Reproductive Issues Research Articles

Fertility in BRCA mutation carriers: counseling BRCA-mutated patients on reproductive issues.

Genetic testing rates for hereditary breast and ovarian cancer (HBOC) have steadily increased during the past decades resulting in a growing population of young and healthy mutation carriers. Available data on fertility issues in BRCA mutation carriers is rising but the results remain to some extent still conflicting. We have performed a systematic literature review in order to get an overview concerning the current evidence on fertility issues in BRCA mutation carriers. Data were analyzed critically with the aim to deliver physicians a solid basis for (onco) fertility counseling in women with BRCA mutations. We present the latest data on cancer risks in women with HBOC and analyze the influence of cancer treatment and preventive surgery on the reproductive potential. Epidemiological studies on fertility issues in BRCA mutation carriers showed heterogeneous results. However, several authors showed a decreased ovarian reserve with lower Anti-Müllerien hormone (AMH) levels and poorer response to ovarian stimulation in BRCA positive women. The diagnosis of BRCA mutations influences reproductive decision-making. Additionally, the shortened reproductive window and the need to complete family planning early has a significant psychological impact. This article highlights the importance of fertility counseling in BRCA mutation carriers. Individual fertility counseling is mandatory. Fertility preservation strategies should be discussed.

Proteome and Microbiome Mapping of Human Gingival Tissue in Health and Disease.

Efforts to map gingival tissue proteomes and microbiomes have been hampered by lack of sufficient tissue extraction methods. The pressure cycling technology (PCT) is an emerging platform for reproducible tissue homogenisation and improved sequence retrieval coverage. Therefore, we employed PCT to characterise the proteome and microbiome profiles in healthy and diseased gingival tissue. Healthy and diseased contralateral gingival tissue samples (total n = 10) were collected from five systemically healthy individuals (51.6 ± 4.3 years) with generalised chronic periodontitis. The tissues were then lysed and digested using a Barocycler, proteins were prepared and submitted for mass spectrometric analysis and microbiome DNA for 16S rRNA profiling analysis. Overall, 1,366 human proteins were quantified (false discovery rate 0.22%), of which 69 proteins were differentially expressed (≥2 peptides and p < 0.05, 62 up, 7 down) in periodontally diseased sites, compared to healthy sites. These were primarily extracellular or vesicle-associated proteins, with functions in molecular transport. On the microbiome level, 362 species-level operational taxonomic units were identified. Of those, 14 predominant species accounted for >80% of the total relative abundance, whereas 11 proved to be significantly different between healthy and diseased sites. Among them, Treponema sp. HMT253 and Fusobacterium naviforme and were associated with disease sites and strongly interacted (r > 0.7) with 30 and 6 up-regulated proteins, respectively. Healthy-site associated strains Streptococcus vestibularis, Veillonella dispar, Selenomonas sp. HMT478 and Leptotrichia sp. HMT417 showed strong negative interactions (r < −0.7) with 31, 21, 9, and 18 up-regulated proteins, respectively. In contrast the down-regulated proteins did not show strong interactions with the regulated bacteria. The present study identified the proteomic and intra-tissue microbiome profile of human gingiva by employing a PCT-assisted workflow. This is the first report demonstrating the feasibility to analyse full proteome profiles of gingival tissues in both healthy and disease sites, while deciphering the tissue site-specific microbiome signatures.

Endometrioma and reproductive issues: a well-informed patient may be the driver for change.

Endometriosis affects a great proportion of women during their reproductive years and may impair female fertility in several ways. Ovarian endometrioma (OE) is the most frequent phenotype and growing evidence suggest an endometrioma-mediated damage to the ovary, ovarian reserve and oocyte quality. Traditionally, surgery has been the first-line treatment in cases of OE. Great advances in assisted reproduction and fertility preservation techniques opened new possibilities towards a more conservative approach. Herein we discuss multiple mechanisms responsible for the deterioration of the reproductive capacity in cases of OE as well as the pros and cons of different treatment options. The management of endometrioma-related subfertility remains controversial and it will depend on patient's intentions and priorities. In the "internet era" patients tend to be hyper-informed and more participative, but they are often misguided and misinformed. Thus, doctors should be able to convert these individuals into well-informed patients in order to facilitate the process of shared decision making, which is extremely relevant in the context of OEs.

