BACKGROUND: Infertility increases stress and affects life quality. Mindfulness reduces stress and improves life quality, but its role in infertility remains unclear.
OBJECTIVE: To evaluate the effect of mindfulness on stress and quality of life of women with infertility.
METHODS: An exploratory clinical study was conducted in women under infertility treatment, together with an 8-week mindfulness intervention (MND) or only infertility treatment (CTRL). Anxiety and quality of life were assessed at baseline and at the end of intervention with IDARE and FertiQoL questionnaires respectively, as well as salivary alpha-amylase and cortisol concentrations. Non-parametric statistics was used for analysis using an alpha value of 0.10.
RESULTS: 14 MND and 15 CTRL completed follow-up. At baseline, CTRL patients exhibited better quality of life than MND; anxiety scores correlated negatively with quality of life. At the end of intervention, cortisol concentrations (p = 0.097), and the increments of amylase (p = 0.039), were higher in CTRL than in MND. Increases in quality of life were associated with basal anxiety score (p = 0.002), improvements in tolerability (p < 0.001), and mindfulness intervention (p = 0.014).
CONCLUSIONS: Our results suggest that mindfulness reduces stress and improves quality of life in women under infertility treatment.
BACKGROUND: La infertilidad incrementa el estrés y afecta la calidad de vida.
OBJECTIVE: Evaluar el efecto de mindfulness (atención plena) sobre la ansiedad, estrés y calidad de vida de mujeres infértiles.
UNASSIGNED: Estudio exploratorio en pacientes tratadas por infertilidad más una intervención de ocho semanas con mindfulness (grupo MND) o solo tratamiento de la infertilidad (grupo de control). Al inicio y después de ocho semanas se evaluaron la ansiedad (Inventario de Ansiedad Rasgo-Estado), la calidad de vida (FertiQoL), y las concentraciones salivales de α-amilasa y cortisol. Se utilizó estadística no paramétrica, con α = 0.10.
RESULTS: 14 mujeres del grupo MND y 15 del grupo de control completaron el seguimiento. Al inicio, las pacientes del grupo de control mostraron mejor calidad de vida; las puntuaciones de ansiedad correlacionaron negativamente con la calidad de vida. Al final, el incremento de cortisol (p = 0.097) y amilasa (p = 0.039) fueron mayores en el grupo de control. Los incrementos en la calidad de vida se asociaron a ansiedad basal (p = 0.002), incremento en la subescala tolerabilidad (p < 0.001) y mindfulness (p = 0.014).
UNASSIGNED: Los resultados sugieren que mindfulness disminuye el estrés y mejora la calidad de vida de pacientes bajo tratamiento de la infertilidad.

OBJECTIVE: This systematic review and meta-analysis study aimed to examine the relationship between infertility and sleep quality in women.
METHODS: The literature search was conducted between October and November 2022 with full-text studies from PubMed (MEDLINE), Cochrane, Google Scholar, and Scientific Information Database (SID). The study is based on the recommendations of the Cochrane guidelines. The data were analyzed using the Review Manager computer software (Version 5.3).
RESULTS: A systematic literature review was conducted, with 11 studies included. The meta-analysis revealed a significant difference between infertility and sleep quality in women, that the sleep quality of infertile patients decreased (SMD: -0.75 95% CI: -0.84 to -0.66, Z = 16.46, P < .00001), and that there was a significant difference between infertility and depression (SMD: -0.18 95% CI: -0.27 to -0.09, Z = 4.00, P < .0001).
CONCLUSIONS: The results of this study indicate that sleep quality is low in infertile women. PROSPERO ID: (CRD42023404389).

