Changes In Semen Parameters Research Articles

A systematic review and meta-analysis of the placebo effect on both semen quality and male infertility.

Placebo influence on such objective indicators, as sperm quality and infertility, has not been studied previously, but some studies report that placebo may distort even objective outcomes. The aim of current study is to assess the placebo effect on fertility in patients suffering from sperm abnormalities and/or infertility. We conducted a search of two databases (Scopus and MEDLINE) and identified placebo-controlled clinical trials which focused on sperm abnormalities and/or male infertility treatment. Primary outcomes included changes in semen parameters (volume, total count, sperm concentration in semen, progressive motility, morphology (normal cells)). Secondary outcomes included DNA fragmentation and change in pregnancy rate. Seventy-seven articles published from 1983 to 2022 were included. Statistically significant changes were observed for the following values: total sperm count, mean change 0.16 (95% CI 0.05, 0.26); P=0.004, I2=75.1%; and progressive motility, mean change 0.13 (95% CI 0.02, 0.24); P=0.026, I2=84.9%. In contrast, placebo did not affect sperm concentration, sperm volume, sperm morphology or DNA fragmentation index. The publication bias for all the values measured with Egger's test and funnel plots was low. The current meta-analysis indicated a statistically significant increase of total sperm count and progressive motility in the placebo group. In contrast, placebo did not affect sperm concentration, sperm volume, sperm morphology and DNA fragmentation index. These findings should be considered while planning or analyzing placebo-controlled clinical trials.

Anti-sperm Antibodies as an Increasing Threat to Male Fertility: Immunological Insights, Diagnostic and Therapeutic Strategies.

It is a fact that sperm possess antigenic properties. Substantial scientific research suggests that specific antibodies that attach to sperm antigens can induce infertility in both humans and other species. Antisperm antibodies (ASA) represent a significant etiology of infertility in humans, leading to immunoinfertility. The association between ASA and infertility is multifaceted. The observation of sperm agglutination, although not conclusive for the diagnosis of immunological infertility, may suggest the presence of ASA. Nevertheless, ASA may also manifest in the lack of any sperm agglutination. Managing ASA from an andrological perspective depends on the underlying cause and the specific approaches healthcare professionals adopt. The precise etiology of male infertility resulting from ASA remains unclear. Current research has examined the impact of ASA and its prevalence among infertile males to understand the relationship between ASA and changes in semen parameters. However, the findings have been inconclusive. Numerous techniques have been documented for the management of immunoinfertility. This review examines the importance of ASA in the context of infertility, encompassing the postulated mechanisms underlying the development of ASA, the various assays employed for detecting them, and the available treatments.

Intra-individual changes in sperm parameters and total motile count with time among infertile men.

Paternal age association with sperm parameters has been previously studied, demonstrating a decrease in semen volume, sperm motility, and sperm morphology, but not in sperm concentration. However, scarce data exists on the individual intra-personal changes in semen parameters with time. Retrospective cohort study. To evaluate the changes in semen parameters and total motile count of infertile men over time. In this retrospective cohort study, infertile men without known risk factors for sperm quality deterioration and at least two semen analyses done>3 months apart, between 2005 and 2021, were evaluated. Allocation to groups was according to time between first and last semen analyses - 3-12 months, 1-3 years, 3-5 years, and>5 years. Basic characteristics and first and last semen analyses were compared. The primary outcome was the change in sperm parameters and the secondary outcome was the occurrence of a total motile count<5 million in men with an initial total motile count>10 million. A total of 2018 men were included in the study. The median age at first semen analyses was 36.2 (interquartile range: 32.8-40.1) years and the median time between semen analyses was 323 days (range 90-5810 days).The overall trend demonstrated an increase in concentration in the 3-12 months and the 1-3 years groups, whereas volume, motility, and morphology remained similar in these time groups. Semen analyses done more than 5 years apart showed decreased volume (p<0.05), motility (p<0.05) morphology (p<0.05), and steady sperm concentration. Significant declines in TMCs were found over time (p<0.001), with 18% and 22% of infertile men with an initial total motile count>10 million dropping to<5 million after 3 and 5 years, respectively. The factors independently predictive of total motile count<5M in the last semen analyses in men with an initial total motile count of>10M in a multivariate logistic regression model were baseline volume (odds ratio 0.80, p=0.03), baseline total motile count (odds ratio 0.98, p=0.01) and time between semen analyses - 3-5 years (odds ratio 3.79, p<0.001) and>5 years (odds ratio 3.49, p=0.04) DISCUSSION: Our study demonstrates, at the individual level, that while improvement in sperm concentration is observed in the first year and between 1 and 3 years, possibly due to fertility treatments, fertility-related counseling, and lifestyle changes, semen parameters decline with time over 3 years in individuals. Of significance, close to 22% of men with an initial total motile count>10 million (a range where spontaneous pregnancy is attainable) declined to<5 million (a range usually indicating a need for in-vitro fertilization/intracytoplasmic sperm injection) over 5 years. This data could contribute to individualized family planning for infertile men regarding the mode and timing of conception and the need for sperm banking, in order to minimize the need for future fertility treatments.

