Alterations In Semen Parameters Research Articles

Consequences of Exposure to Hypobaric Hypoxia Associated with High Altitude on Spermatogenesis and Seminal Parameters: A Literature Review.

Preclinical research has provided compelling evidence indicating that exposure to hypobaric hypoxia (HH) results in a deterioration of spermatogenesis. This adverse effect extends to the underlying molecular mechanisms, progressively leading to impairments in the seminiferous epithelium and germ cells and alterations in semen parameters. Indeed, several studies have demonstrated that animals exposed to HH, whether in natural high-altitude environments or under simulated hypoxic conditions, exhibit damage to the self-renewal and differentiation of spermatogenesis, an increase in germline cell apoptosis, and structural alterations in the seminiferous tubules. One of the primary mechanisms associated with the inhibition of differentiation and an increase in apoptosis among germ cells is an elevated level of oxidative stress, which has been closely associated with HH exposure. Human studies have shown that individuals exposed to HH, such as mountaineers and alpinists, exhibit decreased sperm count, reduced motility, diminished viability, and increased sperm with abnormal morphology in their semen. This evidence strongly suggests that exposure to HH may be considered a significant risk factor that could elevate the prevalence of male infertility. This literature review aims to provide a comprehensive description and propose potential mechanisms that could elucidate the infertility processes induced by HH. By doing so, it contributes to expanding our understanding of the challenges posed by extreme environments on human physiology, opening new avenues for research in this field.

Are they functional hypogonadal men? Testosterone serum levels unravel male idiopathic infertility subgroups

PurposeTo evaluate total testosterone distribution in male idiopathic infertility.MethodsA retrospective, real-world case-control clinical study was conducted. Cases consisted of men evaluated for couple infertility, specifically those with alterations in semen parameters and normal gonadotropin levels, and after excluding all known causes of male infertility. Controls were male subjects who underwent semen analysis for screening purposes, without any abnormality detected. The total testosterone distribution was evaluated in cases and controls. Further analyses were performed subgrouping cases according to total testosterone reference threshold suggested by scientific societies (i.e., 3.5 ng/mL).ResultsCases included 214 idiopathic infertile men (mean age 38.2 ± 6.2 years) and controls 224 subjects with normozoospermia (mean age 33.7 ± 7.5 years). Total testosterone was not-normally distributed in both cases and controls, with positive asymmetric distribution slightly shifted on the left in cases. The rate of subjects with testosterone lower than 3.5 ng/mL was higher in cases (23.8%) than controls (4.5%) (p < 0.001). In cases with testosterone lower than 3.5 ng/mL, a significant direct correlation between testosterone and the percentage of normal morphology sperms was highlighted, also applying multivariate stepwise linear regression analysis (R = 0.430, standard error = 0.3, p = 0.020).ConclusionAlthough idiopathic infertile men show by definition altered semen analysis and gonadotropins within reference ranges, testosterone serum levels are widely variable in this population. Approximately a quarter of these patients present some sort of functional hypogonadism. Our data support the need to better classify idiopathic male infertility and total testosterone serum levels could be a supportive parameter in tracing the patient’s therapeutic profile.

COMPARISON OF SPERM DEFORMITY INDEXES BETWEEN PATIENTS WHO HAVE AND HAVE NOT EXPERIENCED COVID-19

Objective: Ever since its identification in December 2019, the novel coronavirus SARS-CoV-2 has rapidly disseminated worldwide, giving rise to the COVID-19 (coronavirus disease-19) pandemic. The male reproductive system is susceptible to the effects of COVID-19, leading to potential alterations in semen parameters. In this study, we conducted a comparison between patients who have previously contracted COVID-19 and those who have not, specifically focusing on the sperm deformity index (SDI) as a parameter for assessing sperm morphology.&#x0D; Material and Method: 134 patients over the age of 18 who applied to Hospital Andrology Laboratory between 29 November 2022 and 29 December 2022 were included in the study. Of these, 44 were patients who have had COVID-19, and 90 were patients who have not had COVID-19. These patients were compared in terms of SDI parameter and other semen parameters (ejaculate volume, sperm concentration, total sperm count, total motility, progressive motility and percentage of normal morphology sperm). The calculation of the SDI was performed by dividing the total number of observed deformities by the total count of sperm. &#x0D; Results: A noteworthy distinction was observed in the SDI values between the two groups, with a statistically significant difference (p0.05).&#x0D; Conclusion: SDI, one of the semen parameters, was found to be significantly different in both groups. Further comprehensive studies are warranted to thoroughly investigate the impact of COVID-19 on semen parameters.

