Review of the impact of COVID-19 on male reproduction, and its implications on assisted reproductive technology services.

The announcement in 2019 of a new coronavirus disease that quickly became a major pandemic, is an exceptional challenge to healthcare systems never seen before. Such a public health emergency can largely influence various aspects of people's health as well as reproductive outcome. IVF specialists should be vigilant, monitoring the situation whilst contributing by sharing novel evidence to counsel patients, both pregnant women and would-be mothers. Coronavirus infection might adversely affect pregnant women and their offspring. Consequently, this review paper aims to analyse its potential risks for reproductive health, as well as potential effects of the virus on gamete function and embryo development. In addition, reopening fertility clinics poses several concerns that need immediate addressing, such as the effect of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) on reproductive cells and also the potential risk of cross-contamination and viral transmission. Therefore, this manuscript summarizes what is currently known about the effect of the SARS-CoV-2 infection on medically assisted reproductive treatments and its effect on reproductive health and pregnancy.

Vacuoles in sperm head are not associated with head morphology, DNA damage and reproductive success.

In this retrospective study of 873 men enrolled for assisted reproduction techniques, relationships between sperm quality parameters, motile sperm organelle morphology examination (MSOME), DNA damage and live birth rate were evaluated. The presence of vacuoles in the sperm heads was detected by MSOME. Either chromatin decondensation or DNA fragmentation was used to study DNA damage. Results show that age significantly affected some of the examined parameters. In particular, sperm concentration was positively correlated (R = 0.088; P = 0.01) and chromatin decondensation was negatively correlated (R = -0.102; P = 0.003) with age. Furthermore, live birth rate was significantly lower in men aged 40 years or older (P < 0.02) compared with the younger age groups. The presence of sperm head vacuoles was not associated with head morphology, main sperm quality parameters, DNA fragmentation and live birth rate. Considering sperm heads in relation to the shape (normal/abnormal) and vacuoles (presence/absence), no significant variations in the occurrence of vacuoles in either normal or abnormal heads were found. These data suggest that vacuoles are physiological features that do not alter sperm functionality, and it seems that MSOME is not necessary for increasing the success of assisted reproduction techniques.

Effects of cryostorage on human sperm chromatin integrity.

The integrity of sperm chromatin structure has proven to be of great importance for human fertility. In this study, we investigated whether sperm cryopreservation has an effect on nuclear DNA tertiary structure, (i.e. condensation), measured by aniline blue staining, in 103 male patients who required consultation for hypo-fertility. Sperm DNA damage was significantly higher in patients showing oligospermia and severe morphological abnormalities than in native sperm populations. Furthermore we observed that chromatin decondensation was related to the cryostorage technique and to the duration of storage. This increase in decondensation was highly significant (P < 0.01) immediately after cryopreservation and from 90 days of cryostorage onwards. The possible mechanisms involved in sperm chromatin cryoinjury and the need to incorporate new methods for testing sperm nuclear structure alteration into the routine spermiogram are discussed.

The impact of in vitro fertilization on health of the children: an update.

Infertile couples make up approximately 10% of the worldwide population, and around 1% of current live births are a result of assisted reproductive technology (ART). Since the time that this technology was first applied, many studies have been performed in order to determine the risk associated with infertility treatments. Short- and long-term risks have been identified, which confirm that the major complications are due to multiple pregnancies. In a previous study we described in detail the main reproductive processes, the techniques for in vitro fertilization (IVF) and the risks associated with each of them, with a focus on intracytoplasmic sperm injection (ICSI). In this review we provide an update from 2007 to the present. In particular, in addition to new information on post-pregnancy complications and infant morbidity and malformations, we report data on rare syndromes, including recent case reports. Although data are controversial, an association between IVF and a minor increase in the incidence of birth defects has been confirmed. Several lines of evidence also suggest that there may be a link between ART and psychological disorders in the parents and the child. Finally, recent findings draw attention to the need for accurate clinical and psychological counselling of couples before any treatment decisions are made.

Fine needle cytology of endometriosis: experience with 10 cases.

OBJECTIVE: To evaluate whether commonly used cytologic criteria for the diagnosis of endometriosis are sufficiently specific, to assess the possible role of special methods in the differential diagnosis and to assess the clinical meaning and drawbacks of a cytopathologic diagnosis of endometriosis by fine needle aspiration. STUDY DESIGN: We retrieved 10 cases of endometriosis from our files that had been diagnosed primarily by fine needle cytology (FNC) with subsequent tissue study. In some cases additional cytospin preparations and/or smears had been used for cytochemistry (periodic acid-Schiff stain, mucicarmine) or immunocytochemistry (pan-cytokeratin, cytokeratin 7, vimentin, CD10) using a 3-step streptavidin-biotin-immunoperoxidase reaction. RESULTS: The cell pattern and immunocytochemical profile of the cases suggested a diagnosis of endometriosis. All cases were histologically confirmed. CONCLUSION: With optimal preparations a confident cytologic diagnosis of endometriosis may be made with ease, permitting correct treatment of the disease and, in selected cases, planning of preoperative pharmacologic therapy.