Male reproductive function before and after the adjustment of the COVID-19 prevention policy: a multicenter study in China.

At the end of 2022, the adjustment of the coronavirus disease 2019 (COVID-19) pandemic control policy in China resulted in a large-scale increase in public infection. To compare the fertility parameters of male patients before and after the adjustments of the COVID-19 pandemic control policy in China, we collected data on patients' medical histories and laboratory examinations on their first visits between June 2022 and March 2023 in five different hospitals. Data were divided into five groups according to the timeline of the policy adjustment. The data we collected from male patients included semen quality and serum reproductive hormone levels, and intergroup comparisons were made using the Mann-Whitney U and Chi-square tests. In total, 16 784 cases underwent regular semen analysis, 11 180 had sperm morphology assessments, and 7200 had reproductive hormone analyses. The data showed declining trends in semen volume, sperm motility, and the progressive sperm motility rate after the policy adjustment. Subgroup comparison revealed an initial decrease and gradual recovery in progressive motility rate. Sperm morphology analysis showed increased neck and tail abnormalities after the policy adjustment. No significant change in hormone levels was observed. Following the adjustment of the COVID-19 prevention policy in China, a decline in sperm motility and morphology was observed. This trend may gradually recover over 2 months. After the policy adjustment, reproductive hormone levels were relatively stable throughout, except for an increase in luteinizing hormone (LH). These changes in semen parameters suggest that the policy adjustment had a short- to medium-term impact on male reproductive function.

Correlation between seminal plasma biochemical markers and semen parameters in idiopathic oligoasthenoteratospermia: identification of biomarkers for L-carnitine therapy.

L-carnitine therapy for idiopathic sperm abnormalities exhibits variable effectiveness, and currently, there are no established criteria to predict patient response. This study investigated correlations between seminal plasma markers and semen parameters to identify biomarkers that can guide indications for L-carnitine therapy indications in patients with idiopathic sperm abnormalities. A retrospective review was conducted on 223 male patients with idiopathic oligoasthenoteratospermia, who sought medical attention at our clinic between January 2020 and October 2022. These patients underwent a pretreatment seminal plasma biochemical analysis, followed by a three-month continuous L-carnitine treatment. The correlation between seminal plasma biochemical parameters and pretreatment semen parameters was analyzed. Semen quality was compared between cases with normal and abnormal seminal plasma biochemical parameters, both pretreatment and posttreatment. The correlation between the changes in semen parameters after treatment and seminal plasma biochemical parameters were investigated. Correlation analyses revealed significant associations between all pretreatment semen parameters and seminal plasma biochemical markers, except for liquefying time and the ratio of normal morphology. Subgroup analysis, stratified by seminal fructose, zinc, citric acid, and neutral glycosidase levels, demonstrated that abnormal groups exhibited significantly different levels of semen parameters compared with the normal groups. The changing difference and changing ratio in the ratio of forward motile sperm showed a negative correlation with seminal fructose levels (r=-0.165 and -0.144). The changing difference in semen volume was negatively correlated with the level of seminal neutral glycosidase (r=-0.158). The changing ratio in semen volume, sperm concentration, total sperm count, and count of forward motile sperm all exhibited negative correlations with the levels of seminal neutral glycosidase (range from -0.178 to -0.224). Seminal plasma biochemical markers, particularly fructose and neutral glycosidase, may serve as valuable indicators for determining the eligibility of patients with idiopathic sperm abnormalities for L-carnitine therapy.

