BACKGROUND: Many cancer treatments pose a threat to fertility for patients. Semen cryopreservation before cancer treatment is an effective method to preserve fertility. There are sparse long-term data on the usage of samples from Canadian oncology sperm banks.
METHODS: A retrospective chart review of all oncology sperm banking samples at a Canadian academic fertility centre from 2001 to 2020 was conducted.
RESULTS: From 2001 to 2020, 4521 samples were banked by 2504 patients. The most frequent diagnoses among these patients were testicular cancer (29.5%) and lymphoma (26.9%). Of these patients, only 81 (3.2%) patients returned to use their samples with intrauterine insemination (IUI) or in vitro fertilisation (IVF) treatment and 62 (2.5%) patients transferred their samples to another clinic. The time between banking and return for usage of the sperm ranged from 1 to 131 months with a median of 18 months after banking. A total of 66 IVF cycles (104 embryo transfers) and 101 IUI cycles from 67 patients were reviewed. Of the 67 couples who used their samples, 53.7% achieved a clinical pregnancy. The clinical pregnancy rate was 6.6% per cycle for IUI and 30.8% per embryo transfer for IVF. Higher sperm concentration or total motile count was not associated with a higher chance of pregnancy. Patients who conceived had on average 1.9 ± 0.8 (p=0.02) more usable embryos per cycle than those who did not conceive.
CONCLUSIONS: Sperm cryopreservation provides a valuable option for patients with cancer to achieve parenthood after potentially gonadotoxic cancer treatment. However, the overall usage of banked oncology sperm samples is very low.

Previous studies reported that exposures to per- and polyfluoroalkyl substances (PFAS), largely in higher exposed populations, were associated with elevated risk of polycystic ovary syndrome (PCOS). However, studies evaluating PCOS risk in populations with lower background exposures to PFAS are limited. This study aimed to examine the associations between serum PFAS concentrations and PCOS risk among women attending a U.S. academic fertility clinic during 2005-2019. A total of 502 females who sought fertility evaluation and assisted reproduction treatments were included. Nine PFAS were quantified in non-fasting serum samples collected at study entry. Diagnosis of PCOS was based on the Rotterdam criteria. We used logistic regression to examine the odds ratio (OR) of PCOS in relation to individual PFAS concentrations (continuous and by tertiles) and quantile g-computation (QGC) and Bayesian Kernel Machine Regression (BKMR) to examine the joint associations of PFAS mixture with PCOS. Most participants were White and had a graduate degree or higher. Per doubling of serum perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) concentrations were associated with higher odds of PCOS [OR (95%CI): 1.70 (1.06, 2.81) and 1.45 (1.02, 2.08) for PFOS and PFHxS respectively]. There was a dose-response relationship of PFOS with PCOS risk (p of trend by PFOS tertiles = 0.07). Both QGC and BKMR identified PFOS as the most important contributor among the mixture to PCOS risk. No clear joint effects were found for other PFAS or PFAS mixtures on PCOS risk. Our findings are consistent with existing evidence in populations with higher background PFAS concentrations and highlight the adverse effects of PFAS exposure on reproductive health. Findings can inform public health measures and clinical care to protect populations vulnerable to PCOS, in part, due to environmental exposures.

Despite major advances in infertility services, barriers to care as well as disparities in outcomes remain a significant problem. The cost of treatment, lack of or inadequate coverage, and location of infertility clinics are obvious contributors, however, advanced pathology, coexistent medical conditions, and lack of preconception care also contribute to delay in fertility particularly in underserved communities. Previous studies have discussed the role of trainee-run clinics in lower socioeconomic populations in providing low-cost infertility evaluation and management. This study uses a retrospective chart review to compare the etiology and duration of infertility in our patients to the general infertility patient population, to describe the coexistent medical pathologies within our population at initial presentation to infertility care, and to discuss how our clinic is addressing the gap in infertility care. PRECIS: Resident-run clinics offer a unique role in increasing access to care through preconception care and low-cost fertility treatment.

Considering the growing demand for egg donation (ED) and the scarcity of women coming forward as donors to meet this demand, scholars have expressed concerns that clinics may (initially) misrepresent risks to recruit more donors. Additionally, (non-)monetary incentives might be used to try to influence potential donors, which may pressure these women or cause them to dismiss their concerns. Since the internet is often the first source of information and first impressions influence individuals\' choices, we examined the websites of fertility clinics to explore how they present medical risks, incentives and emotional appeals. Content Analysis and Frame Analysis were used to analyze a sample of Belgian, Spanish and UK clinic websites. The data show that the websites mainly focus on extreme and dangerous risks and side effects (e.g. severe OHSS) even though it is highly relevant for donors to be informed about less severe but more frequently occurring risks and side effects (e.g. bloating), since those influence donors\' daily functioning. The altruistic narrative of ED in Europe was dominant in the data, although some (hidden) financial incentives were found on Spanish and UK websites. Nonetheless, all information about financial incentives still were presented subtly or in combination with altruistic incentives.