BACKGROUND: Although most patients with celiac disease (CD) have digestive manifestations, in some of them they may be of extraintestinal (atypical) nature, such as chronic anemia, ataxia, and fertility disorders.
OBJECTIVE: To determine the prevalence of CD-related antibodies in Mexican women with fertility disorders.
METHODS: Case-control study of women who attended evaluation for fertility disorders in a specialized center. h-tTG-IgA, gliadin IgA II and gliadin IgG II were quantified; titers > 30 IU were considered positive.
RESULTS: One-hundred and seventy-one cases and 171 controls were included; 137 patients (80.1%) had infertility, and 34 (19.9%), sterility. Eight patients (4.6%, 95% CI = 2.3-8.9) had at least one positive marker for CD in comparison with one woman in the control group (0.5%, 95% CI = 0.01-3, p = 0.04, odds ratio = 8.3). Six of the eight patients had unexplained infertility.
CONCLUSIONS: Up to 4.6% of women with infertility had at least one positive marker for CD. As in other parts of the world, screening for CD could be recommended in women with infertility, especially in those with unexplained infertility.
BACKGROUND: Aunque los pacientes con enfermedad celiaca (EC) tienen en su mayoría manifestaciones digestivas, algunos pueden presentarlas de índole extraintestinal (atípicas), como anemia crónica, ataxia y trastornos de la fertilidad.
OBJECTIVE: Determinar la prevalencia de anticuerpos relacionados con EC en mujeres mexicanas con trastornos de la fertilidad.
UNASSIGNED: Estudio de casos y controles de mujeres que acudieron a valoración por trastornos de la fertilidad en un centro especializado. Se cuantificó h-tTG IgA, gliadina IgA II y gliadina IgG II; los títulos > 30 UI fueron considerados como positivos.
RESULTS: Se incluyeron 171 casos y 171 controles; 137 pacientes (80.1 %) tuvieron infertilidad y 34 (19.9 %), esterilidad. Ocho pacientes (4.6 %, IC 95 % = 2.3-8.9) tuvieron al menos un marcador positivo para EC comparadas con una mujer del grupo control (0.5 %, IC 95 % = 0.01-3, p = 0.04, razón de momios = 8.3). Seis de las ocho pacientes presentaron infertilidad inexplicable.
CONCLUSIONS: Hasta 4.6 % de las mujeres con infertilidad presentó al menos un marcador positivo para EC. Al igual que en otras partes del mundo, podría recomendarse el escrutinio para EC en mujeres con infertilidad, en especial en quienes padecen infertilidad inexplicable.

Klinefelter syndrome is the most frequently found aneuploidy among male patients. Its clinical presentation is very heterogeneous, and thus poses a challenge for a timely diagnosis.
A retrospective study was carried out with 51 consecutively selected patients diagnosed with Klinefelter Syndrome from Jan/2010 to Dec/2019. The karyotypes were identified using high resolution GTL banding at the Genetics Department. Multiple clinical and sociological parameters were studied by collecting data from the clinical records.
44 (86%) of the 51 patients presented a classical karyotype (47,XXY) and 7 (14%) showed evidence of mosaicism. The mean age at diagnosis was 30.2±14.3 years old. Regarding the level of education (N=44), 26 patients (59.1%) had no secondary education, with 5 (11.4%) patients having concluded university studies. Almost two thirds of the sample revealed learning difficulties (25/38) and some degree of intellectual disability was present in 13.6% (6/44). Half of the patients were either non-qualified workers (19.6%) or workers in industry, construction, and trades (30.4%), which are jobs that characteristically require a low level of education. The proportion of unemployed patients was 6.5%. The main complaints were infertility (54.2%), followed by hypogonadism-related issues (18.7%) and gynecomastia (8.3%). 10 patients (23.8%, N=42) were biological parents. With regards the question of fertility, assisted reproductive techniques were used in 39.6% of the studied subjects (N=48), with a success rate (a take home baby) of 57.9% (11/19), 2 with donor sperm and 9 with the patients\' own gametes. Only 41% of the patients (17/41) were treated with testosterone.
This study identifies the most important clinical and sociological findings of Klinefelter syndrome patients that should be considered when deciding workout and disease management.

