Long-term health, well-being, life satisfaction, and attitudes toward parenthood in men diagnosed as infertile: challenges to gender stereotypes and implications for practice.

OBJECTIVE: To investigate attitudes toward parenthood, long-term life satisfaction, and health and well-being in men diagnosed as infertile. DESIGN: A cross-sectional survey of a cohort of men 5 years after diagnosis of infertility. SETTING: The andrology clinic at the Royal Women's Hospital Reproductive Services, Melbourne Australia. PATIENT(S): All men diagnosed at this center as infertile in 2001 and 2002. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Attitudes to parenthood (Meaning of Parenthood), quality of intimate relationship (Intimate Bonds Measure), personality characteristics (Vulnerable Personality Style Questionnaire), life satisfaction (Satisfaction with Life Scale), and self-rated physical health (Physical Component Summary of SF-12 [PCS-12]) and relationship with mental health (Mental Component Summary of SF12 [MCS-12]). RESULT(S): A total of 112 (41%) of 276 men completed the survey. Of these, 96% had pursued infertility treatment and 87% had become fathers. Only 10% thought that fertility confirmed by fatherhood reflected masculinity, and 84% desired parenthood as much as their partners did. When all other factors were controlled for, men who had not become fathers had poorer mental health (MCS-12 score = 43.9 +/- 9.9) than those who were fathers (MCS-12 score = 49.25 +/- 8.7). CONCLUSION(S): Clinical practice should not presume that infertile men conflate fertility and masculinity, are less distressed than women about the potential loss of parenthood, or adjust more readily to childlessness, which appear to be inaccurate but widespread stereotypes.

Antenatal mood and fetal attachment after assisted conception.

OBJECTIVE: Australian women conceiving with ART are at fourfold risk of admission to early parenting treatment programs compared with those conceiving spontaneously. This study aimed to identify prevalence and determinants of antenatal mood disturbance and other risks for early parenting difficulties after assisted conception. DESIGN: A prospective longitudinal investigation from conception to 18 months postpartum using telephone interviews and self-report questionnaires. SETTING: Melbourne IVF and Royal Women's Hospital Reproductive Services, Victoria, Australia. PATIENT(S): A consecutive cohort of English-speaking women with ultrasound-confirmed ART-conceived pregnancies. MAIN OUTCOME MEASURE(S): Standardized psychometric measures of mood, quality of marital relationship, mother-to-fetus emotional attachment, and personality. INTERVENTION(S): None. RESULT(S): Of the 288 women with confirmed pregnancies, 239 were contactable, and 183 (77%) were recruited, 95% of whom completed both early and late pregnancy assessments. Participants were socioeconomically advantaged, had very good pregnancy health, exceptional marital relationships, normal personality styles, and intense affectionate attachment to the fetus. Very few (<5%) had clinically significant mood disturbance in late pregnancy. CONCLUSION(S): There were low rates of antenatal mood disturbance and other risk factors for postpartum depression. Pregnancy and motherhood might be idealized after ART conception, and preparation for the realities of infant care might then be insufficient.

Recombinant human zona pellucida proteins ZP1, ZP2 and ZP3 co-expressed in a human cell line.

AIM: To produce biologically active recombinant human (rh) ZP proteins in a human cell for use in sperm function tests. METHODS: The human embryonic kidney cell line 293T was employed to produce rhZP1, rhZP2 and rhZP3 proteins individually and together by co-expression. Presence of these proteins in the culture medium and cell lysate was assessed by Western blotting analysis. The effect of the recombinant proteins on the human AR was assessed. RESULTS: RhZP2 and rhZP3 were secreted into the culture medium, whereas rhZP1 was found only in the cell lysate. Interestingly, when all zona pellucida proteins were co-expressed in the same cells, rhZP1 was also secreted into the culture medium. However, despite the presence of all three ZP proteins in sufficient concentration and evidence of heavy glycosylation on gel electrophoresis, biological activity to induce the AR was not observed. CONCLUSION: RhZP1, rhZP2 and rhZP3 were successfully expressed in the human embryonic kidney cell line 293T. It appears that an interaction amongst these proteins may be required for release of rhZP1 from the cell. Although this approach is not satisfactory for producing active human ZP proteins, it makes a significant contribution to the understanding of the structural and functional characteristics of the ZP proteins.

