Klinefelter syndrome: An argument for early aggressive hormonal and fertility management

15 08 2012

To the Editor:

We would like to thank Drs. Mehta and Paduch for their fine article (1). The aim of their systematic review/meta-analysis was to investigate the effect of early hormone replacement therapy (HT) on sperm retrieval rates in patients with Klinefelter syndrome (KS). In this article the authors reported that early HT is recommended in patients with KS, but its effect on fertility potential has not been studied in detail. Cryopreservation of sperm containing semen or testicular tissue from a significant proportion of affected adolescents should be considered to maximize future fertility potential. We greatly appreciate this paper, but there are some issues that should be highlighted. Read the rest of this entry »

Letter regarding use of laptop computers connected to internet through Wi-Fi decreases human sperm motility and increases sperm DNA fragmentation.

3 02 2012

To the Editor:

We read with great interest the article by Avendaño et al (1), “Use of laptop computers connected to internet through Wi-Fi decreases human sperm motility and increases sperm DNA fragmentation.” We want to congratulate the authors for their original and interesting work. However, this study has also raised a few questions.

First of all, the issue of sperm analysis method should be addressed. Indeed, sperm analysis was performed manually before selection, after swim up, and after 4 hours of incubation under the computer or not (control group). Despite efforts towards improvement and standardization of laboratory procedures (2), manual sperm analysis still suffers from a lack of precision and accuracy (3), particularly when counting progressive motile spermatozoa in an enriched supernatant. Moreover, sperm analysis was conducted here by a single observer and apparently not repeated, which leads to a high risk of intra observer variability. We also would like the authors to precise if the study was operator-blinded or if the operator was aware of the origin of the samples he was assessing. All these limitations could constitute a bias and prevent from relevant interpretation of the results. Could the authors consider automated sperm analysis as a reliable alternative in order to improve reproducibility and precision of their results? (4) Moreover, CASA could bring new insights into a potential WiFi-induced sperm motility alteration and kinetics modification. Read the rest of this entry »

Re: Use of laptop computers connected to internet through Wi-Fi decreases human sperm motility and increases sperm DNA fragmentation

12 01 2012

To the Editor:

We read with interest the article “Use of laptop computers connected to internet through Wi-Fi decreases human sperm motility and increases sperm DNA fragmentation” by Avendano et al.(1). However, we do actually think that the evidence presented in this paper cannot support the claim that the observed effects are nonthermal and caused by exposure to a Wi-Fi radiofrequency electromagnetic field.

Keeping constant the temperature under the computer by an air conditioning system is not sufficient to ensure homogeneity of the temperatures within the experimental area, since the heat source from the laptop is not homogenous itself, and to exclude that there is no local variation in the samples temperatures. Read the rest of this entry »

Does uterine artery ligation, performed because of a severe postpartum hemorrhage, alter fertility?

26 04 2011

To the Editor:

We read with interest the case series report by Blanc et al. that highlights the risk of synechia after uterine-sparing procedures (1). The authors concluded that their “results suggest that triple ligation (TUAL), with or without haemostatic multiple square suturing (HMSS), exposes patients to the risk of subsequent abnormalities of the uterine cavity.” (1).

Regarding HMSS, we could not agree more with the authors, as we have been attempting to alert physicians to the possible hidden mid-term or long-term effects of uterine compression sutures (2–6), although these procedures were adopted promptly throughout the world. Read the rest of this entry »

High prevalence of endometriosis in infertile women with normal ovulation and normospermic partners

12 11 2009

To the Editor:

We read the article by Meuleman et al. (1) with interest. The high incidence of endometriosis (47%) and other pelvic pathology (29%) in this cohort makes a strong case for offering laparoscopy and hysteroscopy to couples with “unexplained infertility” (a diagnosis of exclusion). This diagnosis however requires confirmation of tubal integrity, and the issue is whether laparoscopy should be the first-line investigation to establish tubal patency. The authors did not say how many women in their cohort had a completely normal pelvis following laparoscopy and hysteroscopy. Read the rest of this entry »

Parity and Subfertility Effects of Continuous Oral Contraceptives on Fertility Are Important

18 06 2009

To the Editor:

In recent articles, Barnhart and colleagues present data on time to conception following discontinuation of continuous oral contraception (OC) (1). They compare these and other data and conclude that “the return of fertility in former OC users … is comparable to … other contraceptive methods” (2). While we are pleased to see the addition of empirical evidence to this debate, we have some concerns about the role of parity in the time to conception, and are concerned that an uncritical acceptance of this conclusion may cause harm. Read the rest of this entry »