Differences In Semen Parameters Research Articles

Hyperlipidemia Is Not Related to Semen Quality, but to Serum Testosterone Levels

Background. Currently, there are few studies on the effects of hyperlipidemia on semen parameters and serum hormones in men. In this study, we divided the study subjects into two groups of normal and hyperlipidemia according to the criteria, and observed the differences between semen parameters and serum reproductive hormones in hyperlipidaemic men and normal men, to explore the potential associations between the indicators. Materials and Methods. Eight hundred eighty five men attending infertility clinics in six hospitals from September 2016 to June 2017 were selected. Their lipid levels, semen parameters, and serum reproductive hormone levels were tested, and a total of 480 men with normal lipids and 405 men with hyperlipidemia were selected according to the criteria, and the relationship between semen quality, serum reproductive hormones, lipids and semen parameters, and serum hormones was statistically analyzed. Results. There was no significant difference in semen parameters between hyperlipidaemic men and normal men (P >0.05), serum testosterone levels were significantly lower in hyperlipidaemic men (P <0.05), and there was a negative correlation between triglycerides (TG) and testosterone in the blood (P <0.05).Conclusion. Hyperlipidemia does not affect male semen parameters, and changes in testosterone in hyperlipidaemic men may be related to triglycerides.

(379) The Effect of 5-α Reductase Inhibitor on Male Reproductive Function

Abstract Introduction 5α-reductase inhibitor (5-ARI) such as finasteride or dutasteride has been approved to treat benign prostatic hyperplasia and androgenic alopecia (male pattern hair loss), which blocks the conversion of testosterone to dihydrotestosterone. With expanding usage among young men, concerns exist regarding potential negative influence of this hormonal agent on male reproductive function. Objective We investigated the effect of 5-ARI usage on the sexual and reproductive function in men of reproductive age. Methods This study included healthy males of reproductive age who visited single fertility center. We compared the sexual and reproductive function between those who take 5-ARI for androgenic alopecia (n=40) and no medication group (n=48). Erectile function was surveyed using IIEF-5 questionnaire. In addition to basic fertility evaluation, semen parameters and serum reproductive hormone were compared between groups. Semen samples were collected with abstinence period of more than 48 hours. Patients with chronic medical disease, previous scrotal surgery or exposure to gonadotoxic agents were excluded. Results The mean duration of 5-ARI intake was 54.2 months and there was no significant difference in IIEF-5 score between the two groups (5-ARI group vs. control group). There was no significant difference in semen parameters; sperm concentration ([101.5 ± 68.7]×10^6/mL vs. [97.5 ± 65.5]×10^6/mL, p=0.783), sperm motility (39.8% ± 9.0% vs. 42.0% ± 8.5%, p=0.224), sperm progressive motility (37.4% ± 9.4% vs. 39.0% ± 9.0%, p=0.404), sperm morphology (normal forms: 4.5% ± 1.4% vs. 4.8% ± 1.1%, p=0.308), except smaller semen volume in 5-ARI group (2.3 ± 0.9 mL vs. 3.4 ± 1.4 mL, p<0.001). Serum testosterone and FSH were higher in 5-ARI group. Two patients experienced adverse events while taking 5-ARI. Conclusions Our study suggests that administration of 5-ARI does not significantly affect male reproductive function. However, a prudent approach is recommended in men with oligospermia or ejaculatory dysfunction. Disclosure No.

(092) Racial/ethnic Differences in Semen Parameters and Male Reproductive Hormones in the United States: A Systematic Review and Meta-Analysis

Abstract Introduction Semen quality and reproductive hormones are key indicators of male fertility potential, but studies have reported inconsistent results on racial/ethnic differences in these factors in the United States. Objective To perform a meta-analysis evaluating pooled differences in semen analysis parameters and male reproductive hormones across racial/ethnic groups in the United States through a systematic literature search. Methods PubMed, Scopus, and Web of Science were systematically searched up to December 17, 2022, with no language limitation. All studies on racial/ethnic variations in semen parameters and male reproductive hormones among the general population of the United States were included in this meta-analysis. Standardized mean difference (SMD) and its 95% confidence interval (95%CI) between races/ethnicities were pooled using the random-effects model. Newcastle–Ottawa Quality Assessment Scale (NOS) was used for risk of bias assessment. Heterogeneity was assessed by the I2 index. Results Our search yielded 731 articles. After screening, 9 studies were included. These studies had a low risk of bias (NOS ≥ 7) and involved a total of 7,641 participants. The pooled analysis showed no significant differences between White and Black men in the percent of total motility (p-value=0.513; I2=99.76%), total testosterone (p-value=0.272; I2=99.79%), free testosterone (p-value=0.220; I2=99.78%), and estradiol (p-value=0.876; I2=96.90%). However, higher sperm concentration (SMD=3.64; 95%CI: 0.18, 7.09; p-value=0.039; I2=99.53%) and total sperm count (SMD=6.04; 95%CI: 0.09, 11.99; p-value=0.046, I2=99.68%) were estimated for White men compared to Black men. Additionally, higher sperm concentration (SMD=1.39; 95%CI: 0.56, 2.23; p-value=0.001, I2=92.06%) and total motility (SMD=3.06; 95%CI: 0.09, 6.02; p-value=0.043, I2=99.14%) were estimated for Hispanic men compared to non-Hispanic men, with no differences in total sperm count (p-value=0.579, I2=97.79%) or total testosterone (p-value=0.078, I2=95.95%) (Figure 1). Conclusions This meta-analysis demonstrated reductions in semen analysis parameters, especially sperm concentration, for Black and non-Hispanic men relative to White and Hispanic men in the United States. Disclosure No.