Recombinant human zona pellucida proteins ZP1, ZP2 and ZP3 co-expressed in a human cell line / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To produce biologically active recombinant human (rh) ZP proteins in a human cell for use in sperm function tests.</p><p><b>METHODS</b>The human embryonic kidney cell line 293T was employed to produce rhZP1, rhZP2 and rhZP3 proteins individually and together by co-expression. Presence of these proteins in the culture medium and cell lysate was assessed by Western blotting analysis. The effect of the recombinant proteins on the human AR was assessed.</p><p><b>RESULTS</b>RhZP2 and rhZP3 were secreted into the culture medium, whereas rhZP1 was found only in the cell lysate. Interestingly, when all zona pellucida proteins were co-expressed in the same cells, rhZP1 was also secreted into the culture medium. However, despite the presence of all three ZP proteins in sufficient concentration and evidence of heavy glycosylation on gel electrophoresis, biological activity to induce the AR was not observed.</p><p><b>CONCLUSION</b>RhZP1, rhZP2 and rhZP3 were successfully expressed in the human embryonic kidney cell line 293T. It appears that an interaction amongst these proteins may be required for release of rhZP1 from the cell. Although this approach is not satisfactory for producing active human ZP proteins, it makes a significant contribution to the understanding of the structural and functional characteristics of the ZP proteins.</p>

Induction of spermatogenesis by recombinant follicle-stimulating hormone (puregon) in hypogonadotropic azoospermic men who failed to respond to human chorionic gonadotropin alone.

A multicenter, open-label, randomized efficacy and safety study was performed with combined human chorionic gonadotropin (hCG) and recombinant follicle-stimulating hormone (recFSH) (Puregon(R)) treatment to induce spermatogenesis in hypogonadotropic hypogonadal male patients. Patients were pretreated for 16 weeks with hCG to normalize testosterone levels. A total of 30 of 49 (61%) subjects had normalized testosterone levels but were still azoospermic after the hCG-alone phase. These patients were randomized into 2 treatment schemes with recFSH (2 x 225 IU recFSH per week [group A] or 3 x 150 IU recFSH per week [group B]), in combination with hCG for a period of 48 weeks. Total testosterone increased during the hCG-alone period from 1.08 and 1.22 ng/mL to 6.26 and 4.52 ng/mL for groups A and B, respectively. Combined gonadotropin treatment was effective in inducing spermatogenesis (sperm count >/=1 x 10(6)/mL) in 14 of 30 subjects (47%) and this was achieved after a median duration of treatment of approximately 5.5 months. Treatment time necessary for first sperm cells to appear in the ejaculate was related to the initial testicular volume. Subjects with a history of maldescended testes (11 of 30 subjects, 37%) showed a lower mean response to treatment as indicated by the relatively lower number of subjects reaching levels of at least 1 x 10(6) sperm cells per milliliter. Combined testicular volume increased during combined gonadotropin treatment from 11.4 to 24.0 mL. Although subjects with a history of maldescended testes had a lower starting testicular volume, subjects with and without a history of maldescended testes showed approximately the same relative increase in testicular volume. Total testosterone levels showed only a minor further increase during the combined gonadotropin treatment period. In conclusion, a weekly dose of 450 IU (3 x 150 IU or 2 x 225 IU) recFSH, in addition to hCG, was able to induce spermatogenesis in many hypogonadotropic azoospermic men who failed to respond to treatment with hCG alone.

Ultradian rhythms in performance on tests of specialized cognitive function.

Performance on cognitive tasks cycled at ultradian frequencies for 24 males over a test period of eight hours. The verbal task of written word production cycled at 80 minutes; the spatial task of locating points in space cycled at 96 minutes. Multiple cycles were seen for a perceptual speed task that factor loads on both the verbal and spatial task. Replication of the results for the first 12 and second 12 subjects demonstrated their robustness. The verbal and spatial tasks were chosen to reflect specialized functions of the left and right cerebral hemispheres, respectively. Accordingly, the results are interpreted as evidence that specialized task performances are associated with independent neurochemical systems. In addition, blood samples were taken at task performance to assess cyclicity of hormone levels. Luteinizing hormone had a period of 120 minutes, testosterone and cortisol were inconsistent and none seemed to be related to the cognitive tasks. However when subjects were divided according to a winter or summer testing schedule, the spatial periodicity was absent for the summer group and the verbal periodicity was absent for the winter peak.

