The effect of time on racial differences in epithelial ovarian cancer (OVCA) diagnosis stage, overall and by histologic subtypes: a study of the National Cancer Database.

PURPOSE: Previous studies assessing racial and ethnic differences in ovarian cancer (OVCA) diagnosis stage fail to present subtype-specific results and provide historic data on cases diagnosed between 10 and 20 years ago. The purpose of this analysis is to assess non-Hispanic Black (NHB) and non-Hispanic White (NHW) differences in late-stage diagnosis including; (1) factors associated with late-stage diagnosis of invasive epithelial OVCA overall and by histologic subtypes, (2) potential changes across time and (3) current patterns of trends in a national cancer registry in the USA and Puerto Rico between 1998 and 2011. METHODS: NHB and NHW OVCA cases were derived from the National Cancer Database (NCDB). Diagnosis stage was analyzed as a dichotomous and a four level-category variable, respectively; early (stages I and II; localized) versus late (stages III and IV; regional and distant) and stages I, II, III and IV. Diagnosis period was trichotomized (1998-2002, 2003-2007, 2008-2011). Racial differences in stage were tested using Chi-square statistics. Odds ratios (OR) and 95 % confidence intervals (95 % CI) were estimated using multivariable binomial and generalized ordered logistic regressions. Interactions between race and diagnosis period were evaluated. RESULTS: Between 1998 and 2011, 11,562 (7.8 %) NHB and 137,106 (92.2 %) NHW were diagnosed with OVCA. In adjusted models, NHB were significantly more likely diagnosed with late-stage OVCA than NHW (ORadj 1.26, 95 % CI 1.19-1.33). Interaction between race and diagnosis period was marginally significant (p value = 0.09), with racial differences in stage decreasing over time (1998-2002: ORadj 1.36, 95 % CI 1.23-1.49; 2003-2007: ORadj 1.27, 95 % CI 1.15-1.39; 2008-2011; ORadj 1.15, 95 % CI 1.05-1.27). NHB were also more likely to be diagnosed with stage 4 high-grade serous (ORadj 1.46, 95 % CI 1.22-1.74), clear cell (ORadj 2.71, 95 % CI 1.94-3.79) and mucinous (ORadj 2.78, 95 % CI 2.24-3.46) carcinomas than NHW. CONCLUSIONS: Racial differences in late-stage OVCA diagnosis exist; however, these differences are decreasing with time. Within NCDB, NHB are significantly more likely diagnosed with late-stage OVCA and more specifically high-grade serous, clear cell and mucinous carcinomas than NHW.

Case report: A healthy live birth following icsi with retrograde ejaculated sperm.

Retrograde ejaculation, sometimes called dry orgasm, refers to the medical condition when semen enters the urinary bladder (retrograde) instead of emerging through the penis after orgasm (antegrade). In some instances, a very minute quantity of antegrade semen appears in the ejaculate and may or may not be devoid of spermatozoa. Complete retrograde ejaculation causes male infertility. Intracytoplasmic sperm injection (ICSI) has been employed to achieve fertilization in some cases of male subfertility, e.g., severe oligoasthenoteratozoospermia. Assisted reproductive techniques to aid conception in cases of retrograde ejaculation have been described extensively elsewhere but there is paucity of knowledge on the occurrence and treatment in Africa. This case report describes the identification and successful treatment of a couple where the male partner suffered from retrograde ejaculation.

Prevalence of blood borne viruses in IVF: an audit of a fertility Centre.

OBJECTIVE: The rate of infertility continues to be on the increase in the developing world. Similarly, the rates of blood-borne viral infections (BBVs) such as Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are also on this rise. In 2014, the World Health Organization (WHO) quoted prevalences of 1.5% (HIV), 15% (HBV) 1.3 - 8.4% (HCV) in the Ghanaian general population. It has been reported that BBVs can adversely affect male fertility, specifically sperm count and progressive motility. The aim of this study was to evaluate the prevalence of BBVs in people with infertility attending an IVF clinic and whether or not BBVs impacted on sperm parameters. METHODS: A retrospective cohort study at a private fertility center in Accra, Ghana. We had 229 recruited couples assayed for HBV, HCV and HIV. Sperm parameters of the male partners were also assessed. The analysis performed included student t-test and Fisher's exact test. RESULTS: We found prevalence rates of 1.7% (HIV), 7.9% (HBV) and 0.4% (HCV), which is similar to what has already been reported in the Ghanaian community. There was no significant difference between BBV positive and negative subjects for sperm count (13.6 million/ml vs. 17.7 million/ml, P = 0.0599), percentage of progressive motility (26% vs. 30%, P = 0.2129), percentage of normal forms (3% vs. 3%, P = 0.0617) and clinical pregnancy rates per embryo transfer (36.1% vs 34.9%, P = 0.5) between BBV positive and BBV negative subjects, respectively. CONCLUSION: There is a similar prevalence of BBVs in sub-fertile couples and the general Ghanaian population. However, no detrimental effect has been reported for sperm parameters on grounds of BBV infectivity of the male partner.