Effects of Systolic Blood Pressure Elevation on Internal Sperm Artery Identification During Microsurgical Subinguinal Varicocelectomy.

Microsurgical subinguinal varicocelectomy (MSV) is the gold standard for treating varicoceles. Preservation of the internal spermatic arteries (ISAs) during MSV is important for sperm production. This study aimed to evaluate the safety and efficacy of elevating systolic blood pressure (SBP) using MSV. Data from 252 consecutive adult male patients were retrospectively reviewed. The patients were divided into two groups: a traditional group that underwent conventional MSV (n = 134) and a modified group that underwent MSV with a transiently elevated SBP of 140-160 mm Hg (n = 118). Arterial identification time, unilateral operative time, number of ISAs, arterial injury rate, and other postoperative indicators, including postoperative complications and sperm parameters, were compared between the groups. All the procedures were successful. The arterial identification and unilateral operative times were significantly shorter in the modified group (31.34 ± 10.44 vs. 42.94 ± 12.39 min and 61.48 ± 8.78 vs. 76.35 ± 12.33 min, p < .01, respectively). Intraoperatively, the number of preserved ISAs was significantly higher in the modified group (1.92 ± 0.53 vs. 1.45 ± 0.32, p < .01). The arterial injury rate did not differ significantly between the groups (2.74% vs. 0%, respectively). Compared with preoperative values, sperm parameters improved significantly 6 months postoperatively. Significant differences in semen parameters or postoperative complications were not observed between the groups. Elevated intraoperative SBP can be used to rapidly, safely, and effectively identify ISAs, increase the number of retained spermatic arteries, and markedly reduce the operative time for MSV.

Effect of leukocytes on semen quality in men from primary and secondary infertile couples: A cross-sectional study.

Leukocytospermia (LCS) is a known cause of male infertility. However, the relationship between seminal leukocytes and semen quality among infertile couples remains controversial. This study aims to investigate the association between semen quality and LCS in male partners of infertile couples. Semen samples were collected from 512 men who asked for a fertility evaluation in a reproductive center in China. Seminal leukocytes were counted following peroxidase staining with benzidine. Other semen parameters were compared in subfertile men with and without LCS. Poor semen quality (e.g., low semen volume, sperm concentration, and sperm progressive/total motility) was observed among men with LCS compared to those without LCS. Men with LCS had a higher risk of low sperm progressive motility (OR = 0.99, 95% CI = 0.98-0.99, p = 0.02) and total motility (OR = 0.99, 95% CI = 0.98-0.99, p = 0.02), even after adjustment for potential confounders (both OR = 0.99, 95% CI = 0.98-0.99, p = 0.03). Lower sperm viability was observed in LCS from male partners of secondary couples, while no significant difference in semen parameters was found between men with and without LCS in male partners of primary infertile couples. Low sperm motility and viability were associated with LCS in men from secondary infertile couples after adjusting for confounders (OR = 0.97, 95% CI = 0.95-0.99, p = 0.04; OR = 0.94, 95% CI = 0.89-0.99, p = 0.04, respectively). Our findings indicate that a higher risk of abnormal semen parameters was correlated with an increased number of leukocytes in men from secondary infertile couples.

Paternal pre-conceptional smoking and semen quality in the adult son.

Growing evidence suggests intergenerational effects of paternal pre-conceptional smoking through the germ line, but its specific impact on offspring semen quality remains uncertain because of challenges in isolating paternal exposure from maternal passive smoking or underreporting. We reran previous analyses estimating differences in semen parameters and testicular size according to paternal smoking in 867 young adult men, adding first-trimester maternal plasma cotinine to the original adjustment for maternal self-reported smoking. We also estimated differences in sperm DNA fragmentation. Paternal smoking was reported by the pregnant women around gestational week 16. Analyses were additionally adjusted for household occupational status, parental ages at birth, maternal pre-pregnancy body mass index and alcohol consumption, and abstinence time, and accounted for spillage, minutes from ejaculation to analysis, and son's own smoking. We found no association between paternal preconceptional smoking and any of the semen parameters or testicular size. Adjustment for son's own smoking did not change results. While maternal plasma cotinine offers an objective measure of tobacco exposure and allows for a more thorough adjustment of maternal smoking, the high correlation between paternal pre-conceptional smoking and maternal cotinine exposure may, have resulted in overadjustment removing some paternal effect. Inability to distinguish between paternal never smokers and former smokers, may have led to misclassification of paternal pre-conceptional smoking and underestimation of associations. We found no support for an independent association between paternal pre-conceptional smoking and semen quality in young adult sons, but studies with more detailed paternal smoking history are needed before firm conclusions can be drawn.

