- Browse by Subject
Browsing by Subject "Infertility"
Now showing 1 - 7 of 7
Results Per Page
Sort Options
Item At a Loss for Words: Using Performance to Explain How Friends Communicate About Infertility(2023-06) Binion, Kelsey Elizabeth; Brann, Maria; Beckman, Emily; Bute, Jennifer J.; Longtin, Krista J.In the United States, approximately one in five women are unable to get pregnant after one year of trying. Due to the pervasiveness of pronatalism in Western society, having a child is widely assumed to be a natural and expected part of womanhood. Society’s master narratives reinforce these ideals and stigmatize the experiences of women who have infertility. This multi-phase research study examined how women discuss their infertility journey with their friends. The study’s aims were to understand friendships within the context of infertility, how the relationship affects a woman’s identity, and the communicative behaviors used in conversations. Fifteen interviews were conducted with women who experienced or are experiencing infertility and had discussed their past or current challenges with a friend. Results of a phronetic iterative analysis suggested that women who have personal experience with infertility (a) disclose to close/best friends, (b) communicate their identity as “broken,” (c) desire emotional support, and (d) strategically navigate conversations as they encounter positive and negative messages. These results were transformed into a performance, which included six monologues and a talkback. The purpose of the arts-based methodology was to disseminate results and assess the performance’s impact. Seventy-three individuals attended one of the two performances in April 2023, and 50 attendees completed the post-performance evaluation. The quantitative results suggest that attendees felt informed about the complexities of infertility, gained a new perspective, received advice about how to have future conversations, and did not feel offended by the content. Through a thematic analysis, four themes emerged from the two talkback sessions and evaluation comments: being informed about infertility as a health condition, appreciating the theatrical format to learn, connecting to the performance to understand the illness experience, and feeling comfortable navigating conversations about infertility. Despite the variance in infertility experiences, friends are essential social support figures as women navigate infertility, and there are best practices when having a conversation, as demonstrated in the performance. This study’s implications include providing communication strategies to support women with infertility and recognizing that an arts-based methodology can highlight counterstories, inform about a stigmatized health issue, and engage the community.Item CFP1 governs uterine epigenetic landscapes to intervene in progesterone responses for uterine physiology and suppression of endometriosis(Springer Nature, 2023-06-03) Yang, Seung Chel; Park, Mira; Hong, Kwon-Ho; La, Hyeonwoo; Park, Chanhyeok; Wang, Peike; Li, Gaizhen; Chen, Qionghua; Choi, Youngsok; DeMayo, Francesco J.; Lydon, John P.; Skalnik, David G.; Lim, Hyunjung J.; Hong, Seok-Ho; Park, So Hee; Kim, Yeon Sun; Kim, Hye-Ryun; Song, Haengseok; Biology, School of ScienceProgesterone (P4) is required for the preparation of the endometrium for a successful pregnancy. P4 resistance is a leading cause of the pathogenesis of endometrial disorders like endometriosis, often leading to infertility; however, the underlying epigenetic cause remains unclear. Here we demonstrate that CFP1, a regulator of H3K4me3, is required for maintaining epigenetic landscapes of P4-progesterone receptor (PGR) signaling networks in the mouse uterus. Cfp1f/f;Pgr-Cre (Cfp1d/d) mice showed impaired P4 responses, leading to complete failure of embryo implantation. mRNA and chromatin immunoprecipitation sequencing analyses showed that CFP1 regulates uterine mRNA profiles not only in H3K4me3-dependent but also in H3K4me3-independent manners. CFP1 directly regulates important P4 response genes, including Gata2, Sox17, and Ihh, which activate smoothened signaling pathway in the uterus. In a mouse model of endometriosis, Cfp1d/d ectopic lesions showed P4 resistance, which was rescued by a smoothened agonist. In human endometriosis, CFP1 was significantly