SARS-CoV-2 replicates in the human testis with slow kinetics and has no major deleterious effects ex vivo.

SARS-CoV-2 is a new virus responsible for the Covid-19 pandemic. Although SARS-CoV-2 primarily affects the lungs, other organs are infected. Alterations of testosteronemia and spermatozoa motility in infected men have raised questions about testicular infection, along with high level in the testis of ACE2, the main receptor used by SARS-CoV-2 to enter host cells. Using an organotypic culture of human testis, we found that SARS-CoV-2 replicated with slow kinetics in the testis. The virus first targeted testosterone-producing Leydig cells and then germ-cell nursing Sertoli cells. After a peak followed by the upregulation of antiviral effectors, viral replication in the testis decreased and did not induce any major damage to the tissue. Altogether, our data show that SARS-CoV-2 replicates in the human testis to a limited extent and suggest that testicular damages in infected patients are more likely to result from systemic infection and inflammation than from viral replication in the testis.

O-015 Spontaneous alterations in semen parameters are associated with age, accessory gland function and the FSHB c.-211G&amp;gt;T variant

Abstract Study question Which parameters are associated with spontaneous alterations in semen analysis in infertile men? Summary answer Changes in semen parameters are modulated by abstinence time, accessory gland function and fluctuations in FSH serum concentration, which is bound to FSHB c.-211G&amp;gt;T variant. What is known already There is a strong within-subject alteration of semen parameters in men with infertility. The WHO therefore recommends two ejaculate analyses. However, it remains unknown in which subgroup variations are likely to occur and which semen parameters are affected. We assume that in some men with idiopathic infertility, ejaculate parameters may spontaneously change without interventional medication apart from regression to the mean effects. The study aims to identify factors in conventional semen analysis based on the patients’ clinical data, including reproductive hormones like follicle stimulating hormone (FSH), and factors impacting endocrine activity, like the FSHB-211 promoter gene. Study design, size, duration In this retrospective longitudinal study we selected 3456 deeply phenotyped men with idiopathic infertility who had visited our centre for fertility workup from 2010-2020. The patients were selected from our well curated database Androbase© for analysis of repeated ejaculate samples. Participants/materials, setting, methods Men with idiopathic infertility and at least two ejaculate analyses (70-90 days distance) were included. Exclusion criteria comprised: sperm concentration &amp;lt;1 million/ml, abnormal FSH or low testosterone, bitesticular volume (bTV) &amp;lt;10ml, orchiectomy, cryptorchidism, varicocele testis, oncological disease, genetic findings (i.e. abnormal karyotype, AZF deletions), medication affecting spermatogenesis. Grouped linear 2-level nested mixed-effect models were applied. Analyzed parameters included: somatic, hormonal (including FSH and FSHB c.-211 variants), and semen parameters (including abstinence time, accessory gland markers). Main results and the role of chance Groups were built according to sperm concentration: A (n = 397): ≥1.0 to &amp;lt; 5.0 mill/ml, B (n = 708): ≥5.0 to &amp;lt; 15.0 mill/ml, C (n = 2351): ≥15.0 mill/ml. A, B and C: changes in ejaculate volume were associated with alterations in total sperm count and motility (p &amp;lt; 0.003). Changes were, controlled for abstinence time (p &amp;lt; 0.001), related to alpha-glucosidase, fructose or zinc (p = 0.005-0.02). A+B: fluctuations in FSH concentration influenced sperm concentration/count (p = 0.004-0.02), albeit only in men with FSHB c.-211 GG (p = 0.007-0.02). T-allele carriers did not show changes in FSH concentration (p &amp;gt; 0.1). B: age &amp;lt;50 years (p = 0.007-0.01) and normal bTV (p = 0.008-0.02) were associated with spontaneous increases of sperm concentration, count and motility. Semen parameters exhibit intra-individual alterations associated with organic, hormonal and genetic variables. Changes are pronounced in younger men with normal bTV and oligo- to almost normozoospermia. The effect is modulated by abstinence time, accessory gland function and fluctuations in FSH concentrations which, in turn, are bound to the FSHB-211 promotor gene polymorphism. Limitations, reasons for caution A limitation of our approach is the retrospective nature of the study, which cannot exclude the possibility of bias within the data set. Wider implications of the findings Judgement of semen analysis should be based on two semen samples, with abstinence time between 4-5 days. In future clinical trials, abstinence time should be kept constant. It might be investigated if younger men with normal bTV and FSHB c.-211 GT/TT benefit from improving accessory gland function and increasing FSH. Trial registration number not applicable

