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Re: Pregnancy after Varicocelectomy: Impact of Postoperative Motility and DFI
2210
MALE INFERTILITY
Re: The Role of Carbohydrate Recognition during Human Sperm-Egg Binding G. F. Clark Division of Reproductive Medicine and Fertility, and Division of Reproductive and Perinatal Research, Department of Obstetrics, Gynecology and Women’s Health, University of Missouri School of Medicine, Columbia, Missouri Hum Reprod 2013; 28: 566e577.
Abstract available at http://jurology.com/ Editorial Comment: This extensive review of what we know of human sperm-egg binding begins with a marvelous short history of in vitro fertilization. While the review focuses on the role of carbohydrate dependent interactions involving human zona pellucida glycoproteins, it provides an exhaustive overview of the biochemistry behind the first moment that sperm and egg meet. It is a wonderful read. Craig Niederberger, M.D.
Re: Birth of 16 Healthy Children after ICSI in Cases of Nonmosaic Klinefelter Syndrome E. Greco, F. Scarselli, M. G. Minasi, V. Casciani, D. Zavaglia, D. Dente, J. Tesarik and G. Franco Center for Reproductive Medicine, European Hospital, Rome, Italy Hum Reprod 2013; 28: 1155e1160.
Abstract available at http://jurology.com/ Editorial Comment: Individuals with the nonmosaic form of Klinefelter syndrome are nearly always azoospermic. For these men testicular sperm extraction is typically the only way to obtain sperm. These investigators report that sperm was successfully surgically retrieved from the testes of 15 of 38 men with nonmosaic Klinefelter syndrome, resulting in 15 pregnancies and 16 live births following intracytoplasmic sperm injection. Karyotyping by amniocentesis and after birth revealed that all 16 patients had normal chromosomal complements. While the total number of births in this study is small, it is still one of the largest series of its kind, and it may bring some comfort to men undergoing testicular sperm extraction for nonmosaic Klinefelter syndrome to know that they are unlikely to pass the condition to their offspring. Craig Niederberger, M.D.
Re: Pregnancy after Varicocelectomy: Impact of Postoperative Motility and DFI K. Baker, J. McGill, R. Sharma, A. Agarwal and E. Sabanegh, Jr. Department of Urology, Center for Male Fertility, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio Urology 2013; 81: 760e766.
Abstract available at http://jurology.com/ Editorial Comment: As established as the destructive nature of a varicocele may be to male reproduction, many questions remain regarding its diagnosis and therapy. One outstanding area needing clarification is how to counsel patients postoperatively. Many investigators, including these authors, have demonstrated improvement in bulk seminal parameters and DNA integrity after varicocelectomy. Importantly the best predictor of pregnancy observed in this study was improved motility following surgical repair. Urologists may consider counseling patients whose motility improves after varicocelectomy that they have a particularly promising result. Craig Niederberger, M.D.
MALE INFERTILITY
Re: The Role of Carbohydrate Recognition during Human Sperm-Egg Binding G. F. Clark Division of Reproductive Medicine and Fertility, and Division of Reproductive and Perinatal Research, Department of Obstetrics, Gynecology and Women’s Health, University of Missouri School of Medicine, Columbia, Missouri Hum Reprod 2013; 28: 566e577.
Abstract available at http://jurology.com/ Editorial Comment: This extensive review of what we know of human sperm-egg binding begins with a marvelous short history of in vitro fertilization. While the review focuses on the role of carbohydrate dependent interactions involving human zona pellucida glycoproteins, it provides an exhaustive overview of the biochemistry behind the first moment that sperm and egg meet. It is a wonderful read. Craig Niederberger, M.D.
Re: Birth of 16 Healthy Children after ICSI in Cases of Nonmosaic Klinefelter Syndrome E. Greco, F. Scarselli, M. G. Minasi, V. Casciani, D. Zavaglia, D. Dente, J. Tesarik and G. Franco Center for Reproductive Medicine, European Hospital, Rome, Italy Hum Reprod 2013; 28: 1155e1160.
Abstract available at http://jurology.com/ Editorial Comment: Individuals with the nonmosaic form of Klinefelter syndrome are nearly always azoospermic. For these men testicular sperm extraction is typically the only way to obtain sperm. These investigators report that sperm was successfully surgically retrieved from the testes of 15 of 38 men with nonmosaic Klinefelter syndrome, resulting in 15 pregnancies and 16 live births following intracytoplasmic sperm injection. Karyotyping by amniocentesis and after birth revealed that all 16 patients had normal chromosomal complements. While the total number of births in this study is small, it is still one of the largest series of its kind, and it may bring some comfort to men undergoing testicular sperm extraction for nonmosaic Klinefelter syndrome to know that they are unlikely to pass the condition to their offspring. Craig Niederberger, M.D.
Re: Pregnancy after Varicocelectomy: Impact of Postoperative Motility and DFI K. Baker, J. McGill, R. Sharma, A. Agarwal and E. Sabanegh, Jr. Department of Urology, Center for Male Fertility, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio Urology 2013; 81: 760e766.
Abstract available at http://jurology.com/ Editorial Comment: As established as the destructive nature of a varicocele may be to male reproduction, many questions remain regarding its diagnosis and therapy. One outstanding area needing clarification is how to counsel patients postoperatively. Many investigators, including these authors, have demonstrated improvement in bulk seminal parameters and DNA integrity after varicocelectomy. Importantly the best predictor of pregnancy observed in this study was improved motility following surgical repair. Urologists may consider counseling patients whose motility improves after varicocelectomy that they have a particularly promising result. Craig Niederberger, M.D.