Encyclopedia of Health and Medicine

assisted reproductive technology (ART) 245
fat, and sometimes diminished energy and LIBIDO
(sex drive). Some men experience clinical DEPRES-
SION, loss of BONE mass, ERECTILE DYSFUNCTION, and
other symptoms as a consequence of lower testosterone
levels. Some researchers believe the decline
in testosterone levels contributes to the increased
risk for HEART ATTACK as a man gets older.
Doctors may recommend prescription hormone
supplementation with ANDROGENS (testosterone or
testosterone precursors) for men who have unacceptable
symptoms. However, the long-term therapeutic
value and possible risks of such treatment
remain uncertain. Some men take the over-thecounter
product DEHYDROEPIANDROSTERONE (DHEA),
available in the United States as a dietary supplement,
as an androgen precursor (a substance the
body converts to testosterone during its METABO-
LISM). There are few clinical studies to provide
clear evidence of whether this is effective or safe.
Some doctors believe as long as the DHEA does
not push testosterone levels beyond the normal
range, the risk for adverse health effects is minimal.
However, other doctors worry that sustained
increases in blood testosterone levels in men over
age 50 may increase the risk for PROSTATE CANCER
and CARDIOVASCULAR DISEASE (CVD).
See also ADRENAL INSUFFICIENCY; AGING, REPRODUC-
TIVE AND SEXUAL CHANGES THAT OCCUR WITH; ANABOLIC
STEROIDS AND STEROID PRECURSORS; HORMONE-DRIVEN
CANCERS; MENOPAUSE.
Apgar score A standardized measure of an
infant’s health status, typically assessed one
minute and five minutes after birth. Anesthesiologist
Virginia Apgar (1909–1974) developed the
scoring system that bears her name in 1953,
assigning a point value of 0, 1, or 2 to each of five
categories of vital function (BREATHING, HEART RATE,
REFLEX response, MUSCLE tone, and SKIN color) and
reporting their sum as the overall Apgar score.
Today the Apgar score is an international standard
to assess whether a newborn needs resuscitation
(lifesaving measures) and to evaluate the success
of resuscitative efforts. The highest score possible
is 10; doctors consider a score between 7 and 10 to
reflect good health in the infant. A score between
4 and 7 bears monitoring and perhaps supportive
care such as suctioning of the airways or supplemental
oxygen. A score of 3 or lower indicates a
life-threatening or critical circumstance for the
infant.
See also CHILDBIRTH; PREMATURE BIRTH.
assisted reproductive technology (ART) Medical
interventions to produce PREGNANCY. The US Centers
for Disease Control and Prevention (CDC),
which has a mandate under federal law to report
the success rates of ART at FERTILITY clinics in the
United States each year, defines ART as any
method that involves manipulation of both SPERM
and OVA (eggs). Other methods to aid fertility may
use interventions such as HORMONE therapies to
stimulate OVULATION (the release of ova) in the
woman or techniques such as intrauterine artificial
insemination (placement of sperm within the
UTERUS) to improve sperm viability. ART typically
APGAR SCORES
Apgar Score 0 1 2
BREATHING not breathing slow or irregular breathing 20 to 50 breaths per minute, regular rhythm
HEART RATE no heart rate < 100 beats per minute 100 to 104 beats per minute
REFLEX response no response to facial grimace with nasal stimulation sneeze or cough with nasal stimulation
nasal stimulation
MUSCLE tone flaccid some flexing of the arms and legs active movement
SKIN color cyanotic (bluish gray) cyanotic limbs pink