Does COVID-19 affect sperm quality in males? the answer may be yes, but only temporarily

BackgroundThe Corona Virus Disease 2019 (COVID-19) pandemic has raised concerns regarding its potential impact on male reproductive health. However, the impact of COVID-19 on sperm quality remains uncertain. This retrospective study aimed to investigate the short-term and relatively long-term effects of COVID-19 infection on sperm quality.MethodsA total of 85 males with fertility requirements, who underwent semen evaluation at Guilin People’s Hospital between June 2022 and July 2023, were included in the study. Changes in semen parameters were analyzed across three specific timeframes: within 6 months before COVID-19 infection, within 3 months after COVID-19 infection, and 3–6 months after COVID-19 recovery.ResultsThe results revealed that the sperm concentration and total sperm number were significantly lower after infection compared to before, while in the recovery period, the sperm concentration, total sperm count, progressive motility, and normal morphology significantly increased. Comparing the three periods, the most significant difference was observed in sperm concentration, which exhibited a significant decrease after infection but returned to normal levels after recovery from COVID-19.ConclusionsThese findings suggest that COVID-19 may exert some impact on sperm quality, particularly evidenced by decreased sperm concentration post-infection. Fortunately, these effects on semen parameters appear to be temporary, with gradual restoration of semen parameters within 3–6 months after recovery. However, further research is needed to explore the underlying mechanisms and long-term implications of these observed changes in semen parameters.

Insight into inflammation involvement in varicocele: A narrative review.

Varicocele is one of the main causes of male infertility. Although the pathophysiology mechanism of varicocele is very well described and understood, there are some unanswered questions that remains unknown. Some studies have previously described the state of testicular inflammation and sperm in animal models, especially the mouse model, and the seminal plasma of men with varicocele, with or without changes in semen parameters. This review intended to verify the role of inflammatory mechanism in varicocele, using clinical studies as well as animal model studies on the effect of inflammation caused by varicocele on the function of testicular somatic and germ cells. In-vivo studies confirmed whether anti-inflammatory molecules could treat the semen of men with varicocele and rats with varicocele. The use of different anti-inflammatory agents in mouse model studies provided a new perspective for future clinical studies to investigate the effect of concurrent treatment with surgery to improve surgical outcomes. Similar to animal model studies, previously conducted clinical trials have demonstrated the effectiveness of anti-inflammatory therapy in varicocele patients. However, clinical trials using anti-inflammatory are needed to be conducted agents to evaluate different aspects of this therapeutical approach in varicocele patients.

Comparison of semen parameters in the same patients before and after diagnosis of COVID-19.

Clinical and histopathological evidence suggest that the male reproductive system may be negatively impacted in patients with coronavirus disease (COVID-19). The objective of this study is to investigate the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on semen parameters by comparing semen analyses before and after COVID-19 diagnosis in the same patient. We retrospectively analyzed 342 semen analyses by reviewing medical records. The study included two groups of patients: (i) those who underwent two consecutive semen analyses within 6 months, one before (n = 114) and one after (n = 114) COVID-19 diagnosis, and (ii) a control group (n = 114) that was age-matched and did not receive a diagnosis of COVID-19. The study results indicated a significant decrease in semen volume, total sperm count per ejaculate, progressive motile sperm count, total motile sperm count, and normal sperm morphology after SARS-CoV-2 infection in comparison to their respective values before the infection. Subgroup analyses showed that the duration of COVID-19 diagnosis (short-term vs. long-term) did not impact the changes in semen parameters. However, fever during the COVID-19 process had a negative effect on semen parameters, particularly sperm concentration, unlike in patients without fever. In conclusion, our findings suggest that SARS-CoV-2 infection is associated with a decline in semen quality, which may potentially impact male fertility. Furthermore, it's important to note that the negative effects on semen parameters may persist in the long-term. Our results also indicate that fever during active infection could be a significant risk factor that negatively affects spermatogenesis.

The relationship between electromagnetic radiation of mobile phones and male infertility – a review of the literature

Introduction: In recent years, there have been more and more concerns about whether wearing mobile phones near the reproductive organs, including the testicles, may cause significant health consequences, such as sperm dysfunction, decreased semen production, impaired testicular morphology, and thus become the cause of male infertility. Determining the relationship between the electromagnetic radiation of mobile phones and infertility in men may in the future reduce the male factor in the problem of infertility of couples and thus improve the quality of life.&#x0D; Aim of the study: The aim of this review is to attempt to assess the impact of radiofrequency electromagnetic radiation emitted from mobile phones on male reproductive organs in the context of male fertility disorders.&#x0D; Materials and methods: The work was created based on the PubMed database. Articles were searched in English using the following keywords: mobile phone, testes, male infertility, electromagnetic radiation.&#x0D; Description of the state of knowledge: Changes in semen parameters, including reduced motility and changes in sperm morphology, have been reported in animal studies. Features of damage to living cells under the influence of oxidative stress generated by GSM radiation were also observed. Similar phenomena have been reported in vitro in human semen samples and in clinical trials in men.&#x0D; Summary: There are not enough studies providing strong evidence for the direct negative effect of mobile phones on male fertility. It is necessary to conduct more research in order to eliminate other factors that could potentially change the results of the analyses, as well as to standardize the test methods and the test variables.

