Your Health

The number of baby boys conceived by a fertility treatment known as ICSI may be lower than what is produced by Mother Nature, a new study suggests.

On average, there are 105 baby boys born for every 100 girls — a natural advantage that helps balance out the higher number of deaths among male fetuses and infants. But in the new study, researchers found that this male-to-female birth ratio seems to be reversed when infants are conceived through intracytoplasmic sperm injection, or ICSI.

Among more than 15,000 U.S. babies born in 2005 via assisted reproduction, the investigators found that a particular ICSI approach appeared to result in a smaller-than-average number of boys.

The effect was seen when ICSI was performed using blastocyst-stage embryos — where embryos are allowed to mature a couple days longer than the traditional norm before they are transferred to the mother. This allows doctors to transfer fewer embryos, reducing the odds of couples having triplets or higher-order births.

Among couples undergoing this procedure, just under 50 percent of births were boys. That compared with a U.S. norm of 52.5 percent for 2005, according to findings published in the journal Fertility & Sterility.

ICSI involves injecting sperm from the father directly into eggs taken from the mother; if one or more embryos develop over the next few days, they are transferred to the mother’s uterus.

ICSI is typically used to treat male fertility problems, such as a low sperm count or poor-quality sperm. However, it is also sometimes used when the cause of a couple’s infertility is unclear, and some fertility clinics opt to use ICSI for all patients.

The full implications of the current findings are not clear, according to the researchers, led by Dr. Barbara Luke of Michigan State University in East Lansing.

About 1 percent of U.S. births result from all assisted reproductive techniques combined, meaning ICSI accounts for only a small number of births. So it is unlikely that the small effects on male-to-female birth ratio seen in this study would have “any major implications for public health,” Luke and her colleagues write.

Still, they conclude, “because our findings suggest that ICSI may reduce the sex ratio, we recommend that ICSI only be done if medically necessary, in an effort to prevent this potential side effect.”

It is not clear why ICSI might reduce the proportion of male births. However, Luke and her colleagues point out, the study found no evidence that male infertility itself was related to a lower sex ratio — supporting the idea that something about the ICSI process is to blame.

If you love the five-week holiday smorgasbord from Thanksgiving to New Year’s, but are already stressing about the added pounds you’ll have to sweat off come Jan. 1, help is at hand.

It’s possible, say nutrition experts, to enjoy holiday eating and make it to 2010 weighing the same as you do today.

It’s all about devising a strategy and thinking about holiday food just a little differently, said Connie Diekman, director of university nutrition at Washington University in St. Louis, and Julie Redfern, manager of the Nutrition Consult Services at Brigham and Women’s Hospital in Boston.

Both are registered dietitians who shared their best holiday eating tips.

First, have a plan. Ponder it before family dinners and parties, said Redfern. For instance, you may decide before going to a family sit-down dinner that you will fix your plate once and it will include lots of vegetables. About one-fourth of the plate will be protein-rich food and about one-fourth carbs. You will not go back for seconds.

Eat before you go. Starving guests are more apt to load up their plates, so Diekman suggests having a piece of fruit smeared with peanut butter or a small container of yogurt prior to heading out. You can then approach the buffet table more relaxed.

Think ”pick and choose,” not ‘’sample.” Picking and choosing is a great strategy, said Redfern, if it involves picking the one dessert or other goodie you love and can’t live without. Instead of sampling all three pies at a holiday dinner, decide which one you’ll wish you had had, and then go for it, she suggested.

Remember, alcohol is loaded with calories. Start off at a party with seltzer water or sparkling water, then switch to alcoholic beverages. Delaying the alcohol may also make you take in fewer calories from foods, Redfern said. “Once you have alcohol, it lessens your resolve,” she said.

Enlist the waiter’s help. If your holiday dinner is in a restaurant, focus on your first course of vegetables, salad or soup, and ask the waiter to hold your main course until you finish, Diekman suggested. You may be fuller than you think, and waiting to eat the main course may mean you’ll eat less.

Take control as hostess. If you’re the holiday host or hostess, you have a lot of work — but also enjoy control. Take advantage of that, Diekman said. “Prepare or serve [ready-make] broth-based soups that are packed with vegetables as a first course,” she said. “Switch from buffets to meals served by the course to pace eating,” she said. It’s probable you’ll eat less overall that way.

If you love gravy, make it from fat-free broth. Include more casserole dishes — you can increase the vegetables with hardly anyone noticing.

Move, even a little. Squeezing in a little exercise, no matter how hectic the schedule, will help, Diekman said. “Walk the mall before you can spend any money,” she suggested. “After spending a predetermined amount, take another mall walk.”

Take a 10-minute walk every day, she said. “Everyone has that time.”

Defend your resolve. Even with the best strategies in play, some people fall apart when face-to-face with those ubiquitous food pushers — those holiday hosts and hostesses who encourage you to eat, eat, eat.

You can resist them, Redfern said. “Start off with a compliment,” she said. Something like: “I love your pie, but I am full.”

This works much better, she said, than telling them you have to cut back. That’s an invitation for them to come back with tough-to-resist lines such as “Oh, it’s only one day,” or “You can afford it.”

If you still experience resistance, tell your hostess: “I’d love to take some home for later.” Redfern added: “They don’t need to know if you actually eat it.”

But if you don’t want that temptation — the pumpkin pie calling from the kitchen at midnight — learn to be firm and repetitive as a guest, Redfern said.

”It almost takes three times for them to get the message,” she said. So, repeat, repeat, repeat, cheerfully but firmly.

Men wondering about the long-term side effects of chemotherapy for testicular cancer may now have a road map defining likely outcomes.

A Norwegian study, published today in the Journal of the National Cancer Institute, reveals that long-term side effects vary depending on the dose of chemotherapy given and how many cycles of chemotherapy the men received.

“A continuous aim in the care of testicular cancer patients is to reduce toxicity without comprising the high cure rate,” Dr. Marianne Brydy of Haukeland University Hospital in Bergen, Norway wrote in an email to Reuters Health. “Treatment plans should thus follow the existing guidelines with recommendations for treatment based on risk,” she advised.

Between 4 and 21 years after treatment for testicular cancer, Brydy and colleagues asked 1,402 men about their symptoms of hearing loss, ringing in the ears (tinnitus), numbness or tingling in the hands or feet, and what’s called Raynaud-like phenomena (discoloration of the hands or feet on exposure to cold).

Compared to men who never received chemotherapy, men who had received any chemotherapy reported significantly more trouble with the aforementioned symptoms, even years after treatment.

Among chemotherapy-treated men, 39 percent reported Raynaud-like phenomena, 29 percent reported hearing impairment, and 22 percent reported tinnitus as major symptoms troubling them quite a bit or very much, the investigators found.

They also found that men who were treated with radiation therapy were much more apt to report numbness or tingling in the hands or feet than men who did not receive radiation therapy.

Studying the common chemotherapy drug cisplatin, the researchers found that the men who had the most severe symptoms years later were the ones who had received high-dose treatment with this drug, or had received five or more cycles of the drug.

Men who had received high-dose cisplatin-based chemotherapy were more likely to have long-term problems with ringing in the ears and hearing loss, whereas those who received five or more cycles of chemotherapy were more likely to experience long-term problems with Raynaud-like symptoms and numbness or tingling in the extremities.

Additionally, men in the study group who smoked on a daily basis were more likely to have symptoms of Raynaud’s, numbness or tingling in the hands or feet, and hearing impairment than the men in the study who had never smoked.

Interestingly, note the researchers, the study found no significant difference in symptom severity according to length of time since treatment, suggesting, they say, that side effects likely remain permanent after a certain length of time.