Tuesday, July 29, 2008

Discuss this fact with your children, husbands, wives, friends, this truth is not widely taught

"Men manufacture new sperm continuously throughout life, with each one living about 74 days. Scientists once thought that defective sperm were doomed to die with the roughly 40 million unrequited suitors in every ejaculation. But now it seems that some kinds of damage do not hinder sperm in their race to fertilization. The result can be embryos with high vulnerability to problems including autism and cancer.

Men's reproductive health is most robust in their twenties, and after that it's downhill. Each year after puberty, a man's spermmaking cells divide about 23 times. By age 40, these vital human building blocks have gone through about 610 rounds of replication, each with a chance for genetic error."


Monday, July 28, 2008

Especially for point mutations, expanded simple tandem repeats and structural chromosome mutations, the contribution of the male germline is dominant

1: Hum Mol Genet. 2008 Jul 1;17(13):1922-37. Epub 2008 Mar 18.
DNA double-strand break repair in parental chromatin of mouse zygotes, the first cell cycle as an origin of de novo mutation.
Derijck A, van der Heijden G, Giele M, Philippens M, de Boer P.
Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
In the human, the contribution of the sexes to the genetic load is dissimilar. Especially for point mutations, expanded simple tandem repeats and structural chromosome mutations, the contribution of the male germline is dominant. Far less is known about the male germ cell stage(s) that are most vulnerable to mutation contraction. For the understanding of de novo mutation induction in the germline, mechanistic insight of DNA repair in the zygote is mandatory. At the onset of embryonic development, the parental chromatin sets occupy one pronucleus (PN) each and DNA repair can be regarded as a maternal trait, depending on proteins and mRNAs provided by the oocyte. Repair of DNA double-strand breaks (DSBs) is executed by non-homologous end joining (NHEJ) and homologous recombination (HR). Differentiated somatic cells often resolve DSBs by NHEJ, whereas embryonic stem cells preferably use HR. We show NHEJ and HR to be both functional during the zygotic cell cycle. NHEJ is already active during replacement of sperm protamines by nucleosomes. The kinetics of G1 repair is influenced by DNA-PK(cs) hypomorphic activity. Both HR and NHEJ are operative in S-phase, HR being more active in the male PN. DNA-PK(cs) deficiency upregulates the HR activity. Both after sperm remodeling and at first mitosis, spontaneous levels of gammaH2AX foci (marker for DSBs) are high. All immunoflurescent indices of DNA damage and DNA repair point at greater spontaneous damage and induced repair activity in paternal chromatin in the zygote.
PMID: 18353795 [PubMed - indexed for MEDLINE]

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Tuesday, July 15, 2008

AN Excellent Video A MUST SEE

Male Biological Clock


Monday, July 14, 2008

Sheena Lewis Professor of Reproductive Medicine

Tuesday, July 15, 2008
Timing is key to fathering children
New research suggests men's biological clocks are also ticking
FERTILITY EXPERTS have warned there is a growing body of evidence showing that the man's age is a significant factor affecting the chances of a couple conceiving and of having a healthy child.
A new study presented last week at the annual meeting of the European Society of Human Reproduction and Embryology in Barcelona found that miscarriage rates increased significantly when the man was older than 35, and that pregnancy rates dropped when the man was older than 40. The study was based on more than 12,000 couples attending a fertility clinic in Paris.
Professor of reproductive medicine at Queen's University Belfast, Sheena Lewis, who also presented a paper at the conference, said the Paris study "provided more data to add to an emerging picture" relating to the significance of the age of the father.
She said people needed to realise that they are taking a risk by waiting until they were 35 years or older to have children - as an increasing number of women and men are. "You cannot assume that it will happen, that it will not be a problem," she said.
Prof Lewis, who is a scientist at the Regional Fertility Centre at the Royal Victoria Hospital in Belfast, said there was a growing trend of people leaving it later to have children when their careers were established, and of people trying to start second families later in life. She said the clinic was seeing an increasing number of men in their 40s and 50s who wanted to have children, often in a second relationship.