‘New eugenics,’ gender and sexuality: a global perspective on reproductive politics and sex education in Cold War Europe

ABSTRACT The article addresses reproductive politics and sex education in Cold War Europe in light of novel historical research. Integrating sex education into reproductive politics it delineates four hitherto little discussed conceptual and topical areas in the field, and points to possibilities for further research. Most importantly, the article places the globalized character of post-World War II reproductive politics at the center of historical investigation. It sheds light on the position of (state socialist) Europe in the global processes that shaped fertility- and sexuality-related discourses, policies and practices during the Cold War, and the role of transnational agencies. Secondly, the article highlights the postwar persistence of eugenic thought in reproductive politics, still largely missing especially from the historiography of state socialist countries. It points to the ways in which “new eugenics” is related to its earlier manifestations in Europe as well as how it adapted to state socialist contexts. Third, the article discusses the important contribution of gender and intersectional scholarship on the history of sex education and reproductive politics in Europe to the social and welfare history of the region. Finally, the article pays specific attention to the role of the Catholic Church in the former “Eastern bloc.” It underlines how reproductive issues enabled the Church to affect politics and engage with the state in heterogeneous ways beyond opposition. The article suggests that further historical analysis could importantly contribute to a better understanding of the present rise of populist right-wing discussion focused on the demise of the traditional family and the fall of birth rates.

A retrospective chart review of subdermal neck coagulation using helium plasma technology

AbstractBackgroundA helium‐based plasma technology has recently been cleared by the Food and Drug Administration for cutting, coagulation, and ablation of soft tissue (Renuvion® System; Apyx™ Medical Corporation). As the safety of helium plasma for treating lax and sagging skin in the neck area has not been previously reported, the objectives of this study were to obtain safety results from helium plasma used for neck rejuvenation, to summarize subject and procedure variables, and to assess treatment outcomes for the development of future treatment protocols.MethodsTwo retrospective chart reviews were performed using data from patients who had undergone a helium plasma procedure in the neck area to assess safety (Study 1) and effect (Study 2). For Study 2, pre‐ and posttreatment images of treatment areas were assessed by blinded reviewers.ResultsIn Study 1 (N = 15), two adverse events felt to be treatment‐related were noted. In Study 2 (N = 13), mean improvements included a 37.29% reduction in submental angle and reduction in the submental area.ConclusionsHelium plasma technology appears to be a safe and well‐tolerated treatment. Consistent and reproducible tissue contraction in the submental and neck area was observed between the authors' sites.

Scope of Practice of Forensic Midwifery: An Integrative Review

Background & aim: Forensic midwifery is a new major which has been established in response to the need of endangered women for forensic services and also the lack of service provision in this domain. However, there are ambiguities in the definition of this major and its scope of practice. The present study was conducted to investigate the scope of practice in forensic midwifery. Methods: In this integrative review, the articles related to the subject of interest were searched in several database including PubMed, Scopus, CINHAL and Google Scholar. All kinds of publications including reviews and standards, qualitative, quantitative, or mixed methods studies were included in the review regardless of the publication date. The data related to the scope of practice in forensic midwifery were extracted using a wide and in-depth analysis, in addition to using an expert panel for validation. To do the analysis, every concept representing scope of practice was coded and similar codes were classified into themes. Results: The search process resulted in retrieval of 43 articles. Based on the reviewed papers, the scope of practice in forensic midwifery divided into four categories including the practices related to reproductive issues, violence, malpractice in obstetrics and gynecology profession, and the improvement of the professionalism in midwifery domain. Conclusion: Considering the potentials of forensic midwifery, the graduates of this major could have an important role in the protection of women’s rights in forensic situations.

Gestantes de alto risco: uma análise da autoestima e fatores associados em uma maternidade de referência na cidade do Recife, PE, Brasil

A pesquisa tem como objetivo correlacionar com os padrões de autoestima e fatores associados em gestantes de alto risco em uma maternidade de referência na cidade do Recife, Pernambuco, Brasil. Trata-se de um estudo descritivo, transversal, com abordagem quantitativa. A população amostral incluiu 112 mulheres, gestantes, adultas. Na coleta de dados foi utilizado um formulário adaptado da versão no Brasil da Escala de Autoestima de Rosenberg (EAR), acrescido de questões socioeconômicas, obstétricas e reprodutivas. Observou-se que escolaridade foi í única variável com associação significativa com autoestima (p &lt; 0,05) e para a referida variável se destaca que o percentual com autoestima insatisfatória reduziu com o grau de escolaridade, sendo 96,0% entre as que tinham até fundamental incompleto, 75,0% entre as que ensino fundamental e 61,0% entre as que tinham ensino médio/superior. Reconhece-se que as maternidades funcionam muitas vezes como porta de acesso para identificação e acolhimento dessas gestantes sendo necessária a atualização/capacitação dos profissionais de saúde para o atendimento adequado e direcionado, uma vez que poucas mulheres têm acesso í avaliação de seu estado emocional durante a gestação.