Effects of preservation period on quality of chilled semen of Boer-cross bucks

Characteristics of fresh semen and the effect of chilling on the quality of semen of Boer-cross bucks were studied. Fresh semen from two Boer-cross bucks was evaluated for volume, mass motility, progressive motility, viability, concentration and proportion of spermatozoa with normal acrosome, mid-piece and tail. The semen was diluted at 1:4 ratios with Tris-fructose-citrate-egg yolk extender, preserved at 4ºC for 72 hours and evaluated for progressive motility and proportion of spermatozoa with normal acrosome, mid-piece and tail at 24-hour intervals for three days. The mean volume, mass motility, progressive motility, sperm viability, sperm concentration and proportion of spermatozoa with normal acrosome, mid-piece and tail of fresh semen of Buck 1 and Buck 2 were 370.0 ± 0.1 and 410.0 ± 0.1 μl, 3.3 ± 0.4 and 3.4 ± 0.1, 74.0 ± 13.9 and 76.0 ± 6.5%, 82.3 ± 7.5 and 84.3 ± 4.2%, 2730.0 ± 740.9 × 106/ml and 2584.0 ± 470.1 × 106/ml, and 93.3 ± 2.9 and 94.9 ± 0.4%, respectively. The progressive motility in chilled semen of Buck 1 at days 1, 2 and 3 was 61.2 ± 7.3, 51.0 ± 7.3 and 39.0 ± 5.5%, respectively; in Buck 2, it was 60.6 ± 6.8, 50.2 ± 6.2 and 39.2 ± 5.4%, respectively. The difference in semen parameters among days of preservation was significant (P&lt;0.05) in both bucks. The proportion of spermatozoa with normal acrosome, mid-piece and tail in chilled semen of Buck 1 at days 1, 2 and 3 was 88.0 ± 7.0, 88.8 ± 5.9 and 87.1 ± 7.7%, respectively; in Buck 2, it was 86.6 ± 4.8, 84.1 ± 4.6 and 81.8 ± 4.9%, respectively. It is suggested that the characteristics of fresh semen of these two Boer-cross bucks were within normal range. The quality of semen of Boer-cross bucks deteriorated with chilling up to 72 hours. Improvement of the preservation protocol is required to obtain satisfactory quality of chilled semen of Boer-cross bucks.&#x0D; Bangl. vet. 2022. Vol. 39, No. 1-2, 34–42

O-020 What is the recovery time for sperm parameters in men who have suffered a mild Covid-19 infection?

Abstract Study question What is the time required in men who have suffered a mild Covid-19 infection, for the seminal parameters to be restored to the pre-Covid values? Summary answer The effect of Covid-19 infection on the concentration and sperm motility is clearly confirmed and is maintained over time, at least beyond 100 days. What is known already Although several studies have been performed on the effect of SARS-CoV-2 on reproductive health in the short term vs. healthy controls, and the negative effect on sperm parameters has been demonstrated, there is a scarcity of data showing the degree to which the virus affects the semen parameters in one group of patients after coronavirus infection compared to before infection. Moreover, there are no conclusive data regarding the long-term effects of SARS-CoV-2 on semen parameters. Study design, size, duration This prospective study was carried out in 6 reproductive centers between February 2020 and October 2022 including 45 male patients with a confirmed diagnosis of mild COVID-19. For each of the semen parameters (volume, sperm count, active and total motility, normal morphology, and vitality) a standardized index was calculated by dividing the value of the parameter from the subsequent semen analysis by that from the semen analysis of the same individual prior to infection. Participants/materials, setting, methods The median age of the participants was 31 years, proving the absence of a relationship between age and any of the parameters analyzed. The post-Covid test was performed between 17 and 516 days after infection, with a median of 100 days. The time elapsed between both samples was a median of 238 days. The effect of time on the affectation of semen parameters was studied, setting 100 days as the cut-off point. Main results and the role of chance There were significant differences in semen parameters before and after COVID-19 in terms of semen volume, sperm concentration, progressive motility, total motility, and vitality which decreased significantly (p &amp;lt; 0,05) after SARS-CoV-2 infection compared to the pre-infection values. Morphology was not significantly affected. The total sperm count is the most clearly affected seminal parameter. Half of the individuals (median) obtained a total count in the second sample less than 57% of the initial one. Considering the time of spermatogenesis, the subjects were separated into two groups: those who performed the semen analysis in the first 100 days after infection and those who performed it later. No differences in any parameter were found between the two groups with U Mann-Withney test. Using the Wilcoxon test for paired samples, it was demonstrated that the deleterious effect of infection on sperm concentration and motility not only does not improve with time, but it becomes more significant in late sperm analysis, performed more than one hundred days after the infection. Limitations, reasons for caution It should be mentioned that impairment of semen parameters may not be due to a direct effect of the SARS-CoV-2 virus. There are likely to be additional factors that contribute to long-term sperm parameters decrease, but whose identity is currently unknown. Wider implications of the findings The present study revealed the long-term impacts of SARS-CoV-2 on various parameters of sperm quality even with a mild infection. Further efforts should be made to study the long-time effects of COVID-19 infection on male reproduction. Trial registration number Not Applicable

Testicular torsion and subsequent testicular function in young men from the general population

