patients. Tailored varicocoele grading for individuals has the potential to enhance treatment effectiveness and overall quality of life.

Clinical Applications of Assisted Oocyte Activation in Couples with Various Reproductive Problems: A Systematic Review.

ICSI may face fertilization failure, prompting the use of assisted oocyte activation (AOA) techniques. While AOA is implemented in infertility clinics, its target patients and definitive application remain uncertain. This systematic review adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to assess reproductive outcomes in ICSI-AOA cycles compared to conventional ICSI and evaluate AOA effectiveness in various infertility disorders. A literature search encompassed PubMed, Web of Science, EMBASE, and Scopus databases until December 2023 for relevant English studies. Included studies compared ICSI-AOA with conventional ICSI in couples with prior fertilization failure, utilizing diverse AOA methods. Control groups consisted of sibling oocytes, previous cycles of the same couples, or couples undergoing conventional ICSI. Evaluated outcomes included fertilization, cleavage, embryo quality, implantation, pregnancy, and live birth rates. Article screening and data extraction were performed by two authors, with risk of bias assessed by another investigator. Out of 3088 initially identified articles, 30 studies were included, focusing on fertilization failure (n = 10), female infertility (n = 3), PLCζ defects (n = 4), poor sperm quality (n = 4), Globozoospermia (n = 4), and surgically retrieved sperm (n = 8). Most studies concluded that AOA could overcome fertilization failure, but success rates varied based on sperm-related or oocyte-related factors in ICSI-AOA cycles. Due to differences in patient inclusion criteria and sample sizes, most studies were not sufficiently similar for pooled analysis, limiting robust conclusions. There is insufficient evidence, particularly from randomized controlled trials (RCTs), to determine the efficacy or safety of ICSI-AOA as a treatment strategy. Registration number is PROSPERO, CRD42024551221.

Exposure to ambient particulate matter and ovarian reserve impairment among reproductive age women in China

Ovarian aging, characterized by a decline in ovarian reserve, is a critical concern in female reproductive health. However, the evidence linking ambient air pollution exposure with ovarian reserve impairment remains limited. We aimed to estimate the association between exposure to fine particulate matter (PM2.5) and respirable particulate matter (PM10) and key indicators of ovarian reserve, including antral follicle count (AFC), ovarian volume (OV), anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), estradiol (E2), luteinizing hormone (LH), FSH/LH ratio, and inhibin B (INHB). The cohort consisted of women attending an infertility clinic at the Tongji Reproductive and Environmental (TREE) study between 2018 and 2020. We used multivariate linear and Poisson regression models to estimate the association between PM2.5 and PM10 exposure and these ovarian reserve indicators. Our results showed that PM2.5 and PM10 exposure were associated with a reduction in AFC and an increase in E2 levels, highlighting the adverse effects of ambient air pollution on ovarian reserve. Our findings have important public health implications, emphasizing the urgent need for interventions to safeguard female reproductive health and reduce exposure to ambient air pollution.

Differential impacts of ambient PM2.5 exposure on sperm quality in northern Thailand.

This study aimed to explore the correlation between ambient particulate matter 2.5 (PM2.5) concentration and sperm quality among northern Thai men exposed to the seasonal air pollution from the agricultural burning process. The demographic data and semen analysis of Thai men living in Chiang Mai, Thailand, who visited the infertile clinic were collected. The correlation test between the monthly amount of PM2.5 and sperm quality was carried out. From 2017 to 2021, 1,109 Thai men visited the Infertile Clinic. The correlation test between PM2.5 and sperm quality in years with a better climate revealed a weak positive correlation between the mean PM2.5 and percentage of progressive motile sperm and normal morphology (r=0.08, p=0.05 and r=0.1, p=0.02). However, there was a negative correlation between the mean PM2.5 and sperm concentration, progressive motility and normal sperm morphology during the years with a higher amount of ambient PM2.5, and especially PM2.5 exposure 3 months before semen collection (r=-0.12, p=0.01, r=-0.11, p=0.003, r=-0.15, p=0.004). Exposure to a high amount of PM2.5 air pollution negatively affects sperm quality.