BACKGROUND: Son preference is known to be prevalent in developing countries and has dire consequences for the family, particularly girls and women. It is speculated that the prevalence of son preference may be high among fertility clinic attendees, and that son preference may be the reason for seeking fertility care in Nigeria.
OBJECTIVE: To determine the prevalence and risk factors for son preference among fertility seekers in Enugu, Nigeria.
METHODS: Questionnaire-based cross-sectional study of fertility clinic attendees from the University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and the Pink Petals Fertility Clinic Enugu from April 1 to September 30, 2023. Eligible and consenting participants were interviewed. Data collection was with a pretested interviewer-administered questionnaire, which contained three sections: biodata, obstetrics and gynecological data and 3-point son preference questions. The proportion of those who scored 3 (son preference) was documented. The analysis was both descriptive and inferential using IBM SPSS statistics for Windows, version 22.0 Armonk, NY, USA: IBM Corp.
RESULTS: Of the 422 participants interviewed, 416 (98.6%) completed the study with a nonresponse rate of 6 (1.4%). The overall prevalence of son preference was 10.1% (42/416) and all 42 (10.1%) were in the clinic to have a male baby. The risk factors for son preference were less than tertiary education (P < 0.001, adjusted odds ratio [AOR] = 6.46, confidence interval [CI] 2.79-14.98) and family pressure to have a male baby (P = 0.03, AOR = 3.41, CI 1.72-7.13).
CONCLUSIONS: One in 10 couples who attend an infertility clinic in Enugu, Nigeria, has a preference for son, and having a male child is the sole purpose of such a visit. Being under family pressure and not having tertiary education were the predictive risk factors for son preference in the study population.
Résumé Contexte:La préférence pour les garçons est connue pour être répandue dans les pays en développement et a des conséquences désastreuses sur la famille, en particulier sur les filles. et les femmes. On suppose que la prévalence de la préférence pour les garçons pourrait être élevée parmi les prestataires des cliniques de fertilité, et que la préférence pour les garçons pourrait être élevée. être la raison pour laquelle vous recherchez des soins de fertilité au Nigeria.Objectifs:Déterminer la prévalence et les facteurs de risque de préférence pour les garçons parmi les facteurs de fécondité. chercheurs à Enugu, au Nigeria.Matériels et méthodes:Étude transversale basée sur un questionnaire auprès de participantes aux cliniques de fertilité de l’Université de l’hôpital universitaire du Nigeria Ituku Ozalla Enugu et de la clinique de fertilité Pink Petals Enugu du 1er avril au 30 septembre 2023. Éligible et les participants consentants ont été interrogés. La collecte des données s’est faite à l’aide d’un questionnaire pré-testé administré par l’intervieweur, qui contenait trois sections: données biologiques, données obstétricales et gynécologiques et questions de préférence pour les fils en 3 points. La proportion de ceux qui ont obtenu un score de 3 (fils préférence) a été documentée. L’analyse était à la fois descriptive et inférentielle à l’aide des statistiques IBM SPSS pour Windows, version 22.0 Armonk, NY, États-Unis: IBM Corp.Résultats:Sur les 422 participants interrogés, 416 (98.6 %) ont terminé l’étude avec un taux de non-réponse de 6 (1.4 %). La prévalence globale de la préférence pour les garçons était de 10.1 % (42/416) et les 42 (10.1 %) étaient toutes à la clinique pour avoir un bébé de sexe masculin. Les facteurs de risque pour la préférence pour les garçons étaient inférieures à l’enseignement supérieur ( P < 0.001, rapport de cotes ajusté [AOR] = 6.46, intervalle de confiance [CI] 2.79–14.98) et pression familiale pour avoir un bébé de sexe masculin ( P = 0.03, AOR = 3.41, CI 1.72–7.13).Conclusions:un couple sur 10 qui fréquente une clinique d’infertilité à Enugu, au Nigeria, a une préférence pour les fils, et avoir un enfant de sexe masculin est le seul objectif d’une telle visite. Être sous la pression familiale et non avoir fait des études supérieures était le facteur de risque prédictif de la préférence pour les garçons dans la population étudiée.