Is prior testicular torsion associated with testicular function (semen quality and reproductive hormones) in young men from the general population? In young men from the general population, no differences in semen parameters were observed in those who had experienced testicular torsion compared to controls and observations of higher FSH and lower inhibin B were subtle. Testicular function may be impaired after testicular torsion, but knowledge is sparse and based on studies with small sample sizes and no control group or a less than ideal control group. A cross-sectional population-based study was carried out including 7876 young Danish men with unknown fertility potential, examined from 1996 to 2020. All men (median age 19.0 years) had a physical examination, provided a blood and semen sample, and filled in a questionnaire including information about prior testicular torsion, birth, lifestyle and current and previous diseases. Markers of testicular function, including testis volume, semen parameters and reproductive hormones, were compared between men operated for testicular torsion and controls, using multiple linear regression analyses. The average participation rate was 24% for the entire study period. In total, 57 men (0.72%) were previously operated for testicular torsion (median age at surgery 13.4 years) of which five had only one remaining testicle. Men with prior testicular torsion were more often born preterm (25% versus 9.5% among controls), and they had significantly higher FSH and lower inhibin B levels, and a lower inhibin B/FSH ratio than controls in crude and adjusted models. The association was mainly driven by the subgroup of men who had undergone unilateral orchiectomy. No differences in semen parameters were observed. A limitation is the retrospective self-reported information on testicular torsion. Also, results should be interpreted with caution owing to the high uncertainty of the observed differences. Overall, the results of our study are reassuring for men who have experienced testicular torsion, especially when treated with orchiopexy, for whom reproductive hormone alterations were subtle and without obvious clinical relevance. Our study found no differences in semen parameters, but follow-up studies are needed to assess any long-term consequences for fertility. Financial support was received from the Danish Ministry of Health; the Danish Environmental Protection Agency; the Research fund of Rigshospitalet, Copenhagen University Hospital; the European Union (Contract numbers BMH4-CT96-0314, QLK4-CT-1999-01422, QLK4-CT-2002-00603, FP7/2007-2013, DEER Grant agreement no. 212844); A.P. Møller and wife Chastine Mckinney Møllers Foundation; Svend Andersens Foundation; the Research Fund of the Capital Region of Denmark; and ReproUnion (EU/Interreg). The authors have nothing to declare. N/A.

O-263 Sperm parameters in cancer patients: the role of cancer and cancer diagnoses

Abstract Study question How do sperm parameters compare in various oncologic conditions when compared with controls? Is there an association between severity of the disease and sperm parameters? Summary answer Most cancer types appear to affect sperm parameters. Motility is reduced in all cancers, while sperm concentration is strongly diminished in testicular cancer. What is known already There is no actual consensus whether cancer is negatively associated with semen quality. Some studies have reported poorer sperm parameters in men with cancer, especially testicular cancer. Others have reported no differences in semen parameters of cancer patients when compared with patients with benign diseases. Furthermore, small studies have shown conflicting differences in sperm parameters when comparing across different cancer types. Study design, size, duration Academic single-centered, retrospective cohort study with men banking sperm for fertility preservation prior to undergoing chemotherapy. A total 965 patients with various cancer types, recently diagnosed, produced at least one sample for sperm cryopreservation between 2004 and 2020. Concentration and progressive motility were analyzed for each sample at the time of cryopreservation, before beginning the chemotherapy treatments. Participants/materials, setting, methods The first sample of each patient was kept for data analysis (n = 965). The control group were unselected homosexual male couples planning parenthood, without any known fertility impairment (n = 39). Cancers were grouped as: testis (n = 297), lymphoma (n = 285), leukemia (n = 79), sarcoma (n = 85), brain (n = 61), gastro-intestinal (GI) (n = 73), ear-nose-throat (ENT) (n = 24), and other (n = 52). The last group included cancers of such as kidney, prostate, melanoma, or lung cancer. T-test and Fisher-test were used for statistical analyses. Main results and the role of chance Patients with testicular cancer had significantly lower mean sperm concentration when compared to controls (30.5 vs 69.9 M/ml; p &amp;lt; 0.01). Other groups showed similar concentration values when compared to controls. Furthermore 47% testicular cancer patients had oligospermia (as determined by WHO criteria) compared with 10% unselected controls (p &amp;lt; 0.001) However, sperm from patients with almost all types of cancer showed lower motility rates when compared to controls (31.5 to 35.0% vs 49.0%; p &amp;lt; 0.001). The only group showing similar motility with controls was ENT cancers (41.1% vs 49%, p = 0.2). Similarly, sperm samples from all cancer groups showed higher proportions with asthenospermia (as determined by WHO criteria) when compared with controls (39.1%-54.7% vs 18%, p &amp;lt; 0.01) For individual cancer groups, comparing sperm parameters between patients who survived and those who died, there were no significant differences, suggesting the severity or stage does not modulate the effect of the cancer itself on the sperm. Patients in the testis, lymphoma, leukemia, sarcoma and brain cancer groups were significantly younger than controls (25.3-29.1 vs 37.3 years old), while GI and ENT groups were similar to controls (37.4 and 36.5 vs 37.3). In the “other cancers” group, patients were significantly older than controls (44.4 vs 37.3). Limitations, reasons for caution The interpretation of the findings of this study is limited by the retrospective nature of the analysis and the potential for unmeasured confounding variables. Wider implications of the findings There is an association between abnormal sperm parameters in samples for pre-chemotherapy cryopreservation and all cancer types. This may affect the future likelihood of pregnancy. Young men with cancer need to be counselled that ICSI may be recommended should they need or choose to use their cryopreserved sperm. Trial registration number Not applicable

