Male fertility: A review of the publications from April - June 2021.

The article provides an overview of the most significant publications on the topic of male infertility. The main selection criteria were considered the practical significance of the article, as well as the impact factor of the journal in which it was published, according to the SCImago Journal Rank (SJR). As a result, a list of 10 works published in the II quarter (April - June) of 2021 was formed. The review includes articles on the following issues: the effectiveness of repeated micro-TESE in non-obstructive azoospermia, the role of COVID-19 in male fertility, the effect of testosterone therapy on spermatogenesis, testicular microlithiasis, electroejaculation as a method of obtaining spermatozoa, harm from carrying cell phones near the genitals, prediction of the effectiveness of intrauterine insemination, the effect of advanced paternal age on sperm aneuploidy, and the importance of the microbiome for male fertility.Copyright © 2021 Rostovskii Gosudarstvennyi Meditsinskii Universitet. All Rights Reserved.

Male fertility: Review of the publications of April - June 2020.

The article provides an overview of the most significant publications on the topic of male infertility. The main selection criteria are the practical relevance of the article, as well as the impact factor of the journal in which it was published, according to the ScImago Journal Rank (SJR). as a result, a list of 10 works published in the II quarter (april - June) of 2020 was formed. The review includes articles on the following topics: the effect of asymptomatic genital tract infection on male fertility, methods of spermatogonia transplantation, the effect of alcohol on fertility, the role of folate status in male fertility, lumicrine regulation of spermatogenesis, oxidative-reductive balance in the male reproductive system, comparison of testicular sperm extraction (TESE) and micro-TESE results, natural conception and intrauterine insemination (IUI) at high MaR test values, and the first data on the effect of cOVID-19 on male fertility.Copyright © 2020 Rostovskii Gosudarstvennyi Meditsinskii Universitet. All rights reserved.

THE UNEXPLORED POSSIBILITIES, PERCEPTIONS AND ETHICAL IMPLICATIONS OF GENE-EDITING ALLERGIC DISEASE: ENGAGING STAKEHOLDERS IN SOUTH AFRICA

Clinically approved cell and gene therapies are opening up future possibilities to treat and prevent myriad diseases, which may include allergic diseases. In South Africa, this could help alleviate the high disease burden and economic cost of treating such diseases. However, even if viable gene-editing options to treat, cure and prevent allergic diseases become safe, effective and affordable for the South African market within the next few decades, the ethical implications and challenges of perceptions, regulation and oversight to ensure safety and equitable access remain. It would be important for all stakeholders involved, including the public and physicians, clinicians and ethicists on clinical and research ethics committees, to be informed about the possibilities, to engage in discussions with one another and to redress any gaps in knowledge. It would be especially important to determine whether cases for gene-editing aimed at allergy would be applied for therapeutic purposes or for enhancement. Much research and discussion remain to be embarked upon;however, it is imperative that research and engagement are expanded and prioritised.

HOW MUCH LONGER? RATES OF ART DELAY OR CANCELLATION DURING THE COVID-19 CRISIS

OBJECTIVE: The strain on the healthcare system and attempts to limit virus transmission during the COVID-19 pandemic reduced patients' access to healthcare services, particularly those seeking specialized or elective health services such as infertility treatment. Mandatory fertility clinic closures prolonged conception efforts and further complicated the already arduous family building journey. This study investigates the incidence of assisted reproductive technology (ART) delay or abandonment during the COVID-19 pandemic and assesses whether these rates varied by U.S. geographic region. MATERIALS AND METHODS: A survey was administered to users of Ovia Health's Fertility mobile application in the United States from March 2020 to April 2021. A Chi-squared test was performed to assess differences in ART delay or cancellation and geographical region. A p-value of < 0.05 was considered statistically significant. RESULTS: A total of 20,047 respondents qualified for inclusion in this analysis. Of the 16,527 respondents currently or formerly trying to conceive within the last six months, 16% reported utilizing intrauterine insemination (IUI), in vitro fertilization (IVF), or another form of ART. Though the majority of treatments proceeded as planned, almost one in five (17%) were delayed or cancelled between March 2020 and April 2021. Main contributors to the decision to delay or cancel ART efforts were temporary fertility clinic closures (28%), concern about the impact of COVID-19 on pregnant people or fetuses (28%), attempting to avoid healthcare facilities (22%), lack of availability of support people during pregnancy and labor (17%), and concerns about finances or job security (16%). ART delay or cancellation did not differ by geographic region (p > 0.05). CONCLUSIONS: Our results demonstrate how the closure of fertility clinics during the COVID-19 pandemic and concern about COVID-19's detrimental impact during pregnancy pushed people seeking these services to delay indefinitely or altogether abandon their family building efforts. These trends were similar across the United States, regardless of geographical region. As ART treatments and care plans resume, reproductive medicine specialists should reinforce safety mitigation strategies to reduce the risk of COVID-19 transmission, foster COVID-19 vaccination discussions, and empower and restore patients' confidence with the latest COVID-19 research findings. IMPACT STATEMENT: Clinical service models resuming ART services should center around addressing patients' main concerns for delaying or abandoning ART efforts, especially focused on empowering patients whose family building journeys were interrupted by fertility center closures during the COVID-19 pandemic.

