Ovarian reserve in women with cystic fibrosis: is this a cause of sub-fertility?

BACKGROUND: Over the past two decades, increasing number of people with cystic fibrosis (CF) survive into adulthood. Compared to the general population, sub-fertility is an obstacle for many women with CF (wwCF). Decreased ovarian reserve has been proposed as a possible cause, but limited data is available to support this. The aim of this study was to evaluate the ovarian reserve in wwCF and to correlate this with patients' demographic and clinical data. METHODS: Reproductive-aged wwCF were enrolled during their routine medical appointments. Assessment included Anti-Mullerian hormone (AMH) levels, routine blood tests and antral follicular count (AFC) evaluation. Additionally, demographic, and clinical information were collected. RESULTS: A total of wenty-three wwCF were enrolled, with ages ranging from 19 to 40 years (median 27 years). Among the fourteen wwCF who were considering pregnancy, five (35.7%) disclosed undergoing an infertility assessment and receiving fertility treatments. All but one patient had an Anti-Mullerian hormone (AMH) level between the 5th and 95th % for age. Measurement of the antral follicular count (AFC) was possible in 12 of the 23 patients and was ranging 8-40 with a median of 17. The proportion of wwCF presenting below median AMH values was not different in sub-fertile as compared to fertile wwCF (P value 0.54). There were no correlations between AMH levels and disease severity parameters. AMH seemed to be relatively higher in wwCF with mild class mutations, but this was not shown to have statistical significance. CONCLUSIONS: Our results, in contrast with the limited available published data, do not support the hypothesis that decreased ovarian reserve plays a major role in infertility in wwCF.

Giant cystic degeneration of the rete testis.

OBJECTIVES: We present a case of giant cyst of the rete-testis. METHODS/RESULTS: 85 year-old patient on follow -up for prostate cancer with maximum androgen blockade (MAB) treatment consults for a left hemiscrotum increase in size over a 2-month period. We performed bilateral orchiectomy confirming the histopathological diagnosis of cystic dilatation of the rete-testis sized 11 x 11 x 9 cm. CONCLUSIONS: This case of cystic degeneration of the rete-testis, with a size out of common (11 x 11 x 9 cm versus medium size in the literature: 3 x 3 x 3 cm), could be related with an androgen-estrogen misbalance caused by a MAB in a prostate cancer context.

Degeneración quística gigante de la rete testis / Giant cystic degeneration of the rete testis

OBJETIVOS: Presentar el caso de un quiste gigante de la rete testis.MÉTODO/RESULTADO: Se trata de un paciente de 85 años que durante el seguimiento por un adenocarcinoma de próstata con bloqueo androgénico completo consulta por aumento del tamaño del hemiescroto izquierdo de dos meses de evolución. Se realizó una orquiectomía bilateral, confirmando en el estudio histopatológico de dilatación quística de la rete testis de 11x11x9cm de tamaño. CONCLUSIÓN: Este caso de degeneración quística de la rete testis, con un tamaño fuera de lo común (11x11x9cm, mientras que en la literatura refieren un tamaño medio de 3x3x3cm) podría estar relacionado con el disbalance andrógeno-estrogénico por el BAC en el contexto de un cáncer de próstata(AU)

OBJECTIVES: We present a case of giant cyst of the rete-testisMETHODS/RESULTS: 85 year-old patient on follow-up for prostate cancer with maximum androgen blockade (MAB) treatment consults for a left hemiscrotum increase in size over a 2-month period. We performed bilateral orchiectomy confirming the histopathological diagnosis of cystic dilatation of the rete-testis sized 11x11x9cm.CONCLUSIONS: This case of cystic degeneration of the rete-testis, with a size out of common (11x11x9cm versus medium size in the literature: 3x3x3cm), could be related with an androgen-estrogen misbalance caused by a MAB in a prostate cancer context(AU)