People often mistakenly assume they will be able to have children later in life, she said. "What happens is that we are inclined to take anecdotal evidence and assume that it applies to the whole population - so people hear about Cherie Blair and Madonna having babies and assume that older mothers can have easy pregnancies.
"And they hear about Picasso fathering a child when he was 81, and they believe that every man can do it, and it becomes the accepted wisdom, but unfortunately it is not the case. We are perpetuating a myth and people often believe it until it is too late," Prof Lewis said.
She said there were now quite a number of studies showing that as a man ages, the likelihood of his sperm being damaged increases. "A sperm is a very specialised little cell - it is just DNA with a tail and it has one single function, to get the DNA to the egg to fertilise it. In order to do that, the cell gets rid of everything but DNA, so it gets rid of repair mechanisms that you find in other cells. So if it gets damaged it can't repair itself."
She said that after fertilisation, the DNA damage of the sperm becomes part of the genetic make-up of the embryo. "If a poor sperm fertilises an egg, and even if you get a pregnancy, there is quite often a miscarriage," Prof Lewis said. While one study had suggested that an egg could repair a damaged sperm, she said there was not a great deal of evidence to support this, and further research would be needed to test it. She said other studies had shown that when a man is older it takes longer for a couple to conceive.
Dr Stephanie Belloc, who led the study at the Eylau Centre for Assisted Reproduction in Paris, told the Barcelona conference: "Until now gynaecologists only focused on maternal age and the message was to get pregnant before the age of 35 or 38, because afterwards it would be difficult. But now gynaecologists must also focus on paternal age and give this information to the couple."
The study examined 12,236 couples who had decided to try intra-uterine insemination (IUI) after having difficulty conceiving. This procedure involves spinning sperm in a centrifuge to separate it from seminal fluid and then inserting it directly into the womb.
Pregnancy, miscarriage and delivery rates were recorded as were the quality, activity and shape of the men's sperm. The analysis separated out male and female factors.
As expected, women over the age of 35 were less likely to get pregnant but the man's age was also found to be a significant factor both in miscarriage rates and pregnancy rates.
For men aged 34, the miscarriage rate was 16.7 per cent, but for men aged between 35 and 39 it rose to 19.5 per cent, and by age 44 it had reached 32.4 per cent.
Pregnancy rates only began to change significantly when the men reached the age of 40. As the men's age rose from 39 to 44 the proportion of treatment cycles producing a pregnancy fell from 13.4 per cent to 10.9 per cent.
Dr Belloc said the study "proves for the first time that there is a strong paternal age-related effect on IUI outcomes" and she said the findings were relevant to all couples wishing to have children.
Prof Lewis and her colleagues in Belfast are currently conducting research into "lifestyle hazards" that affect male fertility. These include smoking, alcohol, sexually transmitted diseases, recreational drugs and substances that mimic oestrogens which are found in some products ranging from certain foods, aerosols and body creams, and plastic food coverings. Much of the research in this area was prompted by a Danish finding in 1992 that men's sperm count had declined by 50 per cent in 50 years.
Prof Lewis said a recent study in Denmark had also found that 40 per cent of young men had a low sperm count. "It appears to be a particular problem in northern Europe," she said.
The paper she presented at last week's Barcelona conference concerned the impact of cannabis use on male fertility. The study found that cannabis use decreased sperm motility - the pace at which sperm can swim. Other studies have also shown that cannabis use reduces sperm production.
She said that men who wanted to become fathers should be aware that it takes about 70 days for a sperm to be produced, so the "lifestyle hazards" such as smoking and recreational drugs should be avoided for at least three months if they want their sperm to be healthy.
She also pointed out that studies suggest that a father smoking, and the resulting damage to the sperm DNA, can lead to an increase in certain childhood illnesses, in particular some forms of cancer and more recently an association has been found with autism.
"When a mother smokes and damages the egg, the egg has the capacity to repair the damage, but the damage to the sperm becomes part of the embryo's genetic make-up," she said.
© 2008 The Irish Times
This article appears in the print edition of the Irish Times