Reproductive Health Right Practice among Preparatory School Female Students of Assela Town, Arsi Zone, Oromia Regional State, Ethiopia.

Introduction Knowledge and practice toward reproductive health right (RHR) is critical to protect young women, especially school girls, from unwanted reproductive outcomes as improving access to reproductive health services. However, the majority of young people including female secondary school students in Ethiopia have very little knowledge on the youth's reproductive health rights. The aim of this study was to assess knowledge and practice toward reproductive health right among preparatory female students in Assela Town, Arsi Zone, Ethiopia. Methods A study was conducted among 403 preparatory school female students in Assela Town. Simple random sampling was employed to select the subjects, and a self-administered questionnaire was used to collect data. The collected data were entered using EPI Info version 3.5.4 and exported to SPSS version 21 for analysis. Descriptive and logistic regression analysis was carried out. Result Sixty percent of girls discussed reproductive issues openly with their peers. About 94% of the respondents knew, at least, one contraceptive method; injectable (91.2%) was the most known type of contraceptives. Marital status, father occupation, discussion on sexual and reproductive issues, and having sexual partners were affecting the practice of reproductive health rights. Conclusions Knowledge of the students was moderate on reproductive health right which was 70%. Practice of sexual and reproductive health rights was 22.6% among the study participants. It is recommended that promotion on sexual and reproductive health right through media is important.

Issues of biopolitics of reproduction in post-war Greece

The Greek biopolitics of reproduction during the post-war period was determined by the demographic figures. Instead of a rise in births, Greece experienced a constant downward trajectory of the birth rate throughout the second half of the twentieth century. The country also witnessed population instability due to the massive immigration in the 1960s and the wave of repatriation in the next decade. The article explores the state's biopolitics in order to achieve demographic equilibrium by adopting a pronatalist perspective. The construction of biopolitics was influenced by the consecutive wars of the first half of the century resulting in the denial of any means suspected of reducing the birth rate, such as contraception and abortion. In parallel, the article investigates the attempts of a group of eugenicists to impose to the state authorities their own views on reproduction control. The key debates were birth control and abortion because these issues of reproduction were entangled with major social fermentations caused by urbanization, modernization, eugenics, and feminism. The Constitution of 1974 was instrumental in changing the biopolitics of reproduction by introducing equal rights to men and women. It provoked a series of legal transformations with regard to marriage, family, and reproduction.

Emergency contraceptive knowledge, utilization and associated factors among secondary school students in Wolkite town, southern Ethiopia, cross sectional study

BackgroundEthiopia is one of the sub-Saharan African countries with high maternal mortality and morbidity, unsafe abortion and adolescent births. Despite different policy measures taken by the government to improve sexual and reproductive health among adolescents their success is not well studied in Ethiopia. The objective of this study is to explore emergency contraceptive related knowledge, practice and its determinants among secondary school students in southern Ethiopia.MethodsAn institution-based cross-sectional study was conducted in selected high schools of Wolkite town, Southern Ethiopia from December to November 2019. Single population proportion formula was used to calculate sample size. A total of 327 female students participated in the study with a total response rate of 97%. Data were collected using a self-administered, structured questionnaire and cleaned, entered and analyzed using Statistical package for social science software version 21.Result153 (54.8%) of the study participants had good knowledge about emergency contraceptives and only (40.5%) of sexually active participates used emergency contraceptives after unprotected sex. Type of admission and grade level of participants and discussion of reproductive health related issues with parents were significantly associated with good knowledge of Emergency contraceptive. Having partner and grade level of students were among the significant determinants of emergency contraceptive utilization.ConclusionThe study showed an acceptable level of emergency contraceptive knowledge but only less than half of sexually active respondents used emergency contraceptives. To prevent unintended pregnancy among secondary school students sexual and reproductive health education should be given to students starting from their enrollment. Furthermore, parents should be encouraged to freely discuss sexual and reproductive health matters with their children.