Spontaneous alterations in semen parameters are associated with age, accessory gland function and the FSHB c.-211G>T variant.

There is a strong within-subject alteration of semen parameters in men with infertility. However, it remains unknown in which subgroup variations are likely to occur and which semen parameters are affected. To evaluate parameters associated with spontaneous alterations in semen analysis. We retrospectively selected 3456 men with infertility without known causes affecting spermatogenesis or sperm output for analysis of repeated ejaculate samples. Exclusion criteria comprised sperm concentration <1 million/mL, abnormal follicle-stimulating hormone or low testosterone, and low bitesticular volume (<10mL). Grouped linear two-level nested mixed-effect models were applied. The analyzed parameters included abstinence time, bitesticular volume, age, accessory gland markers, follicle-stimulating hormone, and FSHB c.-211 variants. Groups include A (n=397): ≥1.0 to <5.0 million/mL, B (n=708): ≥5.0 to <15.0 million/mL, and C (n=2351): ≥15.0 million/mL. Groups A, B, and C: changes in ejaculate volume were associated with alterations in total sperm count and motility (p<0.003). Changes were, controlled for abstinence time (p<0.001), related to α-glucosidase, fructose, or zinc (p=0.005-0.02). Group A+B: fluctuations in follicle-stimulating hormone level influenced sperm concentration/count (p=0.004-0.02), albeit only in men with FSHB c.-211 GG (p=0.007-0.02). T-allele carriers did not show changes in follicle-stimulating hormone levels (p>0.1). Group B: age <50 years (p=0.007-0.01) and normal bitesticular volume (p=0.008-0.02) were associated with spontaneous increases in sperm concentration, count, and motility. Semen parameters exhibit intra-individual alterations associated with organic, hormonal, and genetic variables. Changes are pronounced in younger men with normal bitesticular volume and oligozoospermia to almost normozoospermia. The effect is modulated by abstinence time, accessory gland function, and fluctuations in follicle-stimulating hormone level, which is bound to FSHB c.-211G>T variant. Judgment of semen analysis should be based on two semen samples, with abstinence times between 4 and 5 days. As a future perspective, it might be investigated whether younger men with normal bitesticular volume who are unable to elicit increases in serum follicle-stimulating hormone (FSHB c.-211 genotype of GT/TT) benefit from improving accessory gland function and increasing follicle-stimulating hormone.

Bladder Neck Obstruction: Experience and Management in a Sperm Bank.

Primary Bladder Neck Obstruction (PBNO) management provides medical and surgical treatment, such as transurethral incisions that can lead to retrograde ejaculation. The aim of this study was to investigate the maintenance of anterograde ejaculation and semen quality before and after this surgical procedure. A retrospective evaluation was carried out between 2011 and 2020. A total of 73 patients diagnosed with PBNO were recruited. Ejaculatory function, semen quality, and the fertility of recruited subjects were evaluated. Semen parameters-Baseline, 8.2% of patients were oligozoospermic and 12.3% had a semen volume below the WHO 2010 fifth percentile. Post-surgery, 20% of patients were oligozoospermic. We detected a significant decrease in total sperm number, a significant increase in the number of abnormal forms, and a reduction in the leukocyte concentration. Ejaculatory function-A total of 7.7% of patients reported anejaculation after transurethral incision of the bladder neck. Fertility-9.2% of the patients already had children before surgery; 13.8% had naturally conceived children in the years following surgery; 76.9% had no desire for paternity at the time. Our data have important implications for sperm bank management. The alterations in semen parameters and the risk of anejaculation suggest that the use of sperm cryopreservation before surgery for PBNO should be encouraged.

