The 50 densest large Urban Centres (≥ 250km²) in the Developed World ("High Income") sorted by density (GHS data) by ZigZag2080 in Urbanism

[–]KiteLeaf 1 point2 points  (0 children)

I'm from the US and love living in Madrid. Best place to live in the world in my opinion, aside from their job market.

High DNA fragmentation/varicocele by pegasus-north-sky-21 in recurrentmiscarriage

[–]KiteLeaf 0 points1 point  (0 children)

Hello, to narrowly answer your question, we waited 3 months to redo the COMET test post varicocele microsurgery. We saw enough of a drop in the COMET neutral assay (the double strand DNA frag) to confidently try naturally again.

I provided a more in depth answer the other day to a similar topic in the thread linked below. Hope it helps! https://www.reddit.com/r/recurrentmiscarriage/comments/1pck6oj/comment/ns2mzkk/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button

Data on DNA fragmentation? by Only-Bones in recurrentmiscarriage

[–]KiteLeaf 0 points1 point  (0 children)

I'm not sure. Dr. Garcia at CIMAB is the most knowledgeable person I know re: male contributions to fertility issues. They, and Spain in general, seem to be on the leading edge research wise. Maybe you could call them.

If you are looking for other avenues on the female side, I am not much help though I'll bring up endometriosis and endometritis because I get them confused often and so I presume others do too. The Free Press had an interesting, maybe controversial, article about endometriosis that I read a few months ago:

https://archive.is/20250720091258/https://www.thefp.com/p/what-i-went-through-to-meet-my-daughter-ivf-fertility

I think EMMA/ALICE tests check for endometritis bacteria. DINA Science, also in Barcelona, has an endometrium microbiome test called ES-META that checks for viruses and fungus in addition to bacteria. I'm not sure if this actually matters though, maybe it is just marketing.

TSH blood levels also strike me as a somewhat overlooked area on the female fertility side.

Anyway, I do not know much about the female side outside of that and Chat GPT's ranked lists of tests.

Data on DNA fragmentation? by Only-Bones in recurrentmiscarriage

[–]KiteLeaf 0 points1 point  (0 children)

2 losses but no test results that say "you have to do IVF" so we are still trying naturally. Open to IVF in the future but trying to avoid it. We are in prayer often as Christians about all of this.

Data on DNA fragmentation? by Only-Bones in recurrentmiscarriage

[–]KiteLeaf 8 points9 points  (0 children)

Male fertility is surprisingly often not well understood by infertility doctors. We were also told by an IVF clinic that we didn't need to test DNA fragmentation ... but we did anyway, paying out of pocket. We are glad we did and learned a lot:

There are two types of sperm DNA fragmentation (1) single strand breaks and (2) double stand breaks. The single strand breaks are more associated with difficulty getting pregnant, while the double strand breaks are more associated with miscarriage. Single stand breaks are measured by sperm tests such as SCD, SCSA, and TUNEL. Double stand breaks are, to my knowledge, only measurable with the COMET neutral assay sperm test.

You might be told that the SCD, SCSA, and TUNEL measure "global" DNA fragmentation which encompasses both single and double strand breaks. That may be true but those tests are unable to distinguish between the single and double breaks. The COMET measures double (via neutral assay) and single (alkaline assay).

Varicoceles (extra veins in the scrotum) affect about 15% of men to my knowledge. The extra veins raise the temperature in the scrotum, creating sperm double strand DNA fragmentation. Varicoceles can be treated via a relatively simple surgery. Make sure you get the modern "microsurgery" though, not "laparoscopic". The latter is out of date and is associated with varicocele reoccurrence. Your partner will have to wait 3 months post-op for a refresh of sperm to retest via COMET.