Successful cryptozoospermia management with multiple semen specimen collection

To determine the prevalence of sperm suitable for intracytoplasmic sperm injection (ICSI) in fresh ejaculated semen samples provided by men scheduled for a microdissection testicular sperm extraction (mTESE) procedure. Secondary objectives included an evaluation of the effect of a short abstinence period on semen quality and ICSI outcomes for men with cryptozoospermia. Retrospective cohort study. Academic medical center. All men were scheduled to undergo a mTESE procedure by a single, high-volume surgeon at an academic center from September 1, 2015, to May 1,2021. Presence of sperm suitable for ICSI in the ejaculate on the day of scheduled mTESE. Prevalence of sperm suitable for ICSI in the ejaculate among previously diagnosed men with azoospermia. Secondary outcomes included changes in semen parameters, clinical pregnancy rate, and live birth rate. Of 727 planned mTESE procedures, 69 (9.5%) were canceled because sperm suitable for ICSI were identified in a fresh ejaculated sample produced on the day of scheduled surgery (typically one day before oocyte retrieval). Overall, 50 men (50/727, 6.9%) used these rare, ejaculated sperm for ICSI. Semen samples obtained with <24 hours of abstinence were more likely to have better motility than the sample initially provided on the day of the planned mTESE. The live birth rate per ICSI attempt using these rare, ejaculated sperm was 36% (19/53). Providing a fresh ejaculated semen sample on the day of mTESE allows nearly 10% of men with azoospermia to avoid surgery with satisfactory ICSI outcomes. Providing multiple ejaculated samples over a short period of time does not adversely affect sperm concentration and may enhance sperm motility in men with cryptozoospermia.

Research in Brief.

The Janus kinase 1 inhibitor filgotinib had no measurable effect on semen parameters or sex hormones in men in the phase 2, double-blind, randomised MANTA and MANTA-RAy studies. Walter Reinisch and colleagues randomly assigned 248 men aged 21–65 years with active inflammatory bowel disease or inflammatory rheumatic diseases to receive filgotinib 200 mg once daily or placebo for 13 weeks. Eight (6·7%) of 120 patients receiving filgotinib had a 50% or greater decrease in sperm concentration from baseline to week 13 (the primary outcome) compared with ten (8·3%) of 120 receiving placebo (difference −1·7%; 95% CI −9·3 to 5·8). No clinically relevant changes in semen parameters or sex hormones were seen between treatment groups. Adverse events were similar to those reported in other trials of filgotinib.

Effect of systemic isotretinoin therapy on semen parameters

Purpose Vitamin A has multiple functions in the human body, being involved in growth, epithelial differentiation, vision, immune function and reproduction. While normal spermatogenesis is influenced by several factors, it requires vitamin A. Systemic isotretinoin is a vitamin A derivative that is used in the treatment of many dermatological diseases, especially acne vulgaris (AV). There is limited research on the changes in semen parameters after systemic isotretinoin therapy in humans. Our study investigates the presence of varicoceles in patients undergoing systemic isotretinoin therapy for AV and examines whether there were any changes in the semen parameters before and after treatment. Methods Included in the study were 46 men patients who were scheduled for systemic isotretinoin therapy for AV. Before treatment, the patients underwent a physical examination and ultrasonography for varicoceles assessment. The patients underwent spermiogram before treatment and after 6 months of treatment. The spermiogram assessments included semen volume, sperm concentration, total sperm count, progressive motility, viability and sperm morphology. Results After treatment, there was an increase in semen volume, sperm concentration, total sperm count, progressive motility and vitality from the pre-treatment values, but a deterioration in the sperm morphology (p < .05). Comparing patients with and without varicoceles revealed more changes in semen parameters after treatment in those with varicoceles. There was a statistically significant difference in sperm concentration (p < .001). Conclusions Systemic isotretinoin therapy negatively affects sperm morphology, but has positive effect on other semen parameters, and these changes in semen parameters occur more frequently in patients with varicoceles. KEY MESSAGES Acne vulgaris is a very common disease and systemic isotretinoin is used as the most effective agent in its treatment. Systemic isotretinoin positively affects semen parameters except sperm morphology. Changes in semen parameters are more common in patients with varicocele.