A Study to Assess the Psychosocial Problem and Lived Experience of Woman Attending the Infertility Clinic at Dr. Vitthalrao Vikhe Patil Pravara Rural Hospital Loni

A Study to Assess the Psychosocial Problem and Lived Experience of Woman Attending the Infertility Clinic at Dr. Vitthalrao Vikhe Patil Pravara Rural Hospital Loni

Monogram and Heat Map on Magnetic Resonance Imaging to Evaluate the Recommendation for Myomectomy in Patients with Infertility: A Pilot Study.

Uterine myomas can cause infertility. Studies are attempting to determine the indications for myomectomy. However, the multiplicity and localization of myomas complicate this issue. We aimed to develop a visualization tool to aid patients with infertility in their decision-making for myomectomy. We included 191 women with uterine myoma attending an outpatient infertility clinic, of whom 124 patients underwent myomectomy. Of these, 65 (52.4%) patients became pregnant within 17.6 months after surgery, and 54 (83.1%) of them had a live birth. A logistic regression model predicting the pregnancy rate (area under the curve, 0.82; 95% confidence interval, 0.74-0.89; validation value, 74.6%) was generated using the leave-one-out cross-validation method. This model incorporated five factors: age, maximum level of infertility intervention following myomectomy, presence of submucosal myoma, maximum diameter of the myoma, and type of myomas (multiple or single). We successfully visualized the degree of involvement of each factor in the pregnancy rate by developing a nomogram based on this model. We expanded the data from the preoperative magnetic resonance images and applied machine learning using a convolutional neural network. The classification accuracy was 71.4% for sensitivity and 77.7% for specificity. Heatmap images, generated using gradient-weighted class activation mapping to show the classification results of this model, could distinguish between myomas that required enucleation and those that did not. Although a larger sample size is needed to further validate our findings, this innovative pilot study demonstrates the potential of machine learning to refine assessment criteria and improve patient decision-making.

Vitamin D levels and lipid profiles in patients with polycystic ovary syndrome

BackgroundPolycystic ovary syndrome (PCOS) is the most common endocrine disorder among women. Dyslipidemia is a prevalent metabolic abnormality in individuals with PCOS. Moreover, vitamin D deficiency is widespread across all societal strata, with a particularly heightened prevalence observed in patients afflicted with PCOS. The present study aimed to investigate the level of vitamin D and its correlation with lipid profiles in Iranian women diagnosed with PCOS.MethodsThis cross-sectional study was carried out at the PCOS and infertility clinic of Arash Women’s Hospital in Tehran. The study encompassed the medical records of PCOS patients who attended the clinic from March 2021 to December 2023. All patients underwent blood tests, which included assessments of fasting blood sugar levels, lipid profiles, and 25-hydroxyvitamin D (25(OH)D) levels. The investigation focused on evaluating the relationship between vitamin D levels and lipid profiles. Statistical analyses, including the chi-square test and Spearman’s correlation coefficient, were employed to analyze the data.ResultsA total of 1004 women diagnosed with PCOS were included in the study. The age range of the participants was 14 to 46 years. The majority of the participants had a body mass index (BMI) within the normal range (n = 555, 55.3%). The median vitamin D level among the participants was 26.00 (IQR: 19.00–34.00). The relationship between vitamin D levels and lipid profile parameters was assessed, revealing no significant correlation between vitamin D levels and low-density lipoprotein (LDL) (r = 0.021, p = 0.505), high-density lipoprotein (HDL) (r = 0.011, p = 0.719), or triglyceride (TG) (r = -0.026, p = 0.417) levels, both in non-adjusted and age-adjusted analyses.ConclusionAccording to the present study, there was no significant correlation between serum 25(OH)D deficiency and elevated TG or LDL levels or decreased HDL levels in PCOS patients. Nevertheless, further prospective studies are needed to determine whether there is a causal relationship between vitamin D deficiency and lipid profile alterations, specifically among PCOS patients.