PD20-03 ALDH2 EXPRESSION, ALCOHOL INTAKE, AND SEMEN PARAMETERS AMONG EAST ASIAN MEN

You have accessJournal of UrologyCME1 May 2022PD20-03 ALDH2 EXPRESSION, ALCOHOL INTAKE, AND SEMEN PARAMETERS AMONG EAST ASIAN MEN Daniel R. Greenberg, Hriday P. Bhambhvani, Satvir S. Basran, Brett P. Salazar, Sin-Jin Li, Che-Hong Chen, Daria Mochly-Rosen, and Michael L. Eisenberg Daniel R. GreenbergDaniel R. Greenberg More articles by this author , Hriday P. BhambhvaniHriday P. Bhambhvani More articles by this author , Satvir S. BasranSatvir S. Basran More articles by this author , Brett P. SalazarBrett P. Salazar More articles by this author , Sin-Jin LiSin-Jin Li More articles by this author , Che-Hong ChenChe-Hong Chen More articles by this author , Daria Mochly-RosenDaria Mochly-Rosen More articles by this author , and Michael L. EisenbergMichael L. Eisenberg More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002558.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Mutations in acetaldehyde dehydrogenase-2 (ALDH2) are highly prevalent in the global population. The most common variant, ALDH2*2, is present in 40-50% of East Asian individuals. This mutation causes acetaldehyde accumulation, flushing, and tachycardia after alcohol intake. While alcohol consumption is common, the relationship between alcohol intake and ALDH2 genotype on semen parameters remains unknown. We aimed to determine if ALDH2 genotype and alcohol consumption are associated with differences in semen parameters and ALDH2 expression in East Asian men. METHODS: East Asian men completed a survey and submitted a semen sample for analysis. Participants were genotyped to determine ALDH2 status (wild type vs ALDH2*2 carrier) and immunohistochemical staining was used to determine overall protein expression of ALDH2 in spermatozoa. Demographics, alcohol consumption habits, and sexual habits were also collected. Student’s t test was used to determine differences in demographics, semen parameters, and ALDH2 expression between and among ALDH2 genotypes. RESULTS: 45 (40.2%) of 112 men were ALDH2*2 carriers. There was no difference in alcohol consumption or sexual habits between ALDH2 genotypes. Among ALDH2*2 carriers, alcohol consumption was associated with significantly lower total sperm motility (25.6±16.8% vs 45.2±25.8%, p=0.005) and progressive sperm motility (23.0±15.1% vs 39.0±21.7%, p=0.008). Among alcohol consumers, ALDH2*2 men had significantly lower total sperm motility (25.5±16.8 vs 39.2±23.1%, p=0.021), progressive sperm motility (23.0±15.1% vs 34.9±20.1%, p=0.022) and total motile sperm count (44.7±48.5M vs 101.2±119.9M, p=0.047) compared to wild-type individuals (Figure 1). Secondly, ALDH2 protein expression in spermatozoa was significantly lower in ALDH2*2 carriers (p <0.001). CONCLUSIONS: Alcohol consumption among ALDH2*2 carriers is associated with significantly lower total sperm motility, progressive sperm motility, and total motile sperm count. ALDH2*2 individuals also have significantly decreased protein expression of ALDH2 in spermatozoa. These findings suggest genotyping ALDH2, coupled with alcohol cessation counseling, may improve semen parameters among East Asian men. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e356 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel R. Greenberg More articles by this author Hriday P. Bhambhvani More articles by this author Satvir S. Basran More articles by this author Brett P. Salazar More articles by this author Sin-Jin Li More articles by this author Che-Hong Chen More articles by this author Daria Mochly-Rosen More articles by this author Michael L. Eisenberg More articles by this author Expand All Advertisement PDF DownloadLoading ...

Evaluation of mid- and long-term impact of COVID-19 on male fertility through evaluating semen parameters.

BackgroundThe coronavirus disease 2019 (COVID-19) has spread worldwide with alarming levels of spread and severity. The distribution of angiotensin converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) from bioinformatics evidence, the autopsy report for COVID-19 and the published study on sperm quality indicated COVID-19 could have a negative impact on male fertility. However, whether the negative impact of COVID-19 on male fertility is persistent remains unknown, which requires long-term follow-up investigation.MethodsSemen samples were collected from 36 male COVID-19 patients with a median recovery time of 177.5 days and 45 control subjects. Then, analysis of sperm quality and alterations of total sperm number with recovery time were performed.ResultsThere was no significant difference in semen parameters between male recovered patients and control subjects. And the comparisons of semen parameters between first follow-up and second follow-up revealed no significant difference. In addition, we explored the alterations of sperm count with recovery time. It showed that the group with recovery time of ≥120 and <150 days had a significantly lower total sperm number than controls while the other two groups with recovery time of ≥150 days displayed no significance with controls, and total sperm number showed a significant decline after a recovery time of 90 days and an improving trend after a recovery time of about 150 days.ConclusionsThe sperm quality of COVID-19 recovered patients improved after a recovery time of nearly half a year, while the total sperm number showed an improvement after a recovery time of about 150 days. COVID-19 patients should pay close attention to the quality of semen, and might be considered to be given medical interventions if necessary within about two months after recovery, in order to improve the fertility of male patients as soon as possible.

An evaluation of changes over time in the semen parameters data used for the World Health Organization semen analysis reference ranges.

