Developmental programming: intrauterine caloric restriction promotes upregulation of mitochondrial sirtuin with mild effects on oxidative parameters in the ovaries and testes of offspring.

According to the developmental origins of health and disease (DOHaD) hypothesis, changes in the maternal environment are known to reprogram the metabolic response of offspring. Known for its redox modulation, caloric restriction extends the lifespan of some species, which contributes to diminished cellular damage. Little is known about the effects of gestational caloric restriction, in terms of antioxidant parameters and molecular mechanisms of action, on the reproductive organs of offspring. This study assessed the effects of moderate (20%) caloric restriction on redox status parameters, molecular expression of sirtuin (SIRT) 1 and SIRT3 and histopathological markers in the ovaries and testes of adult rats that were subjected to gestational caloric restriction. Although enzyme activity was increased, ovaries from female pups contained high levels of oxidants, whereas testes from male pups had decreased antioxidant enzyme defences, as evidenced by diminished glyoxalase I activity and reduced glutathione content. Expression of SIRT3, a deacetylase enzyme related to cellular bioenergetics, was increased in both ovaries and testes. Previous studies have suggested that, in ovaries, diminished antioxidant metabolism can lead to premature ovarian failure. Unfortunately, there is little information regarding the redox profile in the testis. This study is the first to assess the redox network in both ovaries and testes, suggesting that, although intrauterine caloric restriction improves molecular mechanisms, it has a negative effect on the antioxidant network and redox status of reproductive organs of young adult rats.

[Epidemiology of male infertility]. / Epidemiologia dell'infertilità maschile.

OBJECTIVE: The aim of the present study has been to analyze the variation of the main parameters which define sperm quality in a group of men who were referred to our center of sterility during the last ten years of activity. MATERIAL AND METHODS: Over the last ten years, we have examined 3203 men ranging from 25 to 50 years of age. We have considered different parameters of evaluation, such as semen volume, motility, total motility count and morphology of spermatozoa; the same parameters have been considered for a group of 192 men accustomed to consuming coffee, alcohol and tobacco. RESULTS: We have observed no significative variations with respect to sperm volume; in spite of this result, we have registered a considerable reduction of the frequency of men with normal sperm quality, when we have considered parameter such as sperm motility. The evaluation of the total motility count has confirmed a progressive reduction during the considered period of time. This parameter has also shown the existence of a circannual rhythm for the production of spermatozoa, which results minimum during the winter and during the warmest months, while it improves during spring and autumn. During the considered period, the study of morphology has shown a progressive reduction of men with normal semen quality. CONCLUSION: The results of our epidemiologic study, conducted over a group of men who have been referred to our center of sterility during the last ten years, confirm that the group representative of Northern Italy has faced a decline of sperm quality.

[The consultation with the candidate couple for intracytoplasmic sperm injection (ICSI) using microsurgical epididymal sperm aspiration (MESA) or testicular sperm aspiration (TESA). The experience of the MATRIS (Medici Associati per la Terapia e la Ricerca dell'Infertilità e Sterilità) center of Milan]. / La consultazione della coppia candidata alla ICSI mediante MESA o TESA. L'esperienza del centro MATRIS di Milano.

The authors examine the relationship between doctor and patient during the consultation for the therapeutic decision for those couples who have to undergo a medical procreation, especially the ICSI by MESA and TESA. The couple's psycho-emotional involvement and the medical terminology hinder the real possibility of communication between doctor and patient. The data relating to a study of 80 couples done by the authors are presented. They show the need to improve the quality of communication between doctor and patient during the consultation. For this purpose, on the basis of the research conducted, modification of the language used and the support of audio-visual media are suggested during the consultation in order to reduce the percentage of the couple's doubts and uncertainties.

Expanded polytetrafluoroethylene surgical membrane in ovarian surgery on the rabbit. Biocompatibility, adhesion prevention properties and ability to preserve reproductive capacity.

OBJECTIVE: To evaluate the biocompatibility, adhesion prevention properties and ability to preserve reproductive capacity of polytetrafluoroethylene surgical membrane in ovarian surgery on the rabbit. STUDY DESIGN: In two groups of female rabbits a standard lesion was made on each ovary. In group 1, one ovary was partially covered with a flat sheet of the surgical membrane, and the other was left uncovered so that each rabbit served as its own control. In group 2, one ovary was again left uncovered to serve as an internal control, and the other was completely covered with a "cap" of the surgical membrane. Laparotomies were performed several weeks postoperatively after the rabbits were mated with fertile males; adhesions were evaluated, and the number of cornual pregnancies was determined. RESULTS: In group 1, 67.9% of the control ovaries and 7.1% of the partially covered ovaries had adhesions (P < .001); in the uterine horn on the control side, 32.1% of the rabbits exhibited cornual pregnancies (1.14 +/- 1.72 [mean +/- SD] pregnancies per rabbit), whereas on the experimental side, 89.3% of the rabbits exhibited cornual pregnancies (3.89 +/- 1.58 per rabbit). In group 2, 83.3% of the control ovaries and 11.1% of the covered ovaries had adhesions (P < .001); in the uterine horn on the control side, 23.5% of the rabbits exhibited cornual pregnancies (2 +/- 1.1 per rabbit), whereas on the experimental side, 100% of the rabbits exhibited cornual pregnancies (4.8 +/- 0.9 per rabbit). CONCLUSION: The surgical membrane is an excellent device for preventing the formation of adhesions to the ovary after surgery in rabbits, preserving the reproductive capacity of the ovary.

[Treatment of uterine fibroma with goserelin]. / Trattamento del fibroma uterino con Goserelin.

The authors evaluated the efficacy of Goserelin, a synthetic GnRh analogue, in 15 patients affected by symptomatic uterine leiomyomata. The answer to treatment has been evaluated on clinical signs, echographically and by serial determinations of FSH, LH, 17 beta estradiol, Cortisol, total Cholesterol, HDL Cholesterol, Triglycerides, Calcemia, Hb, blood iron, MCHC. Clinical answer showed to be satisfactory, with complete subsiding of menometrorrhagia starting from the 3rd month of treatment, and not reappearing during the six months of follow-up. Ultrasound evaluation showed fibroid volume reduction of 70% at the end of the 6 months treatment, but volumes had increased up to only 22% lower than the starting ones at the end of follow-up. A better volume reduction and lesser growth during follow-up were shown for small fibroids. 17-Beta estradiol, total and HDL cholesterol shifted toward menopausal values, with a trend towards starting values during follow-up. Haemocromocytometric values showed to better even in the absence of target anti-anemic treatment, and the result showed to be kept during follow-up. The Authors conclude that such treatment can be useful in premenopausal women affected by symptomatic fibroids, when the need for treatment is likely to be limited in time.