Oxidative Stress Is Associated with Telomere Interaction Impairment and Chromatin Condensation Defects in Spermatozoa of Infertile Males.

Telomere length can be influenced by reactive oxygen species (ROS) generated by lifestyle factors or environmental exposure. We sought to determine whether oxidative stress has an impact on sperm nuclear alterations, especially on chromatin organization and telomere interactions in the spermatozoa of infertile males. We performed an observational and prospective study including fifty-two males, allocated in the “case group” (30 infertile males presenting conventional semen parameter alterations) and the “control group” (22 males with normal conventional semen parameters). ROS detection was determined on spermatozoa using CellROX© probes. Sperm nuclear damage was assessed using quantitative fluorescence in situ hybridization (Q-FISH) for relative telomere length and telomere number, aniline blue staining for chromatin condensation, terminal deoxynucleotidyl transferase dUTP nick-end labeling for DNA fragmentation, and FISH for aneuploidy and 8-hydroxy-2′-deoxyguanosine immunostaining for oxidative DNA damages. Infertile males had significantly increased levels of cytoplasmic ROS and chromatin condensation defects as well as a higher mean number of telomere signals per spermatozoon in comparison with controls. In addition, the mean number of sperm telomere signals were positively correlated with the percentage of spermatozoa with chromatin condensation defect. In infertile males with conventional semen parameter alterations, oxidative stress is associated with telomere interaction impairment and chromatin condensation defects.

Impact of percutaneous embolization versus subinguinal microsurgical ligation on semen parameters in primary varicocele patients: comparative study

BackgroundVaricocele is an abnormally dilated pampiniform plexus of the veins within the spermatic cord and is considered the most common correctable cause of male factor infertility. Many approaches are described for treatment either surgical (tradition inguinal, subinguinal, and laparoscopic) or non-surgical percutaneous embolization. During the period from August 2017 to December 2018, we prospectively analyzed the preoperative and post-operative alteration of semen parameters (at 3 and 9 months) of the data collected from 63 patients with clinically evident varicocele referred to our tertiary hospital. Patients were divided into two groups: group 1, thirty-three patients who underwent subinguinal microsurgical ligation, and group 2, thirty patients who underwent percutaneous embolization.ResultsSixty-three patients enrolled in this study were divided in two groups: group 1, patients who underwent surgery, and group 2, patients who underwent embolization; the mean age is 24.6 ± 1.27 years in group 1 and 23.7 ± 2 years in group 2; there was no statistically significant difference between the two groups as regards BMI, diabetes, hypertension, and smoking. Bilaterality was present in 15.2% of group 1 patients and 10% in group 2 patients (P value 0.06). Most of the patients were classified as grades 2 and 3 with no statistical significance regarding severity of the disease. Preoperative semen parameters for patients including sperm count, motility, and abnormal forms showed no statistically significant difference between the two groups. Post-intervention semen analysis was done twice during follow-up after 3 months and 9 months from the date of intervention. After 3 months, the semen parameters were improved in both groups in spite of the higher sperm count in group 2 but with no statistical significance. After 9 months follow-up, semen analysis showed persistent increase in sperm mobility in group 1 patients in comparison to group 2 patients. Both groups had better improvement in count of normal form with no statistical significant change.ConclusionImprovement of semen parameters while treating primary varicocele by either subinguinal microsurgery approach or percutaneous embolization shows equivalent outcomes.

Low Testosterone and Semen Parameters in Male Partners of Infertile Couples Undergoing IVF with a Total Sperm Count Greater than 5 Million.

