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Re: Paternal Body Mass Index is Associated With Decreased Blastocyst Development and Reduced Live Birth Rates Following Assisted Reproductive Technology
SOCIOECONOMIC FACTORS, UROLOGICAL EPIDEMIOLOGY AND PRACTICE PATTERNS
Re: Paternal Body Mass Index is Associated With Decreased Blastocyst Development and Reduced Live Birth Rates Following Assisted Reproductive Technology H. W. Bakos, R. C. Henshaw, M. Mitchell and M. Lane Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, Robinson Institute, University of Adelaide, Adelaide, Australia Fertil Steril 2011; 95: 1700 –1704.
Objective: To determine the relationship between paternal body mass index (BMI), embryo development and pregnancy, and live birth outcomes after assisted reproductive technology (ART). Design: Retrospective analysis of ART cycles. Setting: Major assisted reproduction center. Patient(S): Three hundred five couples undergoing ART in a private fertility clinic. Intervention(S): No intervention was undertaken in patients involved in this study. Main Outcome Measure(S): Live birth outcomes and clinical pregnancy rates. Result(S): No significant relationship between paternal BMI and early embryo development was found. However, increased paternal BMI was associated with decreased blastocyst development, clinical pregnancy rates and live birth outcomes. Conclusion(S): To our knowledge, this is the first report linking increased paternal BMI and clinical pregnancy and live birth rates after ART treatment. Further work to elucidate the mechanisms involved is required. Editorial Comment: The association between female obesity and worsening in vitro fertilization outcomes is well known, and evidence is accumulating that male obesity is associated with impaired semen quality as well as endocrine dysfunction. However, is male obesity associated with worsening in vitro fertilization outcomes? These investigators report that increasing male BMI is correlated to impaired blastocyst development, decreased clinical pregnancy rates and lower live birth outcomes. Should this effect be true, the first question is why, and the second is, does weight loss help? Craig Niederberger, M.D.
Socioeconomic Factors, Urological Epidemiology and Practice Patterns Re: Satisfaction Profiles in Men Using Intracavernosal Injection Therapy W. Hsiao, N. Bennett, P. Guhring, J. Narus and J. P. Mulhall Department of Urology, Center for Male Reproductive Medicine, Weill Cornell Medical College, New York, New York J Sex Med 2011; 8: 512–517.
Introduction: Intracavernosal injection therapy (ICI) is a well-established second-line therapy used in the treatment of erectile dysfunction (ED). Controversy exists as to whether oral phosphodiesterase type 5 inhibitors (PDE5i) or injection therapy lead to higher satisfaction. Aim: This study addressed ICI satisfaction in a modern cohort of patients in the PDE5i era. Methods: Patients on ICI for at least 6 months were included in our study. Patients were administered the International Index of Erectile Function (IIEF) at the initial visit. On subsequent visits, patients were administered the IIEF and the Erection Hardness Scale (EHS). Main Outcome Measures: Study end points were change in baseline scores in the satisfaction domains (SD) of the IIEF, type of injection medication used, and predictors of satisfaction. Multiple logistic regressions were performed for predictors of satisfaction. Results: One hundred twenty-two patients met inclusion criterion. Mean time to follow-up was 25⫾12 months (range 6 –106 months). Sixty-five percent of patients continued injections at the time of follow-up. When SD scores were examined, intercourse SD scores increased from 4.8⫾1.7 at baseline to 12.3⫾3.1 (P ⬍0.01); overall SD scores increased from 4.1⫾1.8 to 7.2⫾2.0 (P ⬍0.05). On multivariate analysis,
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Re: Paternal Body Mass Index is Associated With Decreased Blastocyst Development and Reduced Live Birth Rates Following Assisted Reproductive Technology H. W. Bakos, R. C. Henshaw, M. Mitchell and M. Lane Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, Robinson Institute, University of Adelaide, Adelaide, Australia Fertil Steril 2011; 95: 1700 –1704.
Objective: To determine the relationship between paternal body mass index (BMI), embryo development and pregnancy, and live birth outcomes after assisted reproductive technology (ART). Design: Retrospective analysis of ART cycles. Setting: Major assisted reproduction center. Patient(S): Three hundred five couples undergoing ART in a private fertility clinic. Intervention(S): No intervention was undertaken in patients involved in this study. Main Outcome Measure(S): Live birth outcomes and clinical pregnancy rates. Result(S): No significant relationship between paternal BMI and early embryo development was found. However, increased paternal BMI was associated with decreased blastocyst development, clinical pregnancy rates and live birth outcomes. Conclusion(S): To our knowledge, this is the first report linking increased paternal BMI and clinical pregnancy and live birth rates after ART treatment. Further work to elucidate the mechanisms involved is required. Editorial Comment: The association between female obesity and worsening in vitro fertilization outcomes is well known, and evidence is accumulating that male obesity is associated with impaired semen quality as well as endocrine dysfunction. However, is male obesity associated with worsening in vitro fertilization outcomes? These investigators report that increasing male BMI is correlated to impaired blastocyst development, decreased clinical pregnancy rates and lower live birth outcomes. Should this effect be true, the first question is why, and the second is, does weight loss help? Craig Niederberger, M.D.
Socioeconomic Factors, Urological Epidemiology and Practice Patterns Re: Satisfaction Profiles in Men Using Intracavernosal Injection Therapy W. Hsiao, N. Bennett, P. Guhring, J. Narus and J. P. Mulhall Department of Urology, Center for Male Reproductive Medicine, Weill Cornell Medical College, New York, New York J Sex Med 2011; 8: 512–517.
Introduction: Intracavernosal injection therapy (ICI) is a well-established second-line therapy used in the treatment of erectile dysfunction (ED). Controversy exists as to whether oral phosphodiesterase type 5 inhibitors (PDE5i) or injection therapy lead to higher satisfaction. Aim: This study addressed ICI satisfaction in a modern cohort of patients in the PDE5i era. Methods: Patients on ICI for at least 6 months were included in our study. Patients were administered the International Index of Erectile Function (IIEF) at the initial visit. On subsequent visits, patients were administered the IIEF and the Erection Hardness Scale (EHS). Main Outcome Measures: Study end points were change in baseline scores in the satisfaction domains (SD) of the IIEF, type of injection medication used, and predictors of satisfaction. Multiple logistic regressions were performed for predictors of satisfaction. Results: One hundred twenty-two patients met inclusion criterion. Mean time to follow-up was 25⫾12 months (range 6 –106 months). Sixty-five percent of patients continued injections at the time of follow-up. When SD scores were examined, intercourse SD scores increased from 4.8⫾1.7 at baseline to 12.3⫾3.1 (P ⬍0.01); overall SD scores increased from 4.1⫾1.8 to 7.2⫾2.0 (P ⬍0.05). On multivariate analysis,
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