MP43-16 VARICOCELE INDUCED TESTICULAR HYPERTHERMIA: INFRARED DIGITAL THERMOGRAPHIC ASSESSMENT EXPLORING THE EFFECT OF SURGICAL VARICOCELE CORRECTION ON POSTOPERATIVE TESTICULAR TEMPERATURE AND REPRODUCTIVE OUTCOME

You have accessJournal of UrologyCME1 Apr 2023MP43-16 VARICOCELE INDUCED TESTICULAR HYPERTHERMIA: INFRARED DIGITAL THERMOGRAPHIC ASSESSMENT EXPLORING THE EFFECT OF SURGICAL VARICOCELE CORRECTION ON POSTOPERATIVE TESTICULAR TEMPERATURE AND REPRODUCTIVE OUTCOME Mohammed Mahdi, Kareim Khalafalla, Ahmed Al Saeedi, Mohamed Arafa, Haitham Elbardisi, Sami Alsaid, and Ahmad Majzoub Mohammed MahdiMohammed Mahdi More articles by this author , Kareim KhalafallaKareim Khalafalla More articles by this author , Ahmed Al SaeediAhmed Al Saeedi More articles by this author , Mohamed ArafaMohamed Arafa More articles by this author , Haitham ElbardisiHaitham Elbardisi More articles by this author , Sami AlsaidSami Alsaid More articles by this author , and Ahmad MajzoubAhmad Majzoub More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003289.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testicular hyperthermia is considered as one of the main pathophysiological mechanisms of spermatogenic dysfunction in patients with varicocele. The aim is to compare scrotal & inguinal temperature measurements between varicocele patients and normal controls linking such measurements with semen parameters, in addition to the evaluation of changes in such variables after varicocele repair. METHODS: Patients with clinical varicocele were included. They were classified into normal semen (group I; n=25); & abnormal semen (group II; n=34). Controls (group III; n=30 ) with no varicocele & normal semen parameters were recruited. Initial conventional semen analysis (WHO 2010) and oxidation reduction potential (ORP) test (MiOXSYS) were performed. Bilateral inguinoscrotal infrared digital thermographic imaging (FLIR E6, Wilsonville, USA) was done.21 patients from group II underwent microsurgical varicocelectomy, temperature measurements & semen analysis were repeated 3 months post-surgery.Temperature were compared between all groups using ANOVA. Paired t-test was used to evaluate changes in temperature & semen parameters after the procedure. Pearson’s correlations were used to explore the association between temperature measurements & different variables and between changes in post-operative temperature with the changes in semen parameters. RESULTS: Bilateral scrotal temperatures, ORP and semen DNA fragmentation were significantly higher in group II compared with the other 2 groups.Left scrotal temperature was significantly negatively correlated with sperm concentration (-0.268, p=0.004), total motility (-0.337, p<0.001), normal morphology (-0.282, p=0.003) & left testicular size (-0.292, p=0.002). While it was significantly positively correlated with ORP (0.374, p=0.01). After varicocelectomy, there was a significant decrease in bilateral testicular temperature (p=0.01), and a significant increase in the sperm count (p= 0.03) & Normal morphology (p≤0.001), however, no significant correlation was identified between changes in testicular temperature & changes in all semen parameters. CONCLUSIONS: Increased scrotal temperature is detected in patients with testicular dysfunction secondary to clinical varicocele. Varicocele repair results in improvements in testicular temperature & semen parameters. Further studies with larger samples are needed to support correlations between post-operative outcomes. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e607 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohammed Mahdi More articles by this author Kareim Khalafalla More articles by this author Ahmed Al Saeedi More articles by this author Mohamed Arafa More articles by this author Haitham Elbardisi More articles by this author Sami Alsaid More articles by this author Ahmad Majzoub More articles by this author Expand All Advertisement PDF downloadLoading ...

