Editor's Choice
E-mail: vansteirteghema{at}humanreproduction.co.uk
This issue sees the start of a ‘new debate’ on whether body mass index (BMI) should be taken into account in the provision of fertility services (p. 1532). This is a relevant question in view of the worldwide epidemic of obesity and the delayed childbearing age, and one that I hope will stimulate others to contribute to the debate. An interesting addition to the ongoing debate series ‘What next for preimplantation genetic screening?’ deals with the question of whether biological factors may be the reason why the valid hypothesis of PGS to improve ART outcome has not been working so far (p. 1538).
Collaboration between the ESHRE and the hESC registry resulted in the creation of a registry for human embryonic stem cells carrying an inherited (chromosomal or monogenic) defect. It is hoped that this registry, the status of which will be updated and published annually in this journal, will prove invaluable to all researchers working in the fields of regenerative medicine and human genetics (p. 1556).
Clinical, semen and hormone characteristics were obtained from 225 male partners of pregnant Australian women to investigate the associations between these characteristics. Well-established andrological associations were confirmed but a lower sperm concentration was observed in men with BMI > 30 kg/m2. Whether this is cause or effect, in terms of adiposity reducing spermatogenesis or reduced testicular function promoting fat deposition, remains to be determined (p. 1561).
The impact of the hepatitis B virus S protein (HBs), the main component of the HBV envelope protein, on human sperm function indicated that sperm motility was reduced in a dose- and time-dependent matter. The molecular pathogenic mechanism for this decrease may be partly related to the polysaccharides of HBs but needs to be further explored (p. 1575).
Outcome of pregnancy in 332 women exposed to levonorgestrel (LNG) for emergency contraception (EC) in the cycle of conception was compared with a matched group of 332 unexposed women. There was no association between the use of LNG-EC and the risk of major congenital malformations or any other adverse pregnancy outcome (p. 1605).
Complementary and alternative medicines (CAM) are widely used by infertility patients. A prospective observational cohort study was done in 728 patients who completed self-report assessments. Ongoing pregnancy and live birth rates were compared in spontaneous users and non-users of CAM during a 12-month period of ART. A 30% lower pregnancy rate was observed in the 223 patients using CAM, although it was not possible to ascertain which type of CAM was most associated with this reduction. This indicates that concurrent CAM use during ART treatment should be monitored (p. 1626).
In the debate on the use of elective single-embryo transfer (eSET), several earlier reports indicated that this practice may reduce the delivery rate per cycle. A large study from Finland indicates that eSET in combination with cryopreservation should become ‘the treatment of choice’ since it is more effective and less expensive than double-embryo transfer (p. 1632).
Preconception sex selection for non-medical reasons is a controversial issue in bioethics, and in many countries, this practice is prohibited by law. A study describing the sex preference and interest in employing sex selection was done in Jordan and reveals that the majority of pregnant women were not in favor of preconception sex selection. Boys were preferred in lower income families and sex selection was also of interest in unbalanced families (p. 1665).
Freezing of ovarian cortical tissue for preservation of fertility among young women facing chemo- or radiotherapy is widely accepted. Several cryopreservation protocols (slow-programmed protocols versus vitrification) were compared and indicated that morphological characteristics were well conserved by both types of procedure. Ovarian stroma's morphological integrity was better conserved after vitrification using a combination of propanediol, ethylene glycol, dimethyl sulfoxide and polyvinyl pyrrolidone (p. 1670).
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