Human neuroscience at National Institute on Drug Abuse: implications for genetics research.

It is becoming clear that there is a genetic component to drug abuse. Family studies, adoption studies, and critical twin studies have all pointed to some genetic vulnerability or risk factors for an individual to abuse psychoactive drugs depending on certain psychopathologies in the biological parents and/or parents' own drug use. The question for the next generation of research at the National Institute on Drug Abuse (NIDA) is to apply the rapidly developing technology in molecular genetics in an effort to determine the candidate genes contributing to the risk.

A neuropsychologic profile of adolescent alcoholics.

Male and female adolescents who qualified for a DSM-III-R diagnosis of Alcohol Abuse or Dependence and a control sample of nonalcohol-abusing male and female adolescents were administered a battery of intellectual, achievement, and neuropsychologic tests. Alcohol-abusing adolescents were found to have significantly lower verbal and full-scale IQ scores than controls. Furthermore, alcohol-abusing adolescents were found to have a trend toward lower age-standardized scores on achievement tests of reading ability and spelling. Surprisingly, alcohol-abusing adolescents made less perseverative errors and commission errors on a learning and memory task than controls. Control males performed worse on the Wisconsin Card Sort than alcoholic males, whereas alcohol-abusing females performed worse than control females. In addition, alcoholic subjects scored better than controls on a measure of visual memory sensitivity. The results indicate that adolescent alcohol abusers in general have poorer language skills than adolescents who do not abuse alcohol. However, in contrast to results obtained from studies of adult alcoholics, there is little evidence of significant brain damage as revealed by using neuropsychologic test performance.

Laterality for music perception in musicians, mathematicians, and dancers: jumping to conclusions.

Group differences for ear asymmetries for a melodies task were reported for talented music, mathematics, and dance students. Evidence is presented that it is premature to conclude that these group differences were the result of specialized training in their areas of expertise.

No difference in cognitive performance between phases of the menstrual cycle.

No differences were seen in performance on either verbosequential or visuospatial neuropsychological tests among three groups of women. There were also no differences among the phases of the menstrual cycle on any of the tests. The design of this study was to sample performance of women on verbosequential and visuospatial neuropsychological tests during phases of the normal menstrual cycle in regularly menstruating women, and at comparable time points among women taking oral contraceptives and among those who had amenorrhea. Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and progesterone were assayed to document these hormone levels at each time point for each group. These data are consistent with previous results in our laboratory but conflict with other reports in which shifts in cognitive function were related to fluctuations in estrogen. The only indications of positive results were weak correlations with gonadotropins and cognitive function across subjects. While some of these correlations replicated previous results, they were weak and should be considered with caution.

The relationship between leftward turning bias and visuospatial ability in humans.

A significant relationship was found between a bias to make complete counter-clockwise (leftward) turns and performance levels on tests of visuospatial function. Subjects who turned preferentially to the left over a four-day period performed above average on visuospatial tests with those having the greatest turning bias performing the best. Subjects who tended to turn to the right performed below average on tests of visuospatial function. There was no relationship between rotational bias and verbosequential skills, but there was a significant relationship between turning bias and a cognitive profile defined as the difference between visuospatial ability and verbosequential ability. The cognitive profile effectively partialed out overall ability suggesting that the turning bias is related to the bias for better visuospatial processing rather than the level of visuospatial performance per se. Asymmetric turning has been shown to be related to asymmetries of dopamine activity in rats. Therefore, the present results are discussed in relation to the possibility that the dopamine neurotransmitter system may underlie both rotational behavior and visuospatial cognitive function in humans.

The influence of gender, handedness, and performance level on specialized cognitive functioning.