Sperm motility is a crucial factor in male infertility and it depends on mitochondrial tail movements. Photobiomodulation light therapy allows the cells to produce their energy through activation of the mitochondria. The aim of the present study was to examine the impact of photobiomodulation on sperm motility in astenozoospermic individuals.
Following semen analyses of 20 astenozoospermic individuals, collected semen samples were centrifuged. Pellet was obtained and homogenized through mixing with culture media in 1:1 ratio. Each semen samples were divided into 3 groups. In the first group, control samples were not exposed to laser irradiation. The Group 2 and Group 3 were exposed to 650nm wavelength of photobiomodulation from 10cm distance in dark environment via a 36cm2 aperture sizer with 200mW output power for 30 and 60min duration, respectively. Sperm motilities were evaluated and chromatin condensation of sperms was determined.
Sperm motilities were significantly increased in photobiomodulation groups compared with the controls. Sperm motilities tended to be different between the 30 and 60min red light exposure groups; however, it was not statistically significant. When the motility grades were compared, no significant difference was observed in non-progressive motility sperms. While immotile sperms decreased significantly in the photobiomodulation groups compared to the control group, progressive sperms increased.
The results of the present study demonstrated that the photobiomodulation is an efficient method to increase the sperm motility of astenozoospermic individuals independent of the duration of exposure.

BACKGROUND: Male breast carcinoma (MBC) is an uncommon disease, accounting for less than 0.5% of cancer diagnoses in men. Data on the prevalence thereof in Argentina are unknown.
OBJECTIVE: To estimate the prevalence of a men\'s health history associated with MBC as well as the anthropometric and clinical characteristics of the study population.
METHODS: This cross-sectional study included all men according to original biological sex over 18 years of age with a history of breast cancer who sought care at the Hospital Italiano de Buenos Aires [Italian Hospital of Buenos Aires] between January 2010 and December 2018.
RESULTS: We included 57 men with breast cancer. Their median age was 71 years. Of them, 53.06% had obesity and 24.53% had diabetes. With respect to men\'s health history, 5.56% (2/36) had infertility, 29.17% (14/48) had gynaecomastia and 60.71% (17/28) had sexual dysfunction. Some 63% (7/11) had androgen deficiency based on laboratory diagnosis; of them, 45.45% (5/11) had high gonadotropins.
CONCLUSIONS: We identified similarities with the literature as to the prevalence of obesity, diabetes and infertility in patients with MBC. The prevalence of testosterone deficiency was higher than reported for men of the same age. Many of these factors support the need to examine the role of endogenous hormones. Further research is required to help physicians care for and counsel men at higher risk of this disease.

Sperm morphology has been used as a prognostic factor in in vitro fertilization, however, in intrauterine insemination (IUI) its predictive role is controversial. The aim of this study was to determine the impact of sperm morphology as isolated parameter of the spermiogram has on the probability of pregnancy in couples that are treated with IUI.
Retrospective study of IUI cycles performed in the Reproductive Medicine Unit of Clínica Las Condes between January 2016 and December 2018. Logistic regression of the following variables: sperm morphology grouped in 0-1%, 2-3% and≥4%, total progressively motile sperm count inseminated, age of the woman and the man.
A total of 385 cases were included and clinical pregnancy was diagnosed in 85 of them. When separating into groups of sperm morphology<4% and≥4%, the pregnancy rate was 22% in both groups. The age of the woman was the only statistically significant factor in the logistic regression. The area under the ROC curve of sperm morphology as a predictor of pregnancy was 0.53.
Our study concludes that sperm morphology should not be considered as a single parameter when deciding whether or not a couple can be treated with IUI, eliminating isolated teratozoospermia as a direct indication for in vitro fertilization. It was not possible to determine a cut-off point for sperm morphology that serves as a predictor of pregnancy.

