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Psychological, social, and sexual challenges affecting men receiving male infertility treatment: a systematic review and implications for clinical care
In recent years, social research surrounding the consequences of infertility has increasingly focused on the male perspective; however, a gap exists in the understanding of men's experiences of male infertility treatment. This review aims to synthesize the existing evidence concerning the psychological, social, and sexual burden of male infertility treatment on men, as well as patient needs during clinical care. A systematic search identified 12 studies that are diverse in design, setting, and methods. Psychological evaluations have found that urological surgery may have a lasting impact on infertility-specific stress, and treatment failure can lead to feelings of depression, grief, and inadequacy. Men tended to have an avoidant coping mechanism throughout fertility treatment, and their self-esteem, relationship quality, and sexual functions can be tied to outcomes of treatment. Partner bonds can be strengthened by mutual support and enhanced communication; couple separation, however, has been noted as a predominant reason for discontinuing male infertility treatment and may be associated with difficult circumstances surrounding severe male infertility. Surgical treatments can affect the sexual functioning of infertile men; however, the impact of testicular sperm extraction outcomes appears to be psychologically driven whereas the improvements after microsurgical varicocelectomy are only evident in hypogonadal men. Clinically, there is a need for better inclusion, communication, education, and resource provision, to address reported issues of marginalization and uncertainty in men. Routine psychosocial screening in cases of severe male infertility and follow-up in cases of surgical treatment failure are likely beneficial.
Journal Article
Restorative reproductive medicine for infertility in two family medicine clinics in New England, an observational study
Background
Restorative reproductive medicine (RRM) seeks to identify and correct underlying causes and factors contributing to infertility and reproductive dysfunction. Many components of RRM are highly suitable for primary care practice. We studied the outcomes amongst couples who received restorative reproductive medicine treatment for infertility in a primary care setting.
Methods
Two family physicians in Massachusetts trained in a systematic approach to RRM (natural procreative technology, or NaProTechnology) treated couples with infertility. We retrospectively reviewed the characteristics, diagnoses, treatments, and outcomes for all couples treated during the years 1989 to 2014. We compared pregnancy and live birth by clinical characteristics using Kaplan-Meier analysis. We employed the Fleming-Harrington weighted Renyi test or the logrank test to compare the cumulative proportion with pregnancy or with live birth.
Results
Among 370 couples beginning treatment for infertility, the mean age was 34.8 years, the mean prior time trying to conceive was 2.7 years, and 27% had a prior live birth. The mean number of diagnoses per couple was 4.9. Treatment components included fertility tracking with the Creighton Model FertilityCare System (80%); medications to enhance cervical mucus production (81%), to stimulate ovulation (62%), or to support the luteal phase (75%); and referral to female laparoscopy by a surgeon specializing in endometriosis (46%). The cumulative live birth rate at 2 years was 29% overall; this was significantly higher for women under age 35 (34%), and for women with body mass index < 25 (40%). There were 2 sets of twins and no higher-order multiple gestations. Of the 63 births with data available, 58 (92%) occurred at term.
Conclusions
Family physicians can provide a RRM approach for infertility to identify underlying causes and promote healthy term live births. Younger women and women with body mass index < 25 are more likely to have a live birth.
Journal Article
The Palgrave handbook of infertility in history : approaches, contexts and perspectives
This ground-breaking, interdisciplinary volume provides an overdue assessment of how infertility has been understood, treated and experienced in different times and places.It brings together scholars from disciplines including history, literature, psychology, philosophy, and the social sciences to create the first large-scale review of recent.
eBook
Sex cells
Unimaginable until the twentieth century, the clinical practice of transferring eggs and sperm from body to body is now the basis of a bustling market. In Sex Cells, Rene Almeling provides an inside look at how egg agencies and sperm banks do business. Although both men and women are usually drawn to donation for financial reasons, Almeling finds that clinics encourage sperm donors to think of the payments as remuneration for an easy \"job.\" Women receive more money but are urged to regard egg donation in feminine terms, as the ultimate \"gift\" from one woman to another. Sex Cells shows how the gendered framing of paid donation, as either a job or a gift, not only influences the structure of the market, but also profoundly affects the individuals whose genetic material is being purchased.
eBook
The fertility doctor : John Rock and the reproductive revolution
As Louise Brown—the first baby conceived by in vitro fertilization—celebrates her 30th birthday, Margaret Marsh and Wanda Ronner tell the fascinating story of the man who first showed that human in vitro fertilization was possible.
John Rock spent his career studying human reproduction. The first researcher to fertilize a human egg in vitro in the 1940s, he became the nation's leading figure in the treatment of infertility, his clinic serving rich and poor alike. In the 1950s he joined forces with Gregory Pincus to develop oral contraceptives and in the 1960s enjoyed international celebrity for his promotion of the pill and his campaign to persuade the Catholic Church to accept it.