Low serum testosterone is found in approximately 15% of subfertile men. Although testosterone is essential in spermatogenesis, it is unclear whether low testosterone levels may have a negative impact on the semen parameters of men belonging to infertile couples with a total sperm count greater than 5 million. Furthermore, it is debatable whether the initial evaluation of the subfertile male should include an endocrine assessment. This was a retrospective, single-center cohort study conducted at a tertiary fertility clinic. Male partners of infertile couples undergoing in vitro fertilization (IVF), with a total sperm count greater than 5 million, were included. All men provided morning blood samples, and none had been on exogenous testosterone or other relevant medications. Low total testosterone (TT) was defined as <264 ng/dL. Free T was calculated using TT and sex hormone-binding globulin (SHBG) levels (nmol/L) by a constant albumin concentration of 43 g/L. In total, 853 patients were included: 116 had low TT (<264 ng/dL) and 737 had normal TT (≥264 ng/dL). Semen volume, sperm cell count, progressive (A + B) motility and morphology (≥4% strict Kruger) were lower in the low TT group but not significantly different between low and normal TT groups (3.2 ± 1.79 vs. 3.23 ± 1.64, p = 0.87; 76.82 ± 83.18 vs. 67.55 ± 57.70, p = 0.7; 54.89 ± 19.45 vs. 56.25 ± 19.03, p = 0.6; 5.77 ± 3.23 vs. 6.89 ± 3.94, p = 0.23). The percentage of patients with below-reference sperm volume (<1.5 mL), cell count (<15 × 106/mL), motility (A + B) (<32%) and morphology (<4%) was higher in the low TT group but not statistically different compared to the normal TT group. Multivariable regression analysis revealed that low TT and free T levels had no significant effect on the aforementioned semen parameters (coefficient: 3.94, 0.88, 1.37, 0.39; p = 0.53, 0.8, 0.3, 0.2; coefficient: 0.001, 0.06, 0.007, 0.0002; p = 0.73, 0.52, 0.85, 0.98). Despite our robust methodological approach, the presence of biases related to retrospective design cannot be excluded. Our findings highlighted the lack of association between low TT levels and semen parameter alterations in male partners of infertile couples undergoing IVF, with a total sperm count greater than 5 million. However, it is important to emphasize that more patients in the low TT group had subnormal semen parameters, albeit the difference was not statistically significant. Larger, prospective studies are warranted in order to validate these findings, as well as to investigate the existence of a TT threshold below which semen parameters might be negatively affected.

Semen Parameter Alteration, Histological Changes and Role of Oxidative Stress in Adult Rat Epididymis on Exposure to Electronic Cigarette Refill Liquid.

Electronic cigarettes (e-cigarettes) are devices intended to substitute conventional cigarettes, with the aim of being less harmful. In a previous report, we showed that intraperitoneal (i.p.) injection of e-cigarette liquid (E-liquid), with or without nicotine, induced toxicity in the testes of Wistar rats by disrupting oxidative balance and steroidogenesis. In the present work, we further evaluated the impact of e-liquid with or without nicotine on the epididymis of rats using the same procedure. Results showed that e-liquid treatments led to alteration of semen parameters, with a significant drop of at least 50% in sperm vitality, a significant increase of morphologically abnormal spermatozoa and an imbalance of redox status in comparison to the control group. A significant raise of 1.4 fold, compared to the untreated rats, in myeloperoxidase (MPO) granules after both treatments was recorded, suggesting an inflammatory state. Histopathological examination confirmed a marked reduction in sperm count in the cauda epididymis. Data of this study suggest that the pro-oxidant properties of e-liquid with or without nicotine, in addition to testicular defects, could lead to an inflammatory state in the epididymis, causing alterations in the semen parameters. These data provide additional information on the impact of e-liquid on the reproductive system.

