Fertility Clock Headlines, Fertility Headlines

New biorepository to help uncover mysteries of pregnancy and childbirth

Laying a foundation for discoveries that will improve maternal, newborn and child health everywhere, PMNCH member the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) has created the world’s first ever standardized, widely accessible repository of high-quality specimens linked to data from diverse populations of pregnant women.

Fertility Clock Headlines, Fertility Headlines

One for the Guys: That Azoospermic Feeling

At the beginning of the office visit, I like to ask men with no sperm in the ejaculate who are unable to conceive a simple question: “What crossed your mind when you first heard that you were azoospermic?” The answers varying greatly but are very telling:

  • “It must be a mistake.”
  • “I shouldn’t have joined that fraternity in college…”
  • “It wasn’t the best sample I’ve ever done.”
  • “I was simply and utterly devastated.”
  • “I was in shock and then got really depressed.”
  • “It changed my life…I always thought that I would be a father.”

The Meaning of Azoospermia

Azoospermia is the lack of sperm in the ejaculate. It can be due to a blockage in the system (obstruction) or failure of the testicles to make sperm (nonobstructive). The most common reason for blockage is a vasectomy. Other causes include infections, prior surgery, injury or congenital absence of certain reproductive tract organs. Failure to make sperm can be due to exposures (hot tubs), medications, varicocele, a history of undescended testicles, cancer and cancer treatment. However the largest chunk of men with poor sperm production have none of these issues. Instead, they have a subtle genetic cause: either they are missing genes on the Y chromosome or have other chromosomes harboring subtle alterations that do not otherwise affect their health or lives.

So, like Captain Renault in the movie “Casablanca,” most men with azoospermia are “shocked, shocked!” because they feel so normal in every other way. And the vast majority are normal (as normal as men can get) in every other way. Most of the things they worry about, like college indiscretions, are exposures that are entirely reversible with time. My response is usually to allay fear and guilt by saying: “This is not something that you have done to yourself; let’s see if we can do something about it at this point.”

Treating Azoospermia

In fact there is a whole lot that we can do with azoospermia. Men with blockages can often be unblocked with microsurgery, one of my favorite things to do. This gives them the chance to conceive naturally again. And most men with poor production as a cause of azoospermia will have pockets of sperm in the testicles that can be identified by techniques like sperm mapping and that can be used for high-technology pregnancies.

What I have learned after caring for hundreds of azoospermic men over two decades is that they really don’t care what their sperm counts are as long as they can be fathers. And once they are fathers, it is clear that that “azoospermic feeling” goes away, as it should.

 

Dr. Paul Turek is founder of The Turek Clinic in San Francisco, a former professor and Endowed Chair at the University of California San Francisco, and a pioneer in innovative techniques for treating male infertilty. He was recently the recipient of a National Institutes of Health (NIH) grant for research designed to help infertile men become fathers. Check out Dr. Turek’s weekly blog on about common medical issues, solutions, and innovations at TurekOnMensHealth.com, where this blog post originally appeared.


Author:
Paul J. Turek, M.D.
Fertility Clock Headlines, Fertility Headlines

Height, BMI, Tied to Ovarian Cancer

A new analysis of published and unpublished studies concludes that risk for ovarian cancer is associated with increasing height. It also finds that among women who have never used hormone therapy for the menopause, the risk for developing the disease is also tied to increasing body mass index, BMI, a measure of obesity.

Fertility Clock Headlines, Fertility Headlines

African American women are more likely to experience infertility

In honor of National Minority Health Month (April), we wanted to bring a bit more awareness to the fact that more African American women are experiencing the heartache of infertility compared to women of other races and ethnicities. According to a release issued by Georgia Reproductive Specialists and Desiree McCarthy-Keith, a doctor with the clinic, “black women have twice the odds of infertility compared to white women. 11.5% of black women report infertility compared to 7% of white women.”

The release goes on to note that black women are less likely to seek the help of a fertility specialist or assisted reproductive techniques (ART) like in vitro fertilization (IVF) or intrauterine insemination (IUI). Possible reasons, says Dr. McCarthy-Keith, are that the cost of treating infertility may be prohibitively high — for black couples as well as those from any ethnic background — and that limited awareness of treatment options and/or access to fertility specialists may hinder black women getting help that would allow them to conceive, carry, and deliver a healthy baby.

Black women may be more medically challenged, too, owing to much higher rates of uterine fibroids, which can impair a woman’s odds of conceiving.

Author:
Lorie A. Parch