human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Most epidemiologic studies of the relationship between alcohol consumption and breast cancer risk  over the past decade have shown that persons who consume a moderate amount of alcohol are at 40%-100 % greater risk of breast cancer than those who do not consume alcohol . Dose-response effects have been observed , but no causal relationship has been established . PURPOSE This study examines the hypothesis that alcohol consumption affects levels of reproductive hormones . METHODS A controlled-diet study lasting for six consecutive menstrual cycles was conducted . Participants were r and omly assigned to two groups , and a crossover design was used . During the last three menstrual cycles , alcohol consumption of the two groups was reversed . Thirty-four premenopausal women , aged 21 - 40 years , with a history of regular menstrual cycles , consumed 30 g of ethanol ( equivalent to approximately two average drinks ) per day for three menstrual cycles and no alcohol for the other three . All food and alcohol consumed were provided by the study . Caloric intake was monitored to ensure that each woman would maintain body weight at approximately the baseline level . Hormone assays were performed on pooled plasma or 24-hour urine specimens collected during the follicular ( days 5 - 7 ) , peri-ovulatory ( days 12 - 15 ) , and mid-luteal ( days 21 - 23 ) phases of the third menstrual cycle for subjects on each diet . RESULTS Alcohol consumption was associated with statistically significant increases in levels of several hormones . Plasma dehydroepi and rosterone sulfate levels were 7.0 % higher in the follicular phase ( P = .05 ) . In the peri-ovulatory phase , there were increases of 21.2 % ( P = .01 ) in plasma estrone levels , 27.5 % ( P = .01 ) in plasma estradiol levels , and 31.9 % ( P = .009 ) in urinary estradiol levels . In the luteal phase , urinary estrone levels rose 15.2 % ( P = .05 ) , estradiol levels increased 21.6 % ( P = .02 ) , and estriol levels rose 29.1 % ( P = .03 ) . No changes were found in the percent of bioavailable estradiol , defined by the sum of percent free estradiol and percent albumin-bound estradiol . However , increased total estradiol levels in the peri-ovulatory phase suggest elevated absolute amounts of bioavailable estradiol . CONCLUSION This study has shown increases in total estrogen levels and amount of bioavailable estrogens in association with alcohol consumption in premenopausal women . IMPLICATION This possible explanatory mechanism for a positive association between alcohol consumption and breast cancer risk merits further investigation The role of alcohol on fertility remains unclear . We aim ed to investigate the association between alcohol and specific alcoholic beverages consumption and the risk of difficulty getting pregnant . We used a case-control study nested within the Seguimiento Universidad de Navarra ( SUN ) cohort , a prospect i ve , dynamic and multi purpose cohort of 21,705 Spanish university graduates , followed biennially with mailed question naires . We identified 686 case-control pairs , matched for age and time in the cohort . Cases were women reporting difficulty getting pregnant . Controls did not consult due to difficulty conceiving and had at least one child during follow-up . After adjustment for potential confounders , we found no association between self-reported difficulty getting pregnant and the number of alcoholic beverages consumed per week , ( Odds Ratio [ OR ] > 5 drinks/week vs. none = 1.04 , 95 % Confidence Interval [ CI ] = 0.72–1.51 ) . No association between types of alcoholic beverage and difficulty conceiving  ( OR > 5 drinks of wine/week vs. none = 1.16 , 95 % CI = 0.72–1.88 ; OR > 5 drinks of beer/week vs. none = 1.06 , 95 % CI = 0.82–1.37 ; OR > 5 drinks of spirits/week vs. none = 1.24 , 95 % CI = 0.84–1.64 ) was observed . In conclusion , we found no association between alcohol intake and risk of consulting a physician due to difficulty conceiving . More studies are needed to clearly eluci date the effects of alcohol intake on women ’s fertility . In the meantime , recommendations about alcohol intake to couples trying to conceive have to be given cautiously BACKGROUND In a prospect i ve study the effect of the behavioral risk factors of both partners on fecundability  was studied . METHODS Information was