Individual differences in performance on neuropsychological tests were analyzed across age (prepubertal to adult), gender, and handedness groups and examined for performance level as a moderating variable. No differences were observed for the factor structure of these tests across ages and between genders, suggesting similar cognitive structures among these groups. Significant differences in performance were observed between males and females and, to a lesser extent, between right and left handers. Of interest, were significant Gender x Handedness and Gender x Handedness x Level (of performance) interactions seen especially in the older (postpubertal and adult) subjects. High performing, right handed males and left handed females performed better on visuospatial tasks while left handed males and right handed females performed better on verbosequential tasks.

Hemisphericity and its validity for education, vocation, and cognitive style.

Six studies are described demonstrating practical use for individual assessment of specialized cognitive function associated with the left and right cerebral hemispheres. Study #1 demonstrates that the majority of referred reading difficulties have a cognitive profile for which verbosequential abilities are 0.5 SD below average, while visuospatial abilities are 0.5 SD above average. Study #2 also demonstrates that first degree family members of dyslexics favor visuospatial skills. Study #3 demonstrates that public school children have lower reading but not lower arithmetic scores if their cognitive profile favors visuospatial skills. Study #4 demonstrates that visuospatial skills were predictive of success in training military pilots. Study #5 demonstrates a modest association of cognitive function and management skill. Finally, study #6 demonstrates that valid tests of brain function were not related to preference inventories purportedly designed to measure the same thing. The conclusion from these studies is that tests assessing specialized cognitive function may be useful in some areas of prediction of academic success and, to a lesser degree, management success. But caution in interpretation is advised because not all predictions were supported by the data.

Ultradian rhythms of right and left hemisphere function.

Two studies are described that demonstrate ultradian shifts in performance on tests of specialized function associated with the left or right cerebral hemispheres. The first study demonstrated that right-handed males who were tested upon wakening from Rapid Eye Movement sleep performed relatively better on visuospatial skills compared to themselves when tested upon wakening from Non-Rapid Eye Movement sleep. In the second study, subjects were tested continuously for eight hours on a written word production test, a test of point localization, and a test of symbol digit substitution. Each of the tests was performed cyclically but with different periods. The results from both studies suggest that underlying cerebral mechanisms for verbosequential and visuospatial function are neurochemical in nature and not neuroanatomical because of the rapid (ultradian) shifts in performance level.

Specialized cognitive function and reading achievement in hearing-impaired adolescents.

This study evaluated the performance of hearing-impaired adolescents on tests of specialized cognitive functioning and explored the linkage between cognitive profile and reading achievement. Other variables noted were mathematics achievement, speech production, etiology, and age of onset of hearing loss. Subjects were 62 severely-to-profoundly hearing-impaired students between 15 and 20 years of age, 31 "high readers" and 31 "low readers." Results indicated that, for this sample, cognitive function was below average for the verbal and sequential skills associated with the left hemisphere but above average for the "visuospatial" skills associated with the right hemisphere. Reading performance proved to be highly correlated with cognitive profile, as did mathematics performance and, to a lesser extent, speech and age of onset. Ramifications for instruction are discussed--in particular, development of strategies for using the right hemispheric cognitive strengths, as identified in this sample, to help overcome the deficits in "verbosequential" processing and reading achievement traditionally associated with hearing-impaired students.

Changes in specialized cognitive function following changes in hormone levels.

Increase of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in men by injection of luteinizing hormone releasing hormone (LHRH) prevented improvement in a spatial orientation test relative to a placebo condition. By contrast, performance on a fluency task was significantly increased after LHRH injection relative to the placebo condition. These data support between-subject results where FSH was negatively correlated with visuospatial skills and positively correlated with fluency. There was no change in cognitive function in males following injection of testosterone. There were also no fluctuations in cognitive function that coincided with hormonal fluctuations of the menstrual cycle in women.

The cognitive laterality battery: tests of specialized cognitive function.

The Cognitive Laterality Battery of neuropsychological tests is described and normative data and statistics are presented. Selection of tests was based on converging evidence from studies on patients with unilateral cerebral lesions, complete forebrain commissurotomy, and on normal subjects suggesting that visuospatial skills are primarily related to the right hemisphere while verbal and sequential skills are primarily related to the left. Factor analyses confirmed the dichotomy of the test choices. It is suggested that test results on individuals be interpreted as a cognitive profile defining the relative performance of specialized functions rather than the relative right or hemisphere locations. Previous studies with the CLB are described.