Professor Sheena E.M. Lewis, BSc PhD
School of MedicineObstetrics and GynaecologyQueen’s University BelfastInstitute of Clinical ScienceGrosvenor RoadBelfast BT12 6BJN Ireland
e: s.e.lewis@qub.ac.uk
t: +44-28-9063-3987
f: +44-28-9032-8247
I am Professor and Director of the Reproductive Medicine research group here in Queen's having previously been Reader in Obstetrics and Gynaecology at Queen's University since October 2000. I was also appointed as an Honorary Consultant in the Royal Group of Hospitals in Belfast in 2003.Services to the scientific communityNationally, I am a regular reviewer for 10 specialist journals and for research charities including The Wellcome Trust, Wellbeing, and BBSRC.I am a member of the Practice and Policy committee of the British Fertility Society and on the Research and Development Fellowship Committee and Northern Ireland Forum for Health and Social Care Research for Northern Ireland.RESEARCH PUBLICATIONS62 peer reviewed publications, 9 review articles, 6 invited chaptersincluding 23 since 2000 (First or final author on 20)RESEARCH GRANTS AWARDED£1,000,000 including three from The Wellcome Trust.PROFESSIONAL SOCIETIES• British Fertility Society• British Andrology Society• Society for the Study of Fertility• International Society of Andrology• Institute of Learning and Teaching in Higher Education• Research and Development Fellowship Committee, N.I• Ulster Obstetrical and Gynaecological Society• Vice Chairperson of the Ladies Committee, Royal Maternity Hospital• Association of University TeachersINVITED GUEST SPEAKER AT RECENT SCIENTIFIC CONFERENCES• First Mediterranean Congress of Reproductive Medicine, Taormina, Sicily• Opening Doors-scientific workshop organised by British and Spanish Councils, Spain,• GSRMC (Good Samaritan Regional Medical Centre Phoenix, Arizona, USA)• UKEMS (The United Kingdom Environmental Mutagen Society)• British Fertility Society• British Andrology Society• Biology of Spermatozoa Annual Meeting• Senior Staff Conference, Royal College of Obstetrics and Gynaecologists• Association of Clinical Biochemists in IrelandINVITED SPEAKER BY MEDIA• BBC Radios 1, 2, 4 and 5• BBC News• Sky news• Ulster Television; UTV LIFE – CHAPS UK Study• Radio Eireann – Donor Sperm• Radio Ulster – Comment on Health Minister’s proposal and comment on BFS in Belfast.• British Satellite News - for CNN news, Tokyo News, Mid Eastern broadcasting and others• Ulster Television The Family Show- Infertility and LifestyleCENTRAL UNIVERSITY ACTIVITIES• Member of Academic Council of Queens University, Belfast• Mentor and mentee in Gender Initiative in Queen’s University, BelfastRESEARCH INTERESTSOur research interest is in Andrology; the study of male reproductive function. Our twin aims are:i) to understand the endocrine, cellular and molecular reproductive dysfunctions in infertile men compared with a fertile baseline. Within this framework, we have focused on specific lifestyle, environmental and disease factors that may exacerbate infertilityii) to establish novel prognostic tests to enhance assisted conceptionOngoing projects:Lifestyle hazards: recreational drugsi) to determine the in vivo and in vitro effects of tetrahydrocannabinoid; THC the primary psychoactive cannabinoid in marijuana on human sperm functionii)the effects of Viagra on sperm function and early embryo development using human and animal modelsEnvironmental hazardsthe effects of dietary phytoestrogens on male reproductive healthDiseases exacerbating male infertilityEndocrine, cellular and molecular effects of diabetes and impotence treatments (first generation Viagra and second generation Tadalafil) on male fertilityDevelopment of novel male fertility tests with prognostic value in assisted conception• assessment of sperm nuclear and mitochondrial DNA iv)investigation of the failure of post-vasectomy testicular sperm to achieve pregnancies by ICSI• the regulation of spermatogenesis by apoptosis in fertile men and males with obstructive azoospermia- clinical implications• Ubiquitin tagging ( internal and surface) on sperm and its implications for male fertility (in collaboration with Dr Peter Sutovsky, Columbia-Missouri )Future Studies• Genetic and epigenetic alterations associated with spontaneous abortion achieved by assisted conception (in collaboration with Dr Ken McIlreavey, Pasteur Institute, Paris and Dr Colum Walsh, University of Ulster )
Obstetrics and Gynaecology at Queen's.

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Saturday, July 12, 2008

Paternal Smoking Plays a Role in Childhood Blood Cancers

CONCLUSION: The results support the hypothesis that only paternal smoking, and not maternal alcohol consumption or cigarette smoking, plays a role in childhood hematopoietic malignancies.