collected on smoking habits , alcohol consumption , and caffeine intake ( e.g. coffee , tea , and cola consumption ) by interviewing 259 female nonmedical hospital workers , i.e. , clerical staff , cleaners , kitchen and restaurant workers , and their partners , who were planning a pregnancy . The occurrence of pregnancy was tested prospect ively during the 12 months after enrollment . RESULTS Among the participants as well as among their partners , smoking a moderate number of cigarettes ( 1 - 10/day ) was associated with higher fecundability ( i.e. , the probability of becoming pregnant each month ) than among those not smoking ( participant : OR = 1.4 ( 95 % CI , 0.9 - 2.2 ) ; partner : OR = 2.1 ( 95 % CI , 1.2 - 3.5 ) ) . The level of alcohol consumption in the female partner was not related to fecundability . However , in the male partner , there was a positive influence for drinking more than 10 alcoholic drinks per week compared with that observed for those drinking less than 5 ( OR = 1.6 ; 95 % CI , 1.0 - 2.4 ) . Participants with a moderate caffeine intake ( 400 - 700 mg/day ) showed a higher fecundability than those with a lower intake level ( ORadjusted = 2.1 ( 95 % CI , 1.2 - 3.7 ) ) . Heavy caffeine intake ( > 700 mg/day ) among partners was negatively related to fecundability when compared with the lowest intake level ( ORadjusted = 0.6 ( 95 % CI , 0.3 - 0.97 ) ) . CONCLUSIONS This study does not support the hypothesis that moderate cigarette smoking , caffeine intake , and alcohol consumption have an adverse influence on fecundability OBJECTIVE To determine the effect of moderate alcohol intake on probability of conception . DESIGN Prospect i ve cohort study . SETTING Normal healthy women enrolled in an artificial donor insemination program . PATIENTS Women starting artificial donor insemination for the very first time were selected . INTERVENTIONS Alcohol exposure was measured through a self-administered question naire at intake of study . MAIN OUTCOME MEASURE A first positive pregnancy test as indicative for conception . RESULTS Women with moderate alcohol intake had a slightly higher , though not significant , probability of conception compared with nondrinkers ( Hazard Ratio 1.20 ; 95 % confidence interval 0.90 to 1.60 ) . CONCLUSION Moderate alcohol intake has no negative impact on female fecundity OBJECTIVE To evaluate the correspondence among measures of self-reported drinking , st and ard biological indicators and the reports of collateral informants , and to identify patient characteristics associated with observed discrepancies among these three sources of research data . METHOD Using data collected from a large-scale clinical trial of treatment matching with alcoholics ( N = 1,726 ) , these three alternative outcome measures were compared at the time of admission to treatment and at 12 months after the end of treatment . RESULTS Patient self-reports and collateral reports agreed most ( 97.1 % ) at treatment admission when heavy drinking was unlikely to be denied . In contrast , liver function tests were relatively insensitive , with positive serum gamma-glutamyl transpeptidase ( GGTP ) values obtained from only 39.7 % of those who admitted to heavy drinking . At 15-month follow-up the correspondence between client self-report and collateral report decreased to 84.7 % , but agreement with blood chemistry values increased to 51.6 % . When discrepancies occurred , they still indicated that the client ' s self-report is more sensitive to the amount of drinking than the biochemical measures . Patients who presented discrepant results tended to have more severe drinking problems , more previous treatments , higher levels of pretreatment drinking and significantly greater levels of cognitive impairment , all of which could potentially interfere with accurate recall . CONCLUSIONS In clinical trials using self-selected research volunteers , biochemical tests and collateral informant reports do not add sufficiently to self-report measurement accuracy to warrant their routine use . Re sources devoted to collecting these alternative sources of outcome data might be better invested in interview procedures design ed to increase the validity of self-report information PURPOSE Common polymorphisms in the N-acetyltransferase-2 ( NAT2 ) metabolic enzyme determine slow or rapid acetylator phenotypes . We investigated the effects of alcohol , smoking , and caffeine on fecundability , and determined whether the effects were modified by NAT2 . METHODS Three NAT2 polymorphisms were genotyped in 319 women office workers participating in a prospect i ve pregnancy study ( 1990 - 1994 ) . Women were ages 20 - 41 and at risk for pregnancy . Discrete-time survival analysis was used to determine the effects of alcohol , smoking , and caffeine on fecundability and evaluate effect modification by NAT2 . RESULTS We followed 319 women ( 161 slow acetylators , 158 rapid ) for an average of 8 menstrual cycles , result ing in 124 pregnancies . There was no effect of caffeine on fecundability . Drinking ≥1 alcoholic drink per day and current smoking were significantly associated with reduced fecundability , but only among slow acetylators ( adjusted fecundability odds ratio [ FOR ] for smoking = 0.34 ; 95 % confidence interval , 0.22 - 0.90 ; adjusted FOR for ≥1 drink per day = 0.20 ; 0.05 - 0.92 ) . There was no effect among rapid acetylators . CONCLUSIONS NAT2 status significantly modified the effects of alcohol and smoking on fecundability , emphasizing the importance of incorporating genetic and metabolic information in studies of reproductive health . Replication of this study is warranted BACKGROUND Assessing couple fecundity on a nation-wide basis without excluding couples who eventually remain infertile is challenging . Our aim was to describe couple fecundity ( in terms of frequency of involuntary infertility ) among the general population living in France . METHODS We used a current- duration design . A r and om sample of 64 262 households was selected in 2007 - 2008 , allowing us to identify 15 810 women aged 18 - 44 years . Eligible women ( n= 1089 ) were those having regular sexual intercourse with a male partner , not using any method of contraception and not having delivered in the previous 3 months . These women reported information on the  current duration of unprotected intercourse ( CDUI , the time elapsed between the start of the period of unprotected intercourse and the time of inclusion in the study ) . The CDUI distribution was used to estimate the frequency of involuntary infertility , using a newly developed statistical technique that does not require couples to be followed up until the end of the period of unprotected intercourse . RESULTS CDUI was defined for 867 women . An estimated 46 % of couples had no detected pregnancy conceived during the first 6 months of unprotected intercourse [ 95 % confidence interval ( CI ) , 36 - 56 % ] . The proportions of couples with no detected pregnancy within 12 and 24 months were 24 % ( 19 - 30 % ) and 11 % ( 8 - 14 % ) , respectively . CONCLUSIONS These results constitute one of the few descriptions of the fecundity of a nation-wide representative sample of couples from the general population , not limited to couples who eventually conceived or to those resorting to medical help OBJECTIVE To identify risk factors for pregnancy outcomes in couples treated with intracervical or intrauterine insemination , with or without superovulation for unexplained or male-factor infertility . DESIGN Secondary analysis of data from a r and omized superovulation and intrauterine insemination trial . SETTING Academic medical centers . INTERVENTION(S ) Treatment continued for four cycles unless pregnancy was achieved . PATIENT(S ) Out of 932 couples r and omized to four treatment groups , 664 couples who had completed the lifestyle question naires were assessed for occurrence of pregnancy and live birth . MAIN OUTCOME MEASURE(S ) Pregnancy and live birth . RESULT ( S ) The pregnancy and live birth rates were significantly higher in couples in which the female partners reported that they had consumed coffee or tea in the past or drank alcoholic beverages in the past ( past users ) compared with those who had never consumed coffee , tea , or alcoholic beverages . Past users also had significantly higher pregnancy and live birth rates than those currently consuming coffee or tea or alcoholic beverages . Demographic , occupational exposure , and other lifestyle factors were not significant . CONCLUSION ( S ) Couples in which the female partners drank coffee , tea , or alcoholic beverages in the past had higher pregnancy and live birth rates compared with never or current users . When discontinuing these habits , they might have made other lifestyle 