Prevelance and risk factors of female sexual dysfunction in females attending infertility clinic at Kasr Alainy hospital: a cross-sectional descriptive study

Background: Female sexual dysfunction (FSD) is a common health problem that is inadequately investigated in Egypt. Sexual problems are reported by approximately 40 percent of females worldwide. There is a strong relationship between FSD, quality of life and infertility. Objective: The aim of this study is to assess the prevalence of female sexual dysfunction and also to investigate possible risk factors that may cause sexual dysfunction in the Egyptian infertile women seeking fertility Patients and Methods: This cross-sectional clinic-based survey was conducted at the infertility clinic, in Kasr Al-Ainy Hospital, Cairo, Egypt from October 2023 to February 2024. During this study, 186 women were enrolled and asked to answer the validated Arabic version of the Female Sexual Function Index and World Health Organization Quality of Life Questionnaire- Brief that were provided by female investigators. Results: 186 females were included in our study. The prevalence of FSD was 56 females (30.1%) while 130 females (69.9%) had good sexual function with FSFI &gt;28.1. Also, patients with sexual dysfunction had mean value of QoL that was (38.5±8.7) while females with good sexual function had mean value of QoL that (64.2±11.2) respectively. We found that the most frequent risk factors of female sexual dysfunction were advanced maternal and paternal age, no maternal occupation, duration of marriage &lt;5 years, nulliparous women ,maternal obesity, timed intercourse and number of IVF trials. On the other hand, no relations were reported between female sexual dysfunction and family income, residence, menstrual Rhythm, associated chronic medical diseases, drug intake, contraception, vaginitis, mode of delivery, circumcision and previous episiotomy. Conclusion: FSD is a major health problem that affect 30.1% of women attending infertility outpatient clinic in Kasr Alainy Hospital and greatly affected their quality of life.

Reduced ovarian cholesterol and steroid biosynthesis along with increased inflammation are associated with high DEHP metabolite levels in human ovarian follicular fluids

The plasticizer di(2-ethylhexyl) phthalate (DEHP) is known to have endocrine-disrupting properties mediated by its many metabolites that form upon exposure in biological systems. In a previous study, we reported an inverse association between DEHP metabolites in the human ovarian follicular fluid (FF) and the responsiveness of the follicles to controlled ovarian stimulation during in vitro fertilization (IVF) treatments. Here, we explored this association further through molecular analysis of the ovarian FF samples.Ninety-six IVF patients from Swedish (N = 48) and Estonian (N = 48) infertility clinics were selected from the previous cohort (N = 333) based on the molar sum of DEHP metabolites in their FF samples to arrive at “high” (mean 7.7 ± SD 2.3 nM, N = 48) and “low” (0.8 ± 0.4 nM, N = 48) exposure groups. Extracellular miRNA levels and concentrations of 15 steroid hormones were measured across FF samples. In addition, FF somatic cells, available for the Estonian patients, were used for RNA sequencing.Differential expression (DE) and interactions between miRNA and mRNA networks revealed that the expression levels of genes in the cholesterol biosynthesis and steroidogenesis pathways were significantly decreased in the high compared to the low DEHP group. In addition, the DE miRNAs were predicted to target key enzymes within these pathways (FDR < 0.05). A decreased 17-OH-progesterone to progesterone ratio was observed in the FF of the high DEHP group (p < 0.05). Additionally, the expression levels of genes associated with inflammatory processes were elevated in the FF somatic cells, and a computational cell-type deconvolution analysis suggested an increased immune cell infiltration into the high DEHP follicles (p < 0.05).In conclusion, elevated DEHP levels in FF were associated with a significantly altered follicular milieu within human ovaries, involving a pro-inflammatory environment and reduced cholesterol metabolism, including steroid synthesis. These results contribute to our understanding of the molecular mechanisms of female reprotoxic effects of DEHP.