Cancer Causes Control. 2008 Jul 10. [Epub ahead of print]
Childhood hematopoietic malignancies and parental use of tobacco and alcohol: the ESCALE study (SFCE).Rudant J, Menegaux F, Leverger G, Baruchel A, Lambilliotte A, Bertrand Y, Patte C, Pacquement H, Vérité C, Robert A, Michel G, Margueritte G, Gandemer V, Hémon D, Clavel J.
INSERM, U754, IFR69, 16, AV. Paul Vaillant Couturier, 94807, Villejuif Cedex, France, rudant@vjf.inserm.fr.

OBJECTIVES: Investigating the role of parental smoking and maternal alcohol consumption in the etiology of childhood hematopoietic malignancies. METHODS: The national registry-based case-control study ESCALE was carried out in France over the period 2003-2004. Population controls were frequency matched with the cases on age and gender. Maternal smoking and alcohol consumption during pregnancy and paternal smoking since before conception were reported by the mothers in a structured telephone questionnaire. Odds ratios (OR) were estimated using unconditional regression models closely adjusted for potential confounders. RESULTS: A total of 765 cases of acute leukemia (AL), 130 of Hodgkin's lymphoma (HL), 165 of non-Hodgkin's lymphoma (NHL) and 1681 controls were included. Paternal smoking was significantly associated with childhood ALL (OR = 1.4 [1.1-1.7]), AML (OR = 1.5 [1.0-2.3]), Burkitt (OR = 2.0 [1.2-3.2]), and anaplastic large cell (OR = 3.2 [1.2-9.1]) NHL. For the four diseases, the ORs significantly increased with the number of cigarettes smoked. No association with HL or with other types of NHL was observed. The associations with maternal alcohol consumption and cigarette smoking during pregnancy were less consistent. CONCLUSION: The results support the hypothesis that only paternal smoking, and not maternal alcohol consumption or cigarette smoking, plays a role in childhood hematopoietic malignancies.

PMID: 18618277 [PubMed - as supplied by publisher]


Monday, July 07, 2008

Study Finds Conception Less Likely With Older Fathers

Study Finds Conception Less Likely With Older Fathers

Researchers have found that younger fathers produce healthier, more viable sperm. It takes both a healthy sperm and a healthy egg to have a successful pregnancy.
AGE & FERTILITY: It is well-known that women have a harder time getting pregnant and face a higher risk of miscarriage as they age. A new study shows men 35 or older also face problems becoming parents.

by Patricia McFadden
Informify Staff Writer
July 8, 2008

French researchers conducted a study of over 12,000 couples undergoing fertility treatments. They found that conception is somewhat more difficult when the father is over 35 and significantly more difficult when he is over 40. The percentage of miscarriages also increased dramatically among women with older partners.

Miscarriages Double When Father Over 40
Researchers at France's Eylau Centre for Assisted Reproduction examined the results of 21,239 cases of intrauterine inseminations (IUI) in more than 12,000 couples. Their findings showed that maternal and paternal age had a significant effect on the outcome:

Age and pregnancy rates:

Women under 35 14.5%
Women over 35 8.9%
Men under 35 12.3%
Men over 40 9.3%

Age and miscarriages:

Men under 35 13.7%
Men over 40 32.4%

Reproductive Aging Affects Men Too
Dr Allan Pacey, a fertility expert at Sheffield University and secretary of the British Fertility Society, said the Eylau study "reinforces the message that men aren't excused from reproductive ageing."

"Previous studies of couples trying to conceive naturally or undergoing IVF [in vitro fertilization] have shown that men over the age of about 40 are less fertile than younger men," Pacey added. (BBC News, 7/06/08)

The Eylau researchers suggest that as men age there is increased DNA damage in their sperm, making fertilization more difficult and miscarriage-causing defects more likely.


Sunday, July 06, 2008

Fertility substantially damaged by delaying fatherhood

Fertility substantially damaged by delaying fatherhood
By Kate Devlin in Barcelona
Last Updated: 10:15PM BST 06/07/2008
Delaying fatherhood can substantially harm a man's chance of having a family, new research suggests.
A study of more than 20,000 couples seeking fertility help shows that middle-aged men are almost a third less likely to conceive with their partner than males under 35

The findings, to be presented today at the European Society of Human Reproduction and Embryology conference in Barcelona, could signal that men need to consider their age when planning a family as much as women do.

Doctors have long warned that too many young women are putting off starting a family until their late thirties or early forties, by which time their fertility levels have started to fall.