Subinguinal microsurgical varicocelectomy vs. percutaneous embolization in infertile men: Prospective comparison of reproductive and functional outcomes

BackgroundVaricocele is a condition characterized by dilated, tortuous veins within the pampiniform venous plexus of the scrotal sac. Presence of varicocele is associated with an increased risk of alteration of semen parameters. The objective of this study was to compare the current standard in varicocele treatment procedures: sub-inguinal microscopic ligation to percutaneous embolization in terms of semen parameters improvement, fertility, and morbidity at the university hospital of Toulouse (France). Seventy six patients with clinical varicocele, alteration of semen parameters and infertility, underwent either procedure (microsurgery in 49 case performed by a single surgeon and embolization in 27 cases) and were prospectively analyzed. Outcome measures were: semen parameters, spontaneous pregnancies, pain, side effects, recovery time and overall satisfaction. All patients were contacted in January 2015 in order to determine reproductive events.ResultsPreoperatively, there was no difference in clinical and biological items between the two groups. Postoperatively, on the overall population, there was a significant improvement of sperm concentration at 3, 6, 9 and 12 months (p = <0.001, <0.001, 0.012, 0.018) and sperm motility at 6 months (p = 0.002). The sperm concentration was higher at 6 months in the percutaneous embolization group (13.42, vs. 8.1×106/ml; p = 0.043). With a median follow-up of 4 years, 27 pregnancies occurred (spontaneous pregnancy rate of 35.5%).There was no significant difference between procedures on the sperm quality, pregnancy rate, and the overall satisfaction. Patients undergoing percutaneous embolization reported a faster recovery time (p = 0.002) and less postoperative pain (p = 0.007).ConclusionOur study shows that percutaneous embolization seems to be an equivalent alternative to sub-inguinal microscopic ligation in term of sperm quality improvement, pregnancy rate, and overall satisfaction with a slight advantage on post-operative morbidity.

Chronic prostatitis and its detrimental impact on sperm parameters: a systematic review and meta-analysis.

Prostatitis is a very common urogenital disease of the male with prevalence ranging from 2.2 to 9.7% worldwide. Interestingly, some recent evidences have showed a significant association between chronic prostatitis (CP) and male infertility including a detrimental effect on sperm parameters, reduction of zinc concentration on semen sperm and production of anti-semen antibodies (ASAs). The aim of the current meta-analysis was to evaluate the association between CP and alteration of semen parameters. This analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines and we included in the final analysis 27 studies, with a total of 3241 participants, including 381 (11.75%) with chronic bacterial prostatitis (CBP), 1670 (51.53%) with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and 1190 (36.72%) controls. CBP was associated with reduction of sperm concentration, sperm vitality, sperm total and progressive motility, while CP/CPPS was related to the reduction of semen volume, sperm concentration, sperm progressive motility and sperm normal morphology. We found that CP was significantly associated with reduced zinc concentration on seminal plasma (SMD: -20.73; p=0.005). Finally, CP statistically increased the risk of developing ASA on seminal plasma (OR 3.26; p<0.01). In conclusion, chronic prostatitis showed a detrimental effect on sperm and both CPB or CP/CPPS may differently show negative impact on sperm.

Is there a role for Serratia marcescens in male infertility: An experimental study?

Establishment of a male BALB/c mouse model to study the role of sperm impairing S.marcescens on mouse reproductive potential. The current study can add to use of reliable animal models to provide a noteworthy evidence for the microbial cause of infertility. The mice in the test groups II, III, IV were intraperitoneally administered with different doses (104, 106 or 108cfu) of S.marcescens whereas, group I serving as control, received PBS, for 10 consecutive days. The groups were evaluated for any change in body weight, tissue somatic index (%), seminal parameters and histology. Confirmation of S.marcescens from reproductive organs was done by reisolating the same by cultural characteristics and biochemical tests. The results showed that weight gain was evident only in mice receiving PBS (group I), whereas a decrease was recorded in the test groups (group II, III and IV). Only testes of test groups showed significant changes in TSI values whereas, no change in TSI was observed in any reproductive organ of any test group. Seminal parameters viz. sperm count, motility and viability were found to decrease in test groups II, III and IV as compared to control group I. Interestingly, the number of pus cells and percent decapitation was more prominent in test groups which received higher doses (i.e. group III and group IV). The histopathological examination revealed mild to dense inflammation in vas deferens and caudal epididymis in all test groups except hypospermatogenesis which was observed only in test group III and IV. However, in group I, neither adverse changes nor any sign of inflammation were observed. Intraperitoneal inoculation of S.marcescens could lead to alteration of semen parameters, induction of decapitation in spermatozoa and histopathological changes, thereby decreasing the reproductive potential of male mice.