Schizophrenia Psychosis in Women

A first step towards personalized medicine is to consider whether, for some disorders, the safest and most effective treatment of women needs to differ from standard guideline recommendations developed on the basis of clinical trials conducted, for the most part, in men. A second step is to consider how women’s reproductive stages—pre-pubertal years, menstrual phases, pregnancy trimesters, lactation and postpartum periods, menopausal and postmenopausal/aging status—affect the optimal choice of treatment. This review focuses on these two steps in the treatment of psychosis, specifically schizophrenia. It discusses genetics, precursors and symptoms of schizophrenia, reproductive and associated ethical issues, antipsychotic drug response and adverse effects, substance abuse, victimization and perpetration of violence, and issues of immigration and of co-morbidity. The conclusions, while often based on clinical experience and theoretical considerations rather than strictly on the evidence of randomized controlled trials, are that clinical recommendations need to consider clinical and role differences that exist between men and women and make appropriate correction for age and reproductive status.

A Study on the Reproduction Strategy through the Planning Process of Baby Shark

In this study, the aim is to understand the strategy of video content production with the case of the baby shark development process of Pink Fong Company, the content is described about the successful planning and strategy of baby shark which has become a global content, and the main point describes the planning of the production process and marketing strategies for each country. The findings of the conclusions resulted in the application of the standards of globalization and the local understanding of culture as the main factors for content success. If the Pink Pong Company's method is applied through this, it is possible to apply what is the main issue of creative content production Reproduction in the future.

Reproductive Health and Reproductive Justice for Muslim Women

Reproductive justice is defined as “women and girls achieving economic, social, and political power, and the resources to make healthy decisions about one's bodies, sexuality, and reproductive health for themselves and their families and their communities in all areas of [their] lives” (Zavella 2016, 1). Women of color are the targets of much prejudice in American society. (Ginsburg and Rapp 1995). Since September 11th and especially in the Trump era, Muslims continue to be “otherized” and racialized, further marginalizing Muslim women. Muslim women's reproductive health is impacted by reductive and essentialized perspective of their religious practice, a typical view held by contemporary America. Analyzing these disparities through an intersectional lens allows the researcher to confront popular essentialisms to understand the simultaneous interaction of race, class, and gender in the lives of Muslim women. Using this approach in her study of the reproductive health of African American women in Harlem, Leith Mullings (2005).identifies certain structural constraints, including political and economic factors, that cause stressors during pregnancy and health problems for both mother and child. Her findings and similar studies on Latina women beg the question: how do gender and racial discrimination, class bias, and Islamophobia affect the reproductive health of Muslim women? In this paper, I argue that intersectionality as a method and theoretical approach should be applied to Muslim women's reproductive health and reproductive justice issues, and I sketch out the beginning of an answer to that question.

Physicians\u2019 attitudes towards reproduction in young patients with early breast cancer in China

BackgroundAs more young patients with breast cancer undergo treatments and obtain good prognoses, the issue of postoperative reproduction in breast cancer patients has attracted more attention.MethodsWe conducted a prospective, cross-sectional survey of 2000 breast cancer-associated physicians using a 24-items questionnaire adapted from prior guides. Then we used a multivariable linear regression model to confirm independent associations between the propensity of physicians’ attitudes toward reproduction and physicians’ specific demographic characteristics.ResultsA total of 911/1249 (72.93%) eligible physicians completed the questionnaire. Regarding the most concerning topic of whether breast cancer patients could conceive, 65 (7.1%) physicians having low and 457 (50.2%) physicians having high propensity for recommending reproduction. For ductal carcinoma in situ (DCIS) after surgery and radiotherapy, 599 (65.8%) physicians did not agree with the recommendation to conceive. 231 (25.4%) highly agree with the recommendation of reproduction for 2 years after surgery in invasive breast cancer patients with lymph nodes-negative. Only 140 (15.4%) physicians did not agree with the recommendation for 5 years after surgery in invasive breast cancer patients with lymph nodes-positive. A total of 861 (94.5%) physicians stated that they advised the patients to consult experts from other disciplines, such as gynecology, oncology, genetic and psychology disciplines. In multivariable analysis, more positive attitude toward reproduction was significantly associated with male, more than 11 times of participating in academic forum on breast cancer, 1–2 times of consulting about reproduction problems after breast cancer surgery per outpatient service and more than 11 min spending on solving the problem about reproduction in early breast cancer.ConclusionThis study showed that attitudes towards reproduction of young breast cancer patients from physicians in China. Physicians had a high propensity for recommending reproduction. Compared with the two reproduction guidelines recommendation when to reproduce in different circumstances for breast cancer patients, physicians from China remained a relatively conservative attitude. Most physicians advised the patients to consult experts from other disciplines, such as gynecology, oncology, genetic and psychology disciplines.