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Most epidemiologic studies of the relationship between alcohol consumption and breast cancer risk  over the past decade have shown that persons who consume a moderate amount of alcohol are at 40%-100 % greater risk of breast cancer than those who do not consume alcohol . Dose-response effects have been observed , but no causal relationship has been established . PURPOSE This study examines the hypothesis that alcohol consumption affects levels of reproductive hormones . METHODS A controlled-diet study lasting for six consecutive menstrual cycles was conducted . Participants were r and omly assigned to two groups , and a crossover design was used . During the last three menstrual cycles , alcohol consumption of the two groups was reversed . Thirty-four premenopausal women , aged 21 - 40 years , with a history of regular menstrual cycles , consumed 30 g of ethanol ( equivalent to approximately two average drinks ) per day for three menstrual cycles and no alcohol for the other three . All food and alcohol consumed were provided by the study . Caloric intake was monitored to ensure that each woman would maintain body weight at approximately the baseline level . Hormone assays were performed on pooled plasma or 24-hour urine specimens collected during the follicular ( days 5 - 7 ) , peri-ovulatory ( days 12 - 15 ) , and mid-luteal ( days 21 - 23 ) phases of the third menstrual cycle for subjects on each diet . RESULTS Alcohol consumption was associated with statistically significant increases in levels of several hormones . Plasma dehydroepi and rosterone sulfate levels were 7.0 % higher in the follicular phase ( P = .05 ) . In the peri-ovulatory phase , there were increases of 21.2 % ( P = .01 ) in plasma estrone levels , 27.5 % ( P = .01 ) in plasma estradiol levels , and 31.9 % ( P = .009 ) in urinary estradiol levels . In the luteal phase , urinary estrone levels rose 15.2 % ( P = .05 ) , estradiol levels increased 21.6 % ( P = .02 ) , and estriol levels rose 29.1 % ( P = .03 ) . No changes were found in the percent of bioavailable estradiol , defined by the sum of percent free estradiol and percent albumin-bound estradiol . However , increased total estradiol levels in the peri-ovulatory phase suggest elevated absolute amounts of bioavailable estradiol . CONCLUSION This study has shown increases in total estrogen levels and amount of bioavailable estrogens in association with alcohol consumption in premenopausal women . IMPLICATION This possible explanatory mechanism for a positive association between alcohol consumption and breast cancer risk merits further investigation The role of alcohol on fertility remains unclear . We aim ed to investigate the association between alcohol and specific alcoholic beverages consumption and the risk of difficulty getting pregnant . We used a case-control study nested within the Seguimiento Universidad de Navarra ( SUN ) cohort , a prospect i ve , dynamic and multi purpose cohort of 21,705 Spanish university graduates , followed biennially with mailed question naires . We identified 686 case-control pairs , matched for age and time in the cohort . Cases were women reporting difficulty getting pregnant . Controls did not consult due to difficulty conceiving and had at least one child during follow-up . After adjustment for potential confounders , we found no association between self-reported difficulty getting pregnant and the number of alcoholic beverages consumed per week , ( Odds Ratio [ OR ] > 5 drinks/week vs. none = 1.04 , 95 % Confidence Interval [ CI ] = 0.72–1.51 ) . No association between types of alcoholic beverage and difficulty conceiving  ( OR > 5 drinks of wine/week vs. none = 1.16 , 95 % CI = 0.72–1.88 ; OR > 5 drinks of beer/week vs. none = 1.06 , 95 % CI = 0.82–1.37 ; OR > 5 drinks of spirits/week vs. none = 1.24 , 95 % CI = 0.84–1.64 ) was observed . In conclusion , we found no association between alcohol intake and risk of consulting a physician due to difficulty conceiving . More studies are needed to clearly eluci date the effects of alcohol intake on women ’s fertility . In the meantime , recommendations about alcohol intake to couples trying to conceive have to be given cautiously BACKGROUND In a prospect i ve study the effect of the behavioral risk factors of both partners on fecundability  was studied . METHODS Information was collected on