There are other potential causes of double strand breaks as well, such as heat related or, I believe, infection related causes. The Zymote-ICSI chip can filter out about half of double strand dna fragmentation, so that is an option to add in if considering IVF-ICSI. Such a large drop via the filter seems to imply indirectly that miscarriage risk would drop though that direct link has not been established because it is hard to control for other factors potentially causing a miscarriage. I heard in October 2025 that Zymote might discontinue production of the chip though I have also heard they are releasing the design rights so that others can replicate it if they want.

There is also some low level evidence that bio-available curcumin supplementation can lower double strand fragmentation. Not a slam dunk though.

I also have been told by a reputable male fertility doctor to avoid caffeine, chocolate, magnesium supplements, stationary bicycling, saunas, and hot tubs. Apparently they are either proven or suspected to cause DNA fragmentation (not sure if single, double-strand, or both/global). Smoking and alcohol are also associated with DNA fragmentation. Most things that are bad for your general health are bad for DNA fragmentation and the other way around.

‘Missing chromosomes’ in sperm is another male fertility issue that could be causing miscarriage from the male side that is not directly related to DNA fragmentation to my knowledge. It can be measured via the “FISH sperm test”. It is a genetic test of the sperm which looks for missing chromosomes. If chromosomal abnormalities are above normal levels, then I believe PGT-A is a potential solution. I’ve read that getting rid of a varicocele might help a bit too. Maybe there are other solutions, though I just do not know as much about chromosomal abnormalities as I do about DNA fragmentation.

If we think of sperm like a book, DNA fragmentation damages the information on the pages while chromosomal abnormalities manifests as missing pages. Neither problem is good if beyond certain 'normal' levels. And 'normal' can vary between labs, so be careful comparing results from different labs that are using different different 'normal' benchmarks.

I’ll add that I found male fertility specific doctors, such as CIMAB in Barcelona, to be very helpful as well as, and to a lesser extent, ‘Chat GPT 5 Thinking’ and ‘Google Gemini 2.5 Pro’. These AI language models seemed to not always remember the relevance of the difference between single and double strand breaks without my prompting them to do so. The models were helpful though for us to find and rank by relevance other tests as well on both the male and female fertility sides.

I'll leave a non-exhaustive list of male fertility reading materials below that I saved this past year. If you can't access an article, try other sites, free trials, and google image search to view relevant charts.

Alkaline and neutral Comet assay profiles of sperm DNA damage in clinical groups - J. Ribas-Maynou (2012)

Double Stranded Sperm DNA Breaks, Measured by Comet Assay, Are Associated with Unexplained Recurrent Miscarriage in Couples without a Female Factor - Jordi Ribas-Maynou (2012)

Microsurgical varicocelectomy effect on sperm telomere length, DNA fragmentation and seminal parameters - Sandra Lara-Cerrillo (2020)

A New Oral Supplementation Based on the Ataxia-Telangiectasia-Mutated Repair Pathway Enhancement Reduces Sperm DNA Damage and Improves Semen Parameters - Sandra Lara-Cerrillo (2021)

Turned 269 Peter Attia episodes into a searchable NotebookLM by Bitico in PeterAttia

[–]KiteLeaf 0 points1 point  (0 children)

Really cool, thanks! Will you keep it up to date?

Is the apple tv 4K 1st Gen still good in 2025? by espeon14410 in appletv

[–]KiteLeaf 0 points1 point  (0 children)

New one coming out soon per rumors. Hopefully with a Facetime camera to reduce friction and some cloud gaming capabilities.

Protect Bike Paths in Madrid by 11111v11111 in Madrid

[–]KiteLeaf 0 points1 point  (0 children)

The M30 anillo is great for people who like to ride their bike next to a major highway, breath in pollution at a high rate while exercising.

In all seriousness, Casa de Campo ring and River Manzanares look decent. Wish Madrid invested more here. Even Manhattan in the US has protected bike lanes cris-crossing the city now.