Rock became a more controversial figure by the 1970s, as conservative Christians argued that his embryo studies were immoral and feminist activists contended that he had taken advantage of the clinic patients who had participated in these studies as research subjects.
Marsh and Ronner's nuanced account sheds light on the man behind the brilliant career. They tell the story of a directionless young man, a saloon keeper's son, who began his working life as a timekeeper on a Guatemalan banana plantation and later became one of the most recognized figures of the twentieth century. They portray his medical practice from the perspective of his patients, who ranged from the wives of laborers to Hollywood film stars.
The first scholars to have access to Rock's personal papers, Marsh and Ronner offer a compelling look at a man whose work defined the reproductive revolution, with its dual developments in contraception and technologically assisted conception.
eBook
Rheotaxis-based separation of sperm with progressive motility using a microfluidic corral system
The separation of motile sperm from semen samples is sought after for medical infertility treatments. In this work, we demonstrate a high-throughput microfluidic device that can passively isolate motile sperm within corrals inside a fluid channel, separating them from the rest of the diluted sample. Using finite element method simulations and proposing a model for sperm motion, we investigated how flow rate can provide a rheotaxis zone in front of the corral for sperm to move upstream/downstream depending on their motility. Using three different flow rates that provided shear rates above the minimum value within the rheotaxis zone, we experimentally tested the device with human and bovine semen. By taking advantage of the rheotactic behavior of sperm, this microfluidic device is able to corral motile sperm with progressive velocities in the range of 48–93 μm·s−1 and 51–82 μm·s−1 for bovine and human samples, respectively. More importantly, we demonstrate that the separated fractions of both human and bovine samples feature 100% normal progressive motility. Furthermore, by extracting the sperm swimming distribution within the rheotaxis zone and sperm velocity distribution inside the corral, we show that the minimum velocity of the corralled sperm can be adjusted by changing the flow rate; that is, we are able to control the motility of the separated sample. This microfluidic device is simple to use, is robust, and has a high throughput compared with traditional methods of motile sperm separation, fulfilling the needs for sperm sample preparation for medical treatments, clinical applications, and fundamental studies.
Journal Article
Spermatogonial stem cells
Spermatogonial stem cells (SSCs) are the most primitive spermatogonia in the testis and have an essential role to maintain highly productive spermatogenesis by self-renewal and continuous generation of daughter spermatogonia that differentiate into spermatozoa, transmitting genetic information to the next generation. Since the 1950s, many experimentalmethods, including histology, immunostaining, whole-mount analyses, and pulse-chase labeling, had been used in attempts to identify SSCs, but without success. In 1994, a spermatogonial transplantation method was reported that established a quantitative functional assay to identify SSCs by evaluating their ability to both self-renew and differentiate to spermatozoa. The system was originally developed using mice and subsequently extended to nonrodents, including domestic animals and humans. Availability of the functional assay for SSCs has made it possible to develop culture systems for their ex vivo expansion, which dramatically advanced germ cell biology and allowed medical and agricultural applications. In coming years, SSCs will be increasingly used to understand their regulation, as well as in germline modification, including gene correction, enhancement of male fertility, and conversion of somatic cells to biologically competent male germline cells.
Journal Article
The effect of job stress on fertility, its intention, and infertility treatment among the workers: a systematic review
Introduction
The effect of job stress on childbearing is an important but less known consequence. Three important agents for childbearing include fertility, its intention, and infertility treatment. The adverse effect of job stress on these agents remains controversial. Therefore, this systematic review study aimed to investigate the effect of job stress on them.
Methods
Four electronic bibliographic databases, including Scopus, PubMed, Web of Science, and Embase were systematically searched up to 25 November 2023. The combinations of three groups of keywords were used. The first group of keywords included “job”, “occup*, work, and indust* and the second group consisted of stress, distress, and strain. The third group of keywords comprised pregnancy rate, fertility, infertility, fecundability, and childlessness. Then, the articles were screened by researchers. In the next step, the researchers extracted the information from the selected papers. To assess their quality, critical appraisal tools of the Joanna Briggs Institute (JBI) were used.
Results
Sixteen papers were entered into this study. Based on the results, job stress showed significant associations in 5 out of 8 studies on fertility, 3 out of 3 studies on fertility intention, and 6 out of 8 studies on infertility treatment process. Some probable mechanisms include the physiological effects of job stress on fertility, the effect of changed behavioral habits due to job stress on fertility, the psychological effects of job stress on fertility intention, and the effect of job stress on the infertility treatment process.
Conclusions
The results showed that job stress may affect fertility, its intention, and the infertility treatment process among people. Therefore, it is required that necessary measures are planned and performed to decrease job stress and strain in workplaces.
Journal Article