Previous meta-analyses concluded that there is a decline in sperm parameters over time. This conclusion might be incorrect due to inherent biases or focusing only on a single parameter - sperm concentration. To study trends in sperm parameters over the past 20 years using data from the trials that defined the reference ranges of the World Health Organization manual. Retrospective evaluation of the data used to define the World Health Organization reference ranges. The data from 11 studies, including 3589 participants between 1996 and 2016, were divided into three period groups based on the decade of study. Differences in semen parameters' distribution were presented in boxplot. p-values were calculated by the Kruskal-Wallis rank-sum test followed by Dunn post hoc test. Analyses were conducted using the R programming language. A small decrease was noted in mean sperm concentrations (88.1 million/ml, 87.6 million/ml, and 77.2 million/ml for the first, second, and third decades, respectively) (p<0.01). However, the 5th percentile of sperm concentration for the third decade was higher than the first or second decades (18 million/ml versus 14.9 million/ml and 15 million/ml, respectively). No significant differences were noted in progressive motility over the years (p=0.32). The percent of morphologically normal sperm decreased between the first (24.2%) and the second (12.6%) periods of the study (p<0.001) and then increased in the third decade (14.2%) (p<0.01). Total motile sperm count (TMC) declined between the second and third decades (189 million and 153.9 million, respectively, p<0.001), at levels unlikely to decrease fertility. However, the 5th percentile of the TMC remained stable at 24.9, 20.8, and 20.6 million, for the first, second, and third decades respectively (p=0.36). Trends in sperm parameters over the last three decades do not seem to be clinically significant.

P–034 Social distancing protocol changes during the COVID–19 pandemic; the effect of at-home semen collection on intrauterine insemination outcomes

Study questionHow have the coronavirus 2019 (COVID–19)-driven changes in semen collection protocols, from on-site to at-home collection, impacted intrauterine insemination (IUI) cycle outcomes?Summary answerOur data suggest that at-home semen collection within 2 hours of processing does not negatively impact semen parameters and IUI pregnancy outcomes. What is known already: There are mixed reports regarding the effect of at-home semen collection on IUI outcomes. In a study of 633 cycles, no differences in semen parameters or pregnancy rates were observed between home and clinic collections1. Conversely, in a smaller cohort, at-home collection was associated with worse pregnancy outcomes when IUI was coupled with gonadotropin stimulation, but not when coupled with clomiphene2. We previously reported no differences in semen parameters and in-vitro fertilization (IVF) embryo transfer outcomes, when cycles using semen collected at-home were compared to cycles with on-site collection3. However, such findings cannot necessarily be extended to the IUI setting.Study design, size, durationThis is a retrospective cohort study of all 529 IUI cycles that took place in 2020 at an academic fertility center. Semen collected at the “clinic” was used for 143 cycles before the COVID–19 pandemic, and “at-home” collected specimens were used for the 386 cycles following the revised semen collection protocol. Participants/materials, setting, methods: Prior to the COVID–19 pandemic, semen was collected at our “clinic” and processed within ∼30 minutes. Post-COVID, in order to maintain social distancing, semen was collected “at-home”, at an IUI-approved cup, and transported to our center within 2 hours, while maintained to room temperature. Logistic regression models were performed to evaluate the effect of “at-home” collection on achieving pregnancy (positive pregnancy test-PPT) and clinical pregnancy (sonographic confirmation-CP), adjusting for age and anti-Mullerian hormone (AMH).Main results and the role of chanceThe mean age (SD) (years) of the female partner was 35.4 (4.2) vs. 35.4 (4.4) (p = 0.978) and of the male partner 36.6 (4.4) vs. 37.1 (p = 0.328) for the “clinic” vs. “at-home” groups, respectively. There were no significant differences in day–3 follicle stimulating hormone and AMH. In both groups the most common diagnoses were idiopathic and combined factors infertility (27.3% and 18.9% & 24.1% and 25.1%, respectively for the “clinic” & “at-home” groups, p = 0.376). Similarly, there were no differences regarding ovarian stimulation, and gonadotropins were the most common medication used in both groups (“clinic”: 44.1% vs. “at-home”: 39.4%, p = 0.775). Semen analysis parameters (volume, motility, forward progression, total motile count) were comparable between the 2 groups, with the exception of concentration (mil/ml) which was higher with “at-home” collection [66.1 (45.0) vs. 81.1 (63.0), p = 0.009].In unadjusted models, “at-home” collection had no significant effect on the odds for a PPT [OR (95%CI): 0.691 (0.427–1.119), p = 0.133] or CP [0.751 (0.447–1.263), p = 0.281]. These results persisted even when adjusting for maternal age and AMH: PPT [0.708 (0.435–1.153), p = 0.165] and CP [0.773 (0.455–1.312), p = 0.340]. When sub-analysis was performed within the different medication groups, the above findings persisted for both gonadotropin and oral medication cycles.Limitations, reasons for cautionThe limitations of the study include its retrospective design and the absence of livebirth data, given the limited follow up period. However, regarding the latter, one can use the ongoing clinical pregnancy rate as an accurate estimate of livebirth.Wider implications of the findings: At-home semen collection within 2 hours of processing did not negatively impact semen analysis parameters or pregnancy outcomes following IUI. These data constitute an important addition to the current limited literature on the subject and provides an additional level of safety for our patients and staff during the COVID–19 crisis.Trial registration numberNot applicable

P–460 Impact of various cancers on semen parameters in a tertiary onco-fertility unit in India