Addressing the Gendered Interests of Victims/Survivors of Conflict-Related Sexual Violence and Their Children Through National Action Plans on Women, Peace and Security

There is growing acknowledgement of the need to address the impacts of conflict-related sexual violence (CRSV), with less recognition of conflict-related reproductive and maternal harms and children born of war (CBW). An intricate set of common as well as distinctive interests arise for both victims/survivors and their children that remain unfulfilled. National Action Plans on Women, Peace and Security (NAPs-WPS) present an opportunity to redress these gaps. This article examines to what extent are NAPs-WPS responsive to the specific rights and gendered interests of victims/survivors of CRSV and their children? It advances thinking on gender planning for peace and security and makes three significant analytical contributions: a ‘Typology of Impacts and Losses’ advancing understanding of CRSV; a ‘Gender Interests Analysis’ framework, identifying the practical and strategic gender interests of victims/survivors and their children; and application of these frameworks to produce a critical analysis of the NAPs-WPS of Indonesia, Nepal, Philippines and Timor-Leste. It finds that planning under WPS is failing to ensure that multi-sectoral services are available, while reproductive and maternity issues and CBW are completely neglected in the selected NAPs-WPS. The article discusses the implications of these findings for gender planning through NAPs-WPS going forward.

Quality of life of cervical cancer patients

ABSTRACT Cervical cancer is known as the highest cause of death after breast cancer. It is gynecological cancer contributing to the top cause of death in women. Sexual and reproductive issues can reduce the quality of life of women with cervical cancer. WHO defines the quality of life as an individual's perception in the cultural context and value system in which the individual experiences and is related to their goals, expectations, standards, and affairs. It gives the concept of an individual's physical health, psychological conditions, one's beliefs, social relationships, and one's involvement with something meaningful in their environment. This article will explain the definition, symptoms, and staging of cervical cancer, the definition of the quality of life, the meaning of excellence for the cervical cancer patient, and the facts that affect the quality of life. Keywords : quality of life, cervical cancer, reproductive organ cancerCorrespondence : mayangwulan8@gmail.com

Regional variations of childhood immunisations in Senegal: a multilevel analysis.

To estimate geographical variations of child immunisation at the regional level in Senegal, to identify individual and contextual factors that could explain these regional discrepancies, and to measure their effects. Data come from the 2015, 2016 and 2017 Senegalese Demographic and Health Survey, a national survey targeting women aged 15-49, with a questionnaire focusing on health and reproductive issues including their children's immunisation status. We restricted the analysis to children aged 12-23months (n=4955) and conducted a multilevel logistic regression to assess individual and contextual factors associated with complete immunisation coverage. The complete immunisation coverage rate of children was estimated at 68% and ranged from 41% in the region of Kedougou to 83% in the region of Dakar. The inter-regional variance was significantly different from zero (P=0.006) in the empty multilevel model. It decreased by more than half (57 %) after adjusting for individual factors but remained significantly different from zero (P=0.010). Regional variations of complete immunisation rates drastically decreased and were no longer statistically significant (P=0.343) after adjusting for the following regional factors: population density, density of hospitals, literacy rate and proportion of health facilities with an antenatal care service. Regarding health policies designed to improve childhood immunisation and to reduce related inequalities, our results highlight the need to take into account both individual and contextual factors, with a focus on rural and deprived areas where children are at higher risk of incomplete immunisation.

Sexagem de Aves da Espécie Amazona aestiva (Papagaio Verdadeiro) por meio de técnica de PCR

In most species of birds, it is not possible to identify the genus by the external phenotypic characteristics in young animals since the reproductive organs are internal. Therefore, as it is fundamental for breeders to carry out this sexual differentiation not only for the reproductive issue but also for the fact that in some species only males show certain characteristics such as song, it is extremely important to perform the sexing of birds through DNA analysis , which besides giving 99.9% reliability to the result, brings other advantages in relation to other techniques, such as the reduction of stress and the risk of damage to the bird and also the fact that it is applied from any age (ideal for the chicks). The objective of this work was to sex 13 birds of the species of Amazon aestiva (Papagaio-Verdadeiro) using the PCR technique. Since in birds the heterogametic sex is that of females, two bands were observed for this genus and only one was observed for males, with 5 males and 3 females being identified. From the results obtained it was possible to conclude that the PCR technique allowed to confirm the animals' genus in an efficient and non-invasive way, representing an important tool for targeting mating and conservation of the wild bird species.

