American Society of Andrology

Andrology lost one of its staunchest supporters with the recent death of Stuart B. Moss, PhD, in Washington, DC, on Saturday, November 13, 2021. Stuart received his undergraduate degree with honors from Union College in 1972 and then attended graduate school at the University of Rochester, where he received his PhD working in the laboratory of Jerome Kaye. From 1980 to 1985, he was a Research Fellow in Physiology at Harvard Medical School with Anthony Bellvé and, from 1985 to 1989, was Staff Scientist in the laboratory of Mark Groudine at the Fred Hutchinson Cancer Center in Seattle. In 1989, he moved to Philadelphia to join the faculty of the Temple University School of Medicine and was recruited in 1992 to join the Center of Research on Reproduction and Women's Health of the University of Pennsylvania School of Medicine. Fifteen years later, Stuart left to take administrative positions in the US National Institutes of Health (NIH), first as a Scientific Review Officer with the Center for Scientific Review and, 2 years later, as a program officer with the Fertility and Infertility Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). He also worked since 2014 in the NICHD Office of the Director on legislative matters. Stuart's research examined several important aspects of spermatogenic cell differentiation. His work on sperm nuclear structure instilled a long-term interest in the roles of histones in mouse and avian spermatogenesis. He also incorporated techniques of molecular biology to examine gene regulation during spermatogenesis, dissecting the cellular and molecular processes involved in building other sperm structures such as the flagellum. These studies led to the discovery and elucidation of several new proteins involved in anchoring and regulating signaling processes important for sperm motility. His work was some of the first to demonstrate that haploid-expressed proteins encoded by the X-chromosome are components of both the X and Y chromosome-bearing spermatids. In 2002, while on sabbatical as a Visiting Professor in the laboratory of Masaru Okabe (2017 ASA Distinguished Andrologist) in Osaka University, Japan, Stuart expanded his repertoire of techniques to include gene editing and functional fertilization studies using spermatozoa from mice containing experimentally induced mutations. As a laboratory scientist dependent on grant funding, Stuart learned first-hand how important it is to have grant proposals fairly evaluated and to have the feedback from reviews clearly communicated to the applicants. He took this understanding to his positions at NIH, first in the reviewing process and later as a Program Officer responsible for the portfolio of grants dealing with andrology. In this role, he assisted many early-stage investigators navigate the granting process and helped to guide more senior scientists entering the field for the first time. On a personal level, Stuart had a quiet, nonassuming outward demeanor. He came from a small, tight-knit family that included his parents and a younger sister. Although he had no children of his own, he was very close to his niece. He often took her or children of his friends to amusement parks or sporting events. To many, he was an honorary "uncle". In the field of andrology, we often speak of our colleagues as "family." At some level, conferences such as the Annual Meeting of the American Society of Andrology are "family reunions". Stuart was an active participant in the ASA meetings where he annually presented an update of the funding climate at NIH. He also took part in symposia and luncheons for trainees. In conversations with colleagues at these meetings, the questions "Have you met Stuart yet" and "Have you spoken to Stuart about your research idea" were frequently uttered; only his first name needed to be said, we all knew who was meant. The announcements of Stuart's death released an outpouring of emotions of sorrow for his passing and gratitude for everything he had done for his scientific family and the field of andrology. Our hearts go out to all who knew him and, especially, to his companion of 20 years, Pat Pileggi; his mother, Dorothy Moss; his sister, Wendy Moss; his niece, Jordana Haviv; and his grand-nephew Julian Joshua Torres.

Background: Research evidence published 10 to 15 years ago has shown that the type of vasectomy surgical technique performed can influence the effectiveness and the safety of the procedure. The objective of this study was to determine if evidence-based vasectomy surgical techniques are integrated in the vasectomy programs of selected low-resource countries.Methods: The surgical techniques recommended to perform the two steps of the vasectomy procedure (isolation/exposition and occlusion of the vas deferens) were extracted from current evidence-based clinical practice guidelines. Documents describing male sterilisation standards and practice from Kenya, Rwanda, India, Nepal, Mexico, Honduras, Colombia and Haiti were reviewed to assess adequacy with international guideline recommendations.Results: Best recommended techniques are 1) a minimally invasive technique including the no-scalpel technique (known as the no-scalpel vasectomy (NSV)) to isolate and expose the vas deferens, and 2) cautery of the mucosa of the vas preferably combined with interposition of the fascia (FI) to occlude the vas deferens. The NSV is largely adopted and performed to isolate the vas in selected low-resources countries. Ligation and excision (LE) of a small segment of the vas deferens combined with FI is the most common vas occlusion technique mentioned in the country standards. Cautery as recommended in the guidelines is seldom used in selected countries.Conclusions: Effective and adapted vasectomy vas occlusion techniques are available, but are still underused in many low-resource countries. Providing the most effective vasectomy surgical techniques increases users’ confidence and satisfaction regarding male sterilization and may lead to higher acceptability and uptake.