Mary SamplaskiMale Infertility, University of Southern California
- University of Southern California
- United States of America
Certainly these are unprescedented and challenging times, with barriers that no one was able to predict. I will be curious to know how many fellows match into programs, in cities that they have never actually seen in person... and how happy they are long-term. Only time will tell.
The authors are to be commended on a large series of men looking at VV outcomes. I would be curious to know how many of these men underwent at least a unilateral VE, and how that impacted outcomes. Also, were any of these men being treated with EMTs? Lastly, were they able to separate out sperm parts versus intact sperm?
This is compelling data showing that there are likely many genetic causes for male infertility outside of the currently available options. Did the authors look at individual semen parameters and did they see any correlations between individual gene abnormalities and semen abnormalities (ie gene x correlated with poor motility, gene y correlated with poor counts)? It may have been difficult with the small sample size.
This work represents a growing body of evidence on the role of elevated sperm DNA fragmentation rates on reproductive outcomes. What was the authors assay for sperm DNA fragmentation? Was it measured at the same lab?
This is excellent data on a topic that patients ask about commonly. Did the authors look at any groups more than 15 years? Also, were different cryopreservation protocols used?
This is new and exciting data. Did the authors also look at semen parameters or sperm DNA fragmentation? I would be curious to see if the thread is consistent. Also, I would be curious to see if other nutritional and vitamin parameters were also low/high in men with low/high folate levels.
Were the authors able to gain any insight as to why these differences were seen? Were Asian donors less contacted because of government restrictions on outside communication? Lack of access to telephones or long distance calling capabilities? Or was it that these women were less "emotionally attached" to the donor process? Did they see themselves as simply egg donors and desire no connection with their offspring? This is compelling data.
I personally believe that many of our men with NOA have genetic abnormalities that are yet undetectable. This type of data continues to show us that a variety of genetic abnormalities exist in these men. As the data continue to accumulate, hopefully more diagnostic tests will exist that can give these men more answers.