Abstract Study question This study evaluated differences in semen parameters in male cancer patients in our ethnic population who banked their sperms prior to cancer treatment Summary answer We found significant differences in semen concentration, motility and morphology between different types of cancers, especially testicular cancers What is known already Impaired spermatogenesis and abnormal semen parameters in cancer patients has been noted, however certain cancer types are more damaging than others. In testicular cancer, spermatogenesis impairment is more quantitative than qualitative with sperm morphology being the most affected parameter. Among non testicular cancers, lymphoma cases usually show the most significantly impaired semen parameters Study design, size, duration We conducted a retrospective study analyzing semen parameters in 49 cancer patients between October 2014 to January 2020 who presented to the onco-fertility unit, Max Multispeciality Hospitals, New Delhi. Furthermore, we did our analysis based on total of 101 samples and were broadly divided into testicular (37 samples) and non testicular cancers (64 samples). Patients who had previously received any form of cancer treatment including chemotherapy or radiotherapy were not included in this study Participants/materials, setting, methods Testicular Cancer(TC) group was further subcategorized into Seminoma and Non Seminoma groups whereas Non Testicular Cancer (NTC) group was subcategorized into Lymphoma and Non Lymphoma groups. Semen was collected by masturbation and analysis was performed in keeping with the WHO criteria. Statistical analyses was performed using SPSS software. p values &amp;lt;0.05 were considered to indicate statistical significance. Main results and the role of chance In Testicular cancer (TC), 92% samples (34/37) had abnormal semen parameters whereas only 24.4% samples (22/64) were abnormal in Non Testicular cancer (NTC). Additionally, there were significant differences in sperm concentration, motility and morphology between TC and NTC groups. Individually, TC: Oligozoospermia was seen in 73% (27/37) with subdivision between Seminoma and Non Seminoma groups being 81.3% (13/16) and 61.9% (13/21). Asthenozoospermia was seen in 86.5% (32/37) samples with subdivision between Seminoma and Non Seminoma groups being 87.5% (14/16) and 81% (17/21). Teratozoospermia was seen in 59.5% (22/37) samples with subdivision between Seminoma and Non Seminoma groups being 75% (12/16) and 42.86% (9/21). Combined OATS observed in 59.5% (22/37) samples with subdivision between Seminoma and Non Seminoma groups being 75% (12/16) and 42.86% (9/21) NTC: Oligozoospermia was seen in 18.8% (12/64) samples with subdivision between Lymphoma and Non Lymphoma groups being 26.92% (7/26) and 26.32% (10/38). Asthenozoospermia was seen in 32.8% (21/64) samples with subdivision between Lymphoma and Non Lymphoma groups being 34.62% (9/26) and 34.21% (13/38). Teratozoospermia was seen in 17.2% (11/64) samples with subdivision between Lymphoma and Non Lymphoma groups being 26.9% (7/26) and 23.68% (9/38). Combined OATS observed in 17.2% (11/64) samples with subdivision between Lymphoma and Non Lymphoma groups being 26.9% (7/26) and 23.68% (9/38). Limitations, reasons for caution Study was conducted in a single institution with lesser overall number of patients. Duration, staging and grading of cancers were also not individually assessed, which could be a further limiting factor. Wider implications of the findings: Testicular cancers, especially seminomas, have the most severe effect upon semen parameters. Among NTC patients, lymphomas have the worst impact. Knowing the varying effect of different cancers on semen parameters in our ethnic population helps ART specialists and oncologists to appropriately modify patient counseling and improve fertility outcomes. Trial registration number RMO13019

Impaired semen parameters in patients with confirmed SARS-CoV-2 infection: A prospective cohort study.

In this prospective study, we investigated the impact of SARS‐CoV‐2 infection on semen parameters in a cohort of men who had recently recovered from COVID‐19. A total of 24 men who had recently recovered from mild COVID‐19 were included in the study. Their semen parameters were normal before COVID‐19 according to the World Health Organization 2010 reference values. Semen samples were collected from these participants in the recovery phases of COVID‐19. To determine the effect of SARS‐CoV‐2 infection on semen parameters, the patients' pre‐COVID‐19 and post‐COVID‐19 semen analyses were compared. The mean age of the participants was 34.7 ± 6.4 years. The median interval between the positive nasopharyngeal swab test and obtaining semen samples was 111.5 (158) days. There was no significant difference in semen parameters before and after COVID‐19 in terms of semen volume (p = .56), sperm concentration (p = .06), and progressive motility (p = .14). Total motility (p = .01) and total motile sperm count (p = .02) decreased significantly after SARS‐CoV‐2 infection compared to the pre‐infection values. This study demonstrated that sperm motility and total motile sperm count were the semen parameters which showed a significant reduction in cases with a history of mild COVID‐19.

Global sperm DNA methylation and intra cytoplasmic sperm injection outcomes.

Routine semen analysis is a poor predictor of pregnancy rates after intra-cytoplasmic sperm injection (ICSI). There is an assumption that embryos' quality and fertilization rates could be influenced by epigenetic factors. We aimed at comparing global sperm DNA methylation level (GSDML) between normal and abnormal semen, investigating its relationship with sperm parameters and assessing its effect on ICSI outcomes; fertilization, good embryo and pregnancy rates. Ejaculates were obtained from 104 infertile and 60 fertile males undergoing ICSI at Faculty of Medicine, Alexandria, Egypt. Data was analyzed using IBM SPSS software package, 20. Inter-group differences in semen parameters were assessed by t-test. GSDML, measured by ELISA, showed significant positive correlation with sperm count, concentration and motility. It correlated positively but insignificantly with morphology and fertilization rate. High levels were significantly associated with embryos having good quality and positive pregnancy rates. GSDML could predict good embryo rate and pregnancy occurrence after ICSI.

No detection of SARS-CoV-2 from urine, expressed prostatic secretions, and semen in 74 recovered COVID-19 male patients: A perspective and urogenital evaluation.