Metaplastic breast carcinoma on fine-needle cytology samples: a report of three cases.

Metaplastic breast carcinoma (MBC) may have a varied presentation on fine-needle cytology samples. We herewith describe three cases of MBC found in our series. One of these cases showed a peculiar mixture of malignant ductal, apocrine type, and squamous epithelial cells with fascicles of spindle cells with variable degree of atypia and was diagnosed as metaplastic carcinoma of the carcino-sarcomatous type. The other two lesions were characterized by an abundant chondroid extracellular matrix to which were variably admixed carcinomatous and chondroid-type cells, with variable degree of atypia. Both these latter cases were defined as matrix-producing metaplastic carcinomas. Because of the various presentation of MBC on fine-needle cytology samples and the possible influence of needle "sampling" on the cytological specimen, the spectrum of differential diagnoses to be considered may encompass a number of benign and malignant entities, like keratinous subareolar cysts, malignant fibroepithelial lesions with myxo-chondroid stroma, and true sarcomas of the breast, with cartilaginous metaplasia. It is the Authors' feeling that, with optimal samples, the cytomorphological findings of this rare variant of breast carcinoma permit its accurate pre-operative diagnosis.

Adenocarcinoma apócrino de localizador axilar / Apocrine adenocarcinoma ofthe axilla

El adenomarcinoma apócrino es una entidad rara, que se localiza principalmente en regiones axilar y ano-genital. son nódulos firmes, rojizos, de crecimiento lento. Los pacientes tienen entre 15 y 90 años, con un pico de mayor frecuencia a los 58 años. El tamaño de las lesiones oscila entre 1,5 y 8 cm de diámetro. Desde el punto de vista histológico hay tres tipos de adenocarcinoma apócrino: ductal, papilar y enfermedad de Paget extramamaria. Presentan decapitación apical celular y gránulos de hierro intracitoplasmáticos. El diagnóstico diferencial debe realizarse con el carcinoma de la corteza renal. Presentamos el caso de una mujer de 73 años de edad, que consulta por la existencia de una masa tumoral en axila derecha, de 12 cm de diámetro, con extensa ulceración de la piel que la reviste. Dicha tumoración tenía 4 años de evolución y su estudio histopatológico con técnicas de rutina y especiales reveló la presencia de un adenocarcinoma apócrino de tipo ductal

Granuloma anular profundo / Granuloma annulare profundus

El granuloma anular profundo (GAP) es una variedad clínica del granuloma anular. Varios autores consideran que es de baja incidencia, sin embargo hemos encontrado 4 casos, en una población de aproximadamente 40.000 habitantes, en el lapso de un año y seis meses. Todos los casos fueron en niños - 3 varones y una mujer-, consistentes en tumoraciones cupuliformes de miembros inferiores en tres casos y de antebrazo en el restante. Ninguno de los pacientes presentaba sintomatología sistémica, ni antecedentes personales o familiares que resaltar. Los resultados de los estudios complementarios fueron normales en todos los casos. Concluímos por lo que antecede, en coincidencia con Rubin y Lynch que, al menos en nuestra experiencia, el GAP no es tan raro como se supone. La búsqueda y estudios metódicos permitirían un diagnóstico más frecuente

Angioma serpiginoso: a propósito de un caso / Angioma serpiginosum: case report

Presentamos un caso de Angioma serpiginoso(AS) en una niña de 8 años de edad, debido a la infrecuente aparición de esta enfermedad. El cuadro clínico y los hallazgos histopatológicos cumplen con los criterios diagnósticos propuestos. Se comentan los distintos aspectos de la entidad, con mayor énfasis en lo referente al diagnóstico diferencial con la Púrpura Pigmentosa Crónica, el Angioqueratoma Circunscripto Neviforme y el Nevus Flammeus

Quiste triquilemal proferante de localización infrecuente / Proliferating trichilemmal cyst in an unusual site

El quiste triquilemal proliferante (Q.T.P.) es un tumor que recibió varios nombres en el pasado. Aproximadamente el 89%de los mismos se localizan en cuero cabelludo, tienen una dilatada evolución y son de curso biológico benigno. Se realiza una revisión histórica de los conceptos histogenéticos, en especial el análisis del tema efectuado por Pinkus. Se presenta un caso de Q.T.P., localizado en la nalga derecha de un varón de 75 años de edad. Se comparan series presentadas por otros autores, donde no se indica la existencia de estas lesiones en la ubicación infrecuente del caso en cuestión. El propósito del trabajo es presentar un caso, creemos el primero, de Q.T.P. localizado en glúteo