MP30-08 EVALUATING THE CHANGES IN SEMEN PARAMETERS OVER TIME FOR MEN WITH AZOOSPERMIA FACTOR C (AZFc) MICRODELETIONS

You have accessJournal of UrologyCME1 Apr 2023MP30-08 EVALUATING THE CHANGES IN SEMEN PARAMETERS OVER TIME FOR MEN WITH AZOOSPERMIA FACTOR C (AZFc) MICRODELETIONS Jessica Marinaro, Jonathan Gal, Anna Mielnik, and Peter Schlegel Jessica MarinaroJessica Marinaro More articles by this author , Jonathan GalJonathan Gal More articles by this author , Anna MielnikAnna Mielnik More articles by this author , and Peter SchlegelPeter Schlegel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men with complete azoospermia factor C (AZFc) microdeletions may have variable degrees of spermatogenic failure. While some are persistently azoospermic, most intermittently or consistently have sperm in the ejaculate. It has been proposed that these men may experience a temporal decline in semen quality with age. The objective of this study was to assess changes in semen parameters over time among men with complete AZFc deletions. METHODS: We retrospectively reviewed 163 men with complete AZFc deletions who were tested at our center from 4/1996 to 7/2022. Of these, 41 had ≥2 semen analyses performed (SA). ANOVA tests were used to compare mean demographic values between azoospermic, intermittently azoospermic, and non-azoospermic men. Wilcoxon matched-pairs signed rank tests were used to compare initial and final semen analyses. RESULTS: In total, 179 SAs were reviewed. The mean number of SAs per patient was 4.4 ± 2.2. The mean time between each SA was 189.6 ± 420.0 days, and the mean time between the first and last SA was 638.9 ± 850.9 days. Of 41 men, 13 (32%) were azoospermic, 9 (22%) intermittently azoospermic, and 19 (46%) were non-azoospermic. Of the non-azoospermic men, most (n=14, 73.7%) had severe oligospermia (<1 million/mL).Of 9 men with intermittent azoospermia, most had an increase in sperm concentration (n=8, 89%), total sperm count (TSC) (n=8, 89%), and total motile sperm count (TMSC) (n=6, 67%) between the first and last SA. Similarly, most non-azoospermic men also had an increase in sperm concentration (n=12, 63%), TSC (n=11, 58%), and TMSC (n=11, 58%). In comparing semen parameters, men with intermittent azoospermia had an increase in sperm concentration (p=0.0078) and TSC (p=0.0078) between the first and last SA, but no change in TMSC. There was no difference in concentration, TSC, or TMSC over time for non-azoospermic men.While non-azoospermic men were older (mean: 37.0 +/- 5.6 years; p=0.004) versus intermittently azoospermic (mean: 33.4 +/- 3.3 years) or azoospermic men (mean: 30.3 +/- 5.6 years), there were no differences in baseline testosterone (p=0.24), baseline FSH (p=0.31), or testis size (p=0.17 right, p=0.50 left). CONCLUSIONS: In this study, there was no significant decline in sperm concentration, TSC, or TMSC over time for men with complete AZFc deletions; rather, sperm number tended to increase over time. These data suggest that men with AZFc deletions are not at substantive risk of decline in sperm production and do not need to take aggressive early measures for fertility preservation. Source of Funding: Authors JM and JG are supported in part by the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e393 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica Marinaro More articles by this author Jonathan Gal More articles by this author Anna Mielnik More articles by this author Peter Schlegel More articles by this author Expand All Advertisement PDF downloadLoading ...

PD42-08 PRELIMINARY RESULTS OF A FIRST IN HUMAN DOSE-RANGING CLINICAL TRIAL OF ADAM®, A NONHORMONAL HYDROGEL-BASED MALE CONTRACEPTIVE