The coronavirus disease 2019 (COVID-19) has been spreading all over the world since December 2019. However, medical information regarding the urogenital involvement in recovered COVID-19 patients is limited or unknown. To comprehensively evaluate urogenital involvement in recovered COVID-19 patients. Men aged between 20years and 50years who were diagnosed with SARS-CoV-2 infection and recovered when the study was conducted were enrolled in our study. Demographic and clinical characteristics, and history of hospitalization were collected and analyzed. Urine, expressed prostatic secretions (EPSs), and semen samples were collected for SARS-CoV-2 RNA detection. Semen quality and hormonal profiles were analyzed. Among 74 male recovered COVID-19 patients, 11 (14.9%) were asymptomatic, classified into mild type, and 31 (41.9%) were classified into moderate type. The remaining patients (32/74, 43.2%) had severe pneumonia. No critically ill recovered COVID-19 patient was recruited in our cohort. The median interval between last positive pharyngeal swab RT-PCR test and semen samples collection was 80days (IQR, 64-93). The median age was 31years (IQR, 27-36; range, 21-49), and the median body mass index (BMI) was 24.40 (IQR, 22.55-27.30). Forty-five (61.6%) men were married, and 28 (38.4%) were unmarried. Fifty-three (72.6%) patients denied cigarette smoking, 18 (24.7%) were active smokers, and 2 of them were past smokers. The majority of our participants (53/74, 72.6%) did not consume alcohol. Fever occurred in most of the patients (75.3%), and 63 of them had abnormal chest CT images. Only one patient complained of scrotal discomfort during the course of COVID-19, which was ruled out orchitis by MRI (data not shown). A total of 205 samples were collected for SARS-CoV-2 detection (74 urine samples, 70 semen samples, and 61 EPS samples). However, viral nucleic acid was not detected in body fluids from the urogenital system. In terms of hormonal profiles, the levels of FSH, LH, testosterone, and estradiol were 5.20 [4.23] mIU/mL, 3.95 [1.63] mIU/mL, 3.65 [1.19] ng/mL, and 39.48 [12.51] pg/mL, respectively. And these values were within the normal limits. The overall semen quality of recovered COVID-19 patients was above the lower reference limit released by the WHO. While compared with healthy control, sperm concentration, total sperm count, and total motility were significantly declined. In addition, different clinical types of COVID-19 have no significant difference in semen parameters, but total sperm count showed a descending trend. Interestingly, subjects with a longer recovery time showed worse data for sperm quality. Small sample size and lacking semen parameters before the infection are the major limitations of our study. To the best of our knowledge, it is the largest cohort study with longest follow-up for urogenital evaluation comprehensively so far. Direct urogenital involvement was not found in the recovered COVID-19 male patients. SARS-CoV-2 RNA was undetectable in the urogenital secretions, and semen quality declined slightly, while hormonal profiles remained normal. Moreover, patients with a long time (≥90days) since recovery had lower total sperm count. Great attention and further study should be conducted and follow-up on the reproductive function in the following months.

The association of rs11457523 in HSP90AA1 with idiopathic male infertility in the Chinese population.

The association of single nucleotide polymorphisms (SNPs) in heat shock protein 90 (HSP90) genes with idiopathic male infertility remains unclear. In this study, the five selected SNPs in HSP90AA1 namely rs10133307, rs10873531, rs11547523, rs11621560 and rs7145597 were genotyped in 116 idiopathic infertile males and 185 ethnically matched fertile males using the Sequenom MassARRAY assay. The role of these SNPs in male infertility was then studied using multiple genetic models. We observed that genotype distribution (p=.028) and allelic frequency (p=.032) of rs11547523 were significantly different between the infertile and fertile groups. In particular, A genotype of rs11547523 was associated with an increased risk of infertility in the allele (OR=2.508, p=.048), dominant (OR=2.733, p=.030) and additive models (OR=0.366, p=.031). However, there were no significant differences in semen parameters including seminal volume (p=.452), sperm concentration (p=.727), total sperm number (p=.588), motility (p=.282) and morphology (p=.975) between A and A/G genotypes of rs11547523. These results indicate that rs11547523 in HSP90AA1 may be associated with idiopathic male infertility in the Chinese population. The outcome of this study contributes to the development of the diagnosis of male infertility.

Use of Personal Care Products and Semen Quality: A Cross-Sectional Study in Young Danish Men.

Personal care products (PCPs) may contain multiple chemicals capable of harming male reproductive function. The aim of this study was, therefore, to assess aggregated PCP exposure and potential associations with measures of semen quality in young men. Participants (n = 1058, age 18–21) were sampled among young men from the Danish National Birth Cohort (DNBC). Upon recruitment in 2017–2019, each man answered an online questionnaire and provided a semen sample. Exposure to 12 common types of PCPs was derived from the questionnaire, and the extent of use and co-use was analyzed. We applied a negative binomial regression model to estimate percentage differences in semen parameters between low, medium and high PCP exposure groups. All participants were exposed to at least one PCP more than once a week, resulting in a mean number (SD) of 5.3 (2.0) PCPs currently used. Most participants (92%) were also exposed to fragranced products on a weekly basis. Little association was observed between aggregated exposure to PCPs and sperm concentration, total sperm count, semen volume, sperm motility and morphology. Despite prevalent use of multiple PCPs, we found little indication of adverse effects of aggregated overall or fragranced PCP exposure on semen quality.