CDC 2003 Report Highlights 1

Here are some highlights from the recent CDC report on fertility clinics. The report goes back to 2003 because they have to wait one year until the baby is born and then another year to collect the data

Do ART success rates differ among women of different ages?

Age <23,>45, Pregnancy rate 3.3%, Live birth rate 1.9%, Singleton live birth rate 1.4%

Please keep in mind that these numbers refer to infertile women trying to conceive so although you cannot extrapolate the rates to the normal population you can probably extrapolate the attrition effect due to age

Some scientific evidence of sperm damage caused by varicocele

Interesting article on the December 2005 of the scientific journal Human Reproduction. The article was designed to determine the extent of sperm nuclear DNA damage in patients with varicocele and to examine its relationship with oxidative stress.
The investigators compared semen of individuals with varicocele with normal controls and concluded that

the presence of a varicocele is associated with high levels of DNA-damage spermatozoa even in the presence of normal semen profile. The results also indicate that oxidative damage is associated with sperm DNA damage in these patients.

An interesting conclusion . Much is said about the role of varicocele and infertility but there is scant evidence of a clear biologic effect so far. The common wisdom is that varicoceles induce an elevation in testicular temperature, but oxidative stress is now a novel theory. Whether treatment of varicocele is beneficial for most patient is still debated .

Source: Hum Reprod. 2005 Dec 16

Male fertility testing home kit goes on sale in the UK

The BBC news reports today that

The world's first over-the-counter home fertility test for men has been developed by scientists at Birmingham University

The test takes an hour, and forces the sample sperm to swim through a mock female cervix. Dependent on how many sperm get through the barrier, the test measures whether or not the male has enough sperm to fertilize an egg

First of all I must say that a similar test is available in the US. Second as far as I am concerned (until clinical studies prove otherwise) all this test does for a man is to confirm whether or not he has any sperm at all. Obviously that is good to know but let me reemphasize that all one will be able to tell by taking the test is that one is not completely infertile not how fertile one is .

SSRI antidepressant and pregnancy risk

The FDA has determined that exposure to paroxetine (Paxil) in the first trimester of pregnancy may increase the risk for congenital malformations, particularly cardiac malformations. At the FDAÂ’s request, the manufacturer has changed paroxetineÂ’s pregnancy category from C to D and added new data and recommendations to the WARNINGS section of paroxetineÂ’s prescribing information. FDA is awaiting the final results of the recent studies and accruing additional data related to the use of paroxetine in pregnancy in order to better characterize the risk for congenital malformations associated with paroxetine.
This is quite relevant because , to my knowledge this is the first time that a SSRI antidepressant is classified as a Fcategoryory D. Many women in their reproductive age do currently take antidepressants and many may be undergoiinfertilityity treatments. At this time women taking paxil and are pregnant or planning a pregnancy should consult their physician and possibly discontinue the drug or switch to another preparation.

Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants that evolve their effects at the serotonin transporter. They increase the extracellular level of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell. Examples of SSRI's are
Citalopram (Celexa, Cipramil, Emocal, Sepram)
Escitalopram oxalate (Lexapro, Cipralex)
Fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem)
Fluvoxamine maleate (Luvox, Faverin)
Paroxetine (Paxil, Seroxat, Aropax, Deroxat)
Sertraline (Zoloft, Lustral)