Comparaison de la cure de varicocèle par ligature microchirurgicale subinguinale vs embolisation percutanée chez l’homme infertile

Subinguinal microscopic ligation is the current standard of treatment of varicocele, and percutaneous embolization is a new alternative. We aimed to compare these procedures for reproductive and functional aspects. A consecutive series of 76 patients with clinical varicocele, alteration of semen parameters and infertility, undergoing either procedure (microsurgery in 49 cases and embolization in 27 cases) was prospectively analyzed preoperatively and postoperatively (at 1, 3, 6, 9 and 12 months). Outcome measures were: semen parameters, pregnancies, pain, side effects, recovery time and overall satisfaction. Subsequently, all patients were contacted by telephone in January 2015 (with a median delay of 4 years after the procedure) in order to determine reproductive events. Preoperatively, both groups were identical for clinical and biological items. We observed an improvement of sperm concentration at 3, 6, 9 and 12 months (P<0.001, <0.001, 0.012, 0.018, respectively) and sperm motility at 6 months (P=0.002). The sperm concentration was higher at 6 months in PE group (P=0.043). With a median follow-up of 4 years after the procedure, 27 pregnancies occurred (spontaneous pregnancy rate of 32%). There was no difference between procedures on the sperm quality, pregnancy rate and the overall satisfaction. Patients undergoing percutaneous embolization reported a faster recovery time (P=0.002) and less postoperative pain (P=0.007). Both procedures give equivalent results regarding sperm quality, pregnancy rate and satisfaction even though recovery seems faster and postoperative pain seems lower after percutaneous embolization. 4.

Varicocele management in the era of in vitro fertilization/intracytoplasmic sperm injection.

Varicocele is the most common surgically treatable cause of male infertility, and often results in alterations in semen parameters, sperm DNA damage, and changes to the seminal milieu. Varicocele repair can result in improvement in these parameters in the majority of men with clinical varicocele; data supporting repair in men with subclinical varicocele are less definitive. In couples seeking fertility using assisted reproductive technologies (ARTs), varicocele repair may offer improvement in semen parameters and sperm health that can increase the likelihood of successful fertilization using techniques such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), or may decrease the level of ART needed to achieve successful pregnancy. Male infertility is an indicator of general male health, and evaluation of the infertile male with an eye toward future health can facilitate optimal screening and treatment of these men. Furthermore, varicocele may represent a progressive lesion, offering an argument for its repair, although this is currently unclear.

Antisperm antibodies in infertile men and their effect on semen parameters: A systematic review and meta-analysis

BackgroundAntisperm antibodies (ASA) in males cause the autoimmune disease ‘immune infertility’. The mechanism of ASA cause male infertility is not clear. Present studies have investigated the effect of ASA and their incidence in men with unexplained infertility, as well as to evaluate the correlation between the ASA and semen parameter alterations but have shown inconsistent results. We performed a systematic literature review and meta-analysis to assess the association between ASA and basic semen parameters in infertility men. MethodsSystematic literature searches were conducted with PubMed, EMBASE, Science Direct/Elsevier, CNKI and the Cochrane Library up to October 2014 for case–control studies that involved the impact of ASA on semen parameters. Meta-analysis was performed with Review Manager. Standard mean differences (SMD) of semen parameters were identified with 95% CI in a random or fixed effects model. ResultsEight studies were identified, including 238 cases of ASA positive infertility male and 929 ASA negative controls. Our results illustrated that the sperm concentration and sperm motility (a+b) from ASA positive patients were significantly lower than ASA negative controls (SMD (95% CI) −23.64 [−43.47, −3.81], −16.40 [−27.92, −4.88], respectively). However, semen liquefaction time in the ASA positive group was significantly longer than the control group (SMD (95% CI) 4.19 [1.72, 6.66]). There was no significant effect of ASA on the sperm volume, sperm viability, sperm progressive motility, sperm normal morphology and sperm abnormal morphology. ConclusionsThe present study illustrates that there was a significant negative effect of ASA on sperm concentration, sperm motility (a+b) and sperm liquefaction.

