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

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.

Acupuncture: when classical meets modern

To the Editor:

We read with great interest the recent article by Moy, et al. (1)

After its mysterious origination over 2500 years ago, acupuncture had spread rapidly through Asia, and been applied in Europe since the early seventeenth century. (2) Based on controlled clinical trials, extensive data about the efficacy of acupuncture have been gathered over the past three decades, providing valuable insight into the experience-based practice. We have the following concerns about the present study:

Ongoing pregnancy after hMG stimulation and timed intercourse in a 40-year-old woman with undetectable AMH levels

To the Editor:

We read with interest the reports of Fraisse et al. (2008) (1) and Tocci et al. (2009) (2) published in Fertility Sterility on a total of three cases of pregnancies despite undetectable serum anti-muellerian hormone (AMH) levels. Herein we report a similar case, which we would like to bring to the attention of our colleagues.

PCOS is common in patients undergoing bariatric surgery in a British center

To the Editor:

We read with great interest the article by Gosman et al (1). The authors highlight that 13.1% of female patients undergoing bariatric surgery had already been diagnosed with PCOS by a health care provider. Data on the incidence of polycystic ovary syndrome (PCOS) in this population from outside the U.S. and the U.K. in particular are limited.

A call to provide multiple options for women in developing countries

To the Editor:

I was encouraged to read the article by Vayena et al, which justly addressed the needs of women experiencing infertility in developing countries (1). What is not clear is whether the authors are truly concerned with fairly evaluating “innovative approaches in treatment” (1) or whether they are simply one-sided advocates for assisted reproductive technology (ART).

Acupuncture and IVF trial

I have some real concerns about the implications and conclusions drawn from the study of Domar et al. (1).

This study explores the effects of one protocol on IVF treatment. The study was indeed attempting to make sure that this was as close to the same protocol as used in the 2002 study.

IVM of immature oocytes in stimulated cycles

Johnson et al’s (1) efforts to rescue and utilize immature oocytes generated during ovarian stimulation cycles which would otherwise be wasted are commendable. This author’s experience in a similar endeavor (2) suggests that ovarian stimulation regimes may generate approximately 20% immature oocytes (1, 2), which is a significant loss if efforts are not made to rescue and utilize them.

Lack of clinical and scientific evidence to justify the systematic use of ICSI in HIV-serodiscordant couples wishing to conceive where the male partner is infected

 

To the Editor:

 

Sauer et al. (1) reported, in a recent Fertility and Sterility issue, 10 years’ experience of an ICSI program in 181 HIV-serodiscordant couples. One hundred three deliveries were reported. It’s noteworthy that the multiple pregnancy (MP) rate was 41%, and 43% of infants were born preterm. Twenty-one infants weighed less than 1500 grams. No female HIV-seroconversions occurred.