You have accessJournal of UrologyCME1 Apr 2023PD42-08 PRELIMINARY RESULTS OF A FIRST IN HUMAN DOSE-RANGING CLINICAL TRIAL OF ADAM®, A NONHORMONAL HYDROGEL-BASED MALE CONTRACEPTIVE Paul Anderson, Damien Bolton, and Nathan Lawrentschuk Paul AndersonPaul Anderson More articles by this author , Damien BoltonDamien Bolton More articles by this author , and Nathan LawrentschukNathan Lawrentschuk More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003352.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Since the introduction of modern contraception in 1960, the focus has been on women, with a large assortment of hormonal and nonhormonal contraceptive options available for females. In contrast, male contraceptive options currently include only condoms, vasectomy, and the withdrawal method. Here we present the initial results from a first in human clinical trial of ADAM, a nonhormonal, nonpermanent, hydrogel-based contraceptive. METHODS: The preliminary safety and efficacy of ADAM® (Contraline, Inc.), a highly biocompatible nonhormonal, nonpermanent hydrogel designed for injection into the vas deferens, was assessed in an open-label, single-arm, prospective, multi-center, dose-ranging clinical trial with up to 30 male subjects with normal semen parameters, ages 25-65 years. After institutional review and ethics board approval, an initial cohort of 4 men were implanted with the first dose and rate of the ADAM® hydrogel (120 uL at 800 uL/min) under general anesthesia at the time of this writing. A no scalpel vasectomy (NSV) approach was used to identify and externalize the vas deferens, followed by cannulation with a 24G over-the-needle catheter, and ADAM® injection using a proprietary, automated injection device. An additional 26 men will be implanted with variable doses pending initial safety and efficacy data. Participants will be monitored for changes in semen parameters and for adverse events for up to 36 months, or until the average of two semen analyses demonstrates ≥15 million sperm/mL. Men who do not achieve azoospermia within 6 months, and all men at 36 months, will be offered a vasectomy. RESULTS: A volume of 120 uL of ADAM® was implantated intravasally into 4 men with a mean±SD age 41.3±7.3 years and baseline semen parameters of volume 2.15±0.81 mL, pH 8.14±0.13, concentration 78.45±28.12 M/mL, motility 56.8±7.5%, morphology 13.5±3.7% normal forms, TMC 70.0±15.7 M sperm. Implantations resulted in no serious adverse events within 2 weeks of the procedure, with post-procedure recovery characteristics similar to those in men receiving vasectomy. Post-procedure semen analyses at 14±3 days demonstrated volume 1.9±1.0 mL, pH 8.3±0.2, concentration 1.1±1.2 M/mL, motility 0.0±0.0%, and TMC of 0.5±0.6 sperm. Two patients had azoospermia and a third only 5 motile and 6 immotile sperm / 30 HPF in the initial post-procedure sample. CONCLUSIONS: Intravasal injection of ADAM® into human male vas deferens is feasible, and initially safe and effective at rapidly inducing near-azoospermia. Additional data will define the longer-term safety and efficacy of ADAM® and its feasibility as a male contraceptive. Source of Funding: Contraline, Inc., Charlottesville, VA; Male Contraceptive Initiative, Durham, NC © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1114 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paul Anderson More articles by this author Damien Bolton More articles by this author Nathan Lawrentschuk More articles by this author Expand All Advertisement PDF downloadLoading ...

Identification of a Methylation Pattern in the SNRPN Gene Promoter and its Association with Semen Abnormality Among Iraqi Males

Infertility considered as a multifactorial condition; the small nuclear ribonucleoprotein polypeptide N (SNRPN) gene is an imprinted gene. However, abnormal imprinting of this gene due to the methylation may result in abnormal function or silencing of the gene. Main aim of this study is to investigate the methylation present at the promoter of (SNRPN) gene and its role as a risk factor for male infertility. Sixty- three infertile males with age mean (32.28 ± 6.88 years) and 13 fertile males as a control age mean (34.07 ± 6.52 years) were investigated. Whole genomic DNA was extracted, DNA integrity was checked using β-globin gene as an internal control. The targeted region was amplified by polymerase chain reaction (PCR) technique. In addition, the SNRPN gene's promoter methylation was qualitatively detected using Real time polymerase chain reaction (qPCR) utilizing two sets of primers: methylated and un-methylated. Results reveled that all of the 63 infertile males were experiencing decrease in sperm concentration 9.42 ± 8.70 million/ml, reduced progressive motility 2.89 ± 5.45% as well as strange sperm morphology 27.06 ± 16.50%, while the values in the control group are normal. The results of the current investigation showed that the promoter of SNRPN was hypermethylated in some samples 22.7%, somewhat methylated in others 20.4%, and unmethylated in other samples 56.8% from infertile samples, while none of the 13 control samples had any methylation. These findings suggest that SNRPN gene may be associated with the negative changes in semen parameters, which could lead to male infertility.

Transurethral resection of ejaculatory ducts (TURED) for the management of ejaculatory duct obstruction: a Saudi cohort

This retrospective study aimed to investigate the clinical characteristics, changes in semen parameters, and outcomes of adult patients with ejaculatory duct obstruction (EDO) who underwent transurethral resection of ejaculatory ducts (TURED). The study included 25 patients diagnosed with EDO who underwent TURED at King Faisal Specialist Hospital &amp; Research Center in Saudi Arabia between January 2015 and December 2021. The results showed that 68% of the patients had complete ED obstruction, while 32% had partial obstruction. Primary infertility was reported in 68%of the patients, with 4% experiencing secondary infertility. The analysis revealed a significant increase in semen volume greater than 0.6 after TURED, while there was a significant decrease in volumes ranging from 0.1 to 0.3 and from 0.4 to 0.6. Patients with partial ED obstruction demonstrated a significant improvement in semen parameters compared to those with complete ED obstruction. The findings suggest that TURED is a safe and effective treatment option for EDO, leading to significant improvements in semen parameters and potentially resulting in spontaneous pregnancy. However, further research is needed to identify specific patient subgroups that may benefit the most from TURED. While magnetic resonance imaging (MRI) with an endorectal coil has been proposed for more detailed evaluation, transrectal ultrasound (TRUS) has been suggested as the standard examination technique.

