Infertility and eating disorders

Article Abstract:

As many as eight percent of all women have eating disorders such as anorexia nervosa (self-imposed starvation) or bulimia (binge eating followed by vomiting or other drastic weight-control measures). Anorectics in particular are characterized as being fearful of fatness and possibly of sexual maturation, and many patients with eating disorders develop amenorrhea, lack of menstruation. However, the reproductive ramifications of eating disorders have not been studied well. Several studies have found that a high proportion of women attending infertility clinics have eating disorders. In one study, a majority of infertile women who followed a diet to gain weight resumed menstruation and spontaneously achieved conception. The extent of these trends was investigated in a study of 66 women who attended an infertility clinic. A questionnaire about eating attitudes was completed by 63 women, whose age averaged 30 years. Body weights ranged from 72 to 143 percent of ideal, and 12 women had menstrual dysfunctions. Twelve women were identified by questionnaire scores as having eating disorders (five of which were anorexia nervosa or bulimia), and two more volunteered they were being treated for the same. Further interviews confirmed that 11 had eating disorders, a prevalence of 16.7 percent of the total group. Of the 12 women experiencing menstrual irregularities, 7 had eating disorders, a 58.3 percent prevalence. Body weight did not differ between women with and without eating disorders. None of the women had previously divulged the eating disorder when being treated for infertility, but most expressed relief, when answering the questionnaire, on being able to discuss the problem. The study indicates that the eating attitudes questionnaire is useful in screening for eating disorders among infertile patients. However, women who are overweight dieters and those who deny symptoms of eating disorders may be falsely identified or missed, respectively, with this test. Women positively identified should be treated for the underlying eating disorder before further hormonal studies and treatment are pursued. More complications are associated with women whose eating disorders persist through pregnancy and after delivery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Risk factors, Eating disorders

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Prospective analysis of sperm-oocyte fusion and reactive oxygen species generation as criteria for the diagnosis of infertility

Article Abstract:

Male fertility is traditionally assessed by a method of semen analysis which may, in fact, be unable to measure significant aspects of fertility. Two analyses are described and evaluated for their ability to predict fertility in 139 couples in which no reproductive abnormalities were found in the female member. Two measures were of interest: the ability of spermatozoa to fuse with a specially prepared hamster egg cell (oocyte); and the extent to which spermatozoa generated reactive oxygen species (oxygen molecules containing unpaired electrons). Only sperm that have undergone the acrosome reaction, a necessary prerequisite for fusion with the membrane surrounding the egg cell, can fuse with these hamster eggs: thus, this test measures the sperms' ability to initiate fusion. Excess reactive oxygen molecules can damage the membrane surrounding the spermatozoa, causing it to lose its ability to fuse with the egg. The couples studied had been infertile for an average of 60 months. The males submitted semen samples for analysis and the couples were untreated for an average of 17 months, during which period conception took place in 32 cases (23 percent). Results showed a definite negative correlation between spontaneous pregnancy and the magnitude of the rate of reactive oxygen species generation; 22 patients with very low levels of reactive oxygen species production achieved a pregnancy rate of 40 percent. A strong positive relationship was seen between the hamster oocyte penetration rate and fertility, with the pregnancy rate increasing with the level of oocyte penetration. No correlations were found between pregnancy and results from the conventional semen profile. This prospective study shows the limitations of conventional approaches to semen analysis. It also demonstrates the merits of two sperm function tests that can predict male fertility far more accurately than the conventional approach. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Medical examination, Semen, Infertility, Male, Male infertility

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HIdden costs of infertility treatment in employee health benefits plans

Article Abstract:

Infertility treatment will probably cost most employers 40 to 50 cents per employee per month. Although many health plans do not cover infertility treatments, most employers are paying for it anyway because there are 41 CPT codes and 68 ICD-9 codes that could be used for infertility treatments.

Analysis, Economic aspects, Medical care, Cost of, Health care costs

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