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OBJECTIVE: : To examine the effect of paternal age on intracytoplasmic sperm injection (ICSI) outcomes in unexplained infertility. SUBJECTS AND METHODS: : This retrospective study, done at the Hamad Medical Corporation, Doha, Qatar screened infertile couples who underwent ICSI between 2014 and 2019 for the inclusion and exclusion criteria defining 'unexplained infertility'. Couples recruited were allocated into two groups: Group A (paternal age <35 years) and Group B (paternal age ≥35 years). Baseline characteristics, investigations including semen and advanced sperm function tests and ICSI records were compared for primary outcomes such as fertilisation, cleavage, clinical pregnancy, miscarriage and live birth; and secondary outcomes such as semen parameters and advanced sperm functions (DNA fragmentation index and oxidation reduction potential). RESULTS: : We found that final pregnancy outcomes including clinical pregnancy rate (P = 0.231), live-birth rate (P = 0.143), and miscarriage rates (P = 0.466) were not significantly different between the two age groups. Normal fertilisation (P = 0.01) and cleavage rate after ICSI (P = 0.001) were statistically significant when the age groups were compared. Also, normal sperm morphology was found to be significantly different (P = 0.041). CONCLUSIONS: : Advanced paternal age affects sperm morphology, fertilisation and embryo cleavage in ICSI but does not appear to affect clinical pregnancy, miscarriage or live-birth rates. ICSI appears to be a valid fertility treatment option in advancing paternal age.
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UNLABELLED: A case report and review of an extraskeletal neuroectodermal tumour of the vagina. BACKGROUND: Ewing's sarcoma (ES) and primitive neuroectodermal tumours (PNETs) account for approximately 6-10% of primary malignant bone tumours and, following osteosarcoma, are the second most common group of bone sarcomas in children. Ewing's sarcoma rarely affects the genitourinary tract. We report a rare case of extraskeletal Ewing's sarcoma diagnosed in a 47-year-old Indian woman presenting with a simple cystic lesion in the posterior wall of the vagina. The histopathology revealed a rare presentation of a primitive malignant extraskeletal neuroectodermal tumour. CONCLUSION: As our PubMed review found only six previously reported cases of vaginal extraskeletal Ewing's sarcoma. Presentation as vaginal masses helped in early disease detection.