downregulated, and expression levels between CFP1 and these P4 targets are positively related regardless of PGR levels. In brief, our study provides that CFP1 intervenes in the P4-epigenome-transcriptome networks for uterine receptivity for embryo implantation and the pathogenesis of endometriosis.Item Erectile dysfunction and the baculum(Oxford University Press, 2019-08-26) Smith, Theodore C.; Hechtel, Laura; Medicine, School of MedicineErectile dysfunction (ED) is clinically defined as the inability to consistently acquire or maintain an erection of sufficient firmness for sexual intercourse. ED has several implicated causes with major predictors consisting of obesity, cardiovascular disease, medication use and psychological disease. Not just a condition of aging, ED has been shown to present in 38% of infertility patients. Humans rely completely on increased blood flow to the penis to maintain an erection, while most primates receive additional assistance from the baculum or os penis. The baculum is a bone located dorsally of the corpus spongiosum and varies in overall size, length and shape among the major groups of mammals possessing it.Item Patient and Parent Perspectives on Testicular Adrenal Rest Tumors in Congenital Adrenal Hyperplasia(Karger, 2023-10) Nebesio, Todd D.; Kim, Mimi S.; Szymanski, Konrad M.; Kokorowski, Paul J.; Geffner, Mitchell E.; Eugster, Erica A.; on behalf of the Life with Congenital Adrenal Hyperplasia Study Group; Pediatrics, School of MedicineBackground: Testicular adrenal rest tumors (TARTs) increase the risk of infertility in males with classic congenital adrenal hyperplasia (CAH). There is no consensus regarding at what age screening testicular ultrasounds should begin and how often they should be repeated. Furthermore, it is unknown whether patients and parents are aware of the significance of TARTs. Objective: The objective of the study was to investigate awareness, concern, and screening rates for TARTs in males with classic CAH. Methods: Males with CAH and parents completed an online questionnaire from 2019 to 2020. Responses to questions about TARTs were analyzed. Fisher’s exact test was used to determine statistical significance. Results: Of 123 responders, 14 were males with CAH (range 16–54 years) and 109 were parents of males with CAH (son’s age range infancy to 37 years). Of all responders, 74% were concerned about the possibility of TARTs, 48% had discussions about TARTs with their endocrinologist, and 42% were aware of possible infertility in males with CAH. There was no difference between responses provided by affected males and parents for these topics (p ≥ 0.08). Among male responders with CAH, 93% had at least one testicular ultrasound, and 77% had undergone more than one. Among parent responders, 30% of their sons had at least one testicular ultrasound, and 61% had more than one. The frequency, total number, and age when the first testicular ultrasound was obtained were inconsistent in both groups. Fifty percent of male responders with CAH and 11% of sons were referred to a urologist for evaluation. Conclusions: Although most responders were concerned about TARTs, less than half recalled discussing this issue with their endocrinologist, and less than half were aware of the possibility of infertility. Although TARTs are most often treated medically, several responders were referred to a urologist. Standardized patient education and consensus guidelines are needed for the surveillance and management of TARTs in males with classic CAH.Item Sexually transmitted diseases and infertility(Elsevier, 2017-01) Tsevat, Danielle G.; Wiesenfeld, Harold C.; Parks, Caitlin; Peipert, Jeffrey F.; Obstetrics and Gynecology, School of MedicineFemale infertility, including tubal factor infertility, is a major public health concern worldwide. Most cases of tubal factor infertility are attributable to untreated sexually transmitted diseases that ascend along the reproductive tract and are capable of causing tubal inflammation, damage, and scarring. Evidence has consistently demonstrated the effects of Chlamydia trachomatis and Neisseria gonorrhoeae as pathogenic bacteria involved in reproductive tract morbidities including tubal factor infertility and pelvic inflammatory disease. There is limited evidence in the medical literature that other sexually