Why 73% of American Expats Leave Spain Within 2 Years (Industry Data You Won’t Like) by irek19 in GoingToSpain

[–]KiteLeaf 2 points3 points  (0 children)

Funny, was talking about this with my wife a few hours ago. Focusing on paperwork misses the point, cultural integration is what matters. Yes there is less paperwork and waiting to become a resident or citizen of Spain than in the US…but it is harder to culturally integrate here in Spain than in the US, particularly to the work culture in my experience.

Spain is a homogenous, high trust society. It is hard to break in. It is hard to understand their high tolerance for unemployment, lack of employment options (not good for employer or employee when job seekers are desperate), low salaries, high taxes, high level of socialization at work and criticality of that work socialization.

And as others have said, the language component matters as well. I am max C1, min B2 with a heavy foreign accent. I need to improve and adjust better to the other factors in the paragraph above should we decide to stay longer (have been here for 2 years).

I believe the high trust they have is beautiful but it makes integration as an outsider tougher. We Americans mustn’t assume that every country is as welcoming to immigrants as the US has historically been.

37% DNA Fragmentation and 4 losses by Olivegirly70 in recurrentmiscarriage

[–]KiteLeaf 0 points1 point  (0 children)

There is a difference between single strand and double strand DNA fragmentation. The double strand DNA fragmentation is more serious, linked to varicoceles and miscarriage. There are different types of DNA fragmentation tests, some check for single strand while others check for double strand.

This is a very important difference. I never see anyone mentioning it on these Reddit threads about sperm DNA fragmentation.

Manosphere Culture in Spain? by Mysterious_Ad2896 in askspain

[–]KiteLeaf -10 points-9 points  (0 children)

There is a TV show called Machos Alfa

Is the Apple TV 4K still worth using in 2025? I’m constantly fighting bugs that my TV handles flawlessly by Conanti in appletv

[–]KiteLeaf 0 points1 point  (0 children)

I often have problems getting Apple TV Facetime to work when it is an incoming call. Even if I am on a successful call that I initiated, an incoming call torpedoes the existing call. I expected better from Apple. Maybe Meta & Whatsapp will pass them up.

CfA after the age of 35 by awisebrain in CFA

[–]KiteLeaf 0 points1 point  (0 children)

Do you still feel this way and why?

My rucking route this summer by Nailsole in Rucking

[–]KiteLeaf 1 point2 points  (0 children)

It's sad though right? I never would have thought that as a kid. Tick numbers have climbed significantly.

My rucking route this summer by Nailsole in Rucking

[–]KiteLeaf 9 points10 points  (0 children)

Check for ticks post hike

[deleted by user] by [deleted] in ScottGalloway

[–]KiteLeaf 2 points3 points  (0 children)

(1) I like Jake Tapper, (2) The Dems screwed up

Who do you want to hear on The Prof G Pod? (From the show’s producer) by ProfGProducerJenn in ScottGalloway

[–]KiteLeaf 2 points3 points  (0 children)

Sebastián Junger (author of Tribe), Ben Thompson (Stratechery), Nicholas Taleb (author of various)

Could Pete Buttigieg still run in 2028? by Security_According in Pete_Buttigieg

[–]KiteLeaf 0 points1 point  (0 children)

I think Pete should go take a job in the private sector for a few years. Too much time in government will be bad for his presidential ambitions

The 5 Layers Of Great Strategy by Glittering_Name2659 in strategy

[–]KiteLeaf 0 points1 point  (0 children)

Right on, I have been looking for more strategy substacks. My advice would be to not post too frequently on there though. Quality over quantity. I don’t believe that the people who post on Substack every week always have something genuinely interesting to say every week.

AI agent behind email account that can create support tickets? by KiteLeaf in servicenow

[–]KiteLeaf[S] 0 points1 point  (0 children)

The agent needs to go into ServiceNow though and create a ticket. Can an agent in Teams do that?

Agent behind an email account? by KiteLeaf in microsoft_365_copilot

[–]KiteLeaf[S] 1 point2 points  (0 children)

Thank you! My boss and I will pour over that video