OBJECTIVE: To analyze existence of an association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism with male infertility.
METHODS: A case-control study was conducted from June 2017 to August 2018 in which 88 infertile and 40 fertile were recruited. Polymerase chain reaction (PCR) - restriction fragment length polymorphism (RFLP) assay was carried out to study the allelic frequency of C677T polymorphism. The differences in allelic and genotypic frequencies of C677T locus between fertile and infertile groups were evaluated by the Pearson chisquare test. A logistic regression model was used to calculate Odds ratios and 95% confidence intervals, p value<0.05 was considered significant. The Hardy-Weinberg equilibrium was tested using HWE software.
RESULTS: In infertile subjects, frequency distribution of CC allele was (60.2%), the CT allele was (30.7%) the TT allele was (9.1%) and in the fertile controls the frequency was CC allele (75%), CT allele (20%) and TT allele (5%) respectively. Analysis revealed MTHFR 677 CC genotype associated significantly with male infertility (p<.046, OR=2.385; 95% CI=1.014-5.608); Frequency of CT (30.7%) and TT (9.1) genotypes were higher in infertile men as compared to CT (20%) TT (5%) in fertile controls but statistically these were not significantly different (p=0.097; OR=0.455; CI=0.179-1.153 and p=0.431; OR=0.526; CI=0.107-2.599 respectively). Significant association of age and BMI with MTHFR genotypes and infertility was observed.
CONCLUSIONS: Our results showed that MTHFR C677T polymorphism is not a risk factor for male infertility in our Pakistani population.

OBJECTIVE: To investigate the role of suprapubic bladder aspiration (SBA) in the diagnosis of retrograde ejaculation (RE) which is diagnosed with the observation of sperm in post-ejaculatory urine (PEU). However, sperm is also observed in PEU after the wash out of the retained ejaculate in the urethra with the expulsion of urine in several subjects. Therefore, detection of sperm in PEU in the diagnosis of RE is problematic and a better method is needed to overcome the ambiguity of positive PEU and to identify which patient experience true RE.
METHODS: A cohort of patients underwent an examination for RE over a two-year period at a single specialist centre. All patients underwent SBA and semen analysis. Sperm was investigated in urine aspirated from the bladder and in PEU.
RESULTS: Thirty-two patients (age range 18-62 years) underwent SBA and PEU for investigation of RE. Sperm was detected both in SBA and PEU in 19 patients, while 5 patients revealed sperm only in PEU. The mean number of sperm found in SBA was less than the mean number of sperm observed in PEU in all 19 patients.
CONCLUSIONS: SBA is a reliable and feasible method in the diagnosis of RE and can distinguish the true RE in which sperm flows backward into the bladder from the retained ejaculate in the urethra. The whole ejaculate does not likely flow retrogradely and RE could be a partial leakage of the ejaculate into the bladder.

To describe the development and characteristics living donor uterine transplantation program of the Hospital Clínic (Barcelona, Spain) and to report the first successful procedure in Southern Europe.
A 31-year-old female suffering of Rokitansky Syndrome underwent uterus transplant from her living sister, as a part of our research protocol. Before the transplant, the patient underwent an in vitro fertilization procedure and twelve embryos were obtained and cryopreserved. The uterus obtention procedure was performed entirely by robotic surgery and lasted 10h, being the main objective to obtain arterial and venous pedicles of good quality in order to ensure the vitality of the graft. The surgical procedure in the recipient was performed by laparotomy and the vascular anastomoses were performed in a terminolateral fashion, with polypropylene 8-0, the vaginal cuff of the graft was sutured to the recipient vaginal vault and the round and utero-sacral ligaments were fixed to the remaining recipient ligaments. Immunosuppressive treatment was prescribed following the protocols from other groups modified according to the solid organ transplantation protocols from our center.
The donor and recipient were discharged without any major complications. The recipient ultrasound scan showed a normal flow in both uterine arteries and veins. A grade II rejection was treated with high dose corticoids with subsequent normal biopsies and a vaginal stricture was treated with the placement of an esophageal stent for 4 weeks. The patient had her first menstrual period 47 days after the surgery.
The case reported here open new options in Spain for a wide group of patients that had no medical solution for a disease that deeply impairs their quality of life.