DIFFERENCES IN ANXIETY CONCERNING THE COVID-19 VIRUS AND COVID-19 VACCINE BETWEEN WOMEN UNDERGOING INFERTILITY TREATMENT AND THOSE NOT PURSUING TREATMENT

OBJECTIVE: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people. With the development and administration of the SARS-CoV-2 vaccines, there is growing evidence to suggest that there has been reduced transmission of the virus. However, the novelty of the vaccine has raised many questions for infertility patients due to the lack of research. This study examines the perceived anxiety level of patients at a fertility clinic in Manhattan who are undergoing infertility treatments, such as Timed Intercourse (TIC), Intrauterine Insemination (IUI), and In-Vitro Fertilization (IVF). Understanding the mental state of patients with infertility problems during the COVID-19 pandemic is vital for fertility clinics in their future patient assessments. MATERIALS AND METHODS: Surveys were administered to approximately 100 patients at a fertility clinic in Manhattan during early April 2021 - a few months after the first Covid vaccine was administered in the USA. The questionnaire asked patients to specify their treatment plan (TIC, IUI, IVF, oocyte cryopreservation, or no infertility problem). The survey included a 20-item Spielberger State-Trait Anxiety Inventory (STAI) assessing their current state of anxiety. For the STAI score cutoff, <40 = not anxious;40+ = high anxiety. Continuous variables were measured as mean and standard deviation and compared with a two-sample t-test or ANOVA. Categorical variables were compared with a Fisher test. A p-value <0.05 was considered statistically significant. Statistics were done with R version 4.0.5. RESULTS: There is no statistical significance in which group was more likely to have received at least one dose of the COVID-19 vaccines. However, the ''undecided'' group had the lowest percentage of individuals receiving the vaccine. There is also no statistical significance in the anxiety levels of the different groups of patients. The group with the greatest percentage of anxiety according to the STAI score is the ''undecided'' group. Fear of the COVID-19 virus being greater than the fear of the COVID-19 vaccine is a commonality between all the groups. CONCLUSIONS: The survey found that the greatest cause of apprehension in patients was the virus's unknown effects on their physical health. Majority of the hesitancy in receiving the vaccine was due to the potential side effects posed by the injection on pregnant women and their fetus. Interestingly, patients not in treatment had a trend towards higher fear and anxiety compared to patients undergoing infertility treatment. When broken down even further, patients who are undecided in their treatment are more anxious about both the COVID-19 virus and the vaccine. This indicates that the patient's treatment plan influences their view of the pandemic. IMPACT STATEMENT: Women with infertility issues experience tremendous amount of emotional turmoil, which can further interfere with their fertility. Recognizing the root of this population's anxiety during the COVID-19 pandemic can assist reproductive endocrinologists in forming treatment plans that integrate management of patient's psychological wellbeing.

The effect of semen collection at home on intrauterine insemination outcomes.

BACKGROUND: The WHO 2010 guidelines recognize at-home semen collection as an acceptable alternative to standard collection at the clinic in "exceptional circumstances." There is lack of sufficient data to determine the need for revisiting these recommendations for treatment purposes. OBJECTIVES: To determine whether at-home semen collection has any effect on intrauterine insemination (IUI) cycle outcomes. MATERIALS AND METHODS: This is a retrospective cohort study of 729 IUI treatment cycles (382 patients) performed at an academic fertility center from September 19, 2019 to December 31, 2020. Semen collected at the "clinic" was used for 343 cycles before the Coronavirus Disease 2019 (COVID-19) pandemic (September 19, 2019 to March 21, 2020), and "at-home" collected specimens were used for 386 cycles following revised protocols with COVID-19-driven changes (May 30, 2020 to December 31, 2020). Logistic regression models were performed to evaluate the effect of "at-home" semen collection on achieving a positive pregnancy test (PPT) and a clinical pregnancy (CP). RESULTS: Male and female partners' age, ovarian reserve biomarkers, and stimulation regimens used were similar in the "clinic" and "at-home" groups. In unadjusted models, "at-home" collection had no significant effect on the odds for a PPT [OR (95%CI): 0.733 (0.503-1.069)] or CP [0.816 (0.543-1.226)]. These results persisted even when adjusting for maternal age and anti-Müllerian hormone: PPT [0.739 (0.505-1.081)] and CP [0.826 (0.547-1.248)]. Of the semen analysis parameters under evaluation, only motility appeared to significantly impact the odds of achieving a PPT [1.014 (1.004-1.025)] and a CP [1.017 (1.006-1.029)]. This effect was slightly attenuated for samples collected "at-home" [1.012 (0.997-1.027) and 1.015 (0.999-1.031), respectively, for PPT and CP]. DISCUSSION: This study adds important information to the limited literature regarding the effect of at-home semen collection on IUI outcomes. Under adequate protocols, at-home semen collection should be considered a safe alternative. Additional research is needed to optimize such protocols. CONCLUSION: Our data suggest that at-home semen collection does not negatively impact IUI pregnancy outcomes.