smoking habits , alcohol consumption , and caffeine intake ( e.g. coffee , tea , and cola consumption ) by interviewing 259 female nonmedical hospital workers , i.e. , clerical staff , cleaners , kitchen and restaurant workers , and their partners , who were planning a pregnancy . The occurrence of pregnancy was tested prospect ively during the 12 months after enrollment . RESULTS Among the participants as well as among their partners , smoking a moderate number of cigarettes ( 1 - 10/day ) was associated with higher fecundability ( i.e. , the probability of becoming pregnant each month ) than among those not smoking ( participant : OR = 1.4 ( 95 % CI , 0.9 - 2.2 ) ; partner : OR = 2.1 ( 95 % CI , 1.2 - 3.5 ) ) . The level of alcohol consumption in the female partner was not related to fecundability . However , in the male partner , there was a positive influence for drinking more than 10 alcoholic drinks per week compared with that observed for those drinking less than 5 ( OR = 1.6 ; 95 % CI , 1.0 - 2.4 ) . Participants with a moderate caffeine intake ( 400 - 700 mg/day ) showed a higher fecundability than those with a lower intake level ( ORadjusted = 2.1 ( 95 % CI , 1.2 - 3.7 ) ) . Heavy caffeine intake ( > 700 mg/day ) among partners was negatively related to fecundability when compared with the lowest intake level ( ORadjusted = 0.6 ( 95 % CI , 0.3 - 0.97 ) ) . CONCLUSIONS This study does not support the hypothesis that moderate cigarette smoking , caffeine intake , and alcohol consumption have an adverse influence on fecundability OBJECTIVE To determine the effect of moderate alcohol intake on probability of conception . DESIGN Prospect i ve cohort study . SETTING Normal healthy women enrolled in an artificial donor insemination program . PATIENTS Women starting artificial donor insemination for the very first time were selected . INTERVENTIONS Alcohol exposure was measured through a self-administered question naire at intake of study . MAIN OUTCOME MEASURE A first positive pregnancy test as indicative for conception . RESULTS Women with moderate alcohol intake had a slightly higher , though not significant , probability of conception compared with nondrinkers ( Hazard Ratio 1.20 ; 95 % confidence interval 0.90 to 1.60 ) . CONCLUSION Moderate alcohol intake has no negative impact on female fecundity OBJECTIVE To evaluate the correspondence among measures of self-reported drinking , st and ard biological indicators and the reports of collateral informants , and to identify patient characteristics associated with observed discrepancies among these three sources of research data . METHOD Using data collected from a large-scale clinical trial of treatment matching with alcoholics ( N = 1,726 ) , these three alternative outcome measures were compared at the time of admission to treatment and at 12 months after the end of treatment . RESULTS Patient self-reports and collateral reports agreed most ( 97.1 % ) at treatment admission when heavy drinking was unlikely to be denied . In contrast , liver function tests were relatively insensitive , with positive serum gamma-glutamyl transpeptidase ( GGTP ) values obtained from only 39.7 % of those who admitted to heavy drinking . At 15-month follow-up the correspondence between client self-report and collateral report decreased to 84.7 % , but agreement with blood chemistry values increased to 51.6 % . When discrepancies occurred , they still indicated that the client ' s self-report is more sensitive to the amount of drinking than the biochemical measures . Patients who presented discrepant results tended to have more severe drinking problems , more previous treatments , higher levels of pretreatment drinking and significantly greater levels of cognitive impairment , all of which could potentially interfere with accurate recall . CONCLUSIONS In clinical trials using self-selected research volunteers , biochemical tests and collateral informant reports do not add sufficiently to self-report measurement accuracy to warrant their routine use . Re sources devoted to collecting these alternative sources of outcome data might be better invested in interview procedures design ed to increase the validity of self-report information PURPOSE Common polymorphisms in the N-acetyltransferase-2 ( NAT2 ) metabolic enzyme determine slow or rapid acetylator phenotypes . We investigated the effects of alcohol , smoking , and caffeine on fecundability , and determined whether the effects were modified by NAT2 . METHODS Three NAT2 polymorphisms were genotyped in 319 women office workers participating in a prospect i ve pregnancy study ( 1990 - 1994 ) . Women were ages 20 - 41 and at risk for pregnancy . Discrete-time survival analysis was used to determine the effects of alcohol , smoking , and caffeine on fecundability and evaluate effect modification by NAT2 . RESULTS We followed 319 women ( 161 slow acetylators , 158 rapid ) for an average of 8 menstrual cycles , result ing in 124 pregnancies . There was no effect of caffeine on fecundability . Drinking ≥1 alcoholic drink per day and current smoking were significantly associated with reduced fecundability , but only among slow acetylators ( adjusted fecundability odds ratio [ FOR ] for smoking = 0.34 ; 95 % confidence interval , 0.22 - 0.90 ; adjusted FOR for ≥1 drink per day = 0.20 ; 0.05 - 0.92 ) . There was no effect among rapid acetylators . CONCLUSIONS NAT2 status significantly modified the effects of alcohol and smoking on fecundability , emphasizing the importance of incorporating genetic and metabolic information in studies of reproductive health . Replication of this study is warranted BACKGROUND Assessing couple fecundity on a nation-wide basis without excluding couples who eventually remain infertile is challenging . Our aim was to describe couple fecundity ( in terms of frequency of involuntary infertility ) among the general population living in France . METHODS We used a current- duration design . A r and om sample of 64 262 households was selected in 2007 - 2008 , allowing us to identify 15 810 women aged 18 - 44 years . Eligible women ( n= 1089 ) were those having regular sexual intercourse with a male partner , not using any method of contraception and not having delivered in the previous 3 months . These women reported information on the  current duration of unprotected intercourse ( CDUI , the time elapsed between the start of the period of unprotected intercourse and the time of inclusion in the study ) . The CDUI distribution was used to estimate the frequency of involuntary infertility , using a newly developed statistical technique that does not require couples to be followed up until the end of the period of unprotected intercourse . RESULTS CDUI was defined for 867 women . An estimated 46 % of couples had no detected pregnancy conceived during the first 6 months of unprotected intercourse [ 95 % confidence interval ( CI ) , 36 - 56 % ] . The proportions of couples with no detected pregnancy within 12 and 24 months were 24 % ( 19 - 30 % ) and 11 % ( 8 - 14 % ) , respectively . CONCLUSIONS These results constitute one of the few descriptions of the fecundity of a nation-wide representative sample of couples from the general population , not limited to couples who eventually conceived or to those resorting to medical help OBJECTIVE To identify risk factors for pregnancy outcomes in couples treated with intracervical or intrauterine insemination , with or without superovulation for unexplained or male-factor infertility . DESIGN Secondary analysis of data from a r and omized superovulation and intrauterine insemination trial . SETTING Academic medical centers . INTERVENTION(S ) Treatment continued for four cycles unless pregnancy was achieved . PATIENT(S ) Out of 932 couples r and omized to four treatment groups , 664 couples who had completed the lifestyle question naires were assessed for occurrence of pregnancy and live birth . MAIN OUTCOME MEASURE(S ) Pregnancy and live birth . RESULT ( S ) The pregnancy and live birth rates were significantly higher in couples in which the female partners reported that they had consumed coffee or tea in the past or drank alcoholic beverages in the past ( past users ) compared with those who had never consumed coffee , tea , or alcoholic beverages . Past users also had significantly higher pregnancy and live birth rates than those currently consuming coffee or tea or alcoholic beverages . Demographic , occupational exposure , and other lifestyle factors were not significant . CONCLUSION ( S ) Couples in which the female partners drank coffee , tea , or alcoholic beverages in the past had higher pregnancy and live birth rates compared with never or current users . When discontinuing these habits , they might have made other lifestyle 
    Output:
    