The relationship between semen quality in male infertility clinic patients and bisphenol A：A Chinese cross-sectional study

Bisphenol A (BPA) is a growing concern as an endocrine-disrupting chemical due to its adverse health effects. However, the association between BPA and sperm quality in adult human males remains unclear. The aim of this study was to assess the daily life exposure level of BPA and analyze its correlation with sperm quality in males. Patients who sought treatment in Chinese infertility clinics between May and October 2023 were selected as study subjects. We determined participants' serum BPA content using high-performance liquid chromatography. Sperm count and motility were assessed using a computer-aided sperm analysis system, while sperm morphology was analyzed using an improved Papanicolaou stain. A total of 405 participants, averaging 33.01 ± 5.44 years old, were included. We observed low semen quality among participants in infertility clinics. Principal component analysis was performed for each semen quality index, and three principal components reflecting sperm motility, count, and morphology were extracted. The participants' mean serum BPA level was 6.96 ng/mL. Negative correlations were observed between serum BPA content and total sperm count, sperm density, forward motility rate, and non-forward motility rate. A positive correlation was found between the non-motile sperm rate and the head deformity rate. Morphological abnormalities were the predominant adverse effects observed. Despite low daily life BPA exposure, long-term low-dose exposure in the general population may damage semen quality. This study provides a scientific basis for managing health risks associated with BPA exposure.

A cross-sectional study on domestic violence among infertile women in western Iran

Background: To date, no study has examined domestic violence among infertile women in western Iran. Aims: This study aims to investigate the prevalence of domestic violence among infertile women in the region. Materials and Methods: A cross-sectional study was carried out at the infertility clinic in Hamadan. A total of 200 eligible infertile women, with a mean age of 31.48 ± 4.57 years, were recruited for the study. The Domestic Violence Questionnaire (DVQ) was administered to all participants. Data analysis was performed using Stata Statistical Software (version 17), with a significance level set at P ≤ 0.05. Results: This study included 200 infertile women with an average age of 31.48 ± 4.57 years. The mean duration of infertility was 1.9 ± 0.76 years. Regarding education, approximately 66% of the women and 69% of their spouses had completed high school or attained a diploma. Female-related causes accounted for 72.5% of infertility cases. Among the participants, 59.4% reported experiencing domestic violence. Emotional violence scored the highest percentage (67.5%), while sexual violence had the lowest percentage (43.63%). Statistical analysis revealed significant associations between age, spouse’s education level, frequency of sexual intercourse, and the level of violence experienced by women. Conclusion: The findings of this study reveal that 59.4% of women experienced various forms of domestic violence. Moreover, significant associations were observed between domestic violence and factors such as age, spouse’s education level, and frequency of sexual intercourse.

Exposure to ambient ozone and sperm quality among adult men in China

BackgroundLimited evidence exists regarding the association between ozone exposure and adverse sperm quality. We aimed to assess the association between ozone exposure and sperm quality, and identify susceptible exposure windows. MethodsWe recruited 32,541 men aged between 22 and 65 years old attending an infertility clinic in Wuhan, Hubei Province, China from 2014 to 2020. Ozone data were obtained from a satellite-based spatiotemporal model. Generalized linear models were used to estimate the association between ozone exposure and sperm quality parameters, including sperm concentration, sperm count, sperm total motility, and sperm progressive motility during the entire stage of sperm development (0–90 days before ejaculation) and three crucial stages (0–9 days, 10–14 days and 70–90 days before ejaculation). Stratified analyses were performed to evaluate whether associations varied by age, body mass index, and education levels. ResultsThe final analysis included 27,854 adult men. A 10 μg/m3 increase in ozone concentrations during the entire stage of sperm development was associated with a −4.17 % (95 % CI: −4.78 %, −3.57 %) decrease in sperm concentration, −6.54 % (95 % CI: −8.03 %, −5.60 %) decrease in sperm count, −0.50 % (95 % CI: −0.66 %, −0.34 %) decrease in sperm total motility, and −0.07 % (95 % CI: −0.22 %, 0.09 %) decrease in sperm progressive motility. The associations were stronger during 70–90 days before ejaculation and among men with middle school and lower education for sperm concentration. ConclusionsOzone exposure was associated with decreased sperm quality among Chinese adult men attending an infertility clinic. These results suggest that ozone may be a risk factor contributing to decreased sperm quality in Chinese men.