Context In recent years, the COVID-19 pandemic became a threat to human health and induced global concern. The SARS-CoV-2 virus causes various disorders in the body\'s systems, and the reproductive system is no exception. Further, the rate of infertile couples is increasing and part of this is related to male infertility. Aims The aim of the present study was to investigate the impacts of COVID-19 infection history on semen quality in men referred to public and private infertility centres. Methods In this research, patients were divided into two groups: 88 men with a history of COVID-19 (Covid+) and 51 men without (Covid-). After semen collection, sperm parameters, fertilisation rate and oxidative stress were investigated. Key results Sperms with normal morphology and mature chromatin in patients with COVID-19 infection history decreased, and seminal oxidative stress and sperm DNA fragmentation were increased; moreover, the fertilisation rate in the Covid+ group decreased in compare to the Covid- group. Conclusion COVID-19 infection increases oxidative stress in the semen, so has a negative effect on some sperm parameters and fertilisation rate. Implications COVID-19 infection impairs semen quality by increasing in oxidative stress, thus reducing the fertility potential.

In medically assisted reproduction (MAR) success has mostly been measured in terms of achieving (healthy) livebirths. We argue this focus is too narrow and that success should be measured in terms of alleviating patient suffering caused by an unfulfilled child wish. The major implication is that clinics must better tailored care to effectively support patients who do not have child(ren) with treatment. First, we argue that clinics have a duty of care towards patients for whom MAR does not result in children because this is a common treatment outcome, because treatment is burdensome and creates new losses for patients, and because the field has the necessary expertise to provide support and it is part of patient-centred care. Then, we examine concerns about the adequacy of addressing the possibility that treatment may end without children, namely, that this may hinder patients\' hope and put them off doing treatment, and that it may be perceived as a sign of clinical incompetence, as well as concerns about the required skill set. We end with a set of research-informed recommendations to promote healthy adjustment to ending fertility treatment without children. These focus on the need to reconceptualize \'success\' and \'failure\' in MAR, to promote open discussion about the possibility of treatment not resulting in children and encourage patients to develop \'plan(s) B\', to support patients who end treatment without children, and to create the organizational structures needed to support clinics and healthcare professionals in this endeavour.

OBJECTIVE: To explore men\'s and women\'s experiences regarding their history of sexual health when attending a fertility clinic.
METHODS: A qualitative study with semi-structured individual interviews was conducted among heterosexual males and females seeking infertility care at a public fertility clinic in Sweden in 2022-2023. The interviews were audio-recorded, transcribed verbatim and analyzed using qualitative content analysis.
RESULTS: Eight males and ten females were included. The analysis resulted in an overarching theme: A change from spontaneous to scheduled intercourse affects various aspects of sexual health. In the beginning of the relationship sex had been spontaneous, joyful and satisfying. However, sex was not always unproblematic, and there had been sexual changes. Sex with a reproductive purpose was scheduled according to ovulation, leading to changes in sexual behavior. Increased erectile problems in men and decreased frequency of orgasms in women, and a lack of sexual desire in both, were experienced. Men and women felt pressured to have sex when it became a requirement. Men\'s sexual and women\'s reproductive failures led to negative emotional reactions, including stress, frustration, disappointment, anxiety and guilt. Sexual and reproductive problems affected the relational well-being, leading to feelings of sharing the burden but also conflicts and sexual avoidance.
CONCLUSIONS: Experiencing reproductive failures, sexual problems and negative emotional reactions can affect men\'s and women\'s sexual health. Therefore, an implication for clinical practice among healthcare professionals during evaluation of infertility, is a need to be aware of and ask questions about sexual health after reproductive failures.

This study aims to systematically analyze the provision of information on Time-lapse Imaging (TLI) by UK fertility clinic websites. We conducted an analysis of 106 clinic websites that offer fertility treatment to self-funded patients. The analysis aimed to examine whether these clinics offer TLI, the associated cost for patients, and the clarity and quality of the provided information. Out of the 106 websites analysed, 71 (67%) claimed to offer TLI. Among these websites, 25 (35.2%) mentioned charging patients between £300 and £850, 25 (35.8%) claimed not to charge patients, and 21 (29.6%) did not provide any cost information for TLI. Furthermore, 64 (90.1%) websites made claims or implied that TLI leads to improved clinical outcomes by enhancing embryo selection. Notably, 34 (47.9%) websites did not mention or provide any links to the HFEA rating system. It is crucial to provide patients with clear and accurate information to enable them to make fully informed decisions about TLI, particularly when they are responsible for the associated costs. The findings of this study raise concerns about the reliability and accuracy of the information available on fertility clinic websites, which are typically the primary source of information for patients.

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