transmitted organisms, including Mycoplasma genitalium, Trichomonas vaginalis, and other microorganisms within the vaginal microbiome, may be important factors involved in the pathology of infertility. Further investigation into the vaginal microbiome and other potential pathogens is necessary to identify preventable causes of tubal factor infertility. Improved clinical screening and prevention of ascending infection may provide a solution to the persistent burden of infertility.Item Sperm hyaluronidase is critical to mammals' fertilization for its ability to disperse cumulus-oocyte complex layer(Wolters Kluwer, 2022) Seol, Dong-Won; Joo, Sang Hoon; Kim, Young-Hyun; Song, Bong-Seok; Sim, Bo-Woong; Kim, Sun-Uk; Park, Soojin; Wee, Gabbine; Kim, Ekyune; Biochemistry and Molecular Biology, School of Medicine; Biochemistry and Molecular Biology, School of MedicineGlycosylphosphatidylinositol-anchored sperm hyaluronidases have long been believed to assist in sperm penetration through the cumulus-oocyte complex (COC); however, their role in mammalian fertilization remains unclear. Previously, we have shown that hyaluronidase 5 (Hyal5)/Hyal7 double-knockout (dKO) mice produce significantly fewer offspring than their wild-type (WT) counterparts because of defective COC dispersal. Male infertility is mainly caused by a low sperm count. It can be further exacerbated by the deficiency of sperm hyaluronidase, which disperses the cumulus cells of the outer layer of the COC. In the current study, we evaluated the effects of a low count of Hyal-deficient sperm and conditions of ovulated oocytes on the fertilization rate using a mouse model. Our results demonstrated that a low sperm count further decreases the in vitro fertilization (IVF) rate of Hyal-deficient dKO spermatozoa. In addition, the dKO spermatozoa resulted in a fertilization rate of 12.5% upon fertilizing COCs with a thick cumulus layer, whereas the IVF rate was comparable to that of WT spermatozoa when oocytes with a thin or no cumulus layer were fertilized. Finally, we proved that the IVF rate of dKO spermatozoa could be recovered by adding rat spermatozoa as a source of sperm hyal. Our results suggest that a deficiency of proteins involved in fertilization, such as sperm hyal, has a vital role in fertilization.Item Tenuous Transcriptional Threshold of Human Sex Determination. I. SRY and Swyer Syndrome at the Edge of Ambiguity(Frontiers Media, 2022-07-26) Chen, Yen-Shan; Racca, Joseph D.; Weiss, Michael A.; Biochemistry and Molecular Biology, School of MedicineMale sex determination in mammals is initiated by SRY, a Y-encoded transcription factor. The protein contains a high-mobility-group (HMG) box mediating sequence-specific DNA bending. Mutations causing XY gonadal dysgenesis (Swyer syndrome) cluster in the box and ordinarily arise de novo. Rare inherited variants lead to male development in one genetic background (the father) but not another (his sterile XY daughter). De novo and inherited mutations occur at an invariant Tyr adjoining the motif’s basic tail (box position 72; Y127 in SRY). In SRY-responsive cell lines CH34 and LNCaP, de novo mutations Y127H and Y127C reduced SRY activity (as assessed by transcriptional activation of principal target gene Sox9) by 5- and 8-fold, respectively. Whereas Y127H impaired testis-specific enhancer assembly, Y127C caused accelerated proteasomal proteolysis; activity was in part rescued by proteasome inhibition. Inherited variant Y127F was better tolerated: its expression was unperturbed, and activity was reduced by only twofold, a threshold similar to other inherited variants. Biochemical studies of wild-type (WT) and variant HMG boxes demonstrated similar specific DNA affinities (within a twofold range), with only subtle differences in sharp DNA bending as probed by permutation gel electrophoresis and fluorescence resonance-energy transfer (FRET); thermodynamic stabilities of the free boxes were essentially identical. Such modest perturbations are within the range of species variation. Whereas our cell-based findings rationalize the de novo genotype-phenotype relationships, a molecular understanding of inherited mutation Y127F remains elusive. Our companion study uncovers cryptic biophysical perturbations suggesting that the para-OH group of Y127 anchors a novel water-mediated DNA clamp.