Sperm-Impairing Escherichia coli, Alcohol and Male Infertility: An In Vivo Study

Purpose: Establishment of a male Balb/c mouse model to study the role of sperm immobilizing E. coli with or without alcohol on mouse reproductive potential. Materials and Methods: The mice in the experimental groups were intraperitoneally administered with different doses (104, 106 or 108 cfu) of sperm immobilizing E. coli alone or in combination with alcohol and as control group alcohol alone or PBS for 10 consecutive days. The groups were evaluated for change in body weight, seminal parameters, bacterial load and histopathological changes. Results: Weight gain was observed only in mice receiving PBS, whereas there was decrease in weight in all the groups except the group receiving 104 cfu where weight remained constant. No significant change in tissue somatic index was observed in any group. Reduced motility and viability was noticed in all groups except group receiving PBS. Decapitation was observed in groups instilled with 104 cfu and 104 cfu along with alcohol. Seminal parameters could not be evaluated due to non-specific aggregation of sperms in group administered with 106 and 108 cfu alone as well as with alcohol. Histopathological studies of testes showed very few mature spermatozoa and maturation arrest at later stage in all groups except PBS group. Conclusion: Intraperitoneal inoculation with sperm immobilizing E. coli with or without alcohol consumption could lead to alteration of semen parameters, induction of decapitation in spermatozoa, thereby decreasing the reproductive potential of male mice.

Oxidative stress and cytotoxic potential of anticholinesterase insecticide, malathion in reproductive toxicology of male adolescent mice after acute exposure.

The present study was undertaken to determine the effects of acute exposure to malathion on oxidative stress and cytotoxic potential of anticholinesterase insecticide, malathion in reproductive toxicology of adolescent male mice. Thirty two adolescent male mice at pubertal age were treated with 500 mg/kg body weight (BW) of malathion for three days. After exposure, biochemical markers and sperm analysis were evaluated and finally histological modifications of testis and sperm were assessed. Our data showed that treatment of male mice with malathion (500 mg/kg, BW) could lead to oxidative stress. Induced oxidative stress status can be assessed due to increased malondialdhyde (MDA) content, decreased thiol group content, as well as increased antioxidant enzyme activities. On the other hand, exposure to malathion at the pubertal age led to alteration of semen parameters; sperm production and percentage of motile sperm were decreased in the treated groups compared to the control. Furthermore, exposure of male mice to malathion led to a decrease of testosterone level, inhibition of acetylcholinesterase, and decrease of the reproductive performance of male mice after three days of treatment at the age of puberty. The importance to carry out in vitro reproductive toxicology assays lies on the need of knowing the alterations these insecticides may cause at cellular level, since they are endocrine disruptors that interfere with reproductive functions.

Variability of Semen Parameters with Time in Placebo Treated Men

We describe the variability of semen parameters with time in normal men receiving placebo. We also report the impact of season and geographic region, among other variables, on these parameters. Data from the placebo arms of 5 randomized, controlled trials were pooled. All trials set minimum standards for semen parameters as an eligibility criterion for entry. Semen parameters examined include volume, density, motility, total count, total motile count and morphology. Mixed model repeated measure analysis was used for statistical analysis. Coefficients of variation for each semen parameter and the percent change from baseline were calculated. The mean within-subject coefficient of variation for each semen parameter ranged from a low of 10% to a high of almost 50%. The contribution of season and region to variability was negligible. The reduction in variability with an increasing number of samples per time point had decreasing returns beyond 2 samples. There was considerable variation in semen parameters with time in subjects who received placebo. Variation could not be attributed to season or region. We observed a general negative trend in semen parameters in this population selected for normal baseline semen parameters, which was likely due to the placebo response or to regression toward the mean.