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But the example of older celebrity fathers, including Sir Paul McCartney and Rod Stewart, have encouraged many men to believe that they can postpone having children for much longer than women.

However, the research at the Eylau Centre for Assisted Reproduction in Paris found that the older a prospective father, the less chance that their partner would become pregnant. The study involved a form of fertility treatment, where the sperm is "washed" before being inseminated into the woman. This helps the sperm to survive for longer.

For men between 30 and 35 the successful pregnancy rate was 13.6 per cent. But that fell to 9.3 per cent if the man was older than 45, a decrease of almost a third

The findings also showed that men over 35 were 75 per cent more likely to have their partner suffer a miscarriage. Although lower than the miscarriage rate for older mothers, which was more than twice that of younger mothers, the researchers still described it as significant.

They believe there could be a number of reasons behind the findings, including that the DNA of sperm decays over time.

Professor Yves Menezo, who was involved in the study, said: "We found that by around the age of 40 men were starting to face serious problems. Much more work needs to be done to understand why."

Fertility specialists warned that the results could be an early warning for men who want to be fathers in the future.

Dr Gillian Lockwood, the medical director at the Midland Fertility Services clinic in Wolverhampton, said: "We have known for some time that there are specific genetic condition, for example autism, that are linked to older fathers. However, the fact that older sperm is just not as good as younger sperm is very interesting indeed.

"Often you find that the 34-year-old woman is ready to settle down and have children but the 34-year-old man is not because he believes he has another 20 years left.

"Maybe men should realise that is not necessarily true."

She added that the results could have a profound effect on the use of volunteer sperm donors, numbers of which have fallen dramatically since a decision to overturn their guarantee of anonymity.

"We have been told to target older men who have finished their families, and would be less fazed by children contacting them in the future," said Dr Lockwood.

"But this study raises serious questions about the viability of that sperm."


Men past 35 sperm DNA decay

We have known there was a paternal effect for a while but we didn't expect to find these kind of miscarriage rates," he said in a telephone interview.

The researchers do not know exactly why but said a link between a man's age and DNA decay in sperm that causes it to fragment could be a likely explanation.

The sperm they studied showed that many samples taken from men over 40 had defects that could cause miscarriage, the researchers added.

"Until now, gynecologists only focused on maternal age, and the message was to get pregnant before the age of 35 or 38 because afterwards it would be difficult," Belloc added.

"But now the gynecologists must also focus on paternal age and give this information to the couple."

(Reporting by Michael Kahn; editing by Philippa Fletcher)


Male biological clock 'ticks too' to say the least

Male biological clock 'ticks too'
By Caroline Parkinson
Health reporter, BBC News, Barcelona

Previous studies have linked ageing to a lower chance of fatherhood
Scientists say they have found more evidence that men as well as women have biological clocks and that they start to tick in their mid-30s.

A French study of over 12,200 couples having fertility treatment suggests the chance of a successful pregnancy falls when the man is aged over 35.

It adds that the chance is significantly lower if he is over 40.

Previous studies have shown that both natural and assisted conception is more difficult if the man is over 40.

The researchers told a European reproductive health conference that it was likely the problems were caused by DNA damage in sperm.

Miscarriage risk

The researchers studied couples who had sought treatment for infertility at the Eylau Centre for Assisted Reproduction in Paris between January 2002 and December 2006.

All were given intrauterine inseminations (IUI), also known as artificial insemination, where sperm is inserted into the womb when the woman is ovulating.

It is given to couples where the woman has no fertility problems and is less invasive than IVF.

The men's sperm were examined for quantity, their ability to move and swim and their size and shape.

Rates of pregnancy, miscarriage and births were recorded.

In addition, the researchers analysed detailed data on the pregnancies, which allowed them to pinpoint factors associated with the man and the woman.

As expected, maternal age had an effect in women over 35, who had a significantly higher chance of miscarriage and lower rate of pregnancy.

But the team also found that, where the father was in his late 30s, miscarriages were more common than if the man was younger.

And if a man was over 40, the chances of a successful pregnancy were even lower.

For those couples, a third of pregnancies ended in miscarriage and only 10% of treatments resulted in pregnancies.

'Growing evidence'

Dr Stephanie Belloc, who presented the work to the European Society of Human Reproduction and Embryology (ESHRE) conference in Barcelona, said: "This research has important implications for couples wanting to start a family."

