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Despite being used in practice for around 30 years, the safety of assisted reproductive technologies is still questioned. Studies are hampered by issues related to trial design and consistency of reporting. Some long-term data are, however, now available for offspring conceived after assistance by a variety of technologies. This Review aims to summarize the reported risks. Assisted reproductive technologies are increasingly used in the treatment of both male and female infertility. The techniques, including in vitro fertilization, with or without intracytoplasmic sperm injection as an adjunctive treatment, represent a tremendous step forward for infertile couples who previously had no treatment options. As we move towards the 30th anniversary of the birth of the first baby conceived by in vitro fertilization, questions about the safety of these procedures linger. We review here the available literature regarding the safety of assisted reproductive technologies; these data are made far more robust by the inclusion of long-term follow-up data from the first generation of children arising after the introduction of these technologies.

Testicular hypotrophy is the most widely accepted indication for correcting adolescent varicocele. Previous studies in adolescents have shown a relationship between increasing grade of varicocele and the likelihood of testicular hypotrophy. As this relationship has significant clinical implications, we studied the correlation between grade and testicular volume disproportion in our adolescent varicocele population.We reviewed the adolescent varicocele database at our institution. A total of 168 patients 8 to 21 years old were studied. We routinely calculated testis volumes using scrotal ultrasound. Testicular disproportion was calculated using the equation [(size of unaffected testis) - (size of affected testis)]/(size of unaffected testis) x 100%. Disproportion was categorized as less than 10%, 10% to 20% and more than 20%. Varicoceles were graded by an attending urologist with the patient standing, using the system of Dubin and Amelar. Analysis of variance and Pearson chi-square indicated no significant differences in volume differential between varicocele grades.Mean +/- SD volume differential was 18% +/- 15% for grade I, 25% +/- 20% for grade II and 19% +/- 14% for grade III. ANOVA revealed no significant difference in mean volume differential between the 3 varicocele grades (p = 0.10). When categorizing patients into 3 levels of volume differential (less than 10%, 10% to 20%, more than 20%) no significant correlation was observed between varicocele and volume differential (p = 0.48, chi-square test).Grade of varicocele does not correlate with presence or severity of testicular disproportion in adolescent boys with varicocele as measured by scrotal ultrasound.

in both groups. In the treatment group 71.1% were able to achieve adequate erections for intercourse with vaginal penetration 12 months postoperatively, as opposed to 31.2% in the control group (p=0.038; RR=2.26; 95% CI: 1.02-4.97). A strong association between recovery of potency and urinary continence was observed, with continent patients having a 3.29 higher chance of being potent than incontinent patients (p=0.0016; 95% CI: 1.37-7.92). CONCLUSIONS: Early PFBT appears to have a significant impact on the recovery of erectile function after ORRP. Urinary continence status was a good indicator of erectile function recovery, with continent patients having a 3.3 higher chance of being potent than incontinent patients.