Knowledge and practice of induction of lactation in trans women among professionals working in trans health

BackgroundBreastfeeding is emerging as an important reproductive rights issue in the care of trans and gender nonconforming people. This study sought to understand the tools available to professionals working in the field of trans health to help trans women induce lactation and explore the concept of unmet need.MethodsIn November 2018, we conducted a cross-sectional study which surveyed attendees at the World Professional Association for Transgender Health (WPATH) symposium in Buenos Aires, Argentina. Eligible participants were 18 + years old, had professional experience with transgender populations, were able to complete a survey in English, and were conference attendees. Descriptive data were collected using a 14-item written survey encompassing demographic characteristics, experience in transgender health, and lactation induction in trans women.ResultsWe surveyed 82 respondents (response rate 10.5%), the majority of whom were healthcare professionals (84%). Average age of respondents was 42.3 years old. They represented 11 countries and averaged 8.8 years of work at 21.3 h/week with trans populations. Healthcare professionals in this sample primarily specialized in general/internal medicine, psychology, endocrinology, and obstetrics/gynecology. One-third of respondents (34%) stated that they have met trans women who expressed interest in inducing lactation. Seventeen respondents (21%) knew of providers, clinics, or programs that facilitated the induction of lactation through medication or other means. Seven respondents (9%) have helped trans women induce lactation with an average of 1.9 trans women in the previous year. Two protocols for lactation induction were mentioned in free text responses and 91% believe there is a need for specialized protocols for trans women.ConclusionThis exploratory study demonstrates healthcare professionals’ interest in breastfeeding protocols for lactation induction in trans women. Additional studies are needed to capture insights from breastfeeding specialists, e.g. lactation consultants and peripartum nurses, and to understand patients’ perspectives on this service.

Relationships between the age of 25,445 men attending infertility clinics and sperm chromatin structure assay (SCSA®) defined sperm DNA and chromatin integrity

To determine relationships between age of men with potential male factor infertility and sperm chromatin structure assay (SCSA) measures of sperm DNA fragmentation (SDF) and high DNA stainable sperm (HDS), and to compare these data with those obtained from healthy donor men without reproductive issues. Retrospective study. Infertility clinics and diagnostic laboratory. A total of 25,445 men attending infertility clinics. Donors were 87 men working at Lawrence Livermore National Laboratory. None. SCSA measures (% DNA fragmentation index (DFI), X DFI, SD DFI, and %HDS) of men aged 21-80 years. In the study population, advancing paternal age was associated with increased sperm DNA fragmentation (SDF) scored as increased percentage of sperm in semen ejaculates with measurable DNA strand breaks (%DFI). The slope of increase in %DFI prior to age 41.6 years was 0.39, which increased after age 41.6 to more than double at a slope of 0.86. These changes in DNA/chromatin in more than 25,000 aging men attending infertility clinics are similar to those seen over the same age span (20-80 years) in 87 nonpatient, healthy men without reproductive issues. For the age group 20-50 years, there was no major significant difference in %DFI between patients and donor men. According to a logistic regression model, the estimated probability is that, for example, a 40-year-old and a 50-year-old man have a 20% and 40% chance, respectively, to have a pathological DFI ≥25% by age factor alone. The condensation of sperm chromatin in patients increased with age in a linear fashion, from a mean of 12.2 %HDS at age 20-25 to a mean of 7.9 %HDS at age 60-65. Patients had a greater %HDS than donors across all ages. The great heterogeneity of both DFI and HDS values at a specific age prevents the automatic translation of age into an index of DNA fragmentation. However, it reinforces the idea that both DFI and HDS evaluation can play a role in detecting potential male infertility in cases that are not resolved by routine testing and in cases of multiple miscarriages. DFI and HDS data can help clinicians to predict a man's fertility potential, to consider corrective therapeutic approaches, as well as to assess the risk to the offspring's health.