Effects of alpha-lipoic acid on sperm quality in patients with varicocele-related male infertility: study protocol for a randomized controlled clinical trial

BackgroundVaricocele is a high incidence and is considered to be the most common and correctable cause of male infertility. Oxidative stress (OS) plays a central role in the pathogenesis of varicocele-related male infertility. In addition to varicocelectomy, antioxidant supplementation seems to be an effective scheme for the treatment of varicocele-related male infertility, but it is still controversial. The purpose of this study is to determine the effects of alpha-lipoic acid (ALA) supplementation on sperm quality in patients with varicocele-related male infertility.MethodsIn this randomized controlled clinical trial, we will randomize 80 patients with varicocele-related male infertility from Guilin People’s Hospital. The non-surgical observation group (n = 20) will receive ALA, the non-surgical control group (n = 20) will receive vitamin E, the surgical observation group (n = 20) will receive ALA after the operation, and the surgical control group (n = 20) will receive vitamin E after the operation. The course of treatment will be 3 months. The results will compare the changes in semen parameters, sex hormones, testicular volume, sperm DNA fragment index (DFI), seminal plasma malondialdehyde (MDA), and total antioxidant capacity (TAC) between the groups at baseline and after 3 months of antioxidant supplementation.DiscussionWhether it is necessary to use antioxidants in varicocele-related male infertility, how potent antioxidants should be used, postoperative application or non-surgical independent application still needs to be explored. This study attempts to compare the effects of two antioxidants (ALA and vitamin E) on sperm quality in patients with varicocele-related male infertility (surgical or non-surgical) and attempted to answer the above questions.Trial registrationChinese Clinical Trial Registry (ChiCTR) ChiCTR2100054958. Registered on 29 December 2021

Effect of redo varicocelectomy on semen parameters and pregnancy outcome: An original report and meta‐analysis

Recurrence following varicocelectomy is an important cause of treatment failure and persistence of subnormal semen parameters. This original study was combined with a systemic review and meta-analysis aiming to evaluate the efficacy of redo varicocelectomy on male fertility potential and pregnancy outcome. The retrospective study included 32 patients who underwent microsurgical subinguinal varicocelectomy for patients with recurrent varicocele. Changes in semen parameters and hormone profiles before and after surgery were compared. The literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and included seven articles in addition to our original report. Results of the original study revealed statistically significant improvements in sperm concentration, progressive motility, total motile sperm count and normal morphology following redo varicocelectomy. The meta-analysis results echoed those reported in our original study and depicted significant improvements in sperm concentration (mean difference [MD]=+20.281 million/ml, p< 0.001), total motility (MD=+9.659%, p= 0.001), total motile sperm count (MD=+23.258 million sperm, p< 0.001) and normal morphology (MD=+4.460%, p< 0.001). Overall pregnancy outcome was reported in seven studies with a rate of 34.6%. No significant changes were noted in any of the collected hormone results both in this original report and in the meta-analysis. In conclusion, redo varicocelectomy has a beneficial role on male fertility potential and can be offered for men with recurrent varicocele as directed by their individual clinical condition.

Effect of Neuroendocrine Neoplasm Treatment on Human Reproductive Health and Sexual Function.

Neuroendocrine neoplasms (NEN) are characterized by a wide clinical heterogeneity and biological variability, with slow progression and long survival in most cases. Although these tumors can affect young adults, there are few studies that focus on the sexual and reproductive system. The aim of this review was to evaluate the effect of NEN treatment, including somatostatin analogues (SSA), targeted therapy (Everolimus and Sunitinib), radiolabeled-SSA and chemotherapy, on male and female reproductive systems and sexual function. This narrative review was performed for all available prospective and retrospective studies, case reports and review articles published up to March 2022 in PubMed. To date, few data are available on the impact of SSA on human fertility and most of studies come from acromegalic patients. However, SSAs seem to cross the blood–placental barrier; therefore, pregnancy planning is strongly recommended. Furthermore, the effect of targeted therapy on reproductive function is still undefined. Conversely, chemotherapy has a well-known negative impact on male and female fertility. The effect of temozolomide on reproductive function is still undefined, even if changes in semen parameters after the treatment have been described. Finally, very few data are available on the sexual function of NEN treatment.