She said such couples should be offered IVF (where an egg is fertilised in a lab dish), and where the outer membrane of the egg seems to block sperm with DNA damage, and ICSI (where a sperm is injected directly into an egg), where the best sperm can be selected for use.

"These methods, although not in themselves a guarantee of success, may help couples where the man is older to achieve a pregnancy more quickly, and also reduce the risk of miscarriage," she added.

Dr Alan Pacey, a fertility expert at Sheffield University and secretary of the British Fertility Society, said: "There is growing evidence from a number of studies to show that men are not totally immune from reproductive ageing.

"Previous studies of couples trying to conceive naturally or undergoing IVF have shown that men over the age of about 40 are less fertile than younger men. Moreover, if they do achieve a pregnancy their partners are more likely to miscarry.

"This study reinforces the message that men aren't excused from reproductive ageing."


Age and fertility also an issue for men

Age and fertility also an issue for men
Kate Benson
July 7, 2008
IT HAS long been known that a woman's chance of reproducing declines after she turns 35, but now scientists have found that it is the same for men who have some forms of fertility treatment in their 30s.

A study by the Eylau Centre for Assisted Reproduction in Paris followed more than 21,000 men who had intrauterine inseminations at fertility clinics and found that the process, where semen is washed to extract the sperm, resulted in fewer pregnancies and more miscarriages. All the men in the study were older than 35.

"We already believed that couples where the man was older took longer to conceive," the study's author, Dr Stephanie Belloc said.

"But how DNA damage in older men translates into clinical practice has not been shown up to now. Our research shows for the first time that there is a strong paternal age-related effect on (intrauterine insemination) outcomes and this information should be considered by both doctors and patients in assisted reproduction."

She said sperm with DNA damage, common in older men, was still able to enter the egg during intrauterine insemination, which could result in failure to conceive or miscarriage.

But in the case of in vitro fertilisation, the outer membrane of the egg stopped sperm with DNA damage penetrating.

Dr Belloc followed 21,239 patients, and examined the sperm of each partner for count, motility and morphology. Pregnancy rates, miscarriage and delivery rates were also recorded.

"Some recent studies have established a relationship between the results of (intrauterine insemination) and DNA damage, which also correlated to a man's age, suggesting it might be an important factor, but until now there was no clinical proof. We have now found that the age of the father was important in pregnancy — men over 35 had a negative effect."


Wednesday, July 02, 2008

Does The Male Aging Influence Clinical Outcomes On ICSI Cycles?

Does The Male Aging Influence Clinical Outcomes On ICSI Cycles?
Main Category: Urology / Nephrology
Also Included In: Men's health
Article Date: 02 Jul 2008 - 0:00 PDT

Top Causes Of Infertility
Information and support for men and women struggling to conceive

ORLANDO, FL (UroToday.com) - It has been established that aging has an adverse affect on a woman's reproductive potential by natural or assisted reproductive techniques (ART).

These authors attempted to assess the effect of increasing paternal age on ART success. This retrospective analysis included 760 ICSI cycles with fresh spermatozoa. The cycles were divided depending on sperm concentration: < 20x106sperm/ml (n=220) and ≥ 20x106sperm/ml (n=540). Multiple linear regression analysis was performed. When sperm concentration were < 20x106sperm/ml there was a negative correlation between male age and implantation rate. Multivariate regression adjusted to maternal age showed the influence of exclusively male aging on implantation (p=0.014). When the sperm concentration were ≥ 20x106sperm/ml, there was no correlation between male age and implantation rate (r= -0.052; p=0.1838), however maternal age negatively influenced implantation rates (p < 0.0001).

Editorial Comment: Recently there has been significant attention paid to the effect of male aging on reproductive outcomes (eg. Genetic disorders, Alpert syndrome, autism, Down syndrome and schizophrenia (see Lazarou and Moranthaler in Urologic Clinics of North America: Male Infertility: Current Concepts and Controversies. Ed Harris M .Nagler). This study also suggests the possible impact of increasing paternal age on reproductive success as defined as implantation. The authors did not study the full term delivery rates of this same population.

Presented by Renata C Ferreira, MD, Tatiana C S Bonetti, MD, Daniela Braga, MD, Priscila Queiroz, MD, Fabio F Pasqualotto, MD, Assumpto Iaconelli, MD, and Edson Borges, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA

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