RESUMEN
Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm's potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.
Asunto(s)
Femenino , Humanos , Masculino , Antioxidantes , Clasificación , Protocolos Clínicos , Diagnóstico , ADN , Estructuras Embrionarias , Fertilidad , Gastos en Salud , Infertilidad , Infertilidad Masculina , Membranas , Óvulo , Oxidantes , Oxidación-Reducción , Estrés Oxidativo , Especies Reactivas de Oxígeno , Sustancias Reductoras , Salud Reproductiva , Semen , Espermatozoides , DescriptoresRESUMEN
OBJECTIVE: To discover the factors contributing to endometrial thickness, and to assess the impact of endometrial thickness on pregnancy rates (PRs) according to these factors. DESIGN: Retrospective study. SETTING: In vitro fertilization unit in a university hospital. PATIENT(S): All women with primary infertility and no previous pregnancies who underwent IVF treatment at the Chaim Sheba Medical Center, Tel Hashomer, Israel, between August 9, 2001-December 31, 2004. INTERVENTION: Measurement of endometrial thickness by the use of transvaginal ultrasound probe on the day that hCG was administered during an IVF cycle. MAIN OUTCOME MEASURE(S): Factors influencing endometrial thickness and the relationship between endometrial thickness and PRs. RESULT(S): The mean endometrial thickness decreased as a function of the patient's age. The thickest endometrium was found in patients <25 years of age (11.9 +/- 2.5 mm), and the thinnest endometrium was found in patients >40 years of age (9.6 +/- 2.3 mm). Other factors, such as E(2) levels, etiology of infertility, induction of ovulation protocol, and type of gonadotropin used, were also found to contribute to endometrial thickness. CONCLUSION(S): Our data support the case for an "aging" of the endometrium. The chances of achieving a thick endometrium for patients >40 years of age are lower than for younger patients. Furthermore, a thicker endometrium is correlated with a higher PR only for patients >35 years of age.