Herbicide residues as a possible risk factor in semen quality and spermatogenesis

Background Reports from various countries have consistently demonstrated a correlation between herbicide exposure, arising from agricultural practices, and a decline in semen quality, leading to male infertility. This study was conducted at Ekiti State University Teaching Hospital in Ado-Ekiti, a rural community characterized by a predominantly agrarian population to determine the relationship between semen quality and herbicides residues. Methods The study focused on males whose spouses were seeking assistance at infertility clinics. Routine semen analyses were performed according to the World Health Organization (WHO) criteria, categorizing samples into normospermic, asthenospermic, oligospermic, and azoospermic groups. Seminal plasma samples from each group (twenty samples per group) were subjected to analysis for the presence and concentration of herbicides using High-Performance Liquid Chromatography (HPLC). The following herbicides were investigated: halosulfurum, linuron, fluometuron, chlo-rimuron, imaxamox, cloransulam, dicamba, fluroxypor, trichlopyr, propanil, cloclinafop, clethodim, quizalofop, fluazifop, pinoxaden, bentazon, atrazine, and bromoxynil. The obtained results were subjected to statistical analysis using SPSS version 24. Results The analysis revealed significantly higher concentrations of most herbicides in the asthenospermia, oligospermia, and azoospermia groups compared to the normospermic group (P&lt;0.05). These findings suggest a strong association between herbicide exposure and poor semen quality in the studied population.Conclusion This study provides compelling evidence supporting the hypothesis that herbicides exposure could be a contributory factor to diminished semen quality in the investigated rural com-munity. The results underscore the importance of considering seminal herbicide determination as a routine component in male infertility testing. Additionally, the study advocates for the implementation of relevant legislation to mitigate potential risks associated with herbicide exposure.

Prevalence and severity of depression and anxiety in infertile female patients attending an academic hospital in central South Africa

Background. Infertility has an incidence of 15 - 20% in South Africa (SA). It may lead to the development of psychological disorders such as anxiety and depression. Objective. To determine the prevalence of depression and anxiety among infertile women attending the Infertility Clinic at a tertiary hospital in central SA. Methods. In this prospective analytic cross-sectional study, information captured included sociodemographic variables such as age, employment status, type and duration of infertility, marital status, type of marriage and education level. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) test were used to screen for depression and anxiety, respectively.Results. In total, 100 of 108 infertile women completed all the questionnaires correctly. Forty-two (42.0%) of the patients were &gt;35 years and 58.0% were married, with five (8.6%) being in a polygamous marriage. Fifty-three (53.0%) women had never been pregnant before. The prevalence of depression was 53.0%, with 45.0% of these patients showing moderate to moderately severe levels of depression. The level of education was significantly associated with depression (p&lt;0.025). Half of the participants (50.0%) screened positive for anxiety, with 12 (24.0%) having severe anxiety. In total, 40.0% of the participants screened positive for both anxiety and depression. No statistically significant association was observed between depression or anxiety and age, duration of infertility, marital status and employment status. Conclusions. Depression and anxiety disorders are common and often underdiagnosed in women undergoing infertility treatment. Practitioners should screen for these conditions at the initial patient presentation and refer patients for psychological support.