The clinical content of preconception care: Preconception care for men

Department of Family Medicine, Mayo Clinic Arizona, Scottsdale, AZ 85260, USA.
American journal of obstetrics and gynecology (Impact Factor: 4.7). 01/2009; 199(6 Suppl 2):S389-95. DOI: 10.1016/j.ajog.2008.10.024
Source: PubMed


Little attention has been given to men's preconception health and health care. This paper reviews the key elements of an approach to optimizing the preconception health status of men. Preconception care for men is important for improving family planning and pregnancy outcomes, enhancing the reproductive health and health behaviors of their female partners, and preparing men for fatherhood. Most importantly, preconception care offers an opportunity, similar to the opportunity it presents for women, for disease prevention and health promotion in men. Currently, no consensus exists on service delivery of preconception care for men--who should provide preconception care to whom, where, when, and how, and there are significant barriers to this care including the organization, financing, training, and demand. Finally, much more research on the content and how to effectively market and implement preconception care for men is needed.

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    • "Chromosomal abnormalities in spermatozoa were detected (Soares & Melo, 2008). In addition, many studies reported that seminal plasma of smokers contain high levels of oxidative stress markers such as ROS and malondialdehyde (MDA), and smoking markers like cotinine (Kiziler et al., 2007; Frey et al., 2008; Soares & Melo, 2008; Hammadeh et al., 2010). On the contrary, other studies showed that cigarette smoking and alcohol consumption do not appear to significantly affect sperm parameters, such as volume, sperm count, motility and morphology or pregnancy outcome (Ozgur et al., 2005; de Jong et al., 2012). "
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    ABSTRACT: Smoking is strongly associated with abnormalities in histone-to-protamine transition and with alteration of protamine expression in human spermatozoa. A proper protamine to histone ratio is, however, essential for sperm chromatin maturity and DNA integrity. Alterations in these sperm nuclear proteins were observed in infertile men. The present prospective study is aimed at evaluating the possible relationship among smoking, semen quality and the histone-to-protamine transition ratio in mature spermatozoa. Histone H2B and protamine 1 (P1) and 2 (P2) were quantified using acid-urea polyacrylamide gel electrophoresis in the spermatozoa of 35 smokers and 19 non-smokers. Levels of lipid peroxidation marker malondialdehyde (MDA) were measured in seminal plasma by thiobarbituric acid assay. Cotinine concentrations were determined in seminal plasma using an enzyme-linked immunosorbent assay. Histone H2B levels in smokers (292.27 ± 58.24 ng/106) were significantly higher (p = 0.001) than that of non-smokers (109.1 ± 43.70 ng/106), besides, a significant difference (p > 0.0001) was found for the P1 and P2 ratio between smokers (1.71 ± 0.071) and non-smokers (1.05 ± 0.033). The H2B/(H2B+P1 + P2) ratio (0.29 ± 0.71) of smokers were significantly higher (p = <0.0001) than that of non-smokers (0.12 ± 0.01). The concentrations of MDA (μm) (7.13 ± 1.15) and cotinine (ng/mL) (60.44 ± 31.32) in seminal plasma of smokers were significantly higher (p = 0.001) than those in the samples of the non-smoker group (4.42 ± 1.16 and 2.01 ± 2.84 respectively). In addition, smokers showed significantly (p ≤ 0.002) lower sperm count, motility (p = 0.018), vitality (p = 0.009) and membrane integrity (p = 0.0001) than non-smokers. These results revealed that smoker patients possess a higher proportion of spermatozoa with alteration ratios in histone to protamine than non-smoker patients, and suggest that cigarette smoking may inversely affect men fertility.
    Andrology 07/2014; 2(5). DOI:10.1111/j.2047-2927.2014.00245.x · 2.30 Impact Factor
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    • "Even though current evidence suggests that both parents are important for offspring health [1,30], the influence of expectant fathers, and correlations of health variables within expectant couples, have so far received little attention [35,36]. The aim of this study was to explore the prevalence and socio-demographic patterns of overweight and obesity among a population-based sample of expectant parents in Västerbotten, Sweden, and also to assess within-couple associations. "
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    ABSTRACT: Overweight and obesity in pregnancy increase the risk of several adverse pregnancy outcomes. However, both mothers' and fathers' health play an important role for long-term health outcomes in offspring. While aspects of health and lifestyle of pregnant women have been reported, the health of expectant fathers and correlations of health variables within couples have received less attention. This study aimed to explore the prevalence and socio-demographic patterns of overweight and obesity in Swedish expectant parents, and to assess within-couple associations. This population-based, cross-sectional study investigated self-reported data from 4352 pregnant women and 3949 expectant fathers, comprising 3356 identified couples. Data were collected in antenatal care clinics between January 2008 and December 2011. Descriptive, correlation and logistic regression analyses were performed. The self-reported prevalence of overweight (BMI 25.0-29.99) and obesity (BMI >=30.0) was 29% among women (pre-pregnancy) and 53% among expectant fathers. In a majority of couples (62%), at least one partner was overweight or obese. The odds of being overweight or obese increased relative to partner's overweight or obesity, and women's odds of being obese were more than six times higher if their partners were also obese in comparison with women whose partners were of normal weight (OR 6.2, CI 4.2-9.3). A socio-demographic gradient was found in both genders in relation to education, occupation and area of residence, with higher odds of being obese further down the social ladder. The cumulative influence of these factors showed a substantial increase in the odds of obesity for the least compared to the most privileged (OR 6.5, CI 3.6-11.8). The prevalence of overweight and obesity in expectant parents was high, with a clear social gradient, and a minority of couples reported both partners with a healthy weight at the onset of pregnancy. Partner influence on health and health behaviours, and the role both mothers and fathers play in health outcomes of their offspring, underpin the need for a more holistic and gender inclusive approach to the delivery of pregnancy care and postnatal and child health services, with active measures employed to involve fathers.
    BMC Public Health 10/2013; 13(1):923. DOI:10.1186/1471-2458-13-923 · 2.26 Impact Factor
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